Brandon Klym started using marijuana as a teenager when several people close to him died within a short period of time and he struggled to process the emotions.

Soon he was hanging out with friends who introduced him to other drugs and alcohol, starting a cycle of addiction, rehabilitation and relapse. He remembers being taken to a hospital and being too frightened to accept help.

“Even though I was having these negative thoughts and negative emotions, I said what I needed to say to be able to leave,” Klym said.

Klym would later get the help he needed and he now uses his experiences to help others at Spurwink’s Cumberland County Crisis Receiving Center, also known as the Living Room. The first-of-its-kind center provides a 24-hour alternative to the emergency room or jail for people who are going through a mental health crisis.

The state is looking to replicate the center in other communities after the mass shooting in Lewiston in October highlighted the need for more access to mental health care. Gov. Janet Mills unveiled legislation Wednesday that includes opening a new center in Lewiston as a step toward a statewide network based on the Portland model.

“We know these centers work,” Mills said during her State of the State address last month.

A HUMAN RESPONSE 

The Portland center opened in 2022 as a partnership between the Maine Department of Health and Human Services and Spurwink, a nonprofit providing mental and behavioral health services.

Two years later, it has logged over 8,400 visits – including from people who have visited more than once – and over the last year has averaged 172 unique visitors per month.

It’s set up like an actual living room, with a cluster of couches at the center surrounded by smaller rooms where guests can have private meetings or get some rest. There are snacks and other things designed to make people feel at home, as well as shelves with spare clothes that anyone who comes in might need. There’s a daily coffee hour at 4 p.m.

The center is open to walk-in guests 24 hours a day, seven days a week and is staffed by a team that includes a nurse practitioner, clinician, nurse, crisis service providers that are similar to case managers and peer-support specialists like Klym.

“Somebody says, ‘Hello,’ and you walk in,” said Ben Strick, vice president of adult behavioral health for Spurwink. “I think that’s key. It’s not a, ‘Why are you here? Let’s sit down and do all the checklists.’ (Our response) really depends on the individual.”

Strick said people come to the center for a variety of needs. They could be older people who are feeling lonely, a person experiencing a psychotic episode or a person who is newly homeless and doesn’t know what to do. Some may have been recently discharged from protective custody at a hospital.

“It’s very broad,” he said.

It’s the kind of resource that could have helped Klym when he was going through his own crisis, and a place where he now provides help to others as a peer-support specialist.

Klym is one of the people to greet and talk with visitors, many of whom are dealing with suicidal thoughts. He strives to offer an empathetic, human response.

“We bring comfort and let people know, ‘Hey, the thing you’re going through, I’ve been through something similar,’ ” he said.

Visitors are offered one of the private rooms, or they can stay in the public area if that feels more comfortable.

“There’s really a menu of providers you could choose to work with based on your needs,” Strick said. “A typical crisis assessment is done by one of the crisis service providers, but there are some people who only want to talk with a peer, and that’s OK, too. You don’t have to have a crisis assessment. … It’s very tailored to the individual. There’s no set way to do it. That’s the benefit of this model.”

Some people visit the center, talk with a peer, have a cup of coffee and go home. Others are connected with the nurse practitioner to get medication. If a person is experiencing a physical problem, the staff will refer them to a clinic or bring them to the hospital.

Most people who visit the center come back for five or fewer visits. About 33% only visit once.

“I thought we would have people who are stuck forever, but instead what we’ve seen is that when you know you can come back, you don’t have to stay,” Strick said. “You have people who will come in and rather than going to a higher level of care, they say, ‘I know I can come back, so I’m going to go home,’ and then you find they’re perfectly OK overnight at home.”

A smaller portion – about 13% – need higher levels of care and a lot of follow-up and the center will work with them to connect them to other supports and services.

The center does a very small amount of private insurance billing and will help people sign up for MaineCare or another insurance if they don’t have it, but it also uses state funding to cover costs that insurance doesn’t or to cover costs for people who are uninsured.

“Nobody gets a bill,” Strick said. “That’s really one of the highlights here in terms of what the state is doing. You shouldn’t come in and be in crisis and think, ‘I can’t afford it.’ ”

Bridgit Sliwak, behavioral health unit coordinator for the Portland Police Department and a licensed clinical social worker, said her unit at the police department frequently relies on the Living Room as a resource for people with mental health needs.

Without it, police would spend more time responding to the same person multiple times per day or per week, or they might have to bring them to the hospital when it’s not really necessary.

“I think having that face time with someone in a professional capacity in a place where (you’re saying), ‘Hey, I’m here to get help,’ it can really assist a person in feeling like they’re taking the proper steps,” Sliwak said.

GROWING THE MODEL

The Living Room has a $3 million budget, about $2 million of which comes from state and federal funding and the remainder of which comes primarily from MaineCare billing.

The state is already expanding the service and is in the process of creating a specialized crisis receiving center in Kennebec County that will focus on substance use disorder and be paired with a 10-bed medically supervised withdrawal program. The state is looking for a partner to help run the program and is expecting to close a request for proposals within the next few weeks.

The Lewiston center Mills wants to create would be the third and would look more similar to what’s in Portland with a broader focus.

“We certainly know as a result of the tragic shooting that there are going to be ongoing needs related to the trauma that community experienced,” said Sarah Squirrell, director of DHHS’ Office of Behavioral Health. “The victims and the broader community, we want them to have that same access to care.”

After that, the state is hoping to scale up the model in locations around Maine. Squirrell noted that the centers could look slightly different based on the needs of the community.

“In a more rural area, you might have to think about transportation needs,” she said. “How do you triage to support those? And different communities have unique needs based on trends related to opioid use, other substance use, prevalence of mental health challenges.”

While some aspects of the legislation Mills unveiled are expected to face partisan debates, the expansion of crisis receiving centers appears more likely to garner bipartisan support.

“Republicans have been pushing for addressing mental health and getting beds and funding for that,” said House Minority Leader Billy Bob Faulkingham, R-Winter Harbor. “I’m glad to see that in (the governor’s budget proposal). It’s something we support in concept, so we look forward to working with the governor on that issue.”

Senate Minority Leader Trey Stewart, R-Presque Isle, said Senate Republicans agree with the need for more mental health services, though there are some concerns about whether crisis receiving centers would work everywhere, especially in rural areas.

“We have to be careful not to throw money at a problem with a solution that really isn’t one or won’t work,” Stewart said in a statement. “We have to do it smartly and where it will have the greatest impact.”

If funding for the Lewiston center is approved by the Legislature, DHHS said it would start the process to find a partner entity to establish the center and would look to set it up within nine to 12 months.

“The crisis center really has the ability to take the pressure off of the hospitals, as well as give an individual access to the resources they need immediately,” Klym said. “I really think there’s nothing like it, and I hope there’s a way to be able to get one of these crisis centers in every city in the state.”

HOW TO GET HELP

If your life or someone else’s life is in immediate danger, dial 911.

Maine Crisis Hotline: 1 (888) 568-1112

For any other support or referrals, call the NAMI Maine Help Line at 800-464-5767 or email helpline@namimaine.org.

Other Maine resources and referrals are available by calling 211.

National resources are also available, by calling or texting 988 or chatting online at 988lifeline.org.

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