Maryland adopted H.B. 415/S.B. 874, Mental Hygiene Administration – Rights of Individuals with Mental Health Disorders in Facilities [PDF], on May 19, 2009. It became effective October 1, 2009.

The bill amends language of current rights for individuals in the care of a mental health facility and requires facility staff authorized to use physical restraint to undergo training in the method specified in written policy.


(c) Each individual in a facility shall:

(1) Receive appropriate humane treatment and services in a manner that restricts the individual’s personal liberty within a facility only to the extent necessary and consistent with the individual’s treatment needs and applicable legal requirements;

(2) Receive treatment in accordance with the applicable individualized plan of rehabilitation or the individualized treatment plan provided for in § 10–706 of this subtitle;

(3) Be free from restraints or seclusions except for restraints or seclusions that are:

(i) Used only during an emergency in which the behavior of the individual places the individual or others at serious threat of violence or injury; and

(ii) 1. Ordered by a physician in writing; or

2. Directed by a registered nurse if a physician’s order is obtained within 2 hours of the action;

A facility shall:

(1) Have a written policy specifying the method used to ensure that an individual whose primary language or method of communication is nonverbal is able to effectively communicate distress during a physical restraint or hold; and

(2) Ensure that all staff at the facility who are authorized to participate in a physical restraint or hold of individuals are trained in the method specified in the written policy required under item (1) of this subsection.

CPI Can Help!
Facilities across the US use the Nonviolent Crisis Intervention® training program because it's been shown to be effective in both the prevention of and the safe use of physical restraint. CPI training focuses on prevention and de-escalation techniques and other alternatives to restraint and seclusion, as well as how to use safer, less-restrictive physical interventions only as a last resort. Training gives staff tools to organize their thinking about risk behavior and help them determine the most appropriate, least restrictive intervention to use in each unique situation.

Tailoring Training to Your Needs
CPI training is flexible and can be tailored to the unique needs of your facility. With our train-the-trainer option, select staff can be certified to teach the program to other staff on a continuing basis. We also offer specialized materials to help connect the Nonviolent Crisis Intervention® training program skills and strategies with your PBIS plan to increase positive behavior.

How to Get Training
We can bring the Nonviolent Crisis Intervention® training program on site to your facility, or you can attend training in one of more than 150 public locations throughout the US.
Advanced Course
If you’re already a Nonviolent Crisis Intervention® Certified Instructor, you can share strategies with your staff from our advanced course, Trauma-Informed Care: Implications for CPI's Crisis Development ModelSM. This course dives deep into the influence of trauma on behavior and offers additional strategies to help you better support individuals who have experienced traumatic events. Locate an upcoming public program or have us bring the training to you.