May 28, 2020
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Maine considers restoring mental health crisis response system to divert people from jails

Troy R. Bennett | BDN
Troy R. Bennett | BDN
Rep. Charlotte Warren, D-Hallowell.

AUGUSTA, Maine — A group of Maine lawmakers, law enforcement officials and advocates have coalesced around a proposal to restore Maine’s mental health crisis response system instead of new brick-and-mortar facilities while some say structural change is needed.

A bill from Rep. Charlotte Warren, D-Hallowell, originally proposed developing four new brick-and-mortar crisis intervention centers in Maine, similar to a facility the state is looking to build in Cumberland County. That center would provide rapid treatment for an individual needing stabilization with a goal of re-integrating them into the community.

The Mental Health Working Group is now suggesting putting $4.4 million into an existing, state-contracted system for mobile services staffing and peer-support services with the goal of providing more effective treatment and saving money for county jails. It’s wrapped up in long-standing debates over jail funding and criminal justice reform.

The state is supportive of the efforts, although advocates say bigger changes are needed to keep crisis providers afloat and lawmakers will have to find money in the state budget — or Gov. Janet Mills’ $127 million supplemental budget proposal — to move the effort forward this year.

The amended proposal puts a quarter of the funding toward more peer support specialists and recovery coaches, including mental health liaisons in law enforcement agencies. It gives more money to the state’s telephone services for those in crisis — which were in danger of being reduced last year through a new contract, according to Maine Public — and would give providers more money for travel costs.

The Department of Health and Human Services seemed to back the efforts, with the head of its substance abuse and mental health office saying it “strongly agrees” that more efforts to divert people from the criminal justice system are needed while highlighting its own future facility.

Deborah Taylor, the CEO of Sweetser, a mental health care provider that meets people experiencing a mental health crisis where they are to prevent the crisis from escalating through counseling or short-term therapeutic placement in nine counties — said an individual’s interactions with law enforcement sometimes results in that person getting the care they need for the first time.

“We need to work with the system we have,” Taylor told the Legislature’s health and human services panel on Monday. “We don’t necessarily need more brick-and-mortar institutions; we need to use our resources more effectively.”

Warren said those efforts could prevent more Mainers with mental health disorders from ending up behind bars, something the state has wrestled with for years. That could reduce jail populations, the costs of which are largely supported by county taxpayers.

But others say the issue won’t be fixed if the system isn’t changed. Simonne Maline, executive director of Consumer Council System of Maine, a quasi-state agency that weighs in on mental health policy, said providers struggle to be adequately staffed under the current model.

Maine overhauled statewide emergency services for people experiencing a mental health crisis nearly two years ago by switching to a fee-per-service payment structure. That means providers only get paid when they bill for a service, although they must provide 24/7 coverage.

“Mobile crisis should be 24/7,” Maline said. “The peers in the community do not want to be sent to the emergency rooms. They want to be seen in their homes.”

Jenna Mehnert, executive director of NAMI Maine, said more attention needs to be given to state-funded crisis intervention teams, which provide a network of law enforcement and mental health experts to assist people in crisis. She said more money needs to be given to dispatchers working overtime and encouraged lawmakers to let the state — not the Legislature — take the lead on reform efforts.

“NAMI Maine would be comfortable if these program components were expressed as goals, not a mandate,” she said.

 


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