March 29, 2020
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Now is the time to mend Maine’s frayed mental health safety net

Troy R. Bennett | BDN
Troy R. Bennett | BDN
The State House in Augusta, as seen from Capitol Park.

There’s a common thread that connects some of the most important issues facing Maine today — issues that the governor has highlighted and the Legislature is struggling to address.

Whether it’s criminal justice reform, closing Long Creek Youth Development Center, fixing the problems in our child protective system, or fighting back against the impacts of the deadly opioid epidemic, we will not be able to find solutions unless we properly invest in our state’s mental health system.

Maine has taken steps to ensure that everyone has access to the health care they need, with about 43,000 Mainers newly covered by Medicaid. Of those, more than 6,500 are receiving care for opioid use disorder, with another 16,400 finally receiving needed care for mental health services.

But the safety net to provide this care, already stretched thin, is beginning to fray, especially for Maine children.

Service providers — the people and organizations that actually provide health care, including mental health services — are being pushed to the breaking point.

Evidence-based services such as multisystemic therapy, or MST, and functional family therapy, or FFT, that have been shown to work for adolescents who are struggling with mental health, or who are in — or heading toward — the juvenile justice system, aren’t receiving the investment they need.

Aroostook Mental Health Center was forced to eliminate its MST team in 2018, leaving Aroostook and Washington counties with no provider. Other agencies have also had to reduce the number of teams providing these services.

The reason is straightforward. The amount of money the state was willing to pay nonprofits to help Maine youth wasn’t enough to cover the cost of providing the services.

After 27 years of helping adults with mental health challenges, Shalom House has ended its community integration and case management services. They could not continue losing money offering a service the state did not cover the cost of providing, so 170 people will no longer receive the help that they need.

Sweetser, another nonprofit that provides services to people with mental illness, announced in November that it was discontinuing services at five clinics, affecting about 450 people.

Again, the story is the same. The reimbursement rates paid by Medicaid aren’t enough to cover the costs of providing the care.

And the problems are only getting worse.

According to the Office of the Maine Attorney General, third-quarter numbers from 2019 suggest that deaths from overdose are growing. For nine months of last year, 277 people died, up 4 percent from 2018.

Maine’s suicide rate is higher than the national average. It is now one of the leading causes of death for many young people in Maine, according to recent data from the Maine Center for Disease Control and Prevention.

Our system does not have the capacity to care for the number of Maine children and adults in need, who find themselves on the street, confined to emergency departments, involved with law enforcement or on long waiting lists for care.

While more people are receiving care for behavioral health services — thanks to Medicaid expansion — the amount we as a state are investing in treatment still falls far short of the need.

There are hundreds of adults and youth on waitlists for medication management or community-based services to meet the needs stemming from their serious and persistent mental illness. Waitlists for children’s homes and community mental health treatment have been hovering near 500 for several years, with some families waiting upward of a year.

There are some ways to mend these fraying edges.

There is currently a bill before the Legislature’s Health and Human Services Committee that could address the crisis in children’s mental health services. There are also several bills that have already received bipartisan support from the House and Senate that need funding.

These bills need the attention of our leaders — and their support — now.

We are letting our children down, and we are letting vulnerable adults who need our help down.

Malory Shaughnessy is the executive director for the Alliance for Addiction and Mental Health Services, Maine and the Maine Behavioral Health Foundation.

 


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