Children and adolescents · Ages 6–18

Child and adolescent mental health services in Maryland (ages 6–18)

Worried about your child’s mood, worries, attention or school stress? Learn the red flags to watch for, how therapy and psychiatry work for kids and teens, and how to start care in person or by telehealth across Maryland.

Prefer to talk? Call (410) 231-0488

Key takeaways: child and adolescent mental health in Maryland

Growing pains or a child mental health red flag?

Every child has hard days. Moodiness, worry before a test or a short stretch of poor sleep can be part of growing up. The difference is usually how long a change lasts, how intense it is and how much it gets in the way of daily life. Parents are often the first to recognize that something has shifted.

Signs that are worth discussing with your child’s doctor or a mental health provider include:

The National Institute of Mental Health encourages families to seek an evaluation when behavior changes are persistent or severe. MedlinePlus also lists warning signs, such as self-destructive behavior, that call for prompt attention. Talk of self-harm always deserves an immediate response: If you are in crisis, call 911, go to the nearest ER, or call or text 988.

As a Maryland practice offering mental health care for children and teens in person and by telehealth, we can help you sort out what you are seeing and what a sensible next step looks like. For a deeper look at common concerns, see our guide to teen mental health covering depression, anxiety, OCD and school refusal.

Anxiety, ADHD, depression and school refusal in kids

These concerns often overlap, which is one reason a careful evaluation matters. A child who avoids school may be dealing with anxiety, low mood, attention problems, bullying or a learning difference, or several of these at once. Our neurodivergence and ADHD guide covers attention and learning differences in more depth.

Avoidance can make worry grow over time. Therapy approaches such as cognitive behavioral therapy (CBT) help children notice anxious thoughts and practice facing feared situations in small, manageable steps. For some children, a prescriber may also discuss medication as one part of a broader plan that includes therapy and school support.

Families looking for a child psychiatric provider and counseling in Calvert County, Montgomery County or elsewhere in Maryland can access both through our licensed Maryland clinicians, with therapy in person or by telehealth and psychiatry by telehealth. LGBTQIA+ young people and their families can also read our guide to LGBTQIA+ affirming mental health care for youth and adults.

Where to start: evaluations for Maryland families

You do not need to have every answer before you ask for help. Many families start with whoever they already know: a pediatrician, a school counselor or a mental health provider.

First steps for parents

If there is immediate danger, call 911, go to the nearest ER, or call or text 988.

School-based starting points

Your child’s school counselor, school psychologist or student support team can share observations, connect you with school-based services and explain how to request an evaluation for learning or attention concerns. Many Maryland schools also partner with community mental health programs. Ask your school what is available.

If you have a younger child with developmental or autism-related questions, see our page for toddlers and preschoolers and our early-intervention autism program for children ages 2–6.

Pediatric screening and referrals

Pediatricians often use brief questionnaires to screen for anxiety, depression and attention concerns. A positive screen is not a diagnosis. It is a signal that a fuller evaluation could help. In Maryland, pediatric primary care practices can consult with child mental health providers through BHIPP, a free statewide program that supports pediatricians in caring for children’s behavioral health.

Your pediatrician may refer you to a therapist, a psychiatric provider or a psychologist for testing, depending on the concern. For questions about autism, Blue Sails offers autism evaluations and diagnosis with a PsyD clinician. The Maryland Department of Health also lists public behavioral health services for children, adolescents and young adults.

If your child’s needs feel complex, your pediatrician does not have to sort them out alone. Through Maryland BHIPP (Behavioral Health Integration in Pediatric Primary Care), Maryland pediatricians, family doctors, nurse practitioners and school nurses can get free consultation on child mental health questions such as diagnosis, medication and local referral options. BHIPP does not consult directly with families, but you can ask your child’s primary care clinician to call.

Play therapy and emotional regulation (ages 6–11)

Younger children often express feelings through play more easily than through words. In play-based therapy, toys, art and games give children a way to work through worries, make sense of hard experiences and practice new skills. Parents are usually involved too, so skills can carry over to home. For caregiver-focused programs such as parent training, see our relationships and family guide.

