Your (Unofficial) Guide to State-Sponsored Therapy in Maryland

There’s a way to get affordable mental health care that you might not know about. That’s Maryland’s mental health system.

If you qualify, you can get mental health care at a community agency for a small co-pay or low sliding-scale fee. But even if you don’t qualify for services at a state-funded program, Maryland’s system can still give you information, referrals to affordable local providers, and other essential help for free.

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If you’re in a hurry and want to get the most important information about what’s available in the Maryland mental health system and who it’s for, you can read our quick start guide below.

To learn more about public mental health services in Maryland, keep reading. We’ve done the research to uncover essential facts about who’s eligible, what services you can get, when to go, where to call, and how it works so you can decide if Maryland’s mental health system might be right for you.

Who Is Eligible?

You should consider looking into the Maryland mental health system if you (or a loved one) are having a mental health crisis, have a severe mental health condition, have Medicaid, or have a limited income.

Everyone in Maryland can use the state-funded mental health emergency response system. If you or someone you love is in crisis, you can call a state or local crisis line to get the help you need, quickly.

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Public mental health services are usually the best option if you’re having a mental health crisis and need help right away.

State mental health programs are required to provide mental health crisis response services and are one of the fastest ways to get care when you’re having a mental health emergency.

The people who answer state and local crisis lines can provide caring attention and support as they help you determine the best response to a crisis, whether it’s inpatient treatment or an appointment with a counselor.

Even if you’re not in crisis, you can call a state or local mental health hotline for information about affordable mental health services in your area. When you call, you can find out whether you might qualify for state-funded mental health services, schedule an assessment or intake appointment, or get free information about other affordable local providers.

While there are some services in the Maryland mental health system that have stricter requirements than others, in general, the public mental health system is pretty accessible. There are no statewide eligibility criteria for public outpatient mental health services in Maryland.

Instead, admission criteria and available services vary from program to program. Some programs focus on services for people with serious mental illness, while others serve clients with milder conditions.

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You don’t have to have a serious mental illness (SMI) to get basic outpatient mental health services from most publicly-funded outpatient programs in Maryland, but some services and programs are exclusively for people who have SMI.

For example, you’re usually only eligible for case management services if you have a serious and persistent mental illness. In addition, when demand is high or staffing is low, people with SMI are given priority admission at some programs.

So, what is SMI? Serious mental illness is usually defined as a condition that causes you severe distress, limits your ability to function, makes it hard for you to live independently without support, or puts you at risk of hospitalization. Conditions that can qualify as SMI include schizophrenia, bipolar disorder, and major depression.

The primary way Maryland provides state funding assistance for mental health services is through Medicaid.

Most programs that participate in the Maryland public mental health system accept Medicaid as well as many other insurance plans. If you don’t have insurance, you can often get counseling for reduced fees at many state-licensed clinics. Many offer income-based sliding scales.

You may also be eligible for state financial assistance. However, eligibility for financial aid for mental health care in Maryland is pretty strict. The only way to qualify for public funding in Maryland is to either qualify for Medicaid or for what the state calls “Uninsured Eligibility.”

DEEP DIVE

To qualify for Uninsured Eligibility to get financial assistance for public mental health services in Maryland, you must:

Be a United States citizen and a Maryland state resident
Require treatment for a covered behavioral health diagnosis
Have an income of 250 percent of the federal poverty level or less
Not already be covered by Medicaid, Medicare, or any other insurance
Have already applied for Medicaid, the Health Care Exchange, or other state benefits

Some exceptions are made to these requirements depending on other conditions. You may also qualify if you:

Are pregnant
Have HIV/AIDS
Are under age 19
Use injection drugs
Are homeless in the state of Maryland
Were referred by a drug or probate court
Are a veteran with a mental health condition
Are in crisis or have an urgent need for mental health services
Have received public mental health services in the last two years
Have been released from a correctional facility in the last three months
Have been discharged by an inpatient psychiatric or substance use disorder facility in the last three months

While these criteria are still somewhat restrictive, they make it possible to qualify for financial aid if your income level would otherwise disqualify you for Medicaid or other public funding.

