Recent investigative reports about Riverview Psychiatric Recovery Center note that staffing shortages and other problems are widespread in the Augusta facility. Rather than focus on these fundamental challenges, Gov. Paul LePage’s administration’s solutions have involved moving one group of patients to new facilities — mostly affiliated with prisons — to alleviate pressures at Riverview.
A plan announced Monday by LePage and the Department of Health and Human Services seeks a law change to put forensic patients, temporarily, in the Maine State Prison in Warren. Lawmakers rejected a similar law change in 2013. In fact, the final bill had language prohibiting the transfer of such patients to correctional facilities.
An important, fundamental fact gets lost in this debate. People held in the forensic unit at Riverview have been through the court system. Judges have found them either not competent to stand trial or not criminally responsible for the crimes they were charged with, and they have sentenced them to Riverview. There, they remain under the custody of the Department of Health and Human Services. Holding them in a prison would violate the judges’ orders.
“This is the most blatant criminalization of mental illness,” said Jenna Mehnert, executive director of NAMI Maine.
In a press release announcing the latest state prison plan, DHHS Commissioner Mary Mayhew repeatedly refers to “violent forensic patients” and the need to put them in facilities better able to manage them. These statements completely dehumanize this small but diverse group of patients. Certainly, some forensic patients are violent, but many are not — just as some patients in the general population at Riverview are violent and some are not. For both groups, the focus should be on treatment and recovery, not isolation and control.
There are people with mental illness in prisons and jails, but they, despite their illnesses, have been found guilty of crimes and sentenced to jail time. The lines between these two populations should not be blurred.
Yet, they continue to be.
Before Monday’s announcement, LePage talked of moving forensic patients to the Windham Correctional Center, although the governor and his administration have offered few details about this proposal. In late January, he said the Department of Corrections should delay its plans for a $173 million renovation of the Windham center. During a Jan. 21 radio call-in program on the Maine Public Broadcasting Network, LePage said he would soon have a plan that included moving forensic patients to the medium-security prison. When members of the Legislature’s Government Oversight Committee sought more details the next day during a meeting on Riverview, Mayhew simply said that any proposal would go before lawmakers.
In addition, Sen. Stan Gerzofsky, D-Brunswick, through LD 440, proposes that forensic patients and people charged with crimes who are awaiting competency hearings be held in new mental health units at either the Cumberland County or Somerset County jails.
Would such facilities be under the purview of the Department of Corrections, DHHS or both? Daniel Wathen, the former Maine supreme court chief justice charged with overseeing Riverview as part of a consent decree, has made it clear that a hospital-level of care is required to properly treat and house forensic patients. The Department of Corrections, which houses dozens of people with mental illness, has a different set of standards.
Lawmakers must keep pushing for more details on these plans, but they can’t let that focus divert attention away from making changes at Riverview. Every week staffing shortages aren’t fixed, patients continue to receive inferior treatment.
Wathen has documented serious staffing problems, which affect forensic patients and the general population at the Augusta facility. Riverview is so understaffed that employees, including those who work directly with patients, work mandated overtime. This contributes to stress among staff members, diminishes patient care and puts both patients and staff at risk, Wathen said.
DHHS needs to hire and train additional staff as soon as possible to alleviate the problems at Riverview that caused the federal Centers for Medicaid and Medicare Services to pull the facility’s certification in 2013.
Renovating an existing facility or building a new one will take months. Staffing levels at Riverview need the attention of DHHS and lawmakers now.