If you needed a visual of where Maine and the country are currently putting people with mental health conditions, this map from MetricMaps comparing 1955 with 2010 will give you a pretty good idea: jail.
In many ways, the criminal justice system has become the de facto public mental health system.
When the state de-institutionalized psychiatric care beginning in the 1970s, it did not build a new mental health system in its place. In lieu of a more community-based support system, people have ended up behind bars.
The same number of people who once filled Maine’s largest psychiatric hospitals are now taking psychiatric medications in the state’s jails and prisons.
“After a well-intentioned move decades ago to shift the care of the mentally ill away from psychiatric institutions, many Mainers can’t find adequate care in their communities. They still end up institutionalized — but now it’s behind bars,” wrote BDN reporter Nok Noi Ricker as part of an in-depth piece published Feb. 20.
In some instances, patients in residential treatment still encounter a system that, for a variety of reasons, struggles to provide quality care. Riverview Psychiatric Center, which serves people with severe mental illnesses and those referred by the criminal justice system, has used restraints and tasers on patients, and made medication errors, among other problems — leading the federal government to pull its accreditation. The state has fought the decision, which puts $20 million in annual federal funding for the hospital at risk.
Maine’s mental health system also remains under special scrutiny after inhumane conditions led to the deaths of 10 Augusta Mental Health Institute residents in 1989. (Riverview later replaced AMHI and is located on its former grounds.) Plaintiffs acting on behalf of residents brought a class action lawsuit against the state and won. The terms of the resulting AMHI consent decree, a legally binding agreement mandating quality patient care, are still monitored by a court-appointed master today.
That court master, Daniel Wathen, recently issued recommendations to improve care at Riverview. He found that, as of Jan. 19, Riverview had a total of 51 staff vacancies, especially among nurses. Of 87 authorized nursing positions, 23 were vacant.