MARYLAND DEPARTMENT OF HEALTH

BEHAVIORAL HEALTH

Organized in July 2008 as Behavioral Health and Disabilities, Behavioral Health adopted its present name in October 2014 (Chapter 539, Acts of 2014).

Formerly Behavioral Health had been headed by a Deputy Secretary responsible for three administrations: Alcohol and Drug Abuse; Developmental Disabilities; and Mental Hygiene. However, in July 2014, the Alcohol and Drug Abuse Administration merged with the Mental Hygiene Administration to form the Behavioral Health Administration (Chapter 460, Acts of 2014), and, in October 2014, the Developmental Disabilities Administration separated from Behavioral Health (Chapter 539, Acts of 2014).

Today, the Deputy Secretary for Behavioral Health oversees the Behavioral Health Administration.

BEHAVIORAL HEALTH ADMINISTRATION

Dix Building, Dogwood Circle, Spring Grove Hospital Center
55 Wade Ave., Catonsville, MD 21228

The Behavioral Health Administration was created from the merger of two older agencies: the Mental Hygiene Administration, and the Alcohol and Drug Abuse Administration.

The Mental Hygiene Administration originated in 1886 as the State Lunacy Commission (Chapter 487, Acts of 1886). The Commission inspected public and private institutions for the insane and advised their boards of managers. In 1922, the Commission was replaced by the Board of Mental Hygiene (Chapter 29, Acts of 1922). The Board, in turn, was superseded by the Department of Mental Hygiene in 1949 (Chapter 685, Acts of 1949). Not only was the Board of Mental Hygiene abolished in 1949, but so also were the separate governing boards of the State mental hospitals. In that year, the Department of Mental Hygiene became responsible for the custody, care, and treatment of mentally ill persons. The Department of Mental Hygiene became part of the Department of Health and Mental Hygiene in 1969 and subsequently reorganized as the Mental Hygiene Administration (Chapter 77, Acts of 1969). In July 2008, the Administration moved under the Deputy Secretary for Behavioral Health and Disabilities (Chapter 661, Acts of 2008).

The other agency from which the Behavioral Health Administration evolved was the Alcohol and Drug Abuse Administration, which started as two separate agencies: one concerned with alcoholism and the other with addiction to narcotics. The Drug Abuse Authority, formed in 1969, was succeeded in 1971 by the Drug Abuse Adminstration (Chapter 404, Acts of 1969; Chapter 29, Acts of 1971). Thereafter, the Division of Alcoholism Control of the former Mental Health Administration became the Alcoholism Control Adminstration in 1976 (Chapter 746, Acts of 1976). By departmental organization in 1987, the Drug Abuse Administration and the Alcoholism Control Administration merged to form the Addictions Services Administration. In 1988, the Administration was renamed the Alcohol and Drug Abuse Administration (Chapter 758, Acts of 1988).

In July 2014, the Mental Hygiene Administration merged with the Alcohol and Drug Administration to reform as the Behavioral Health Administration (Chapter 460, Acts of 2014; Code Health-General Article, secs. 7.5-101 through 7.5-204).

The Behavioral Health Administration oversees the Public Mental Health System by planning, setting policy, and allocating resources. To ensure that Marylanders receive appropriate treatment, the Administration provides mental health services in the community through core service agencies and State institutions (Code Health - General Article, secs. 10-201 through 10-208).

Core Service Agencies. Under authority of the Secretary of Health, a core service agency is designated by each county government to plan, manage, and monitor the delivery of publicly funded mental health services in the county (Code Health-General Article, secs. 10-1201 through 10-1203).

State Institutions. Under the Behavioral Health Administration are five psychiatric hospitals:

The Administration also is responsible for two residential treatment centers for youth:

Mental Health Crisis Response System. Within the Mental Hygiene Administration, the Maryland Mental Health Crisis Response System formed in October 2002 (Chapter 371, Acts of 2002). The System became part of the Behavioral Health Administration in July 2014.

