Program Launch
The Maryland Department of Health announced Thursday the launch of the Assisted Outpatient Treatment program, a new initiative that allows mental health professionals, family members, friends, or others with a relationship to a patient to petition a circuit court for mandated medical treatment.
The program is designed for individuals with severe mental illnesses such as bipolar disorder or schizophrenia, conditions that can interfere with a patient's ability to recognize they need medical care. Such situations can lead to repeated hospitalization or incarceration for those with behavioral health challenges, and can be heartbreaking for families, according to officials.
"For many individuals living with severe mental illness, maintaining engagement and consistency in treatment can be a daily challenge," Maryland Health Secretary Meena Seshamani said in a statement. "The Assisted Outpatient Treatment program is designed to bridge the gap between an individual's struggle and effective, consistent care by creating a structured pathway to community-based treatment, stability and recovery."
How It Works
The program begins in Baltimore City, Anne Arundel County, and counties on the Eastern Shore, with statewide implementation scheduled for July 2027. A medical professional or any person with a relationship to the patient can petition for an Assisted Outpatient Treatment plan using an online form.
The "respondent" will have the option to voluntarily enter the plan, but few details are available on what happens if the individual does not cooperate.
When the Maryland General Assembly debated the legislation in 2024, Maryland was one of just three states without assisted outpatient treatment programs. The bill passed that year, and all 24 jurisdictions in the state deferred to the state health department for implementation, with none opting to develop a county-run program.
Concerns and Criticism
The program has drawn criticism from disability rights advocates, who have raised concerns that assisted outpatient treatment orders step on a patient's right to make their own medical decisions, referring to the program as "involuntary outpatient commitment." During the 2024 legislative debates, advocates testified against the legislation, citing unanswered questions about how enforcement would work and worrying that interactions with state agents could be traumatizing, potentially leading to further distrust in court systems and hospital settings.
Local officials are also working through logistical issues with state officials. New budget language in the Budget Reconciliation and Financing Act requires local governments to reimburse the state for Assisted Outpatient Treatment services provided by the state, starting in fiscal year 2028 with 25% reimbursement and rising to 100% by 2031.
Karrington Anderson, associate policy director with the Maryland Association of Counties, called the new budget language an unexpected "cost shift" to counties, saying the matter should have had its own hearing. "We're going to work to make this program as successful as we can, because this is a serious program," Anderson said, while noting the state is in a difficult financial situation.