Riverview Psychiatric Center is failing to meet the mission it was given upon opening in 2004, as a replacement for the disgraced Augusta Mental Health Institute. The only questions are to what degree, and how to fix it.

Jay Harper, Riverview’s interim superintendent, says conditions at the hospital have improved dramatically since he took over in March.

However, the federal agency that decertified Riverview last year found that, following a visit in May, the state psychiatric hospital was still not meeting the minimum standards required for federal funding.

And former and current employees told the Maine Sunday Telegram recently that persistent problems at Riverview threaten the safety of patients and staff, and create an atmosphere that substitutes punishment for treatment.

The Legislature’s Government Oversight Committee, which meets Wednesday in Augusta, should open an investigation to determine just how bad things have gotten at Riverview, and if the changes made so far by Harper are moving the hospital in the right direction.

There’s plenty of reason to think otherwise.

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Employees, some of whom were interviewed by the Telegram and others who spoke with legislators, described a dysfunctional environment at the hospital.

Treatment plans are poorly and carelessly created and maintained, they said, and most interactions with patients are left to undertrained, low-level mental health workers, not the clinical staff who should be guiding care. These workers frequently provoke patients, or withhold care or food as punishment, the employees said.

It is enough for Daniel Wathen, a former Maine chief justice who oversees Riverview as part of the court consent decree that closed AMHI, to call Riverview “troubled.” A Riverview psychiatrist, drawing on 25 years’ experience, said the hospital’s Lower Saco unit – which houses the most acutely ill of the patients found not criminally responsible for a crime due to mental illness – is “the most dangerous psychiatric unit I’ve ever seen.”

Granted, changes are underway at Riverview, as Harper notes. There is more money in the budget for training, with more emphasis on diversionary and de-escalation techniques, to better avoid confrontation. New specialists have been hired to deal with patients with behavioral problems. Employee retention has improved. And seclusion rates – which measure how often patients are confined by themselves – are dropping; Riverview’s were once more than 10 times the national average.

But after over a year of disturbing news out of Riverview, that’s not enough. The patients there have been entrusted to the state of Maine for their care, and for a while, at least, that care has been substandard. At its worst – such as when a patient was left in her room for hours, naked, restrained and covered in pepper spray – it has been horrifying and dehumanizing.

With that in mind, the legislative committee that meets Wednesday should task the Office of Program Evaluation and Government Accountability, which previously uncovered fraud in the Maine Turnpike Authority, with getting to the heart of the problems at Riverview.

And Harper, who pledged to be “inclusionary and transparent” when hired, should open Riverview’s doors to the watchdog agency, with the aim of building a hospital that lives up to its mission.


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