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Am I Eligible for DMH Services?

Information about DMH Service Authorization

Most mental health services, including medication and therapy are provided through health insurance – MassHealth (Medicaid), the Massachusetts Health Connector (health insurance marketplace) or through private insurance (employer-based).  The Department of Mental Health (DMH) has a specialized role in the healthcare delivery system.  DMH provides supplemental services for people with the most serious needs.  These services are beyond those supplied through health insurance and require approval by DMH. 

A printable version of this guide is available here

Do I Qualify for DMH Services?

DMH services are provided to adults with a serious mental illness and children and youth with serious emotional disturbance. Service authorization criteria can be found under Regulation 104 CMR 29.

How Do I Request DMH Service(s)?

Complete the following forms and mail, fax or bring the forms to the DMH office near you. The Request for DMH Services application is available in various languages, and DMH can provide translators and other assistance.  Signatures and dates must be included. 

  •     Signed Request for DMH Services application.    
  •     Signed Authorization(s) for Release of Information

The forms and detailed information on how to apply can be found at: https://www.mass.gov/info-details/applications-for-dmh-services

If you're not sure which DMH office you should submit your application to, click on your city or town on this guide to find the correct contact information.

Office

Mailing Address

Phone Number

Fax Number

E-mail Address

Boston

85 East Newton Street

Boston, MA 02118

(617) 626-9200

(617) 626-9216

MBA.serviceauthapplications@mass.gov

Brockton

165 Quincy Street,

Brockton, MA 02302

(508) 897-2000

(508) 897-2047

SEA.serviceauthapplications@mass.gov

Northampton

1 Prince Street

Northampton, MA 01060

(413) 587-6200

(413) 587-6240

WMA.serviceauthapplications@mass.gov

Tewksbury

P.O. Box 387

Tewksbury, MA 01876-0387

(978) 863-5000

(978) 863-5091

NEA.serviceauthapplications@mass.gov

Worcester

361 Plantation Street

Worcester, MA 01605

(774) 420-3140

(774) 420-3165

CMA.serviceauthapplications@mass.gov

What Do I Need to Include in My Application?

DMH needs clinical information about your mental health condition in order to determine if you qualify.  It is recommended that you submit  clinical information with the forms.  DMH can make a decision about your application sooner when all information is received.  Clinical information includes outpatient and inpatient mental records, including testing, admission and discharge reports or summaries, assessments treatment plans, and Individualized Educational Plan (IEP) if one is in place. DMH may ask for additional information if needed. 

What Can I Expect After I Submit the Forms?

A DMH staff member will contact you (or your guardian) within seven (7) of days receiving the forms.   DMH may ask to meet with you or your guardian in person.  If you qualify for services, DMH will determine what service you need and if it is available.  DMH services are limited.  DMH uses criteria to prioritize these services.  http://www.mass.gov/eohhs/docs/dmh/regs/reg-104cmr29.pdf.

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