I am writing to state the position of the Bangor Area Homeless Shelter concerning the fate of the Dorothea Dix Psychiatric Center and the possibility of it being closed.
In the course of providing shelter to an average of more than 700 individuals per year since 1996, I have witnessed many people living lives of crisis due to the consequences of untreated mental illness. The most ill of these, the people suffering the most, have been those with a virulent form of mental illness.
We try to go slowly with folks like these, accepting certain behaviors and giving them room in terms of some of our rules, hoping that they will gradually experience enough trust in the shelter for staff to be able to work with them and any insight they may have in an effort to get them to an evaluation and real treatment.
A significant percentage will privately decide to move on before things can progress to that point. Many lack enough insight to accept treatment. With a meaningful minority we actually experience success, but the only setting in which that truly occurs is Dorothea Dix.
I believe we need to keep services available in this geographic region to serve the poorest and sickest among us. I believe that the patients have the right to receive professional help, and I believe their families have rights including reasonable opportunity to support and be involved in the care of the family member who is receiving treatment.
At the present time the only other facility in Maine that may be described as comparable to Dorothea Dix is in Augusta, but that hospital (Riverview) lacks adequate capacity to meet existing need. And while the hospital in Bangor is a long car ride for many who live in Northern Maine, forcing families to drive to Augusta in order to see a loved one or attend a meeting with their caregiver would not be a defensible action for the state to take.
In addition to not meeting a moral obligation, a lack of access to enough capacity to treat these sick people will result in negative and costly consequences. People who are living in fear and experiencing psychoses and delusions may create situations in which police are called
to respond. Stays in police departments and jails, and appearances in front of the court come with substantial costs, as do lengthy stays in hospital emergency rooms.
These chains of events also take resources away from providers’ normal roles and mission and delay care for other citizens. Homeless shelters, neither designed nor funded to be mental health clinics or mental health group residences, nevertheless would see increased demand for their services. This in turn would result in requests made by people like me for more support from the private sector.
Communities, especially those of a regional service center nature, need a health care system that can deliver the continuum of care needed by the community. Dorothea Dix represents a niche in the system, a small but critical component. The patients and their families need its continued operation, but so do providers in other health care facilities, those working in local law enforcement and the judicial system, our local economy and, ultimately, all of us who live and work in this region.
Dennis R. Marble is executive director of the Bangor Area Homeless Shelter.