Counties stand to benefit from court-ordered, assisted outpatient treatment models adopted by 47 other states as Moore-Miller Administration vows to work on it.
As covered on the MACo blog and Conduit Street podcast, Maryland lags behind 47 states and the District of Columbia in establishing some form of court-ordered outpatient mental health care for adults with severe and persistent mental illness. According to an article from the Associated Press, Maryland, Massachusetts, and Connecticut are the only remaining states that do not give courts this authority. This leaves Maryland among the last three states that appear to still be figuring this out when research shows these programs are found to divert individuals who need intensive mental health treatment away from hospitals, jails, and homeless shelters.
Funneling eligible individuals into these programs and away from law enforcement activity and jails would preserve county resources in public safety and corrections. These already overburdened facilities could then be fully utilized for the intended purposes, while also facilitating the appropriate care for an individual in need. This would come at a time when county jails regularly house detainees that need to be in a hospital rather than a prison cell, but the required state transfer system is backlogged, leaving would-be patients in limbo, and county staff shouldering a burden they are not intended or trained to carry.
Other efforts, covered on the blog, have been made to revise involuntary mental health treatment and commitment with regards to how Maryland interprets the “danger standard,” which as it currently exists in statute has proven to be very vague. A stronger mechanism to ensure individuals who need care are able to access it would bring welcome change to local law enforcement and correctional facilities. This is of particular importance in situations where the mental illness is so severe that the individual is unable to understand or seek the care they need – often patients found to be schizophrenic, schizoaffective, delusional, have a personality disorder, or brief psychotic disorder.
This past legislative session MACo supported HB 823/SB 480 – Mental Health Law – Assisted Outpatient Treatment Programs. This is legislation that would enable county governments to establish an Assisted Outpatient Treatment (AOT) program for individuals suffering from severe and persistent mental illness. 75 pieces of testimony, both written and oral, were submitted with only 13 requests for an unfavorable report. HB 823/SB 480 failed to pass in 2023 but not without a letter of information from the Moore-Miller administration, via the Maryland Department of Health, expounding the merits of AOT and a commitment to issue a report during the interim with recommendations for the 2024 session.