Through the Mental Health Crisis Response System, the Behavioral Health Administration consults with family members, and consumers and advocates of mental health services to develop a statewide network to respond to the current mental health crisis. To reduce threatening situations involving those needing mental health services, the network provides assistance to prevent suicides, homicides, arrests, and unnecessary hospitalizations. This assistance includes a hotline for suicide prevention, treatment referrals, telephone assistance for mental information, and even transportation of patients to emergency appointments. The network coordinates its work with core service agencies (local health departments), police, emergency medical personnel, and mental health providers.

The Director of Behavioral Health heads the Administration, and reports to the Deputy Secretary for Behavioral Health and Disabilities (Code Health-General Article, secs. 7.5-202 through 7.5-204). Appointed by the Secretary of Health, and with the Secretary's approval, the Director of Behavioral Health is empowered to make State grants-in-aid to further community mental health services (Chapter 125, Acts of 1966). The Director supervises programs receiving these grants-in-aid. Local mental health advisory committees also are authorized for each county and Baltimore City (Code Health - General Article, secs. 10-308 through 10-312).

The Administration's work is carried out through five divisions: Children's Services; Clinical Services; Facilities; Operations; and Population-Based Behavioral Health. Three offices report directly to the Director: Consumer Affairs, Forensic Services, and State Opioid Treatment Authority.

OFFICE OF FORENSIC SERVICES

Formerly within the Mental Hygiene Administration, the Office of Forensic Services was made part of the Behavioral Health Administration in July 2014.

The Office is responsible for mental health services that may be court-ordered, such as pre-sentence psychiatric evaluations and competency screenings; and for evaluation and treatment of individuals to determine competency to stand trial or criminal responsibility. The Office also monitors persons found not criminally responsible for their crimes who are released conditionally into the community.

Certain functions of Maryland's sex offender registration for persons within its jurisdiction are administered by the Office of Forensic Services. The Office, for example, conducts pre-sentence mental health assessments of those convicted of sexual abuse of a minor.

CHILDREN'S SERVICES

Under the Mental Health Administration, Child and Adolescent Services formed in 1984 to oversee and coordinate mental health services for children and adolescents within the Public Mental Health System. It was responsible for two residential treatment centers for youth: the Regional Institutes for Children and Adolescents in Baltimore and Rockville. Under the Behavioral Health Administration, Child and Adolescent Services restructured as Children's Services in July 2014.

Children's Services oversees five units: Child and Adolescent Substance Use; Community Programming and Development; Promotion, Prevention, and Early Intervention; Quality Insurance and Improvement; and Suicide Prevention.

CLINICAL SERVICES

In July 2014, Clinical Services formed under the Behavioral Health Administration.

Clinical Services evaluates the network of services funded by the Behavioral Health Administration to ensure that such services meet the needs of Marylanders with mental health conditions, substance-related disorders, or co-occurring conditions and disorders.

Under Clinical Services is the Office of Adult and Specialized Behavioral Health Services, which oversees Adult Services, Special Populations, Treatment and Recovery Services, and Women's Services.

OFFICE OF ADULT & SPECIALIZED BEHAVIORAL HEALTH SERVICES

The Office of Adult and Specialized Behavioral Health Services formed as part of Clinical Services in July 2014.

Under this office are Adult Services, Special Populations, Treatment and Recovery Services, and Women's Services.

ADULT SERVICES
For adults and seniors, Adult Services develops, oversees, and monitors community-based mental health programs and services. It also designs and develops specialized programs and services for youth transitioning into adulthood; seniors continuing to live in their own homes; individuals in State hospitals; and adults who have sustained a traumatic brain injury.

SPECIAL POPULATIONS
In 1991, the Mental Hygiene Administration established the Office of Special Needs Populations. When the Behavioral Health Administration formed in July 2014, the Office was reorganized as Special Populations and placed within the Office of Adult and Specialized Behavioral Health Services under Clinical Services.

