There will be a new psychiatric facility in Bangor, but it won’t be the controversial step-down center that former Gov. Paul LePage tried to force on the state with limited oversight.
The Mills administration avoided being trapped in a plan that may not have met the state’s need for mental health services. Instead, it found a way to use the Bangor facility, which is under construction, to care for Mainers with mental health needs. The focus should be on those who come through the criminal justice system.
Under the LePage plan, attention was focused on what was called a step-down facility, a building that would house and care for patients who no longer needed the restrictive care provided at the state-run Riverview Psychiatric Center in Augusta. The center lost its federal accreditation in 2013, and moving patients to a less restrictive setting was one focal point of LePage efforts to regain the federal certification. The accreditation was restored last week, without consideration of the new Bangor facility, according to the Department of Health and Human Services.
Some of the focus on a step-down facility was misplaced, said Daniel Wathen, the retired state Supreme Court chief justice who oversees the state’s mental health services. Rather than a specific type of facility, the state simply needed more capacity to provide mental health services, he said. There is consistently a waitlist of people who need care and evaluation at Riverview.
Many of these people are awaiting evaluations to determine if they are competent to stand trial. Some have been found by a court not to be criminally responsible for their actions because of their mental health status. Because of a shortage of capacity at Riverview and the Dorothea Dix Psychiatric Center in Bangor, these people are held for weeks or even months at county jails.
Adding more capacity at the front-end of the state’s mental health facilities will help shrink these waitlists. It shouldn’t have taken more than five years of secrecy and shifting plans to alleviate this problem.
The proposed step-down facility was mired in controversy because the LePage administration refused to share many details about the plan. When the former governor learned that building a new facility in Augusta would require legislative approval, he pledged to locate it in Bangor.
Ultimately, his administration committed the state to a new 16-bed facility on the grounds of the Dorothea Dix Psychiatric Center. The building is slated to be completed in May.
Under the LePage administration’s plans, the facility was to be run by a private contractor. And, earlier this month, it was revealed that the LePage administration had committed the state to an $11.3 million, 30-year lease of the building. The lease agreement also specifically bars the state from terminating the lease so it can open a similar facility elsewhere, such as in Augusta.
Then, on Wednesday, Gov. Janet Mills announced that her administration would use the Bangor facility but have changed the plans for how it will be used. The building is now planned to house 20 patients, with a focus on accommodating those who are currently being held in jails. The facility will be state run.
This sends the concept of a new step-down facility back to the drawing board, where it can get the level of scrutiny it long needed.
“We are going to take a comprehensive look at the range of care that is needed in the communities and residential settings to see if there is an additional need,” Jeanne Lambrew, commissioner of the Department of Health and Human Services, said at a Wednesday press conference.
Rep. Drew Gattine, who has tried for years to bring more transparency to the LePage-era project, has introduced a bill to build a step-down facility in Augusta. The Westbrook Democrat’s bill would require that the facility is state run, and that decisions about its management be governed by rules set by an advisory committee that includes representatives of patients and their interests.
Although it may be too prescriptive, Gattine’s bill is a good starting point for long overdue discussion about the need for a step-down facility.
In the meantime, the Mills administration’s plans for the Bangor facility will strengthen the state’s mental health system while also helping the state’s overburdened county jails.