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

Always call 9-1-1 for immediate concerns of safety for yourself, your child or others.

Call the 24-hour Grassroots Crisis Line at 410-531-6677. Individuals may call for a variety of reasons including suicide, family and relationship problems, shelter needs, violent or threatening domestic situations, loneliness or depression, and substance dependency issues, among others. You can also download the Grassroots’ “There is Hope” App from your phone’s app store.

 Visit the Grassroots Crisis Intervention Center for walk-in crisis counseling. Anyone in need of immediate assistance may walk in to the agency at any time to see a counselor. An appointment is not needed to receive services. There is no fee for the service. 6700 Freetown Road Columbia MD, 21044

Contact the Grassroots Mobile Crisis Team. The team is available M-F from 8 am to 11:00 pm and 9 am to 11:00 pm on Saturday and Sunday. The Mobile Crisis Team can be reached 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

Monday – Friday, 10:00am – 9:00am.; Saturdays 10:00am – 6:00pm; Closed on Sundays.


The Howard County Local Care Team provides a forum for families of children with intensive needs to access information on available resources and services with the goal of keeping children in their homes and communities through access to community-based services. The team is comprised of representatives from the major child serving agencies, as well as a parent advocate. The group works together with the family to identify programs and services that can best assist child and family needs. Please contact Candace Ball at 410-313-6552 or [email protected] for more information.


Learn more about accessing peer recovery support with peer recovery specialists. Peer support occurs when people provide understanding, respect and encouragement to help each other. Peers who have faced similar challenges can share resources to assist a person in reaching long-term, positive goals. https://www.howardcountymd.gov/health/peer-recovery-support

Mother consoling her distraught daughter

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