Special Populations oversees certain federal grants which address the mental health needs of certain populations. The Office plans, coordinates, and monitors mental health services for individuals who are incarcerated, homeless, deaf or hard of hearing, victims of natural or man-made disasters, or have co-occurring mental disorders and substance abuse issues. The Office also serves veterans from the wars in Afghanistan and Iraq wars who have behavioral health needs.

WOMEN'S SERVICES
For women and their families, Women's Services develops and coordinates comprehensive treatment and recovery substance-related disorders services. For pregnant women and women with dependent children, contracts for residential treatment services are managed by Women's Services. This office also provides technical assistance to local health departments and treatment providers.

FACILITIES

Under the Behavioral Health Administration, Facilities was established in July 2014 to oversee five psychiatric hospitals, and two residential treatment centers for youth under the Behavioral Health Administration's jurisdiction.

EASTERN SHORE HOSPITAL CENTER

P. O. Box 800
Route 50, Cambridge, MD 21613 - 0800

Eastern Shore Hospital Center began in 1912 as Eastern Shore State Hospital (Chapter 187, Acts of 1912). Built on the banks of the Choptank River, the Hospital admitted its first patients in 1915. The Hospital came under the Board of Mental Hygiene in 1922, the Department of Mental Hygiene in 1949, and the Mental Hygiene Administration in 1969. In 1973, it was renamed Eastern Shore Hospital Center (Chapter 740, Acts of 1973). In August 2001, the original hospital was replaced by a new 80-bed facility in Cambridge. In July 2014, the Center was made part of the Behavioral Health Administration (Chapter 460, Acts of 2014).

The Center provides comprehensive psychiatric care for patients with mental illness who reside on the lower Eastern Shore. The facility is licensed for a daily capacity of 76 patients (Code Health - General Article, sec. 10-406).

THOMAS B. FINAN HOSPITAL CENTER

[photo, Thomas B. Finan Hospital Center, 10102 Country Club Road, Cumberland, Maryland] P. O. Box 1722
10102 Country Club Road, Cumberland, MD 21502 - 1722

Under the Mental Hygiene Administration, the Thomas B. Finan Hospital Center opened in October 1978. It became part of the Behavioral Health Administration in July 2014.

The Center is a multi-purpose psychiatric facility which serves Allegany, Frederick, Garrett and Washington county residents of all ages with mental illnesses (Code Health - General Article, sec. 10-406). Services extend as well to youth from Carroll, Howard and Montgomery counties.

Thomas B. Finan Hospital Center, 10102 Country Club Road, Cumberland, Maryland, July 2006. Photo by Diane F. Evartt.

Staffed to accommodate and treat 72 adult and 24 geriatric patients, and 23 adolescents, the Center consists of small, 25-bed cottages and three cottages that house treatment programs for addicts. These are operated by the Allegany County Health Department.

Licensed by the Maryland Department of Health to the County Health Department, the one-cottage Massie Unit treats adults who abuse drugs and alcohol. Licensed by the Department of Juvenile Justice to the County Health Department, the two-cottage Jackson Unit treats juveniles with substance abuse problems or children in need of supervision. Another cottage is leased to Archway Station, Inc., as a 16-bed rehabilitation apartment complex.

CLIFTON T. PERKINS HOSPITAL CENTER

P. O. Box 1000
8450 Dorsey Run, Jessup, MD 20794 - 1000

The Clifton T. Perkins Hospital Center is the State's only maximum security hospital. Formally established in 1959 as Maximum Security Hospital, it was placed under the Department of Mental Hygiene. In April 1960, the Hospital was renamed to honor Dr. Clifton T. Perkins, Commissioner of Mental Hygiene from 1950 to 1959 (Chapter 814, Acts of 1959). Dr. Perkins had planned and defined the function of the Hospital but died before it opened early in 1960. In 1973, the Hospital reformed as the Clifton T. Perkins Hospital Center under the Mental Hygiene Administration (Chapter 740, Acts of 1973), which became the Behavioral Health Administration in July 2014.

