Dorothea Dix likely to stay open — for now

The Dorothea Dix Psychiatric Center in Bangor.
The Dorothea Dix Psychiatric Center in Bangor. Buy Photo
Posted Oct. 28, 2011, at 12:06 p.m.
Last modified Oct. 28, 2011, at 8:15 p.m.

BANGOR, Maine — Dorothea Dix Psychiatric Center has faced the possibility of closure for several years, including this one, but a draft report submitted Friday by the statewide work group in charge of making recommendations about the hospital’s future said it should stay open.

For the moment, anyway.

The work group was created by a provision in the state’s $6.1 billion biennial budget that passed in June. The 18-member panel has been meeting since August to discuss options. At one point, its members split into two groups: one that advocated closure and another that favored keeping Dorothea Dix open.

At no point during the process did the work group reach a consensus and on Friday the group’s final report recommended neither closure nor keeping the hospital open.

“After consideration of all the information, the majority of work group members concluded that there was insufficient time to develop a plan with the specificity mandated in the legislation,” the report stated. “Closure of the Dorothea Dix Psychiatric Center could not be considered until an analysis is completed regarding costs/savings of privatization, that there is assurance that the specialized care provided at [Dorothea Dix] would continue somewhere locally and that an effective and efficient community service system is established within existing financial resources.”

In short, despite meeting several times and reviewing a large amount of information, the work group decided more information and thought was needed.

Bonnie Smith, deputy commissioner of the Department of Health and Human Services, said she didn’t consider the work group a failure despite the lack of action.

“This is a huge conversation, not just the future of Dorothea Dix, but the future of how mental health services are delivered in Maine,” she said. “I think the group provided a lot of thoughtful input that will help keep that conversation going.”

Mary Louise McEwen, superintendent of the state’s other psychiatric hospital, Riverview in Augusta, said if there were an easy answer, it would have been found by now.

“It’s such a complex issue, but I think the work group advanced the discussion,” she said.

One of the philosophical differences that divided members of the work group was determining who ultimately should be responsible for providing services.

Some argued that private hospitals such as The Acadia Hospital can offer services in a more efficient way. Patients and advocates countered that the quality of care at private facilities is not on the same level as Dorothea Dix.

Together, Dorothea Dix and Riverview have about 150 beds available for psychiatric patients. Riverview reserves some of its beds for suspected criminals awaiting trial and for individuals who have been found not criminally responsible for their actions and are sent to a psychiatric facility rather than jail.

The Dorothea Dix work group had been scheduled to meet at least one more time, but that meeting no longer is necessary.

A final report must be presented to the Legislature’s Appropriations Committee by Dec. 1, but Smith said the report should be done sometime early next month. The Legislature could follow the report’s recommendations or decide to do something else entirely.

At a meeting earlier this month, several mental health advocates and area public safety officials pleaded with the work group to keep the facility open.

Dorothea Dix Superintendent Linda Abernethy, who served on the work group, agreed that the discussion about her facility’s future needs to be part of the broader conversation about mental health services.

“It does weigh on you,” she said of the continued pressure to close or make drastic changes at Dorothea Dix. “A lot of our employees, who are directly responsible for the high level of care that so many patients testified to, have been here a long time, throughout many of these discussions. And they keep coming to work every day.”

Independent of a decision to close the facility or keep it open, Dorothea Dix already faced the reality of operating with significantly reduced funding beginning next year.

When the 2012-13 state budget levied cuts to mental health services, the Bangor hospital lost $2.5 million annually beginning in 2013, although that number is closer to $7 million because state dollars are used to leverage federal funds. Riverview’s budget was not cut.

Earlier this month, Abernethy said the hospital would stop accepting new patients in order to reduce the number of daily beds and begin addressing that $2.5 million gap.

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