AUGUSTA — A group formed to devise what could be sweeping changes to Maine’s mental health system held its first meeting Friday, discussing ideas for reducing the number of people with mental health illness in the state’s jails, prisons and hospital emergency rooms.

“Our community mental health system is really in tatters,” said Sen. Cathy Breen, D-Falmouth, who is co-chairing the Mental Health Working Group with Rep. Charlotte Warren, D-Hallowell. “We want to reverse the trend of re-institutionalization.”

Sen. Cathy Breen, co-chair of the Mental Health Working Group

The Legislature this spring approved forming the working group, which is composed of lawmakers, hospital officials, state officials, nonprofit groups that offer mental health services, law enforcement and others. The group, which met at the Maine Department of Health and Human Services offices in Augusta, will come up with recommendations by December.

Warren and Breen said after delving into a bill this spring by Warren that would have created four “assessment centers” – which would provide temporary care to patients who do not need hospital-level care and help keep patients out of Maine’s jails and emergency rooms – they realized the entire system needed to be examined. The assessment center bill was shelved, but a form of it could be revived in January.

The assessment centers could be part of the recommendations, or the working group could come up with entirely different proposals.

About 115,000 Mainers, nearly one in 10, have mental illness, and of those, roughly 40,000 have more severe forms of the disease, such as schizophrenia, bipolar disorder or severe depression, according to the National Institute of Mental Health.

Mental health experts long have said that Maine’s patchwork system of community-based mental health programs is insufficient for the demand, but working group members at Friday’s meeting said they needed more data to get a better handle on the scope of the problem.

After a series of scandals and deaths, the Augusta Mental Health Institute closed in 2004 – at its peak capacity AMHI had 1,800 patients. One of AMHI’s much-smaller successors, the 92-bed Riverview Psychiatric Center, also has had numerous problems with patient abuse, and Riverview for several years lost federal certification and funding over failing to meet performance standards.

Meanwhile, the state never developed a satisfactory community-based system for mental health patients, health experts have said.

Rep. Charlotte Warren, co-chair of the Mental Health Working Group, said mental health patients are “cycling in and out of our jails and emergency rooms.”

Warren said the fact that 86 percent of jail inmates in the state receive medications to treat their mental illness makes it clear that Maine uses the correctional system to house mental health patients.

“Folks on the ground are seeing patients cycling in and out of our jails and emergency rooms,” Warren said.

Randall Liberty, commissioner of Maine’s Department of Corrections, said while it’s difficult to estimate what percentage of prisoners should instead be in community-based programs, there’s no doubt that the jail and prison population would be reduced if more and effective mental health programs would be made available.

He said it takes $44,000 per year to house a prisoner, and if the jail and prison population declined, that money could be re-invested into mental health programs.

Jessica Pollard, who will take over as the Maine’s director of Substance Abuse and Mental Health Services at the end of September, said there needs to be improved data on waiting lists, how long it takes for patients to get their first appointment, and communication between the Department of Corrections, hospitals, DHHS and the groups that provide mental health services. Pollard said one of the first steps will be to survey what is the actual capacity of the current system. Pollard said the state could set up a system that lets people know “in real time” where and what types of services are available.

“How do we devise a system to better connect people to treatment?” Pollard said. “People end up in jails and emergency departments and it’s not obvious what treatment is readily available.”

 

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