Last week, the Department of Health and Mental Hygiene heard from three Maryland parents whose adult children grapple with severe mental illness. 

The tales the trio shared described a harrowing cycle: A son with a severe mental diagnosis would stop taking the medicine that had enabled him to lead a stable life, or another would fire the counselor who had been providing him treatment and support. The chaos that would follow and would envelop the men’s families could involve everything law enforcement barring one from entry to specific stores to forced hospitalization for another. Worsening the cycles are the men’s beliefs that they require no treatment, that the voices they hear tell them they are above the law are true and that the people to whom they send angry letters deserve their wrath.

A return to treatment would bring stability for a while – the calm before the storm, nothing more – until the son again would turn away from treatment. “I fear my son's next treatment plan might be in the county jail,” said one of the parents, as she recounted his illness and her futile search for appropriate supports in Maryland. 

DHMH is trying to change that. The event coincided with the submission to the General Assembly of a state workgroup’s recommendations for a more responsive mental health system in Maryland. The report and its appendices may be downloaded here, under "Final Report."   

One of the recommendations of the group is for Maryland to adopt outpatient civil commitment – court-ordered, involuntary treatment to stabilize the population representative of the aforementioned Marylanders’ relatives. While that population is relatively small, the people it comprises tend to drain resources quickly with their cycles of treatment and crisis. Maryland is one of five states in the nation that lack an outpatient civil commitment framework. As a result, one of the parents described having to send her son to stay with his father in Pennsylvania, where outpatient civil commitment has worked to bring him stability. He was set to begin a white-collar job, as a result of that treatment. 

Since last week, a number of people have written editorials and letters to the editor in support of outpatient civil commitment being adopted in Maryland. 

Editorials
"Refusing treatment" (Baltimore Sun) 
"When Johnny refuses treatment" (Frederick News-Post)
 
Baltimore Sun letters to the editor

If you or a loved one requires mental health assistance, a list of core services agencies can be found here​