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State committee gets earful about mental health deficiencies

Sun Journal
Jun 15, 2017

June 15--LEWISTON -- Officials from Maine jails, law enforcement, legal system and advocacy groups told a state advisory committee Wednesday that Maine's psychiatric hospital and county jails are overcrowded, underfunded and under-equipped to meet the needs of people with mental illnesses.

The Maine Advisory Committee to the U.S. Commission on Civil Rights held a daylong public briefing at City Hall'sCity Council chambers seeking input on the criminalization of people with mental illnesses.

"The largest mental institutions in the state are, in fact, the jails and prisons, bar none," said Daniel Wathen, a former chief justice of the Maine Supreme Judicial Court and the court master in a class-action litigation involving the operation of a state psychiatric hospital and the community mental health system throughout Maine that sought to deinstitutionalize the state's mentally ill population.

The 92-bed capacity of Riverview, the state's sole psychiatric hospital in Augusta, is "not nearly enough," he told the committee. Roughly half of those beds are reserved for forensic patients who fall into one of four categories for processing into the hospital: determined to be not criminally responsible for a crime; incompetent to stand trial; awaiting mental evaluations; and transferred from Maine jails and prisons because those facilities can't address their mental health needs.

Starting in 2012, the population of criminal patients at the hospital grew until it reached a total of 70, Wathen said, housed in civil wards that were designed for non-criminal clients.

"That proved to be unwise," he said, because the management systems in place for the civil population is different from that of the criminal population.

Some people charged with crimes who have been found by psychologists not competent to stand trial because of mental illness are not in hospitals receiving treatment where they should be, Wathen said. "They're waiting in jail and these are people who really are in need of help."

For juveniles in Maine, the picture painted by Tonya DeMillo, chairwoman of the Board of Visitors for the Long Creek Youth Development Center in South Portland isn't much brighter.

Even in the wake of a suicide at the facility last fall, the population of those with mental health needs is not being met, DeMillo said. Several others have harmed themselves or attempted to, she said. They are being managed for safety only, not for their underlying mental health problems.

"Simply put, Long Creek Youth Development Center is not a mental health facility," she said.

The center is seeing a rise in acute care cases and is finding it increasingly difficult to find appropriate residential settings for that population.

"If there was some place for them to go, they would place them there," she said.

The staff is under trained in the scope of their responsibilities, she said. Safety management of youths in acute crisis includes use of corrections restraints, removal of clothing and use of a "smock cover-up."

A survey of the population beginning in 2009 found that 67 percent received special education services, nearly 85 percent arrived at the facility with three or more mental health diagnoses. For females, the most common diagnosis (24 percent) was post-traumatic stress disorder, followed by mood disorder (19 percent) and substance abuse disorder (15 percent). Twenty-six percent of the male population was diagnosed with attention-deficit hyperactivity disorder, 20 percent with mood disorder, 20 percent with depressive disorder and 20 percent with PTSD.

Despite the urgent need for mental health services at the center, Gov. Paul LePage's original proposed budget last winter included a 10 percent overall cut to mental health and medical services across the board for the Department of Corrections, including Long Creek, DeMillo said.

"Long Creek is not medically equipped to deal with the delicate needs of these vulnerable youth," she said. "Youth in acute crisis must be immediately placed in an appropriate therapeutic facility to receive intensive mental health evaluations and acute care treatment. More in-depth training is needed for Long Creek staff to understand and to help interventions. A multidisciplinary review of acute care therapeutic options in Maine and the barriers to access them or maintain these placements is essential."

According to published reports Wednesday, Long Creek laid off six of 14 teachers and an assistant principal.

Advocates said more mental health crisis training is needed for first responders in law enforcement who encounter that population on the streets, but funding is lacking. Mental health workers who ride along with first responders also are needed, advocates said.

Penobscot County Sheriff Troy Morton told the committee that the current approach to dealing with Maine's mentally ill population must change.

"We're trying to do this backwards," he said. "We are trying to get the criminal justice system to take care of the mental health system."

The U.S. Commission on Civil Rights is an independent, bipartisan agency charged with advising the president and Congress on civil rights matters and issuing an annual federal civil rights enforcement report.

cwilliams@sunjournal.com

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