Patients referred by the courts of Maryland for pretrial psychiatric evaluation are treated by the Center, which also provides a residence for individual offenders who have been found not guilty by reason of insanity. Moreover, the Center serves as a hospital for prisoners who become mentally ill and require involuntary psychiatric hospitalization. Prisoners are committed to the Center for an indefinite length of time and only can be released upon the authorization of a judge. From other State psychiatric hospitals, the Center also accepts patients whose illness requires maximum security treatment for a period of time.

The Center is licensed to serve 298 resident patients, and in FY2015 was funded to serve a daily average of 248 patients.

SPRING GROVE HOSPITAL CENTER

Wade Ave., Catonsville, MD 21228
[photo, Bland Bryant Building, Spring Grove Hospital Center, Catonsville, Maryland] Spring Grove Hospital Center is the oldest hospital for the mentally ill in Maryland, and the third oldest in the United States. It was established in 1797 in Baltimore at Monument Street and Broadway, the site where the Johns Hopkins Hospital later would be constructed (Chapter 102, Acts of 1797). First authorized as a "common State hospital" (the first public hospital in Maryland), it originally came under the auspices of the Mayor and City Council of Baltimore, and was run by private physicians. In 1834, however, the State assumed its control and called it the Maryland Hospital. It was renamed the Maryland Hospital for the Insane in 1838, and moved to its present site at Catonsville in 1872.

Bland Bryant Building, Spring Grove Hospital Center, Catonsville, Maryland, April 2003. Photo by Diane F. Evartt.

[photo, Foster Wade Building, Spring Grove Hospital Center, Catonsville, Maryland] Renamed Spring Grove State Hospital in 1912 (Chapter 187, Acts of 1912), the Hospital came under the Board of Mental Hygiene in 1922, the Department of Mental Hygiene in 1949, and the Mental Hygiene Administration in 1969. The Hospital then reformed as Spring Grove Hospital Center in 1973 (Chapter 740, Acts of 1973), and was made part of the Behavioral Health Administration in July 2014.

Comprehensive mental health services to adult and geriatric patients from Baltimore City, and Baltimore and Harford counties are provided by the Center. For those jurisdictions, the Center also conducts evaluations to determine competency to stand trial and criminal responsibility (Code Health - General Article, sec. 10-406). Moreover, the Center provides ancillary services to the Maryland Psychiatric Research Center, a joint program between the Maryland Department of Health, and the University of Maryland School of Medicine.

Foster Wade Building, Spring Grove Hospital Center, Catonsville, Maryland, April 2003. Photo by Diane F. Evartt.

In Fiscal Year 2014, the Center had a licensed capacity for 639 inpatients.

SPRINGFIELD HOSPITAL CENTER

[photo, Springfield Hospital Center, Sykesville, Maryland] 6655 Sykesville Road, Sykesville, MD 21784

Springfield Hospital Center originated as the Second Hospital for the Insane of the State of Maryland authorized in 1894 (Chapter 231, Acts of 1894). The Hospital opened for patients in July 1896. Renamed Springfield State Hospital in 1900 (Chapter 70, Acts of 1900), the Hospital came under the Board of Mental Hygiene in 1922, the Department of Mental Hygiene in 1949, and the Mental Hygiene Administration in 1969. It became Springfield Hospital Center in 1973 (Chapter 740, Acts of 1973), and was made part of the Behavioral Health Administration in July 2014.

Springfield Hospital Center, Sykesville, Maryland, August 2006. Photo by Diane F. Evartt.

A regional psychiatric facility, the Center admits patients from northern Baltimore City and Carroll, Howard and Montgomery counties, as well as mentally ill deaf patients statewide.

