Nancy Watson, the daughter of Sandra and Perley Goodrich Sr., says the mental health system failed her family in allowing her brother Perley Goodrich Jr. to leave a Bangor psychiatric hospital on Monday when he was clearly a danger to others.
The 45-year-old man, who reportedly has a history of violence, is charged with murdering his father, Perley Goodrich Sr., and with assaulting his mother, who had sought mental health treatment for her son at area hospitals on Sunday and Monday.
“Maybe if more people had taken my mother more seriously, this wouldn’t have happened,” Watson said.
In a court affidavit, Sandra Goodrich refers to her son as “crazy.” She told police she took him to the hospital three times during the week before the attack and that he had been given a new medication.
Sebasticook Valley Hospital in Pittsfield confirmed that Perley Goodrich Jr. had been seen there on Sunday afternoon and that he was transferred by ambulance to another health care facility.
Officials at The Acadia Hospital and the Dorothea Dix Psychiatric Center in Bangor said on Thursday that they could not provide any information about whether Goodrich had been a patient at any time.
While the facts around the Goodrich case are still unclear, Maine law protects the rights of the mentally ill as well as those of the sane. The process for holding an individual against his will for psychiatric evaluation or treatment is laid out in statute.
In general, a person may voluntarily seek emergency mental health treatment by going or being taken to the emergency department of any community hospital. If a physician or other clinician there determines that the individual is mentally ill and is at risk of harming himself or others because of that illness, the patient may be referred for inpatient admission to a psychiatric facility.
The patient then waits in the emergency room until a bed is found at one of the four psychiatric specialty hospitals in Maine. Those hospitals include The Acadia Hospital and the Dorothea Dix Psychiatric Center in Bangor, the Riverview Psychiatric Center in Augusta and the Spring Harbor Hospital in Westbrook. Patients may be admitted to one of several community hospitals that have psychiatric units.
Upon arriving at the receiving psychiatric hospital or unit, the patient undergoes another clinical evaluation and, if determined to be in need of inpatient care, is admitted.
This process is entirely voluntary and the patient may choose to leave at any time unless, during the admission evaluation, his illness is determined to be severe enough that releasing him would be dangerous. In that case, the patient may be forcibly detained until a multistep legal process is initiated that allows him to be kept in protective custody while he is treated.
An individual also may be brought to a community hospital’s emergency department against his will by law enforcement officials and kept in protective custody throughout the initial evaluation. If the evaluation finds mental illness and threat to self or others, the uncooperative patient may be detained in protective custody through a court-ordered process commonly known as “blue-papering.”
Blue-papered patients may be kept in the community hospital emergency department for up to 24 hours. Once admitted to the receiving psychiatric hospital or unit, they may be held for up to three days before that hospital files a request for an independent court-ordered evaluation. If the independent evaluation finds cause to hold the patient against his will, a judicial hearing for involuntary commitment is scheduled.
Mary Louise McEwan, formerly the superintendent at Dorothea Dix Psychiatric Center in Bangor and now the superintendent at Riverview Psychiatric Center in Augusta, said Friday that patients seeking emergency mental health care are discouraged from coming directly to one of the state’s four psychiatric specialty hospitals.
The initial community hospital evaluation is an important screening element, she said, and emergency clinicians may prescribe psychoactive medications to ameliorate symptoms of psychosis and ward off a crisis. She said it is common for psychiatric beds to be unavailable at any given institution, and community hospitals can keep a patient safe and comfortable while searching for the nearest inpatient bed.
“But if someone shows up on our doorstep … we can’t just say, ‘I’m sorry, we don’t have any beds,’” she said. “We have to provide that service or assign someone to escort [the patient] to a safe place for evaluation.”
McEwen also pointed out that not everyone who becomes violent, as Goodrich Jr. is alleged to have done, is in need of mental health services.
“There are people who are dangerous and have the potential to be violent who are not mentally ill,” she said.