Behavioral Health and the Consent Decree

Background:

In April 2017, the City of Baltimore entered into a consent decree with the U.S. Department of Justice (DOJ) to resolve DOJ’s findings that the Baltimore Police Department (BPD) had engaged in a pattern or practice of conduct that violated the First, Fourth, and Fourteenth Amendments of the U.S. Constitution.

One section of the decree focuses on the City’s response to behavioral health crises and outlines the City’s responsibilities to identify gaps in the behavioral health service system and recommend and implement solutions.  

Purpose of the Assessment:

The City partnered with Behavioral Health System Baltimore (BHSB), Human Services Research Institute (HSRI), and the Collaborative Planning and Implementation Committee (CPIC), since renamed Baltimore City Behavioral Health Collaborative (BCBHC) to conduct a comprehensive review. The goals were to:

  • Analyze police interactions with individuals with behavioral health disabilities
  • Identify systemic barriers and recommend solutions
  • Identify gaps in behavioral health services across the broader Public Behavioral Health System (PBHS)
  • Prevent avoidable criminal justice involvement for people with behavioral health needs
  • This work culminated in the publication of the Public Behavioral Health System Gap Analysis Report in December 2019.

 

Developing the Gap Analysis Implementation Plan (GAIP):

Defining what policing looks like for a community is one of the most consequential decisions a local government can make. The status quo approaches to policing, public safety, and behavioral health crises had not produced the outcomes our residents deserve.
In response, the City developed the Public Behavioral Health System Gap Analysis Implementation Plan (GAIP) — a multi-year strategy to reduce unnecessary police interactions with individuals in crisis through:

  • Non-enforcement alternatives
  • Coordinated system improvements
  • Cross-agency collaboration

This plan aligns with the consent decree’s requirements and demonstrates the City’s commitment to building a system that treats people with dignity, promotes diversion over enforcement, and connects individuals to the support they need.

 

GAIP Timeline and Community Input: 

  • First draft released for public comment: September 30 – October 30, 2021
  • Second draft released for review: May 2 – May 16, 2022
  • Final GAIP published: June 2022

 

Paragraph 97 Implementation and Ongoing Progress:

Since its publication, the GAIP has served as a road map to work across government agencies, organizations and community to address and achieve significant changes in the behavioral health system. These changes have included, but are not limited to:

  • the creation of a 911 diversion program in partnership with BHSB, Baltimore Crisis Response Inc. (BCRI), BPD, and Baltimore City Fire Department (BCFD); 
  • the implementation of Baltimore City Behavioral Health Crisis Incident Review Team to examine behavioral health crises that involve interaction with law enforcement and other emergency responders; 
  • the development of the Open Access Project to support behavioral health service providers to provide same-day or next-day appointments; significant expansion of mobile crisis teams that include certified peers; 
  • and the creation of a city-wide housing fund to increase permanent supportive housing. 

As progress under the Consent Decree continued, the City, BPD, and DOJ found it necessary to outline more specific actions and outcomes that are required under Paragraph 97.  However, the evolving and complex landscape of behavioral health service delivery, not only across Baltimore City but across Maryland and the United States, combined with ongoing community feedback and the generality, and outdated implementation strategies within the GAIP, demonstrated a need for a more specific agreement between the City and DOJ to satisfy the requirements of Paragraph 97 of the Consent Decree. The City, BPD, and DOJ negotiated this agreement, and in September 2023, the Monitoring Team approved and filed it with the Court. 

Reports on Paragraph 97 Implementation are published on a semiannual basis and shared with the public for open comment The intent of this report is twofold: 

  • a mechanism for the Monitoring Team to measure the City’s progress addressing the goals named in paragraph 97 of the consent decree, and 
  • a public document to share how Baltimore City has and is planning to make changes to its behavioral health system. 

In all, this public document aims to garner feedback from the public to shape this critical body of work. 

Reports Available for Download:

Notice: Due to the federal government shutdown, posting of the Paragraph 97 Implementation Report Q1–Q2 2025 has been delayed until further notice.

 

How to Get Involved - Join the Baltimore City Behavioral Health Collaborative (BCBHC):

To support this work, the City invites community members and stakeholders to join the Baltimore City Behavioral Health Collaborative (BCBHC).

Formerly known as the Collaborative Planning and Implementation Committee (CPIC), the BCBHC has convened partners for over 15 years to improve how the Baltimore Police Department responds to behavioral health crises. In 2017, its scope expanded to focus on system-wide transformation.

Today, the BCBHC is jointly led by:

  • The Mayor’s Office
  • The Baltimore Police Department (BPD)
  • Behavioral Health System Baltimore (BHSB)

The Collaborative plays a central role in fulfilling the goals of Paragraph 97 of the Consent Decree. It also provides a platform for ongoing public input, accountability, and collaborative planning.

Meetings are held quarterly and are open to the public. For more information visit Baltimore City Behavioral Health Collaborative (BCBHC) or email behavioralhealth@baltimorecity.gov