The Center is the largest State facility in Maryland for the care of persons with mental illness. It provides acute, sub-acute and long-term inpatient services to Maryland residents. In Fiscal Year 2014, it has a licensed capacity for 522 patients (Code Health - General Article, sec. 10-406).

REGIONAL INSTITUTE FOR CHILDREN & ADOLESCENTS - BALTIMORE

605 South Chapel Gate Lane, Baltimore, MD 21229

In 1958, the Regional Institute for Children and Adolescents - Baltimore opened. It originally was situated on the grounds of Rosewood State Hospital in Baltimore County, but moved to southwest Baltimore, near the U.S. National Cemetery, in the early 1970s. Formerly under the Mental Hygiene Administration, the Institute was made part of the Behavioral Health Administration in July 2014.

A residential mental health treatment facility, the Institute provides intensive inpatient and outpatient psychiatric care, educational services, and community service programs for youths between ages 12 to 18 with serious emotional illnesses. It serves adolescents from Baltimore City, the Eastern Shore, Central Maryland, and parts of Western Maryland.

Licensed to treat up to 45 inpatients, the Institute in Fiscal Year 2013 served a daily average of 36 residential patients and 55 outpatients.

JOHN L. GILDNER REGIONAL INSTITUTE FOR CHILDREN & ADOLESCENTS - ROCKVILLE

15000 Broschart Road, Rockville, MD 20850

In 1980, the Regional Institute for Children and Adolescents - Rockville received its first patients. On May 9, 2001, the Institute was renamed for its founding chief executive officer, John L. Gildner, who died in November 1999. Formerly under the Mental Hygiene Administration, the Institute was made part of the Behavioral Health Administration in July 2014.

The Institute provides treatment and education services to children and adolescents aged 10 to 18 years with severe emotional disabilities. Serving youth from Carroll, Frederick, Howard, Montgomery, Prince George's and Washington counties, it offers an intensive diagnostic and treatment unit, and residential and day treatment. Educational services are provided by the Montgomery County Department of Education.

The Institute is funded to serve an average daily population of 80 young people in residence and 100 children between the ages of 5 and 18 in day treatment.

OPERATIONS

In July 2014, Operations formed under the Behavioral Health Administration.

Operations is responsible for six offices: Compliance; Core Service Agency Liaison; Finance, Grants, and Procurement; Government Affairs and Communication; Management Information Systems and Data Analysis; and Planning.

OFFICE OF FINANCE, GRANTS, & PROCUREMENT

The Office of Finance, Grants, and Procurement was initiated as the Management Services Division. It reformed as part of Operations under its present name in July 2014.

Funds for substance abuse treatment and prevention statewide are awarded and monitored by the Office of Finance, Grants, and Procurement. Further, the Office manages internal operations for the Behavioral Health Administration, prepares its budget, and develops the annual federal block grant application.

Under the Office are three sections: Federal Block Grants; Fiscal Services; and Grants.

GRANTS SECTION
The Grants Section began as the Grants Management Division. In 1994, the Division became Administration and Grants Management, and Grants and Contract Management Division in 1998. It reformed as the Grants and Contracts Management Section in 2001, and the Grants Section under the Management Services Division in January 2011. When the Behavioral Health Administration formed in July 2014, the Grants Section joined the Office of Finance, Grants, and Procurement.

The Section awards and monitors Administration monies for substance abuse treatment and prevention. Grants are received by local health departments, government agencies and private companies. As the Administration's fiscal agent, the Section works closely with the Fiscal Services Administration, and the Program Cost and Analysis Division of the Budget Management Office of the Department.

INFORMATION TECHNOLOGY DIVISION

Under Alcohol and Drug Abuse Administration, the Information Technology Division started as the Management Information Services Division. It then reformed as the Information Services Division in 2004, and reorganized as the Information Technology Division in January 2011, and was made part of Operations under the Behavioral Health Administration in July 2014.

