The case of a Poland man with diagnosed schizophrenia charged in the Thanksgiving murder of his brother has reignited debate between advocates who disagree on how to best serve people with serious mental illnesses.

Justin Butterfield, 34, is charged with the intentional or knowing or depraved indifference murder of his brother, Gabriel Damour, 38.

Damour’s murder reflects a failure in Maine’s mental health system, the brothers’ loved ones and some advocates said.

There were several missed opportunities to get Butterfield into Maine’s progressive treatment program, Butterfield’s former girlfriend, Yaicha Provencher, with whom he shares two children, said at a press conference Monday.

The progressive treatment program was established by a 2010 law by then-Sen. John Nutting of Leeds. The law allows certain medical providers, law enforcement officials or a legal guardian to apply for an order from the Maine District Court to admit a person with a “severe or persistent mental illness” and who poses a likelihood of serious harm, to the program.

Under the program, which may include involuntary hospitalization, a person admitted is required under the law to follow a treatment program.

But Maine barely uses this law to get people into treatment and state officials have called it a “last resort,” said Nutting, who also organized Monday’s conference.

“Just how last ditch do you have to be when people are getting abused in emergency rooms — staff is — and people are getting killed? … You continue to put people out over and over and over again on the ‘cross your fingers’ plan,” he said.

“We’re just not using the law anywhere near the way we should, not anywhere as much as we should, in our opinion,” Nutting said.

“And it’s just very, very frustrating because Mr. Butterfield was an accomplished mechanic. They liked him at work when he was on his treatment plan. And so, you know, Maine is making it so hard to initiate treatment when they don’t think they need to and then we’re getting all these terrible results that are just so tragic and unnecessary.”

But standing in the way is Maine’s federally funded, nonprofit advocacy organization, Disability Rights Maine, Nutting said.

It’s true that Disability Rights publicly spoke against the 2010 bill that established the progressive treatment program, Mark Joyce, DRME’s lead counsel for mental health advocacy, said Friday.

But the bill passed and “the law is the law.”

As for why DRME advocated against it, “we oppose these type of forced community mental health treatment laws because for one thing, we know of no, like, peer review, randomized studies suggesting that a court-ordered commitment — committing individuals to an assertive community treatment or ACT team — for mental health treatment alone improves treatment outcomes,” he said.

Because the program “commits” a person to treatment from an ACT team, “it may work for a select number of people, but what we’ve seen is that when a community mental health system has in it the potential for forced treatment, it discourages people from seeking any treatment.”

Bangor resident Joe Pickering said the state has failed to accept additional resources that would expand services for Mainers with mental illness, including accepting a waiver from the U.S. Centers for Medicare & Medicaid Services that would pay for short-term residential treatment services, a so-called IMD (institution for mental disease) waiver.

He, too, pointed to Disability Rights Maine, who objected to accepting the IMD waiver.

“That is absolutely idiotic. And it’s not only idiotic, it is devastatingly disgusting and destructive to Mainers,” said Pickering, who was director of Bangor-based Community Health and Counseling Services for three decades.

Pickering’s son, Christopher, died in 2020 from an accidental fire that started in his kitchen. Pickering said his son likely fell asleep and left the stove on.

When Christopher was in his late teens to early 20s, he began showing signs of schizophrenia, a serious and lifelong brain disorder that can impair a person’s perception of reality. The disease can cause chronic episodes of psychosis, including hallucinations and delusions.

Pickering said that while Christopher’s death was not directly related to his schizophrenia or the IMD waiver, “he was clearly declining. No question about that,” he said.

The IMD waiver would go against the 1990 settlement agreement in a class action lawsuit brought against the state on behalf of residents of the now-defunct Augusta Mental Health Institute, Joyce said.

In a 2019 letter to the Department of Health and Human Services, Joyce wrote that “the Department’s waiver application is built on an unfounded premise that there is a need for more beds in institutional settings.”

This is a “faulty logic,” that could increase “unnecessary institutionalization” rather than increasing access to community mental health services.

“This is the frustrating part … everybody’s on the same page with getting people services. (This) issue with the PTP and these things, yes, we disagree with their effectiveness but they’re the law,” Joyce said.

“The law allows for all this involuntary treatment but you’re not going to be able to keep somebody in the hospital forever. You’re going to have to figure out a way (to) discharge them with the right services,” Joyce said. “And so that’s where I think it breaks down. It’s like, what kind of services are available?”

Pickering, Nutting and others, like Jeanne Gore of the Maine-based National Shattering Silence Coalition, did say they do not want more people with mental illness to be involuntary hospitalized. But they do want to see a “comprehensive array” of community-based services that they said Maine is lacking.

Provencher, Butterfield’s ex-girlfriend, said the lack of community supports contributed to Butterfield’s decline.

“What was he expected to do when he got out? Was a man in this psychotic state expected to find resources out there to help him with something he believed he didn’t need help with?” she said.

“So what does it take? It has taken a man, who was a loving family man, brutally killing his brother. He took him in from homelessness to help him because he loved him. And is it enough yet? Does he finally get allowed his right to treatment or does he get thrown in prison prosecuted and punished for others’ negligence?”

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