December 16, 2017
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Why privatizing mental health services won’t help patients in state care

By Lisa Cromwell, Special to the BDN
George Danby | BDN | BDN
George Danby | BDN | BDN

As a direct-care worker at Riverview Psychiatric Center in Augusta, I agree with the Maine Department of Health and Human Services that 21 additional beds are needed for a step-down level of care for patients who no longer need to be in a hospital setting.

But I also believe that state workers should manage care for these patients, not private contractors.

These are the patients we care for 24 hours a day, 356 days a year on the Upper Saco unit of Riverview. We know them, and we care about them. We want to see them succeed in their treatment and thrive in their recovery

Mental health workers, nurses, doctors and all staff at Riverview and our other state psychiatric hospital, Dorothea Dix Psychiatric Center in Bangor, provide care for civil and forensic patients. We work hard, often under difficult and stressful situations, to provide the best care possible. We are accountable to our patients, their families and most of all to the people of Maine, not to corporate shareholders.

As the efforts move forward to expand the number of beds and services for forensic patients housed at Riverview, legislators should continue to demand oversight over this process. Legislators have always established mental health policies for administrations to carry out.

We take care of the very same population that would be housed at the administration’s proposed facility, so it’s puzzling why the administration is pushing for a private contractor. It would be much better to have this facility run by the state, so we can provide continuity of care between different levels of treatment. For our patients, this continuity of care is critical to their treatment and success. It doesn’t make sense to have another facility treating the very patients who come through Riverview to be run by a different operator.

If a private for-profit company wins the bid to run this proposed facility, how would the profit motive affect patient care? What impact would it have on staffing levels and quality? The Legislature has an obligation to make sure every mental health patient in state care receives proper care.

Hiring a private, potentially for-profit contractor appears to be the wrong way to go for those looking for quality services and accountability. Last summer, the U.S. Department of Justice announced it is ending the use of private, for-profit prisons for federal prisoners because the level of service in them is so poor and there is no cost savings.

We know that for-profit prison companies have been turning to state mental health services for new contracts. One of them, Correct Care Solutions, is a spin-off of the Geo Group, the second biggest private prison company in the country. Correct Care is a known potential bidder for operating the proposed new facility.

Last February, an organization known as Grassroots Leadership published a critical report about Correct Care Solutions. The report, “Incorrect Care: A Prison Profiteer Turns Care Into Confinement,” notes that many contracts the firm receives are done behind the scenes, out of public view.

Other states have learned the hard way that introducing the profit motive for forensic mental health directly undermines patient care and that contracting out this service means less transparency and accountability for patients, their families and the people of Maine, according to the Grassroots Leadership report.

Staff, patients, family and advocates have a lot of questions about this new facility, and the department has yet to answer them.

Legislative leaders from both parties have raised serious concerns about the lack of transparency the administration has been showing in its proposal of this facility. Sen. Roger Katz, House Speaker Sara Gideon and Rep. Drew Gattine are calling for a hearing and legislative oversight before such a major decision about Maine’s mental health service structure is made. This will help ensure the high level of transparency and accountability that Maine people, especially our patients, deserve.

Lisa Cromwell is a mental health worker at Riverview Psychiatric Center in Augusta. She is a member of American Federation of State, County and Municipal Employees Local 1814.


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