Over 270 diagnoses are considered covered diagnoses in the public mental health system in Maryland, including depressive and other mood disorders, anxiety disorders, personality disorders, dissociative disorders, trauma-related disorders, and psychotic disorders including schizophrenia.

While Maryland leaves clinical eligibility up to each individual provider, it does use statewide eligibility criteria to determine whether you’re eligible for public financial aid.

In many cases, if you don’t qualify for public funds, you can still access community mental health care. The core service agency or behavioral health authority in your county can give you referrals for local programs after they determine your eligibility for state funding assistance. Then, the program you’re interested in will help you figure out if you’re eligible and what your payment options are.

If you don’t qualify for state financial assistance, programs in the public network may still be an affordable option. To find out how fees for programs in the public mental health network compare to fees for other providers, you can call the programs you’re interested in and ask about their rates.

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Medicaid is a great way to access the public mental health system in Maryland. Not only do most programs in the public mental health system accept it, but you can also use it to get services from many other programs and private practitioners.

Maryland accepted federal Medicaid expansion in 2013, so you’re eligible for Medicaid if your income is 138 percent of the federal poverty level or less. You may also qualify based on a combination of your income, your medical history, and your mental health condition.

If you’re not sure whether you’re eligible, it’s worth looking into. You can apply for Medicaid in person, by phone, or online. To learn more, you can visit a local health department or social services office or apply online on the Maryland Health Connection page or Healthcare.gov.

Maryland’s multifaceted mental health system includes small private counseling practices as well as large non-profits and comprehensive for-profit companies.

This is because Maryland’s mental health system is a hybrid public-private system. While the state mental health department and county or regional behavioral health authorities oversee mental health policy and provide some mental health services, most services are provided by independent programs that contract with them. This means what services you can get and whether you’re eligible depends on where you’re looking.

Some programs in the public mental health system focus only on therapy and counseling, while others focus on specialty and intensive services for people with serious mental illness. Some comprehensive programs offer both. So, you’ll need to look through the local programs that serve your county to find the right one for you.

You can find contact information for your county’s behavioral health authority and local state-licensed programs in the directory section of this article.

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Publicly-funded mental health programs in Maryland are great places to find specialized and intensive mental health services like case management and day treatment that can be hard to find anywhere else. These specialty programs can give you extra help when you’re dealing with severe symptoms.

You can call your county’s core service agency or behavioral health authority to learn more about how to get help accessing mental health services where you live.

You can call a local mental health program directly to learn more about what services they offer, whether you’re eligible, and whether there’s a waitlist. You can find the numbers for core service agencies, behavioral health authorities, and local mental health programs in the directory below.

We encourage you to call even if you’re not sure whether you’re eligible or whether you’ve found the right program. Even if you don’t meet the program’s requirements or they don’t offer the service you want, they can probably still help you.

Community mental health workers are knowledgeable about local resources and will often give you free information or even referrals to other affordable providers nearby, including local non-profits that provide free or low-cost counseling.

Where Do You Call to Get Started?

The easiest way to learn more about state mental health services in Maryland is to call your county’s core service agency, behavioral health authority, or mental health hotline. You can find the contact information for your county in the directory in the next section.

There are also many numbers you can call for help no matter where you are in Maryland. You can find the numbers for statewide helplines and hotlines in the information box directly below.

PRO TIP

The statewide Maryland mental health crisis hotline is 988.

The Crisis Text Line for the state of Maryland is 741741.

For help and referrals for mental health and many other needs, you can call 211.

You can directly contact the Life Crisis Center by calling (410) 749-4357 (they answer calls for 988 and 211).

The National Alliance on Mental Illness (NAMI) Helpline is 1-800-950-NAMI (6264).

You can reach the non-emergency NAMI Maryland Help Line at (410) 884-8691.

You can get support and information about mental health by calling the NAMI Maryland Warmline at (877) 878-2371.

If you just need to talk to someone, you can talk to a mental health professional for free between 10AM and 8PM on weekdays (and 6PM on weekends) by calling the Pro Bono Counseling Warmline at (410) 598-0234.

You can contact the Maryland Behavioral Health Administration by calling (410) 402-8300.

