When a mental health crisis unfolds in Miami-Dade County, a call to 1-866-SAFEMIA brings a different kind of first responder. Instead of armed officers, the Freedom House Mobile Crisis Team sends trained medics, therapists and crisis interventionists who focus on listening, de-escalating and connecting people to care — all without involving police.
Run by Dade County Street Response (DCSR), unit members function as both hotline call-takers and outreach workers, providing direct support to callers and people they encounter on the street. Team members conduct on-site assessments, prioritize medical emergencies, develop safety plans and connect people to resources with the goal of avoiding involuntary psychiatric commitment under Florida’s Baker Act whenever possible.
“That reality is central to our approach: we don’t involve the police,” said Dr. Armen Henderson, DCSR’s executive director. “As CAHOOTS (Crisis Assistance Helping Out On The Streets) has demonstrated, they’ve handled over 24,000 calls annually and only required police backup in a few hundred—under 1%. We model our system similarly centered on harm reduction, cultural familiarity and trust.”
Now, with a three-year grant by the Bristol Myers Squibb Foundation, totaling $2.2 million, Freedom House is preparing its largest expansion yet.
An alternative to police response
The program launched in 2022 under Dream Defenders in Liberty City, named after a pioneering Black-led ambulance service that began in Pittsburgh in 1967. That original Freedom House set the standard for modern emergency treatment by putting trained medical staff and equipment in ambulances for the first time.
Miami’s unit was initially funded by a $900,000 grant from the Open Society Foundation to the Dream Defenders’ Healing and Justice Center, a coalition that includes DCSR, Beyond the Bars and Circle of Brotherhood and provides an array of services from free health clinics to youth programs.
The push for alternatives grew after the 2020 police killing of George Floyd, when many cities began sending mental health workers, sometimes without police, to respond to behavioral emergencies.
“Media reporting underscored that police were inadequately prepared for behavioral emergencies, and shocking data showed civilians in crisis are 17 times more likely to be fatally shot by police,” said Henderson.
Henderson said Miami’s model was inspired by Crisis Assistance Helping Out On The Streets, or CAHOOTS, in Oregon, which was launched in 1989 to respond to calls with two-person teams comprised of a medical professional and a crisis worker, both of whom have extensive training in the field of mental health.
“We believed a completely non-police model was both viable and vital,” he said.
Henderson noted that in 2022–2023, 53.8% of Baker Act initiations in Florida came from law enforcement, compared to 43.7% from health professionals, “a staggering statistic underscoring how frequently untrained, coercive responses are applied in mental health crises,” he said.
Not 911, but 1-866-SAFEMIA
Between 2020 and 2022, at least 29 mental health calls to 911 in Miami led to police use of force, according to MindSite News and Medill. The mobile unit was born to change that narrative.
Adejare A. McMillan, DCSR’s Mobile Crisis Response program manager, explained how the process works.
“We receive calls through our non-emergency crisis line, where dispatchers will take the call, gather pertinent information in a similar fashion to PD dispatchers, and relay the call details to our Mobile Crisis Response Unit, which will then physically go out and respond to the call,” McMillan said. “We remain on call for as long as is needed to mitigate the crisis, or until it is no longer safe or our presence is no longer needed/beneficial.”
Anybody within a five-mile radius in Liberty City can call the team. In 2022, the hotline operated two days a week for five hours a day. By 2023, it expanded to six days of 12-hour shifts. That year, the Freedom House team intervened 116 times; 35% of clients received counseling and referrals, 20% were taken to hospitals, and 15% received on-site medical care.
DCSR data scientist Alex Johnson said the van acts as “a trust bridge,” linking clients to wrap-around services like housing, legal aid and primary care. The team tracks call types, dispatch locations and outcomes to better cover hotspots and peak times.
“This is about saving lives and restoring communities,” Johnson said.
Expansion
In 2024, a funding shortage caused a temporary shutdown. The coalition then transitioned the program to function fully under DCSR. Now, with the new Bristol Myers Squibb Foundation grant, Freedom House will be able to operate seven days a week, 10 hours a day.
The grant will fund more crisis response, infrastructure, training, outreach and evaluation to create a “playbook” for national replication.
“We'll also educate residents about 988 and work toward partnering with it in underserved Miami‑Dade neighborhoods, ensuring more people know there are alternatives beyond calling 911 during mental health emergencies,” Henderson said.
The BMS Foundation’s strategy aims to divert people with serious mental illness away from the criminal justice system and into treatment.
“This grant is a stepping stone, not an endpoint,” Henderson said. “Our model is already recognized among healthcare professionals as a more humane, dignified crisis response.”
Circle of Brotherhood Executive Director Lyle Muhammad described the mobile unit as essential.
“We need at least 10 more to cause a paradigm shift in responses to community-based violence intervention and prevention,” he said.
Men and mental health
Black men in Miami are particularly at risk of mental health challenges, from untreated illness and substance misuse to complex trauma, stigma and systemic barriers to care.
“Black men are more likely to be impacted by depression, anxiety and PTSD, while also often being castigated when they ask for help,” said McMillan, a licensed mental health counselor.
In 2023, 83% of people served by Freedom House were Black, and 61% were male.
Suicide was one of the most common issues the team encountered. Nationally, it is the third leading cause of death for Black men ages 15–24, according to the National Alliance on Mental Illness. McMillan said stigma and lack of access often make symptoms more disabling and persistent.
To de-escalate crises, McMillan uses motivational interviewing, verbal and body language cues, active listening and therapeutic conversation.
“In cases of psychosis, the goal should always be to reduce any potential for harm, to get the individual to voluntarily be assessed, and to seek further treatment if it seems necessary,” he said.
DCSR, through its work and through the mobile unit, aims to counter the negative stigma.
“Our patient-centered approach, in combination with our dedication to being in relationship with the communities we serve, positions us to uniquely be of service in these ways,” McMillan said.
Looking ahead
Freedom House, now in the process of rehiring and relaunching, expects to serve 300–400 people a year with its new funding, triple or quadruple its 2023 reach. Henderson envisions the program becoming as influential in crisis care as its Pittsburgh namesake was in emergency medicine.
“In one year, I see Freedom House running with a full mobile crisis response team, robust call coverage and published preliminary study findings, and new learning initiatives such as training academies and webinars,” Henderson said.
He said the team will also apply for federal funding for research, training and advocacy.
For Johnson, the mission remains rooted in trust and visibility.
“The more people know about us and trust what we do, the more it will amplify our impact. Education and awareness are huge priorities.”
