No measures should be off limits when it comes to the restoration and repair of Maine’s failing mental health services – and that includes creative legislative proposals like the one sponsored by state Sen. Russell Black.
In response to the crisis of young patients languishing in hospital rooms and emergency rooms ill-equipped to care for them, Black’s proposal would require the Department of Health and Human Services to establish “secure children’s psychiatric residential treatment facility services” for patients with behavioral health and intellectual and developmental disabilities.
No such facility exists in Maine, putting our young people with severe mental illness or developmental disabilities at a very grave disadvantage.
The damage caused by this oversight is hard to quantify, exactly, but easy to follow; it works against the young people in question; it prevents hospitals from being able to get on with their day-to-day responsibilities; it works against any Mainer in need of a bed or a medical professional, and it puts additional strain on a system already under immense strain.
We applaud the spirit of the Black proposal, born out of deep frustration and dissatisfaction with the harmful limbo to which vulnerable young Mainers are being resigned.
Maine’s Office of Child and Family Services has opposed the bill on the basis that it’s already in the process of introducing psychiatric residential treatment facilities and improving MaineCare reimbursement rates for providers, which is expected to support the expansion of services.
Testifying in support of the bill this week, a mother from Turner noted that her 16-year-old daughter, who struggles with mental health difficulties and behavioral issues, experienced the greatest amount of “success” during a 10-month placement at a program in Florida, 1,800 miles from home. Upon returning to Maine, no such option was available. Almost 70 young Mainers are currently being sent out of state for treatment.
This is just one story illustrative of a harsh reality that militates against parent involvement, makes transitions far more costly and challenging and leads to a stop-start pattern of treatment for young Mainers who need consistency – if they can access treatment in the first place.
Other supporters of the bill this week pointed out that, absent a dedicated facility, the state’s only youth prison has become a destination “of last resort.”
To say that Long Creek Youth Development Center is not fit for the task would be a dramatic understatement. Bear in mind the prison’s history of chronic understaffing, staff misunderstanding of disciplinary policies and mental health services deficient even for routine needs – and recall that this is, at the end of the day, a prison; no amount of wishful thinking can change its mandate or its basic resourcing. Sending patients here is a catastrophic outcome for all involved.
Testifying in support of the proposal, Malory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, nonetheless expressed concern that the focus of the Black bill could deprioritize Maine’s home and community providers and services, a vital and beneficial tier of care for young people that is also in desperate need of investment. The improvement of reimbursement rates for behavioral health services is expected to be a help in this regard.
Concluding her testimony, Shaughnessy asked the committee to give serious consideration to all reform efforts, to take them together, rather than pursuing either-or decision-making when it comes to behavioral health care. In light of the acute need and the destructive lack of capacity, no other approach will do.
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