Maryland Severe Mental Illness Resources & Helpful Info

MD. CODE ANN., HEALTH-GEN. § 10-622(b)(1). The petition for emergency evaluation of an individual may be made by: (i) A physician, psychologist, clinical social worker, licensed clinical professional counselor, clinical nurse specialist in psychiatric and mental health nursing, psychiatric nurse practitioner, licensed clinical marriage and family therapist, or health officer or designee of a health officer who has examined the individual; (ii) A peace officer who personally has observed the individual or the individual's behavior; or (iii) Any other interested person. MD. CODE ANN., HEALTH-GEN. § 10-622(a). A petition for emergency evaluation of an individual may be made under this section only if the petitioner has reason to believe that the individual: (1) Has a mental disorder; and (2) The individual presents a danger to the life or safety of the individual or of others. MD. CODE ANN., HEALTH-GEN. § 10-624 (b) …. (3) Within 6 hours after an emergency evaluee is brought to an emergency facility, a physician shall examine the emergency evaluee, to determine whether the emergency evaluee meets the requirements for involuntary admission. (4) Promptly after the examination, the emergency evaluee shall be released unless the emergency evaluee: (i) Asks for voluntary admission; or (ii) Meets the requirements for involuntary admission. (5) An emergency evaluee may not be kept at an emergency facility for more than 30 hours.

MD. CODE ANN., HEALTH-GEN. § 10-614(a). Except [where the individual alleged to require involuntary admission is currently a state prison inmate], application for involuntary admission of an individual … may be made … by any person who has a legitimate interest in the welfare of the individual. MD. CODE ANN., HEALTH-GEN. § 10-615(6). Each application for involuntary admission shall be “accompanied by the certificates of: (i) 1 physician and 1 psychologist; (ii) 2 physicians; (iii) 1 physician and 1 psychiatric nurse practitioner; (iv) 1 physician and 1 licensed certified social worker-clinical; or (v) 1 physician and 1 licensed clinical professional counselor;” § 10-617. Admission limitations. (a) A facility or Veterans’ Administration hospital may not admit the individual under this part unless: (1) The individual has a mental disorder; (2) The individual needs inpatient care or treatment; (3) The individual presents a danger to the life or safety of the individual or of others; (4) The individual is unable or unwilling to be admitted voluntarily; and (5) There is no available, less restrictive form of intervention that is consistent with the welfare and safety of the individual. MD. CODE ANN., HEALTH-GEN. § 10-632(e)(2). The hearing officer shall [o]rder the release of the individual from the facility unless the record demonstrates by clear and convincing evidence that at the time of the hearing each of the following elements exist as to the individual whose involuntary admission is sought: (i) The individual has a mental disorder; (ii) The individual needs in-patient care or treatment; (iii) The individual presents a danger to the life or safety of the individual or of others; (iv) The individual is unable or unwilling to be voluntarily admitted to the facility; (v) There is no available less restrictive form of intervention that is consistent with the welfare and safety of the individual; and (vi) If the individual is 65 years old or older and is to be admitted to a State facility, the individual has been evaluated by a geriatric evaluation team and no less restrictive form of care or treatment was determined by the team to be appropriate.

