I am writing to state the position of the Bangor Area Homeless Shelter concerning the fate of the Dorothea Dix Psychiatric Center and the possibility of it being closed.
In the course of providing shelter to an average of more than 700 individuals per year since 1996, I have witnessed many people living lives of crisis due to the consequences of untreated mental illness. The most ill of these, the people suffering the most, have been those with a virulent form of mental illness.
We try to go slowly with folks like these, accepting certain behaviors and giving them room in terms of some of our rules, hoping that they will gradually experience enough trust in the shelter for staff to be able to work with them and any insight they may have in an effort to get them to an evaluation and real treatment.
A significant percentage will privately decide to move on before things can progress to that point. Many lack enough insight to accept treatment. With a meaningful minority we actually experience success, but the only setting in which that truly occurs is Dorothea Dix.
I believe we need to keep services available in this geographic region to serve the poorest and sickest among us. I believe that the patients have the right to receive professional help, and I believe their families have rights including reasonable opportunity to support and be involved in the care of the family member who is receiving treatment.
At the present time the only other facility in Maine that may be described as comparable to Dorothea Dix is in Augusta, but that hospital (Riverview) lacks adequate capacity to meet existing need. And while the hospital in Bangor is a long car ride for many who live in Northern Maine, forcing families to drive to Augusta in order to see a loved one or attend a meeting with their caregiver would not be a defensible action for the state to take.
In addition to not meeting a moral obligation, a lack of access to enough capacity to treat these sick people will result in negative and costly consequences. People who are living in fear and experiencing psychoses and delusions may create situations in which police are called
to respond. Stays in police departments and jails, and appearances in front of the court come with substantial costs, as do lengthy stays in hospital emergency rooms.
These chains of events also take resources away from providers’ normal roles and mission and delay care for other citizens. Homeless shelters, neither designed nor funded to be mental health clinics or mental health group residences, nevertheless would see increased demand for their services. This in turn would result in requests made by people like me for more support from the private sector.
Communities, especially those of a regional service center nature, need a health care system that can deliver the continuum of care needed by the community. Dorothea Dix represents a niche in the system, a small but critical component. The patients and their families need its continued operation, but so do providers in other health care facilities, those working in local law enforcement and the judicial system, our local economy and, ultimately, all of us who live and work in this region.
Dennis R. Marble is executive director of the Bangor Area Homeless Shelter.
I understand the value that Dorothea Dix provides, I’m just not convinced that those services need to be directly delivered by the State, in out dated and inefficient facilities. This is something that could be done more cost effectively by a non-profit.
Dorothea Dix is a non profit. It is run by the state. Do you know of any non profit organzations that are available to fill the void if Dix is closed down? One that can fund the building of a new modern facility? One that has staff who are familiar to the psychiatric patients that have to use Dix?
Yeah, I’m sure there are some for-profit companies that would just love to come in and take over – just like the ones that run prisons that states are turning to. Which would be a horrible, horrible mistake. No privately run DDPC!
People are freer in a homeless shelter than a mental hospital. Things people take for granted are not accessible in a mental hospital who would want to stay, or go to a mental hospital under those circumstances? Is there a more humane way to help people?
Those that should and need to stay longer the hospital cannot keep. As someone once told me a mental hospital told them they were not running a hotel service for their relative. They thought the relative needed to be in the hospital because they considered them someone to be a harm to themselves or others.
Also, psychosis or delusional could be a relative term. The idea is that one loses a sense of reality, but what is reality? Someone I once new considered reality to be relative based on one’s perspective. Those who are different are not necessarily psychotic or delusional.
Other mental isssues can be at hand that are not considered illnesses because they do not have to do with chemicals in the brain, but rather have to do with the structure of the brain. People were not tested for things 20-30 years ago like people are tested for now.
Dorothea Dix does serve a nitch for severly ill individuals in the greater Bangor area. Many of those who end up there are dealing with very complicated mental illnesses. While a private hospital can provide services, they ARE inadequate for those whith severe, chronic mental illness. Local private hospitals are focused on short term stays and stabilization, at which time the patient is shuffled to other services. There is a need for Dorothea Dix, for some of our sickest community members. If you could be there as an inpatient, experience a hospitalization, many of you would see the trully heartbreaking illness in our community. From the outside, Dorothea Dix is a money pit, but from the inside, the hospitals saves lives and provides safety and help to our friends, family members, and some very sick, very alone members of our community.