BRUNSWICK, Maine — Donna Deigan struggled more than most days to get out of bed Monday morning.
For about five years, Deigan, diagnosed with post-traumatic stress disorder, bipolar disorder and anxiety disorder, has awakened each day knowing she must get dressed, feed her cat, Angel, and be ready for when one of her direct living support workers arrived about 9 a.m.
The workers, employed until Friday by Merrymeeting Behavioral Health Associates, sometimes would remind Deigan to take the medications that help her manage her symptoms, helping her organize her life or follow the structure she relies on to prevent “spiraling” into depression or hypomania.
But Merrymeeting Behavioral Health Associates closed abruptly Friday, stripping Deigan of the consistent support upon which her stability depends.
“They’re the people who walk into your home, and they’re the first people to see if you’re doing poorly or going downhill,” Deigan said Monday. “They can help you refocus, or say, ‘Let’s get those dishes done, Donna.’ They help you take that next step so possibly you don’t need hospitalization.”
Merrymeeting Behavioral Health Associates announced last week that it would close on April 8 in part because of pending state changes to reimbursement for MaineCare recipients. The company’s 188 employees would lose their jobs and more than 400 clients who suffer from severe mental illness would lose case management, therapy and support services, they announced.
The company closed abruptly a week before expected, panicking clients, advocates and others, many of whom testified that day before a legislative committee about the proposed cuts that would reserve the services for those suffering from only schizophrenia or schizoaffective disorder.
Opponents of the cuts say the services are critical and can prevent or forestall people with mental illness from requiring more expensive urgent care such as hospitalization
Deigan is one of those vulnerable people. She learned that Merrymeeting Behavioral Health Associates closed for good on Friday after reading a newspaper.
“When I found out a week ago they were closing, the very first thought I had was, I want to go in my room, close the doors, take some meds and just die,” Deigan said Monday. “Fortunately I’m at a place where the other part of me says, ‘No Donna, that’s not a good idea,’ but when my symptoms are really at the forefront, it’s very hard for me to fight off those feelings — feelings of wanting to hurt yourself, wanting to cut yourself, wanting to isolate yourself from the world and feelings that this is just hopeless.”
Deigan, who receives Social Security Disability Insurance, has tried without success to work in the past. Still, she said she worries about other clients who may suffer even more than she does.
“I know there are people [for whom] it’s hard to get up every day, to take a shower — people who literally need these services just to live through their day,” she said.
“It’s been extremely difficult to handle,” said Sen. Catherine Breen, a Falmouth Democrat whose 21-year-old daughter suffers from schizophrenia and received services through Merrymeeting Behavioral Health Associates. “We’re doing our best to keep her healthy.”
“I certainly didn’t expect them to close on a Friday,” Breen said. “I got a call at like 4:30 Friday afternoon from an employee who used to do the schedule for the week for the shift people.”
Filling the void
Late last week, several Merrymeeting Behavioral Health Associates clients or their families were summoned to the company’s Pleasant Street headquarters to sign confidentiality waivers that would allow Merrymeeting Behavioral Health Associates to share their records with SequelCare of Maine, a for-profit company that provides behavioral health services as well as home- and community-based treatment, community support services, outpatient mental health, community integration services and daily living support.
Breen said Monday that she and her husband signed forms to allow Merrymeeting Behavioral Health Associates to share their daughter’s records with SequelCare, which has offices in Yarmouth, Belfast and Brewer. She said the provider was presented to them as an option for services, but that no other provider was mentioned. She and her husband are working with their daughter’s case manager to research what provider would best meet her needs.
“I was told by my workers that SequelCare is taking all of [Merrymeeting Behavioral Health Associates’] employees and their clients,” Deigan said. “The employees were to fill out applications and probably had to go through SequelCare training, so there would probably be a gap.”
Calls to SequelCare of Maine were not returned on Monday.
On March 28, the company posted on its Facebook page, inviting people who may have received a DHHS letter about losing services to join SequelCare of Maine in “a new, collaborative and integrative way of receiving case management” that includes access to “your case manager and a peer support partners to help you manage the symptoms of your mental illness on a regular basis. … The behind-the-scenes team includes a psychiatrist, a nurse, a doctor, a clinician and program managers.”
Samantha Edwards, spokeswoman for Maine DHHS, said Monday that she couldn’t speak about specific providers, but that “a number of providers” in the Brunswick area had contacted DHHS to say they could take on extra clients.
A rapid response team from DHHS met Monday with the clinical director at Merrymeeting Behavioral Health Associates to determine how best to redirect clients to new service providers after the abrupt closure on Friday. Edwards reiterated that the company “breached its contract” by failing to provide 30 days notice of closure to ensure a smooth transition for clients.
“You can’t just close your doors,” Edwards said, describing the department’s response to the Merrymeeting Behavioral Health Associates closure as “all hands on deck.” “The department is doing everything we can, since we heard about it, to try to work and make sure everyone is provided for.”
Breen said she’s concerned about those who need treatment and, unlike her daughter, don’t have “two functioning parents and a roof over [their] heads.”
“There are many, many people out there who don’t have that,” she said.
Deigan said she’s one of those people, and that without family or friends, she relies on a direct support provider and case managers to make sure she has what she needs to manage.
“They’re sometimes the only people I see in a week,” she said. “Without them, I’d start spiraling down, and if I spiral down, I’m afraid of what would happen next.”