Article – Health – General. Section 10–6A–01 through 10–6A–11 10–6A–12 “Subtitle 6A. Assisted Outpatient Treatment Programs” *Goes into effect July 1, 2024 with launch of AOT programs July 1, 2025.* MD. CODE ANN., HEALTH-GEN. § 10-6A-01 (A) In this subtitle the following words have the meanings indicated. (B) “Assisted Outpatient Treatment” means a specific regimen of outpatient treatment for a serious and persistent mental illness to which an individual is ordered by the court to adhere. (C) “Care Coordination Team” means a multidisciplinary team under the oversight of a local behavioral health authority or, core service agency, or the department. (D) “Harm to Others” means an act or attempt at or credible threat of serious violent behavior toward others. (E) “Harm to the Individual” means self–harming behavior or an attempt at suicide. (…) (H) “Serious and Persistent Mental Illness” means a mental illness that is severe in degree and persistent in duration, that causes a substantially diminished level of functioning in the primary aspects of daily living and an inability to meet the ordinary demands of life, and that may lead to an inability to maintain independent functioning in the community without intensive treatment and support. MD. CODE ANN., HEALTH-GEN. § 10-6A-03 (A) (1) On or before July 1, 2026, a county may establish an assisted outpatient treatment program in accordance with this subtitle. (2) A county may partner with another county to establish an assisted outpatient treatment program. (b) An assisted outpatient treatment program established under subsection (a) of this section shall be approved and overseen by the county’s local behavioral health authority or core service agency. (c) On or before July 1, 2026, the department shall establish an assisted outpatient treatment program in any county that does not opt to establish an assisted outpatient treatment program. MD. CODE ANN., HEALTH-GEN. § 10-6A-04 (A) A petition for assisted outpatient treatment may be made under this subtitle by the director of a mental health program receiving state funding under subtitle 9, part I of this Title, or by any individual at least 18 years old who has a legitimate interest in the welfare of the respondent. (b) The petition for assisted outpatient treatment shall be in writing, signed by the petitioner, and state: (1) The petitioner’s name, address, and relationship, if any, to the respondent; (2) The name and any known address of the respondent; (3) That the petitioner has reason to believe the respondent meets the criteria for assisted outpatient treatment in § 10–6A–05 of this subtitle; and (4) For each criterion for assisted outpatient treatment in § 10–6A–05 of this subtitle, the specific allegations of fact that support the petitioner’s belief that the respondent meets the criterion. (C) The petition for assisted outpatient treatment shall be accompanied by an affidavit or affirmation of a psychiatrist, stating that the psychiatrist is willing and able to testify at the hearing on the petition and has: (1) Examined the respondent within 30 days before the date of the petition; and (2) Concluded that the respondent meets the criteria for assisted outpatient treatment in § 10–6A–05 of this subtitle. (D) (1) A petition for assisted outpatient treatment shall be filed in the circuit court for the county in which the respondent resides or in the county of the last known residence of the respondent. (2) On the filing of a petition under paragraph (1) of this subsection, the circuit court shall notify the following of the filing of the petition: (I) The respondent; (II) The mental health division in the office of the public defender; (III) As applicable, the local behavioral health authority or, the county’s core service agency, or the department; (IV) the county attorney; and (V) if applicable and known, the respondent’s guardian and health care agent. (E) a petition filed under this subtitle shall be held under seal and may not be published on Maryland judiciary case search. MD. CODE ANN., HEALTH-GEN. § 10-6A-05 (A) The court may order the respondent to receive assisted outpatient treatment on a finding by clear and convincing evidence that: (1) The respondent is at least 18 years old; (2) The respondent has a serious and persistent mental illness; (3) The respondent has demonstrated a lack of adherence with treatment for the serious and persistent mental illness that has: (I) At least twice within the 36–month period immediately preceding the filing of the petition, been a significant factor in necessitating inpatient admission to a psychiatric hospital for at least 48 hours or receipt of psychiatric services in a correctional facility; or (II) At least once within the 36–month period immediately preceding the filing of the petition, resulted in an act of serious violent behavior toward self or others, or patterns or threats of, or attempts at, serious physical harm to self or others; (4) In view of the respondent’s treatment history and behavior at the time the petition is filed, the respondent is in need of assisted outpatient treatment in order to prevent a relapse or deterioration that would create a substantial risk of serious harm to the individual or harm to others; (5) The respondent is unlikely to adequately adhere to outpatient treatment on a voluntary basis, as demonstrated by the respondent’s history of treatment nonadherence in the 36–month period immediately preceding the filing of the petition that is not due to financial, transportation, or language issues in the immediately preceding 36–month period; (6) In consideration of items (1) through (5) of this subsection, assisted outpatient treatment is the least restrictive alternative appropriate to maintain the health and safety of the respondent. (B) time that the respondent spent hospitalized or incarcerated may not be included when calculating the time period under subsection (A)(3)(I) or (II) of this section. MD. CODE ANN., HEALTH-GEN. § 10-6A-06 (A) (1) After the filing of the petition with the court under § 10–6A–04 of this subtitle, but not later than the date of the psychiatrist’s testimony required under § 10–6A–07 of this subtitle, the care coordination team shall develop a treatment plan and provide a copy in writing to: (I) The respondent; (II) The respondent’s attorney; and (III) If applicable and known, the respondent’s guardian and health care agent. (…) (B) (1) The care coordination team shall give the respondent, the respondent’s guardian, the respondent’s health care agent, and any individual designated by the respondent a reasonable opportunity to participate in the development of the treatment plan. (2) If the respondent has executed a mental health advance directive, the care coordination team shall honor any directions included in the advance directive in the development of the Treatment plan in accordance with §§ 5–602(A)(2) and 5–611(A) and (B) of this article. (3) (I) The respondent shall have an opportunity to voluntarily agree to the treatment plan. (II) if the respondent voluntarily agrees to the treatment plan, the care coordination team shall: 1. Notify the court that the parties are dismissing the case in accordance with Maryland rule 2–506; and 2. File a stipulated agreement that includes the treatment plan. (4) the care coordination team shall provide to the respondent, the county attorney, and the office of the public defender the treatment plan and the providers that are included in the treatment plan. (…) MD. CODE ANN., HEALTH-GEN. § 10-6A-07 (…) (E) (1) The petitioner’s presentation of evidence shall include the testimony of a psychiatrist to explain the treatment plan, … MD. CODE ANN., HEALTH-GEN. § 10-6A-08 (A) If, after hearing all relevant evidence, the court does not find by clear and convincing evidence that the respondent meets the criteria for assisted outpatient treatment, the court shall deny the petition. (B) (1) If, after hearing all relevant evidence, the court finds by clear and convincing evidence that the respondent meets the criteria for assisted outpatient treatment, the court shall order the respondent to comply with assisted outpatient treatment for a period not to exceed 1 year. (2) The order of the court shall incorporate a treatment plan that: (I) Is limited in scope to the elements included in the treatment plan presented to the court under § 10–6A–06 of this subtitle; and (II) Includes only those elements that the court finds by clear and convincing evidence to be essential to the maintenance of the respondent’s health or safety.