When the Augusta Mental Health Institute was finally closed, 15 years ago this month, it was because the misery and horror of that crowded, neglected place finally became too much to ignore.
Following the closure of the state-run psychiatric hospital, people with severe mental illness were promised that help would follow them to their communities. The resulting system, an underfunded mishmash of services, has been an improvement, but that’s not saying much. For many Mainers struggling with mental illness, and their loved ones, the misery has been only slightly abated.
Further, it has been spread around – to jails and prisons, hospital emergency departments and wherever homeless people eke out an existence.
That’s because AMHI was closed under promises that have not been kept. And we are all worse off for it.
As detailed by Staff Writer Eric Russell on June 16, the closure came as the result of a class action lawsuit brought on behalf of about 300 AMHI patients following a series of deaths in 1988 – 10, to be exact, including five in one month during a heat wave.
Out of the lawsuit came a consent decree, which stipulated that the mentally ill should be treated in the least restrictive setting possible. It established a “court master,” former Maine Supreme Judicial Court Justice Daniel Wathen, to make sure the state was meeting the standard.
By that time, deinstitutionalization had already started (AMHI was designed to accommodate 1,270 patients; its replacement, Riverview Psychiatric Center, which opened in 2004, was built to house no more than 100), and the problems that continue to today had already begun to materialize. For example, with little support in the outside world, many of those released ended up homeless.
The general story has stayed the same since then. Without adequate treatment, housing and other services, Mainers with serious mental illness fall often into acute crisis. These crises cause them agony, and push them toward the most expensive health care interventions, or into the criminal justice system, which is not equipped to deal with such health issues.
As the Press Herald reports, public health spending on the problem in Maine has never been sufficient, and it even fell in recent years, as the population needing help grew.
Those who say we cannot afford the suite of community-based services necessary to help Maine’s mentally ill, and who are unmoved by the suffering of thousands of fellow residents, must recognize that we are already spending the money – just in the worst way possible.
Instead of funding community-level services, we are paying the costs of untreated mental illness. We pay through the crowded court system and incarceration, through millions of dollars of charity care, and through lost wages and human potential.
The Legislature last session passed a bill that calls for a review of the state’s mental health system and the formulation of a reform plan by December.
In a statement to the Press Herald, Health and Human Services Commissioner Jeanne Lambrew said the state needs to work on offering more preventative services, and more services in our communities.
She’s absolutely right. But it’s also the same thing officials have been saying since AMHI was closed.
It’s time to finally act on those words. Fifteen years ago, Maine made a promise. It’s time to live up to it.
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