Help change the way Maryland cares for those with severe mental illnesses

Our Guest Blogger this month, Evelyn Burton, shares with us exciting news on two bills being drafted up for legislation in the coming weeks. This post is jam-packed with important information on each bill, why we should care, and steps to take action!

UPDATE as of 2/13/19:

Wednesday, February 20th, is the first hearing for the revamping of the OCC (Outpatient Civil Commitment) Program. Maryland needs a much more robust program that is true to the evidenced-based model of AOT. The OCC program currently in place does not do enough for those who have anosognosia (do not understand they are ill).

Call ASAP at (866) 967-9994 if interested in providing either oral or written testimony.


UPDATE as of 1/15/19:

1.  Maryland’s 2019 legislative session started January 9, 2019, and ends April 8, 2019.

2. The Maryland bill to facilitate psychiatric hospital treatment for incarcerated individuals is being drafted and moving forward.  There is not yet a date for the hearing. We will keep you posted when the date is set.

3.  It was decided not to introduce an Assisted Outpatient Treatment (AOT) bill this year.  Instead, time is being devoted to educating legislators (both state and county) and organizations on the need for AOT, to build support for AOT in Maryland.

4. The Maryland Senate Finance Committee will be holding a briefing on psychiatric hospital beds on Jan. 17, 2019 at 1:00 PM where they will receive information from the Maryland Health Department on current capacity and demand.  The briefing can be viewed live or afterward at
Advocates are needed at varioius times during the legislative session to tell stories to legislators (oral or written) to show the need for more psychiatric hospital beds-both short and long term beds (need not be on Jan. 17). Please call me at 301-404-0680 if you know of someone who has waited in an ER for over 30 hours for involuntary placement in a psychiatric hospital bed, or know of someone who has not been able to stabilize with only a short term hospital stay.

5.  REMEMBER THE MARYLAND DANGER STANDARD FOR INVOLUNTARY HOSPITAL COMMITMENT HAS BEEN BROADENED BY A MARYLAND APPEALS COUNT DECISION. The Appeals Court is the highest Maryland Court.  You may need to educate treatment providers that the Maryland Appeals court has ruled a person can be involuntarily admitted to a hospital BEFORE being an imminent danger to self.




I’m thrilled to be guest blogging with my friends here at Help in the Home, LLC. It’s an honor to share with you some important information that not only will change the way our state will care and manage access to care for those with severe mental illnesses but also, pave the way for two critical and time-sensitive bills that need your attention today. These two bills need your support and your testimony to get pushed by our legislative offices. Here is some brief information about each one: 


Bill #1

This bill will provide timely access to psychiatric hospital treatment for jail and prison inmates. This bill requires the transfer of jail and prison inmates to a state psychiatric hospital within ten business days after they are certified by two mental health professionals as having a mental disorder and needing inpatient care or treatment for the protection of the individual or another. The bill also permits certain privately funded mental health professionals to evaluate inmates and complete certificates for hospital admission.  

In other words: Timely and responsive mental health care for jail and prison inmates with severe mental illnesses.


Bill # 2

This bill establishes an AOT (Assisted Outpatient Treatment) program in Maryland. AOT is the practice of delivering outpatient treatment under a civil court order to adults with severe mental illnesses who meet specific criteria, such as:

  • Deterioration resulting in an inability to meet basic needs.
  • The need for hospitalization for the protection of the life or safety of the individual or others.
  • Being unable or unwilling to be admitted to outpatient services voluntarily.

A person’s failure to comply with an AOT order may lead to consideration of the need for inpatient treatment. IMPORTANT: An AOT order does not authorize forcible administration of medication, rather compliance with the order is a result of the perceived authority of the judge and the commitment of the responsible outpatient service provider.  

In other words: Those with severe mental illnesses will have better access to services, even if he or she is unable to accept care voluntarily.


But why should I care?


There comes a time when we need policies and legislation to back up our efforts for better care, better access, and a better life for people with severe mental illnesses. More than ever, mental health stigmas pose a barrier to equitable access to fair, quality, and timely care. That’s why we need your help and your support to push these two bills forward.  

Bill #1 is crucial because it will ensure access to hospital care for inmates in a timely manner. The word ‘timely’ here is critical because having effective care is just as important as care that is responsive and immediate. Timely care will prevent:

  • Psychiatric deterioration
  • Brain damage
  • Suffering from lack of treatment

This bill will limit the current inhumane practice of holding suffering psychotic or depressed individuals, sometimes in solitary confinement, with no medication to treat their illness. By expediting inpatient treatment, it will improve the long-term prognosis and result in inmates being released in better condition with less chance to re-offend. For too long, inmates have not been given the appropriate and timely care they need, and this bill will change their lives if they can access their care more quickly.

Bill #2 is another bill that will change the lives of those with severe mental illnesses. It will create access to outpatient treatment for those who are unable or unwilling to accept treatment voluntarily. It is a tool for assisting those individuals most at risk for the negative consequences of not receiving treatment. Strong evidence suggests that AOT can reduce:

  • Hospitalizations
  • Arrests
  • Incarceration
  • Homelessness
  • Violence
  • Victimization

by 74 to 87%. AOT can significantly improve treatment compliance and quality of life. By placing our loved ones and those who need help into the care they need the most, their chances of living a better life and being active members of society are significantly increased.


Act Now!


Here are four ways you can help:

  1. Talk privately with a legislator in Annapolis, and with me (email me at, about the bills. Having a personal story relevant to tell is preferable but not required. Training will be provided.
  2. Help others write and edit their testimony.
  3. Start writing your oral or written testimony today. Oral testimony can only be three minutes long, and written testimonies can only be one page. A personal story relevant to the bill is preferable. Start by writing out your story and how the bill would help. ***While we don’t know the hearing date yet (see info on DATES below), we need to be ready to produce testimonies once the hearing is announced.
  4. Help with emails, coordination, and logistical support. Email me at with more information on how you can be more involved!


Dates to Remember


We don’t know the exact date for the hearing yet. Here is what we do know:

The 2019 Maryland legislative session starts January 9, 2019, and ends April 8, 2019.  Bill hearings are in Annapolis and may be scheduled any time during January, February, or March. Often, the hearing date is only announced one to two weeks in advance. Hearings are usually scheduled at 1:00 pm and can last 30 minutes to all afternoon. Written testimony can be submitted up to one hour before the hearing. Sign-up for oral testimony starts the day before the hearing and ends about one hour before the hearing. HERE is more information about how the hearings and testimonies work.

So, all that said, my friends here at HITH and myself will keep you all updated on the hearing date. If you haven’t done so, sign-up for the HITH newsletter HERE to stay abreast on our advocacy efforts, and continue to check-in with this blog post and the HITH blog for current news. I look forward to having you involved in our policy work to make sure people with severe mental illnesses are cared for appropriately, timely, and with the quality of life they deserve. Have questions or want to be more involved? Email me at and let’s get in touch!


Helpful Links


Last, but not least, here are some articles that talk more about the Maryland legislation and why we need these two bills:

Maryland Legislature

Serious Mental Illness in Jails and Prisons

Assisted Outpatient Treatment (AOT) and What It Is

Promoting AOT

More about Evelyn Burton:

Evelyn Burton has over fifteen years of experience working and advocating for mental health policies. She currently serves as Advocacy Chair for Parents for Care. Working with Treatment Advocacy Center, Evelyn released a survey of county jails on access to state hospital treatment. She also successfully advocated legislators to require the Health Department to assess the need for civil and forensic state hospital beds and report back to the legislature. You can email Evelyn at anytime with questions or ways to be more involved. 

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