Superior Court Justice Ann Murray oversees Penobscot County's new mental health docket, which brings together lawyers, case managers, mental health care providers and others to figure out how to connect criminal defendants with the mental health treatment they need more quickly. Credit: Natalie Williams / BDN

An Old Town man whose religious delusions led to a nearly 20-hour standoff with police in June is finally out of jail. He’s instead at a psychiatric hospital where he’s receiving treatment and will be evaluated to determine if he’s competent to stand trial.

Thadius Wind’s spot at Riverview Psychiatric Center in Augusta is thanks to a new court program in Penobscot County that’s bringing together lawyers, case managers, mental health care providers, a judge and others to figure out how to connect criminal defendants with the mental health treatment they need more quickly.

The county’s Mental Health Docket is the fourth such program in Maine that aims to identify community resources that allow defendants with mental health problems to receive treatment rather than punishment through the criminal justice system. The others are in Kennebec, Cumberland and York counties.

The new program comes as Penobscot County struggles with chronic overcrowding at its Bangor jail, with many beds occupied by inmates in need of mental health treatment. Convening a group of people focused on criminal defendants’ mental health needs has been helpful, according to defense lawyers and others who have been involved so far. But it will remain difficult to connect defendants in need of intensive treatment with services as long as a statewide shortage of inpatient mental health treatment beds creates a bottleneck in the system.

The key to the mental health docket comes down to scheduling, so all the people aware of the potential services available to defendants come together at the same time, said Superior Court Justice Michaela Murphy, who shepherds the Kennebec County program.

“It really just came down to scheduling, and setting up conferences on these cases where all the people who knew about local resources could figure out a way to get them treatment quickly,” she said.

Having that group together at one time has helped get clients who need treatment connected to services more quickly, said Bangor defense lawyer Caitlyn Smith, who is part of the Penobscot County group.

“Before this, communication about services was in a string of email chains,” she said. “This allows us all to meet at a specific time where we can all be on the same page.”

The group talks about each defendant’s needs, the resources needed to address them and how long it could take to connect defendants with the needed services, Murphy said.

Penobscot County’s mental health docket began in June under the guidance of Superior Court Justice Ann Murray. It has been most successful at getting non-violent defendants out of jail and receiving community-based services. Many agree to undergo treatment.

But finding inpatient treatment beds for violent offenders who resist or refuse treatment, or for those like Wind who have intensive mental health needs, remains difficult because of the statewide shortage of available beds.

Wind’s ordeal since his June 14 arrest shows how long it can take to find a psychiatric hospital bed.

While at the Penobscot County Jail following that arrest,  a fellow inmate attacked him, and he needed emergency surgery. He was released on $1,000 unsecured bail on June 25, in part because he required a feeding tube that jail administrators felt would be difficult to manage.

Wind was arrested again July 15, after his girlfriend told Maine State Police that Wind had a .22-caliber handgun in his “apocalypse go-bag,” a violation of his conditions of release. He was found not competent to stand trial on Sept. 1 and was moved to Riverview Psychiatric Center in Augusta on Oct. 25.

A COVID-19 outbreak at the Penobscot County Jail delayed his transfer there.

Many of the defendants on the mental health docket list need treatment for both mental health and medical problems, according to Penobscot County District Attorney Marianne Lynch. Others have developmental disabilities and traumatic brain injuries.

Some have a biologically based mental illness such as schizophrenia or bipolar disorder along with personality disorders, Murphy said.

“Most have stopped taking medication or stopped getting treatment services for any number of reasons,” she said. “Some just have no place to live.”

Defense attorneys and prosecutors can request treatment for those with suspected mental illness, and a judge may order that defendants be examined by a psychiatrist or psychologist to determine if they can assist in their own defense.

While the law includes deadlines for those examinations, it also allows for extensions that delay treatment.

Judges can order treatment to restore defendants to competency so they can stand trial, which can happen at either of the state’s two psychiatric hospitals — Riverview and Dorothea Dix in Bangor — or at the 32-bed Intensive Mental Health Unit at the Maine State Prison in Warren.

Defendants who are found not guilty by reason of insanity are committed to the state Department of Health and Human Services’ custody until they are well enough to live in the community — if that ever happens.

Since 2019, the wait time for the initial psychiatric examination has dropped slightly, to 18 days this year from 19 two years ago, according to DHHS. But the wait for treatment has lengthened due to the pandemic and county jail outbreaks.

In 2019, 74 people were ordered to undergo treatment and encountered a wait time of about two weeks. During the first three quarters of this year, the wait time for admission ballooned to 36 days. Wind waited about 55 days.

“It is not unheard of for people with very minor charges, but very major mental illnesses, to be incarcerated longer than people who do not suffer from these illnesses who are charged with the same offense,” Murphy said. “If they remain in jail waiting to have hearings on whether or not they should be in the criminal system at all — that is not equal protection.”

There’s some reason to be optimistic that Maine’s bottleneck could start to ease, Murphy said.

Nov. 1 marked the opening of a new Augusta facility with 8 beds for people who can be restored to competency without hospitalization and 10 beds for people who have been found not criminally responsible and may need extra supervision, but don’t need a psychiatric hospital level of care.

“If we can relieve pressure on the hospital and still provide good care to these folks, that will help the whole system,” Murphy said.

The program in the former apartment building on Stone Street will cost about $1.3 million a year, according to DHHS, with much of the annual operating cost reimbursed through MaineCare, the state’s Medicaid program.

The goal of treatment and support services is to keep defendants involved in the criminal justice system from coming back. But that is not always possible, especially when people who do well on medication stop taking it.

“I’ve had a client who cycles through the system because he goes off his meds,” Ellsworth defense lawyer Jeffrey Toothaker said. “I’ve had him at least four times. These are the people who really challenge the system.”