December 10, 2019
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DHHS’ ever-changing plans for housing mentally ill are a cause for deep concern

Historyofmentalhealth.com | BDN
Historyofmentalhealth.com | BDN
A postcard depicting buildings on the Augusta Mental Health Institute campus around 1900.

The Maine Department of Health and Human Services has struggled for years with the management of the Riverview Psychiatric Recovery Center. In 2013, the federal government revoked the facility’s certification, citing concerns for both patient and staff safety.

Since then, staffing shortages at the Augusta hospital have received the most attention. Retired Maine Supreme Court Chief Justice Daniel Wathen warned that Riverview could violate a decades-old consent decree that settled legal claims against the state and required that Maine improve its mental health system. Wathen was especially concerned with staff shortages that required some employees to work mandatory overtime.

This spring, lawmakers overrode a veto from Gov. Paul LePage to approve raises for some workers at the two state-run psychiatric centers, and DHHS stepped up recruitment efforts to fill vacant positions. Today, there are few vacancies at Riverview, and overtime work is rarely mandated.

This is all encouraging, Wathen said in an interview with the Bangor Daily News.

Now, the state has renewed plans to build new facilities to house some current Riverview patients. DHHS has offered scant details on the new building or what types of patients it would house there. This is especially concerning because the new plans come just four months after lawmakers rejected a plan from the LePage administration to move some Riverview patients to the Maine State Prison. The administration, at various times, has also proposed moving violent patients to a new facility to be built at the Windham Correctional Center or to a new private facility.

Given all these different permutations and the lack of communication with lawmakers and advocates, it is hard to know what DHHS plans and for what patients. This rightly has lawmakers, advocates and Wathen concerned, although they agree that more capacity is needed at Riverview.

The proposal raises “a ton of red flags,” Jenna Mehnert, director of the National Alliance on Mental Illness Maine, told the Maine Public Broadcasting Network.

The concern centers on what are known as forensic patients. Judges have found these patients either not competent to stand trial or not criminally responsible for the crimes they were charged with, and they have committed them to Riverview. There, they remain under the custody of the Department of Health and Human Services. Holding them in a prison would violate judges’ orders.

The forensic unit at Riverview is typically full, with another eight to 10 people usually awaiting an open bed there.

DHHS has used the terms “forensic” and “violent” interchangeably. But not all forensic patients are violent and not all violent patients come to Riverview through the court system.

When speaking of the new 21-bed building to MPBN, DHHS Commissioner Mary Mayhew said it would be used to house patients who no longer needed clinical care but had not received a judge’s permission to be placed in a community setting. Such patients would generally not be violent, but Mayhew described the facility as “secure.”

According to Wathen, there aren’t 21 patients who no longer need clinical services at Riverview who would supposedly be eligible for the new facility. DHHS did not respond to an email asking for clarity on which patients would be housed at the new facility.

The department’s changing plans for forensic and violent patients and the lack of details about a proposed new building at Riverview are serious concerns, as is the lack of clarity on the source of funding for construction and staffing of the new facility.

It’s DHHS’ responsibility to offer more details before it moves forward with such a significant change at Riverview, so the public can be assured that the move is one based on improving patient care.

 



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