It is unconscionable that major problems persist at the Riverview Psychiatric Center in Augusta decades after a consent decree was put in place to ensure patient safety and treatment. However, efforts by Democrats to use the problems to score political points are an insult to Riverview patients and their families as well as the facility’s staff.
And, while it may be helpful that yet another review has been launched, this time by the Office of Program Evaluation and Government Accountability, Riverview needs a new direction, not another cataloging of its shortcomings.
Riverview lost its certification from the federal Centers for Medicaid and Medicare Services in September 2013. The decertification was due to a range of issues, the most serious of which involved the use of tasers and restraints on patients. Riverview houses both civilian patients and those referred for treatment by the Department of Corrections and judicial system, many of whom were involved in violent crimes but found not responsible because of mental illness. It is this mix that remains problematic, advocates say.
The decertification could eliminate $20 million in annual federal funding if legal challenges by the state are unsuccessful.
The Department of Health and Human Services announced Thursday that Riverview continues to be accredited by the Joint Commission, a non-profit group. This accreditation, which the Augusta hospital has had since 1958 — despite problems so bad that it was put under a consent decree in 1990 — is not a stand-in for federal certification.
Further, CMS standards are a minimum. “This is the floor under which no one’s services should drop,” Jenna Mehnert, executive director of the National Alliance on Mental Illness-Maine, said in August. “The challenge around Riverview is that these are basic standards. They’re not aspirational standards. … It’s scary to think that one of the state’s biggest mental hospitals can’t meet them.”
In addition to a series of surprise audits by CMS, entities investigating problems at the hospital include the Department of Health and Human Services, which oversees it, the Maine attorney general’s office, and former Maine Supreme Court Chief Justice Daniel Wathen, who is responsible for overseeing the AMHI Consent Decree. Wathen has said he will do his next review in October.
A 1990 agreement, the AMHI consent decree settled a class-action lawsuit by patients at the Augusta Mental Health Institute after several deaths at the state-run facility. The decree called for improving services and reducing the number of patients at the state’s two mental health hospitals (the other being the Bangor Mental Health Institute, which has been dramatically downsized) while continuing to shift more patient care to community settings.
An immediate and continuing problem is that there are not sufficient services outside psychiatric center walls to treat those in need of mental health treatment in their communities. The state has slowly worked with community and private hospitals and mental health care providers to ensure counseling, housing and crisis services are available throughout the state.
“I have a hard time pointing fingers at any one person or political party when you look at the history of this institution,” Mehnert said last week, after Democrats held a press conference to blast the LePage administration’s handling of 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,” she added.
Mehnert suggested creation of a smaller psychiatric hospital specially designed for patients with behavioral problems and a much more robust mental health care system designed to treat illnesses when first diagnosed.
Changes like this could put the state back on track to meet its legal and moral obligations to a group that deserves much more than treatment as a political football.