How play therapy works

In child-centered play therapy, the child leads and the therapist follows, reflecting feelings and setting gentle limits. In more directive approaches, the therapist guides activities that target a specific skill, such as calming down or problem-solving. Many therapists blend both, based on the child’s needs. Research on play therapy is promising, though study quality varies, so we describe it as one helpful option, not a promise of results.

Building emotional regulation skills

Emotional regulation means noticing a feeling and handling it without being overwhelmed by it. Children can learn to name feelings, notice body signals such as a racing heart, and use calming tools like slow breathing or taking a break. These skills support friendships, learning and family life, and can lay groundwork for the years ahead, including lower risk of turning to substance use to cope.

Choosing a play therapist

Ask about training and experience with children your child’s age. The Association for Play Therapy offers a Registered Play Therapist credential for clinicians with specific play therapy training and supervision. You can also ask how the therapist involves parents and how progress will be reviewed. At Blue Sails, ask intake about play-based therapy for young children and which providers are a good fit for your child.

ADHD skills support for elementary students: how it works

Children with ADHD often know what they are supposed to do but struggle to get started, stay organized or follow through. Skills support focuses on the practical side of daily life: routines, planning and self-monitoring.

ADHD often occurs alongside anxiety, learning differences or mood concerns, so an evaluation that looks at the whole child matters. Treatment plans can include therapy, parent support, school accommodations and, when appropriate, medication managed by a prescriber. Ask our team how therapy and medication management can work together for your child.

Teen social anxiety and academic stress: what helps

Some nervousness before a presentation is normal. Social anxiety goes further: a strong, lasting fear of being judged that leads teens to avoid class participation, social events or even school. According to the U.S. Office of Population Affairs, an estimated 31.9% of adolescents will experience an anxiety disorder at some point during their teen years. Low mood is common too. In the 2024–2025 Maryland Youth Risk Behavior Survey, 31.7% of high school students and 31.9% of middle school students reported persistent feelings of sadness or hopelessness, down from 39.2% and 36.8% in 2021–2022.

Recognizing the signs

Social anxiety often begins in childhood or adolescence. Without support, avoidance can narrow a teen’s world over time.

Coping with academic stress

Heavy workloads, tests and college pressure can add up. Helpful habits include protecting sleep, breaking big projects into smaller steps, scheduling breaks and limiting late-night screen time. CBT can help teens challenge all-or-nothing thinking about grades and practice facing stressful situations gradually. The Merck Manual describes CBT as a first-line treatment for social anxiety in children and adolescents.

Social media and screen time

The U.S. Surgeon General’s 2023 advisory on social media and youth mental health notes that children and adolescents who spend more than three hours a day on social media face double the risk of poor mental health outcomes, including symptoms of depression and anxiety. Practical steps can help: keep phones out of bedrooms overnight, set tech-free times such as meals, and talk with your teen about how their feeds make them feel. If online stress, comparison or lost sleep is part of what you are seeing, bring it up with your teen’s provider.

Accessing school-based support

School counselors, school psychologists and school-based health centers can offer support during the day and help with accommodations. With your permission, a teen’s provider can coordinate with the school team. If anxiety escalates into crisis, call 911, go to the nearest ER, or call or text 988.

Teen counseling with CBT and DBT (ages 12–18)

Teens often do well in therapy when they feel respected and have a real say in their goals. We match each approach to your teen’s symptoms, goals and safety needs through outpatient therapy.

Not every provider offers every approach, so ask intake which providers are trained in the approach you are interested in, and whether a teen group is currently available. The American Academy of Child and Adolescent Psychiatry has a helpful overview of psychotherapies for children and adolescents.

Child therapist or pediatric psychiatric provider?

Understanding the roles

A child therapist, such as a licensed clinical social worker, licensed professional counselor or psychologist, provides talk therapy and skills-based treatment. A child and adolescent psychiatrist is a physician who can diagnose, prescribe and monitor medication. Psychiatric mental health nurse practitioners (PMHNPs) can also evaluate and prescribe. Psychologists can also provide psychological testing.

