Staff Report
The Winston-Salem Chronicle
WINSTON-SALEM — For residents experiencing a mental health crisis that does not require police intervention, help in Winston-Salem increasingly arrives in the form of a paramedic and a licensed clinician — not a patrol car.
The city’s Behavioral Evaluation and Response program, known as BEAR, is steadily expanding its impact, according to an update delivered by Fire Chief Trey Mayo during the Feb. 9 meeting of the Public Safety Committee.
The BEAR team now responds to an average of six calls per day, Mayo told council members. When follow-up calls are included — about 10% of daily activity — the team’s workload rivals that of the city’s fifth busiest engine company.
That comparison underscores what city officials describe as a key public safety benefit: while BEAR handles non-violent behavioral health crises, traditional fire and EMS crews remain available for life-threatening emergencies.
A Different Kind of First Response
The BEAR model pairs a paramedic with a licensed clinician to respond to behavioral health calls routed through 911. The goal is to provide specialized, non-escalatory care while connecting individuals to appropriate services.
Programs like BEAR reflect a broader shift in how cities address mental health-related emergencies — recognizing that not every crisis requires law enforcement, and that specialized intervention can reduce strain on police, fire and emergency medical systems.
Chief Mayo said the program’s growing call volume demonstrates both demand and operational effectiveness.
The team’s work includes not only immediate crisis response but follow-up contact to ensure individuals are connected with ongoing care. Those follow-up calls — roughly one in every 10 interactions — are designed to reduce repeat emergencies and build continuity in support.
For residents, that can mean the difference between a one-time response and a pathway to longer-term stability.
From Pilot to Established Program
Like many innovative public safety initiatives, BEAR began as a pilot program. Early discussions in the community and among policymakers focused on sustainability, funding, and how the team would integrate into established emergency response systems.
Questions were also raised about whether a non-police response would be sufficient in certain situations and whether the program might divert resources from other critical needs. But as behavioral health calls increased, so did the recognition that a specialized, non-forceful response was essential.
According to Mayo’s presentation, the program has addressed many of those concerns through operational data and consistent use.
By absorbing non-violent mental health calls, BEAR reduces pressure on police officers and traditional EMS units, allowing those personnel to focus on criminal activity, fires and medical emergencies.
City leaders have framed that shift not as a reduction in service, but as a more precise deployment of resources.
Statewide Attention
The program has also drawn recognition beyond Winston-Salem.
BEAR Director Holly Ryan was acknowledged by the governor during a recent executive order signing related to mental and behavioral health, according to officials at the committee meeting. Council Member Andrew Bowen asked about the implications of the governor’s order and how it might align with Winston-Salem’s efforts.
While specific funding or policy changes tied to the executive order were not detailed during the meeting, council members noted that the state’s increased focus on behavioral health could create opportunities for collaboration and support.
Chairwoman Annette Scippio and other committee members praised the Fire Department for advancing what they described as a forward-thinking and compassionate approach to public safety.
Building Public Awareness
Officials emphasized that awareness remains central to the program’s success.
The Fire Department has launched a public education campaign to inform residents about BEAR’s role. Billboards, transit bus wraps and banners featuring the program’s logo are now visible throughout the city.
The outreach effort aims to help residents understand when a behavioral health response — rather than a law enforcement response — may be appropriate.
Clear communication is especially important in communities where trust in emergency systems has historically been complicated. By visibly promoting the program, city leaders say they hope to ensure residents know help is available and what form that help may take.
Why It Matters
Behavioral health crises intersect with housing instability, substance use, trauma and economic hardship — realities that affect families across Winston-Salem.
For neighborhoods long underserved by mental health infrastructure, access to specialized crisis response can represent a meaningful shift. Rather than defaulting to arrest or emergency room transport, BEAR aims to connect people with care in a way that prioritizes stabilization and dignity.
The program’s continued growth signals the city’s effort to treat mental health as a public health issue, not solely a law enforcement matter.
What Comes Next
City officials did not outline immediate structural changes to the program during the Feb. 9 meeting. However, the sustained call volume and state-level attention suggest BEAR will remain a focal point in future public safety and budget discussions.
As Winston-Salem evaluates long-term funding and expansion strategies, the program’s performance data — including call volume, follow-up engagement and system impact — will likely shape next steps.
For now, the BEAR team continues its daily work: responding, stabilizing and following up — one call at a time.
In a city working to balance public safety with compassion, that approach represents more than a new unit within the Fire Department. It reflects a broader evolution in how Winston-Salem cares for its residents in moments of crisis.