Baltimore City Public Behavioral Health System Analysis
Maryland
Opportunity
We worked with the City of Baltimore, Behavioral Health System Baltimore (a nonprofit), and our partners at Technical Assistance Collaborative to identify and address gaps in Baltimore’s public behavioral health system.
Approach
Protecting civil and constitutional rights
The consent decree that spurred this analysis resulted from an investigation by the DOJ into the death of Freddie Gray while in police custody in April 2015. Subsequent protests in Baltimore highlighted the deaths of unarmed Black men and boys by the police in this country. In their investigation, the DOJ found patterns of excessive force and unconstitutional policing in Baltimore City—including illegal stops, searches, and arrests, especially of Black residents.
Identifying and addressing gaps
As part of our analysis, we reviewed literature and existing documents (including City-specific plans), conducted constituent interviews, attended meetings, and examined police records, Medicaid claims data, utilization data, capacity data, usage patterns, demographic data, etc. We compiled a detailed inventory of services provided through the public behavioral health system in Baltimore City, and we examined the access, utilization, workforce capacity, use of best practices, quality and outcomes of those services. We also compared the current system with national best practices for public behavioral health systems.
A key component of our work was an analysis of sample police interactions with people with behavioral health issues to further understand systemic barriers and solutions for justice-involved individuals, especially populations known to be vulnerable in interactions with police.
Collaborating with local experts
As part of the decree, the City assembled a Collaborative Planning and Implementation Committee composed of a variety of constituents, including behavioral health service users, community members, service providers, behavioral health advocates, and other City and State partners. The Gap Analysis subcommittee of the CPIC advised and guided the gap analysis activities.
Promoting system change
This project provided a comprehensive, data-driven understanding of gaps and barriers and offered specific, actionable recommendations for how the public behavioral health system can better meet the needs of Baltimore City residents.
Impact
The analysis we conducted was a requirement of a consent decree entered into by Baltimore City, the Baltimore Police Department (BPD), and the Department of Justice (DOJ). The aim of our analysis was to identify unmet need, service gaps, barriers to accessing care, opportunities for better collaboration, and other system improvements, particularly as they pertain to decreasing or improving interactions with police.