The Division collects, processes, and reports statistical information related to patterns in alcohol and drug abuse, and assessment of treatment programs; and assists other divisions with data, research, and computerized information systems. All certified providers of public and private treatment and assessors of driving while intoxicated (DWI) report monthly data to the Division. The Administration's website is maintained by the Division, which also publishes reports and newsletters.

OFFICE OF PLANNING

The Office of Planning started as the Office of Planning, Evaluation, and Training. It reformed as the Office of Planning under the Behavioral Health Administration in July 2014.

Implementation of the Administration's annual plans for mental health services is developed and overseen by the Office. Moreover, the Office also prepares federal grant applications, monitors quality improvement surveys and systems, and develops and monitors training programs for the Public Mental Health System.

POPULATION-BASED BEHAVIORAL HEALTH

QUALITY ASSURANCE DIVISION

Some functions of the Quality Assurance Division originated as the Policy, Planning, and Development Division under the Alcohol and Drug Abuse Administration. The Division became the Policy and Program Development Division in 1994. That division merged with Continuous Quality Improvement to form the Quality Assurance Division in 2002, and joined the Behavioral Health Administration in July 2014.

Substance abuse prevention and treatment services funded by the Behavioral Health Administration are evaluated by the Quality Assurance Division for quality, effectiveness, and compliance with regulations. With the data collected by its compliance units, the Division helps plan for service expansion and enhancements, as well as regulatory actions and legislative initiatives. The Division also investigates regulatory violations and recommends corrective actions. In addition, the Division promulgates and updates regulations concerning addiction services found in the Code of Maryland Regulations (COMAR).

REGIONAL SERVICES
Regional Services originally formed as the Regional Field Services Division of the Alcohol and Drug Abuse Administration. Renamed the Treatment and Field Services Division in 1994, and as the Treatment Services Section in 1998, it combined with the Prevention Services Section to form Regional Services in 2002. In January 2011, Regional Services moved from the Community Services Division to the Recovery-Oriented System of Care Division.

To coordinate addiction treatment services, Regional Services serves as liaison between local and State government agencies. To prevent alcohol and drug addiction, Regional Services works with the Governor's Office for Children; the State Department of Education; the Department of Human Services; and the Department of Transportation to fund, develop, implement, and monitor government agency strategies.

TECHNOLOGY TRANSFER

RESEARCH DIVISION

Formerly under the Alcohol and Drug Administration.

OVERDOSE PREVENTION

SPECIAL PROJECTS

Special Projects originated as Statewide Projects under the Mental Hygiene Administration, and was renamed Special Projects under the Behavioral Health Administration in July 2014.

Since January 2011, Special Projects has assumed oversight of Justice Services, and Women's Services.

Local public and private programs that develop services for adolescents, women, women with infants and children, and pregnant women are assisted and monitored by Special Projects.

JUSTICE SERVICES
In 1987, Justice Services began as the Criminal Justice Division under the former Addictions Services Administration. Later, it became the Criminal Justice Section, and in 2004 Justice Services under the Community Services Division.

Justice Services coordinates all evaluations of criminal defendants for drug and alcohol abuse, and all commitments for evaluation or treatment made by circuit courts and district courts (Code Health-General Article, secs. 8-505 through 8-507). It also coordinates all education and treatment for those convicted of driving while intoxicated (DWI). Justice Services works closely with the Division of Parole and Probation, the Division of Correction, the Administrative Office of the Courts, the Motor Vehicle Administration, and local health departments.

OFFICE OF WORKFORCE DEVELOPMENT & TRAINING

The Office of Workforce Development and Training started as the Office of Education and Training for Addiction Services, which began in 1976. Under the Behavioral Health Administration, the Office restructured within Population-Based Behavioral Health under its present name in July 2014.

Public and private agency personnel who treat addicts and work to prevent addiction are trained and educated by the Office of Workforce Development and Training. The Office also helps devise curriculum, and evaluates college and university courses on how to treat and prevent addiction.

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