Public mental health services in Maryland are managed on the state level by the Behavioral Health Administration within the Maryland Department of Health. For general information about Maryland’s mental health system, you can call BHA at (410) 402-8300 or call the Department of Health Helpline at (877) 463-3464.

However, you’ll probably get the best results by calling a behavioral health authority or the program you’re interested in directly. You can find contact information for your county in the directory below.

County-by-County Directory

Public outpatient mental health services in Maryland are provided by private agencies that contract with regional mental health departments called behavioral health authorities or core service agencies.

Core service agencies (and behavioral health authorities) are responsible for making sure area residents have access to essential mental health care including outpatient programs and crisis intervention. Some counties also provide mental health services directly at county mental health clinics, but most publicly-funded services in Maryland are provided by private programs.

Maryland uses an online service called Network of Care to list community agencies and other types of providers that participate in the public mental health system. Each county (or multi-county region) has its own Network of Care page.

Each county (or region) also has a general number you can call for information and a crisis line you can call to get help in a crisis. In the directory below, you can find the numbers for your county as well as a link to your local Network of Care page.

If you need information after hours or aren’t sure whether you’re experiencing a mental health crisis, it’s okay to call a crisis line for help. The staff who answer are trained to quickly figure out what you need and can tell you what steps you need to take to connect with the right services.

Also Consider: Federally Qualified Health Centers

Federally qualified health centers (FQHCs) are another great way to get affordable publicly-funded mental health services in Maryland.

These federally-funded programs provide cutting-edge care in places where good primary healthcare was once hard to find. Most provide integrated care so you can get primary medical and mental health services at the same location. Each FQHC accepts Medicaid and Medicare and offers low sliding-scale fees if you don’t have insurance.

You can search for FQHCs near you by using the online search tool on the U.S. Health Resources and Services Administration website.

Troubleshooting Guide

The state mental health system is complicated and can be confusing to navigate. If you’re having any issues, we’re here to help. Here are some of our solutions to common problems you might experience.

If you’ve run into a problem that we haven’t addressed, don’t give up. Call someone at the program (or a state or local mental health hotline) and tell them what’s going on.

You’re much more likely to get the help you need when you advocate for yourself and are persistent. Tell the person you talk to what you need or what problem you’re having.

If they don’t help the first time, call them back and tell them. If you keep calling and keep calm and focused, you should eventually get through to someone who can help you.

Deep Dive: How Does the System Work?

To understand Maryland’s mental health system, it helps to understand how it started and how it’s changed since then.

Public mental health services have been around for a surprisingly long time. But for over a hundred years in America, the only way to get them was in a psychiatric hospital.

In the 1960s, Americans started thinking differently about mental health care. Conditions in psychiatric hospitals were getting worse and new medications made it possible to provide mental health treatment on an outpatient basis.

In response, new laws were passed that required state and local governments to establish community mental health programs as alternatives to institutionalization for people with serious mental illness. The most important was the Community Mental Health Act, which President John F. Kennedy signed into law in 1963.

DEEP DIVE

To learn more about what the public mental health system was like in the early days—and how psychiatric inpatient care has evolved since then—you can read our article “Do Insane Asylums Still Exist? The Surprising Past and Present.”

To learn more about what inpatient mental health treatment is like now, and the differences between how it works in general hospitals and specialized psychiatric facilities, you can read our article “How Inpatient Mental Health Treatment Works.”

Many state mental health programs trace their origins back to the 1960s when these important changes started to happen. Maryland is no exception.

After the federal Community Mental Health Act was passed, Maryland passed its own Community Mental Health Services Act in 1966 and established the Maryland Department of Health and Mental Hygiene (DHMH) in 1969.

Maryland passed these laws in order to increase the number of community mental health programs in the state and to reduce hospitalization rates. There were less than ten community mental health programs in Maryland in 1969, but over 100 had been created by the mid-1970s.

The Sheppard Pratt hospital system, which made Maryland a leader in mental health reforms when it was founded in the late 1800s, started to build clinics during this period.