Matching care to needs

Many children start with therapy. A psychiatric evaluation may help when symptoms are severe, keep getting in the way despite therapy, or when the diagnosis is unclear. Often the two work together. At Blue Sails, therapy is available in person or by telehealth and psychiatry is available by telehealth, so your child’s providers can coordinate care with your permission.

For urgent concerns that can’t wait, contact a provider right away. If there is immediate danger, call 911, go to the nearest ER, or call or text 988. When you call or text 988, a live, trained counselor will respond.

Medication for children and teens: start low, go slow

If medication is part of the conversation, a prescriber usually starts with a low dose and adjusts slowly, watching for benefits and side effects. There is no standard dose that fits every child, so follow-up visits matter.

Medication is one option, not a requirement. Your child’s prescriber will explain the reasonable options, including non-medication choices, so you can decide together. Learn more about medication management at Blue Sails.

What to expect at your child’s first appointment

Before we ever talk about medication management, we start with a conversation. A first visit usually covers what brings you in, your child’s development, health, school and family life, and what you hope will change. The American Academy of Child and Adolescent Psychiatry describes what a comprehensive psychiatric evaluation can include.

You can start by completing our client intake or calling us at (410) 231-0488.

504 plan vs. IEP in Maryland

If a mental health condition affects learning, your child may qualify for school support. A 504 plan provides accommodations, such as extra time, breaks or a quiet testing space, for students whose disability limits a major life activity. An IEP (Individualized Education Program) provides specialized instruction and services for students who qualify for special education.

Working with the IEP team

Paying for child and teen mental health care

Most health plans include mental health benefits. The Maryland Insurance Administration explains your rights, including what to do if you can’t get an in-network appointment within a reasonable time or distance. For non-urgent behavioral health therapy, that means an in-network appointment within 10 calendar days. Starting January 1, 2026, if your plan can’t offer an appointment within the time or distance set by Maryland regulation, it must help you get one with an out-of-network provider, covered the same as in-network. You can reach the MIA at 800-492-6116. Children with Maryland Medicaid may be eligible for public behavioral health services. Specialty behavioral health care is carved out of managed care, so all Medicaid members, including HealthChoice members, access it through Carelon, Maryland Medicaid’s behavioral health administrative services organization. Most behavioral health medications are also processed by the Medicaid fee-for-service pharmacy program rather than your child’s managed care organization. For children and youth with more intensive needs, Maryland also offers 1915(i) services.

Maryland’s 1915(i) program offers home and community-based services for young people with intensive behavioral health needs who may be at risk of hospitalization or residential treatment. Services can include in-home support, family and youth peer support, and respite care for caregivers. Youth ages 6–21 who have Maryland Medicaid, or are eligible for it, generally need two or more hospital stays, emergency room visits, mobile crisis responses or crisis center visits in the past 12 months, or a residential treatment stay within the past 90 days. Families enroll through a local Care Coordination Organization (Maryland Department of Health).

Some help may also be available at school. The Maryland Department of Health has expanded Medicaid coverage so public schools can offer certain behavioral health services, including diagnostic evaluations and individual, family and group therapy from licensed school psychologists and school social workers, to students enrolled in Medicaid, even without an IEP or IFSP. A behavioral health diagnosis is still required. Ask your child’s school whether these services are available there.

Blue Sails accepts TRICARE. Coverage depends on your plan, so see insurance and costs or ask our intake team to check your benefits before you schedule.

When crisis hits: mobile crisis teams and 988 in Maryland

If you are in crisis, call 911, go to the nearest ER, or call or text 988.

The 988 Suicide & Crisis Lifeline is free, confidential and available 24/7 by call, text or chat. A trained crisis counselor answers. According to the Maryland Department of Health, 988 can also connect you to in-person mobile crisis help when appropriate. Mobile crisis response is available across Maryland, though hours vary by county.

After a crisis, follow up with your child’s providers to update the safety plan and next steps.

Explore related care and resources

Explore related services, the counties we serve and answers to common questions.

You can start with a question

Tell intake your child’s age, what has been going on and what you need help sorting out. Ask about fit, costs and next steps before you schedule.

If you are in crisis, call 911, go to the nearest ER, or call or text 988.