This tier focuses on individuals experiencing severe, complex, chronic, or persistent behavioral health symptoms. Individuals in this tier can benefit from the community’s most specialized and intensive services.

If you or your child are having suicidal thoughts or behaviors, call or text the National Suicide and Crisis Lifeline at 988

Step 4 - Intensive Intervention

What are the signs?

Emotional Health


  • Frequent presence of anxiety, anger and/or depression.
  • Suicidal thoughts or behaviors, inability to focus or follow treatment plan.
  • If your child is having suicidal thoughts or behaviors, call the National Suicide and Crisis Lifeline at 988.
Physical Health


  • Increased sleep difficulty, exhaustion, aches and pains, extreme behavior changes.
  • Substance use.
Performance and Behavior


  • Unable to perform or attend school or work activities.
  • Risky or unsafe behaviors.
Social Activity


  • Isolation, avoiding social events, work, school or family.
  • Increased conflict with family or peers.

Access Immediate and Significant Supports

Individuals experiencing significant mental health symptoms that affect their functioning at home, school, work, or in the community.

Contact Crisis Services

For immediate safety concerns, always dial 9-1-1.

Call the 24-hour Grassroots Crisis Line at 410-531-6677 for issues including suicide, domestic violence, substance dependency, and more. You can also get the "There is Hope" app from your app store.

Walk into the Grassroots Crisis Intervention Center at 6700 Freetown Road, Columbia MD, 21044 for crisis counseling without an appointment or fee.

The Grassroots Mobile Crisis Team is available M-F from 8 am to 11:00 pm and 9 am to 11:00 pm on Saturday and Sunday. Contact them through the Grassroots Crisis Hotline at 410-531-6677.

Mother and child hugging while looking out a window

Meet with Professionals

Sheppard Pratt's Psychiatric Urgent Care is specially designed for people who need an immediate psychiatric triage.

Baltimore/Washington Campus Psychiatric Urgent Care Hours

Address: 7220 Discovery Drive Elkridge, MD 21075

Phone: 410-938-5302

Hours: Monday – Sunday, 10:00 a.m. – 9:00 p.m.


The Howard County Local Care Team helps families of children with intensive needs access community-based services to keep children in their homes and communities. It includes representatives from major child-serving agencies and a parent advocate who work with the family to identify suitable programs and services. Complete a referral form here.  For more information please contact Génesis Aguilar Chávez at [email protected] or 410-313-5441. 


Discover how to access peer recovery support from peer recovery specialists who offer understanding, respect, and encouragement to youth and adults. Peers who have faced similar challenges can share resources to assist in achieving long-term, positive goals. Visit https://www.howardcountymd.gov/health/peer-recovery-support for more information.

Mother consoling her distraught daughter

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