AUGUSTA, Maine — Democrats intensified their efforts to make conditions at Maine’s state psychiatric hospital in Augusta — which have been the subject of legal and regulatory scrutiny for decades — a campaign issue with a news conference outside Gov. Paul LePage’s office Thursday.

LePage ignored the event. Other Republicans brushed it off as a crass attempt to gain political points at the expense of Maine’s most mentally ill residents, and an advocate for people with mental illness said it’s unfair to blame one party or administration for problems that have lingered for decades.

The governor’s opponents argued that LePage is ultimately responsible for everything that happens in the executive branch and should have to publicly defend his record to voters.

LePage, who raised the possibility earlier this week that he will boycott a series of gubernatorial debates scheduled for October and who has been unwilling to appear in forums alongside Democratic gubernatorial nominee Mike Michaud, could conceivably make it to Election Day without having to personally face criticism and questions from his opponents.

In a prepared statement Wednesday, Michaud also lambasted LePage for refusing to hold DHHS accountable and “or to even answer questions about the crisis.”

With LePage’s rock-solid base of support — which has been unswayed by years of withering criticism from Democrats and their allies — and a history of fiery conflicts with Democratic legislative leaders, the Republican governor seems to see little value in facing off against his opponents. But Democrats and other critics of LePage continue to clamor for that chance.

Maine Democratic Party Chairman Ben Grant said during Thursday’s news conference that the governor needs to end a pattern of distancing himself from scandals that have rocked the Department of Health of Human Services.

Grant ticked off a list of DHHS woes that Democrats have been talking about for months: a growing whistleblower lawsuit and document-shredding scandal within the Center for Disease Control, a failed attempt to privatize a Medicaid-funded transportation system, the commissioning of a $925,000 Medicaid study contract by the Alexander Group that ended up being canceled after portions of the study were found to be plagiarized, and mismanagement at the state-run Riverview Psychiatric Center that last year led to a federal decertification that could result in the loss of $20 million in annual funding.

With the exception of the Alexander Group contract, which LePage voided after months of criticism, the governor has consistently distanced himself from the other issues by letting DHHS Commissioner Mary Mayhew and her surrogates respond to the media and legislative committees. Democrats argue that as governor, LePage should take greater public responsibility for the problems at DHHS.

Those criticisms also aim to undercut the image LePage has cultivated as a savvy manager.

LePage did not respond directly Thursday to the Democrats’ criticisms, but Riverview Superintendent Jay Harper said critics are focusing too much on last year’s decertification and not enough on steps taken since then to correct problems — including the ouster of the former superintendent and his own appointment as her replacement.

“Not only are they ignoring the many changes that have been made in personnel and policy … but they are causing undue duress for the patients and family members of those who are receiving care at Riverview Psychiatric Center,” said Harper in a written statement distributed by DHHS. “The new leadership team has addressed safety and patient right issues and much progress has been made to create a safer environment that respects patient rights.”

Many of the improvements cited by Harper — such as the removal of Department of Corrections officers from the hospital and the addition of other staff — result from actions accomplished jointly by the Legislature, which funnelled $1 million in additional funding to Riverview in a supplemental budget bill earlier this year. LePage vetoed that budget, but legislators overrode the veto.

In a prepared statement, LePage campaign spokesman Alex Willette called the criticism “disgusting” and accused Democrats of being “focused on scoring political points.”

The governor and legislators also bear equal responsibility for a bill proposed by LePage and passed by the Legislature during a special session in August 2013 that was supposed to solve many of the problems the federal Centers for Medicare and Medicaid Services identified at Riverview. Most centered on the treatment of a small number of patients with severe behavioral disorders. The bill, which passed with near unanimous support but didn’t head off the CMS decertification, created a $3 million funding stream for the creation of a high-security mental health ward at Maine State Prison.

Despite recent events and the controversy at Riverview, caring for the state’s sickest and most violent psychiatric patients is a challenge that goes back decades and includes a class-action lawsuit that resulted in the 1990 AMHI Consent Decree, a document meant to guarantee proper mental health care in Maine and which led to Riverview’s creation.

“I have a hard time pointing fingers at any one person or political party when you look at the history of this institution,” said Jenna Mehnert, executive director of the National Alliance on Mental Illness-Maine, who said she believes Harper and Mayhew are committed to correcting Riverview’s problems. “This is a really big challenge, and it’s been a historical challenge over decades. … It didn’t start or stop with this administration.”

Mehnert said the real solution to the problem is the creation of a smaller psychiatric hospital specially designed for patients with behavioral problems — Riverview mixes those patients with less-violent people who need long-term care — and a much more robust mental health care system designed to treat illnesses when first diagnosed, often in the youth and teenaged years.

Sen. Roger Katz, R-Augusta, the city’s former mayor, agreed that problems at Riverview date back far before LePage took office. Katz is a member of the Government Oversight Committee, which on Wednesday unanimously authorized a limited investigation at Riverview by the Office of Program Evaluation and Government Accountability.

“The problems are institutional and cultural,” said Katz. “Trying to assign blame doesn’t help us at all in solving the problem. Republicans could easily lay out a litany of problems at Riverview and in the department that started during the Baldacci administration. … Administrators and legislators from both parties could have done a better job.”

Rep. Richard Farnsworth, D-Portland, chairman of the Legislature’s Health and Human Services Committee and one of the participants in Thursday’s news conference, agreed that the problems have been long-term, which he said is all the more reason that LePage should be held accountable.

“When a new administration comes in and they have identified a problem area, then you develop a strategy to deal with it,” said Farnsworth. “That is not what has happened under this administration.”

Christopher Cousins

Christopher Cousins has worked as a journalist in Maine for more than 15 years and covered state government for numerous media organizations before joining the Bangor Daily News in 2009.