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Maryland General Assembly targets suicide prevention

Maryland state house. (File)

At the Maryland state house, a number of legislative proposals are aimed at preventing suicide.  (File)

A rise in suicides and concerns about police interactions with those threatening to self-harm have prompted legislation in Maryland that would ease costs for certain treatment and require more training for law enforcement.

Other legislation would require the state to study and track an increase in the number of Marylanders taking their own lives.

In 2018, 650 people in Maryland died by suicide, according to a 2020 report from the Governor’s Commission on Suicide Prevention, a 37 percent increase from the 474 suicide deaths in 2000; each year an average of 530 people in the state have died by suicide, according to the Centers for Disease Control and Prevention.

Certain populations are at far greater risk of dying by suicide; veterans account for 18 percent of suicide deaths in the state, according to the National Violent Death Reporting System.

The Suicide Treatment Improvements Act (HB442/SB0557), sponsored in the House by Del. Karen L. Young, D-Frederick, would bar certain payments on counseling and assessments for suicidal individuals.
Young told Capital News Service that the removal of coinsurance, deductibles and copayments would erase a major barrier to treatment.

“Research identified that one of the deterrents to getting help and counseling is the financial burden,” she said.

Many people suffering from income loss and other financial pressures due to the pandemic choose not to seek help due to the increased financial burden, Young said.

However, the bill could have unintended consequences.

According to written testimony by the Maryland Insurance Administration, certain health plans and tax exemptions would be adversely affected by the current language barring copays and deductibles.

The administration in testimony requested clarity from the committee on what would fall under the financial provision of the bill.

The bill would also require the Maryland Police Training and Standards Commission to implement training for officers to counsel suicidal individuals.

The commission would be directed to create training policies for dealing with suicidal individuals without the use of force or brandishing a weapon.

Sen. Ronald Young, D-Frederick, said that making changes to the training standards would make it easier to get suicidal individuals the help they need.

He added that a provision in the bill that would require the officer to be accompanied by someone trained to counsel suicidal individuals would give them someone to “fall back on” when giving guidance.

Sen. Young sponsored the Senate cross-file of the bill, SB557, which had a hearing in the Senate Finance Committee on Feb. 17.

The House version, HB442, was heard before the Health and Government Operations Committee on Feb. 3.

During the hearing, Del. Young said a provision in the bill that would require an officer to be accompanied by a trained suicide counselor could be changed to lessen the burden on smaller municipalities.

The Department of Legislative Services found that the Department of State Police could see their expenses climb by at least $200,000 to pay for the required counselors to respond to an incident.

However, those costs could be higher to ensure a significant amount of counselors were on hand to deal with calls for treatments of suicidal individuals.

Original provisions that would have required extra training for Crisis Hotline staff and healthcare workers were stricken from the bill.

Other legislation that addresses suicide prevention is also working its way through the General Assembly.

SB168, which is cross-filed as HB209 in the House, would establish a committee to review the increase in Maryland over the past 20 years.

The proposed Maryland Suicide Fatality Review Committee would conduct confidential investigations after deaths with uncertain causes, as is recommended by the U.S. National Strategy for Suicide Prevention.

Examining the circumstances surrounding possible suicide deaths would allow the committee to  identify red flags, said Sen. Adelaide Eckardt, R-Caroline, Dorchester, Talbot and Wicomico, the bill sponsor.

“That’s part of the dilemma in Maryland, that we have a low rate of clearly identified suicides, but we have a high rate of … undetermined” deaths.

Eckardt, who has a background in psychiatric nursing, says many suicide deaths are not immediately recognizable as suicides; the committee would be able to more thoroughly investigate these deaths

“If we learn more about the completed suicides, but then began to look at other indicators, in some of those other non-suicidal deaths, will we learn more to be able to educate the public and families to determine if anybody is at risk for death by suicide and to be able to have early interventions,” Eckardt said.

The bill passed with amendments unanimously in the Senate on Tuesday, and was assigned to the Health and Government Operations Committee, where a hearing has yet to be scheduled.

Amendments to the bill impose more restrictions on committee membership in order to protect patient privacy and clarify how other existing state fatality review committees would work collaboratively with the Suicide Fatality Review Committee so as not to duplicate work.
If passed it would take effect Oct. 1.

SB164, cross-filed as HB605, which would expand mental health care options for veterans in the state, passed the Senate unanimously on Feb. 8. Both bills have passed their respective chambers unanimously and are awaiting hearings in committees.

The Senate on Feb.19 passed SB41, a bill that would lower the age of consent for pursuing treatment for mental and emotional disorders from 16 to 12 years old.

The bill advanced on a 31-16 vote, despite Republican opposition to the lack of parental involvement in the process.
Sen. Robert Cassilly, R-Harford, said that he was “troubled” that the law could allow anyone to begin counseling young children on mental health issues.

“Just as we find teachers and lawyers and policemen that fall under the standards of care, there are also mental health providers that fall well below the standard of care.”

Sen. Malcolm Augustine, D-Prince George’s, the bill’s sponsor, said the American Academy of Pediatrics and the National Association of Social Workers were among the groups in support of the bill.

The bill now moves to the House of Delegates, where its version, HB132, had a hearing in the Health and Government Operations Committee Feb.16.

Other related bills include SB74 cross-filed, which would create mental health assistance programs for police officers.

SB74 passed the Senate on a unanimous vote on Wednesday with an amendment requiring mandatory mental health consultations for officers returning to duty after a shooting or incident involving serious injury.