Lawmakers grappled Tuesday with how to solve an acute problem at Maine’s hospitals – young psychiatric patients who are ready to be discharged but have nowhere to go because of the state’s lack of mental health services capacity.

State Sen. Russell Black, R-Wilton, is sponsoring a bill that would require the Maine Department of Health and Human Services to open “secure children’s psychiatric residential treatment facility services” for patients with behavioral health and intellectual and developmental disabilities.

“My local hospital is overwhelmed with children in crisis,” Black said during a public hearing Tuesday, referring to Franklin Memorial Hospital.

He said he heard of one mental health patient who was “living in the hospital for months, in a small, windowless room.” Black said staff have been assaulted by patients, and frustrated patients have caused property damage.

These pediatric patients can’t be discharged to their families’ homes because they are a danger to themselves or others, and many community residential programs won’t accept them if the facilities are not secure enough to handle a potentially dangerous patient.

Many community residential treatment programs also are struggling with workforce shortages. Sixty-eight children are currently being sent out of state for treatment because there is not enough capacity in Maine.


While there is no statewide estimate for how many pediatric patients are stuck in hospital rooms in Maine, officials with the two largest hospital systems, MaineHealth and Northern Light Health, testified Tuesday that it is a significant problem. MaineHealth is the parent of Maine Medical Center in Portland and Northern Light Health operates Eastern Maine Medical Center in Bangor, and both systems operate hospitals throughout the state.

Dr. Robyn Ostrander, a MaineHealth psychiatrist, testified that the lack of services is harming children.

“Emergency rooms are not treatment facilities for youth,” Ostrander said. “They are loud environments which separate kids from their families, needed treatment, and their education, and they provide a minimum of medical care.”

According to state statistics, 861 pediatric patients spent time in a hospital emergency department in 2022. How many of those patients stayed much longer than necessary is unknown.

Ostrander said some pediatric patients also stay in psychiatric hospitals much longer than needed because of a lack of secure residential treatment capacity.

“For every child or teen languishing in a bed in our psychiatric hospitals for months to over a year, dozens of acutely ill children in Maine emergency rooms are unable to access the short-term inpatient care they need,” Ostrander said. “Some would benefit from a brief psychiatric hospitalization, for example, after a suicide attempt. Now their parents must choose for their child an extended wait in an emergency room, or going home with a treatment plan piecemealed together with community programs and waitlists.”


Lisa Harvey-McPherson, vice president of government relations for Northern Light Health, said hospital staff have had to watch children “deteriorate mentally and physically” while staying in hospitals longer than needed because of the lack of residential treatment.

“Some children become violent and aggressive, and we’ve had to remove sinks and toilets from some rooms for safety,” Harvey-McPherson said.

Dean Bugaj, associate director of children’s developmental and behavioral health services for Maine’s Office of Child and Family Services, testified against the bill. He said the agency is working to alleviate the problem.

Bugaj said the state has yet to increase capacity with psychiatric residential treatment facilities, but the state is working on that by improving reimbursement rates. The treatment facilities would provide higher levels of care than community group homes. The state was anticipating having 20-bed facilities for patients who temporarily need that higher level of care.

Bugaj acknowledged that no nonprofit agencies have yet opened a treatment facility because of low reimbursement rates, but Maine is going to improve those rates soon.

“We’re right in the midst of this work,” Bugaj said.

Lawmakers asked for more information on the state’s plans and the exact scope of the problem for an upcoming work session on the bill.

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