A Baltimore City Council hearing examining the city’s crisis response revealed a fragmented, leaderless system that almost always sends police officers to deal with mental health emergencies, sometimes leading to deadly outcomes.
The consequences of that system came into focus over eight days in June, when three Baltimore residents died or were killed during interactions with Baltimore police while experiencing behavioral health crises.
Other cities have addressed mental health emergencies by setting up non-police response teams that can be dispatched directly through 911, much like fire or EMS services. The head of Baltimore’s behavioral health authority, Crista Taylor, called for a similar program in Baltimore at the August 27 City Council oversight hearing.
“What we really need are alternative community responders that are not police, not fire, but are trained community responders like (in) Albuquerque and Denver,” two cities with behavioral health response teams, Taylor said.
Members of city council asked for more information but were noncommittal about the idea of establishing a more centralized program that would remove police from the equation. City Council President Zeke Cohen, who convened the hearing following this summer’s deaths, said the city needs a robust infrastructure to deploy the different responses for different kinds of emergencies, but pointed to “siloing” among the agencies that currently handle the crisis response system as a key problem.
The hearing also focused primarily on flaws in behavioral health providers’ crisis systems, glossing over the fact that the much better funded police department was primarily responsible for its own flawed, deadly response to mental health emergencies in Baltimore this summer.
“I do think this is something that ultimately the city needs to own,” Cohen said after the hearing. “There needs to be a person who is accountable for the system, because right now, that I think we heard this evening is that there’s still a lot of muddle.”
A spokesperson also told Baltimore Beat that Cohen is not considering legislation that would create a more centralized crisis response system, and instead prefers to work with Mayor Brandon Scott’s office and the city health department.
A theme of the hearing was the lack of a clear, uniform procedure that should be followed when a resident calls for help with a behavioral crisis. Ray Kelly, the executive director of the Citizens Policing Project, said the existing system “lacks the transparency and accountability needed to rebuild trust.”
“The urgency of this moment cannot be overstated,” Kelly said. “Lives are at stake.”
Other cities have created programs designed to remove police from mental health calls entirely. Albuquerque and Minneapolis, for example, have dedicated behavioral health teams that respond to appropriate calls that come through 911. Instead of re-routing those calls to a contractor or nonprofit, these cities handle them and employ clinicians in-house, much like other jurisdictions employ firefighters or EMTs. Some cities use nonprofits to run these response programs.
Mariela Ruiz-Angel, the director of alternative response initiatives at Georgetown Law’s Center for Innovations in Community Safety, said national data shows that behavioral health responders can do this work without getting hurt.
“Less than 1 to 2 percent of calls actually need backup from a police officer,” Ruiz-Angel said. “If anything, we’re seeing more officers requesting these alternatives to go to them.”
Non-police responses also result in more voluntary transports, because trained responders can sit and spend time with a person experiencing a mental health crisis to convince them to get help. These responders don’t handcuff people, Ruiz-Angel said, because that is seen as an escalation.
Baltimore’s crisis response network currently involves a mix of city and non-profit entities: calls come to the 911 dispatch center, which is overseen by the city’s fire department. Eligible behavioral health calls can be diverted to the 988 helpline for assistance from Baltimore Crisis Response Inc.
When Baltimore’s 988 diversion program first launched in 2021, it was only intended for callers expressing an intent to harm themselves, said Adrienne Breidenstine, the vice president for policy and communications at Behavioral Health System Baltimore, which partnered with the city on the program.
The program has since expanded to all types of behavioral health calls, she said. Most calls can be addressed over the phone, but mobile crisis teams, which do not include police, can also be dispatched.
The problem is that the vast majority of behavioral health calls never get diverted to 988, according to data Cohen shared at the hearing. Cohen said city data shows that between July and December 2024, the 911 system received more than 4,200 behavioral health calls, but only 28 were successfully diverted to 988. Response times from mobile crisis teams also averaged between one and a half hours and over two hours, Cohen said.
Baltimore’s system has other gaps and inconsistencies, too. The protocols dictating the treatment of individuals identified as Emergency Petitions by the Baltimore Fire Department’s Emergency Medical Services are explicit: patients should not be restrained face down, and handcuffed patients are to be secured in a face-up position with their hands anterior, jointly managed with police.
These procedures are designed to prioritize the safety and medical needs of individuals experiencing a behavioral health crisis, reflecting both best practices in emergency medicine and human rights standards. The guidance explicitly references the role of police, signaling a coordinated approach intended to prevent harm during behavioral health interventions.
Yet in practice, these protocols seem to be frequently disregarded. In the case of Dontae Melton Jr., who died after seeking help from police during a mental health crisis on the night of June 24, officers verbally acknowledged him as an Emergency Petition, signaling recognition of his mental health status and the proper protocol, yet officers repeatedly allowed Melton to be placed face down or on his side.
They also handcuffed him behind his back while he lay face down on the ground. These actions directly contradict EMS’s own manual, which clearly prohibits face-down restraint for Emergency Petition patients. EMS and police manuals cross-reference one another’s procedures, creating the expectation of coordination and mutual adherence. Instead, these references appear to serve only as formalities, with officers failing to implement the safeguards that their own policies and joint policies prescribe.
The divergence between written policy and field practice is not unique to Melton’s case. In the shooting death of 70-year-old Pytorcarcha Brooks, whose family sought help when she experienced a behavioral health crisis on June 25, similar failures were observed: protocols designed to protect vulnerable individuals were ignored, and the coordination envisioned in official manuals broke down entirely. The result is a system in which procedural safeguards exist on paper but have no enforceable effect.
A city-led program like Albuquerque’s could streamline Baltimore’s crisis response system and place it all within the same agency, reducing the “silo” effect that Cohen and other members of City Council mentioned at the August 27 hearing.
But when Taylor, who heads Behavioral Health System Baltimore, suggested that alternative response teams would be helpful, City Councilmember Odette Ramos expressed frustration that this was the first time she had heard about the need for these teams. Unlike mobile crisis teams, alternative response teams provide more day-to-day support, including wellness checks and responding to disturbances like a person yelling outside a business.
Cohen asked Taylor to work with the mayor’s office to produce a report explaining “where we need to be and what it will cost” within seven days. The current system, Cohen said, “feels jumbled, and it feels like there are many different partners in the room and it is not clear who is in charge.”
Despite several dozen residents calling for accountability during the public testimony portion of the hearing, residents left without a clearer idea of who is in charge — or who might take charge — and no firm commitments on potentially life-saving changes to the crisis response system from council members.