Sheppard Pratt made an even stronger push to develop community-based care during the 1990s. It now has over a dozen outpatient clinics as well as residential and crisis care facilities. Sheppard Pratt remains the state’s largest and best-funded mental health treatment provider as well as the largest single non-profit mental health care provider in the nation, serving about 80,000 people a year.

DEEP DIVE

The Maryland mental health department is called the Behavioral Health Administration (BHA). The BHA has a central office as well as three types of regional offices: core service agencies, local addiction authorities, and local behavioral health authorities.

The main difference between the three types of regional offices is whether they oversee mental health programs, substance use disorder treatment programs, or both.

These local offices are often part of county mental health departments. Their role is to oversee local networks of state-licensed programs and distribute state and federal mental health funds to them. Some counties directly provide some mental health services, though most state-funded mental health services in Maryland are provided by private agencies that contract with state or local mental health departments.

In addition to overseeing the activities of these regional offices, the BHA also oversees the state’s five public psychiatric hospitals.

Maryland’s public mental health system has faced some challenges, especially since the pandemic. Public providers struggle to meet the need and state inpatient facilities are often at full capacity. People can wait in local emergency departments for inpatient admission for days or even weeks.

It can also be challenging to access outpatient and community-based services due to limited public mental health funding, workforce shortages, and long waitlists. This leaves many people unable to get help until they’re in crisis.

Maryland is taking steps to address these issues and has significantly increased mental health funding in recent years. It launched the statewide 988 crisis line in July 2022 and is using new state and federal funds to expand mobile crisis teams, build mental health urgent care centers, open crisis stabilization units, and develop other crisis services.

You can use these new state services to get the care you need. If you’re in crisis or need mental health care and aren’t sure what to do, you can start by calling 988 or a local crisis line—the people who answer know how the system works and will help you get where you need to go.

Conclusion

According to the Substance Abuse and Mental Health Services Administration, only 41 percent of people in Maryland who have mental health conditions get treatment for them. Many of them qualify for public mental health services but don’t know about them.

You can make a difference by reaching out and connecting with local mental health resources to get the care you need. If you’re not sure whether you qualify for public mental health services, call a core service agency, behavioral health authority, or mental health hotline. You may find out you can get mental health services at a state-funded program or that there’s another affordable option nearby.

The most important thing is to get started—the help you need may be only a call or click away.

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Therapy with No Waiting Rooms or Driving. Take a quick quiz about your preferences and needs and get matched to a therapist in as little as 48 hours.

Your (Unofficial) Guide to State-Sponsored Therapy in Maryland

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

Have you been in therapy before?

Quick Start Guide

Who Is Eligible?

PRO TIP

Use the State System When You're in Crisis

PRO TIP

What Is Serious Mental Illness?

DEEP DIVE

Uninsured Eligibility in Maryland

PRO TIP

Check If You're Eligible for Medicaid

PRO TIP

Check Out the State System If You Need Specialized Services

Where Do You Call to Get Started?

PRO TIP

Important Numbers in Maryland

County-by-County Directory

Maryland Clinics and Crisis Lines

Allegany County, Garrett County, and Washington County Clinics and Crisis Lines

Anne Arundel County Clinics and Crisis Lines

Baltimore City Clinics and Crisis Lines

Baltimore County Clinics and Crisis Lines

Calvert County, Charles County, and Saint Mary’s County Clinics and Crisis Lines

Caroline County, Dorchester County, Kent County, Queen Anne’s County, and Talbot County Clinics and Crisis Lines

Carroll County and Frederick County Clinics and Crisis Lines

Cecil County and Harford County Clinics and Crisis Lines

Howard County Clinics and Crisis Lines

Montgomery County Clinics and Crisis Lines

Prince George’s County Clinics and Crisis Lines

Somerset County, Wicomico County, and Worcester County Clinics and Crisis Lines

Also Consider: Federally Qualified Health Centers

Troubleshooting Guide

Problems and Solutions

Deep Dive: How Does the System Work?

DEEP DIVE

For More Information

DEEP DIVE

What Is the Structure of the Maryland Mental Health System?

Conclusion

Are You Thinking of Online Therapy? Start Here to Get Matched with a Licensed Therapist Right For You.

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