Capitol Notebook: AMHI memorial dedicated as political fight rages

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In the same week that state officials and patient advocates gathered to remember more than 11,000 people who died in the state’s mental hospital, legislators and the state’s top health administrator battled over current problems in the state mental health system.

Known by many names, but most recently as the Augusta Mental Health Institute, or AMHI, the hospital was founded in 1840 in the hope that the state could provide refuge for those who could not be cared for by their families, and whose problems ranged from epilepsy and sunstroke, to mania, dementia and even financial troubles.

“AMHI began with such hope, people were dedicated to building a safe and secure place where people could recover and go home,” Laura Wilder said at the Friday ceremony that remembered the many thousands who died at the state hospital. (My grandfather is among them. He had a productive life as a teacher and Superintendent of Schools in Berwick, but developed a severe dementia in his last years and couldn’t stay at home.)

But although the hospital was founded in optimism, failures happened along the way and mistreatment occurred. As recently as 1988, a heat wave claimed five lives in the old buildings. This hastened the trend for community care, and ultimately, a new hospital, Riverview, that replaced AMHI in 2004.

The failures in that history, and the many lives that ended at the hospital, were remembered Friday afternoon as the memorial that looms over a small cemetery across the street from the old hospital grounds was dedicated. Gov. Paul LePage apologized for past mistreatment, and vowed not to repeat it.

The ceremony provided a sober contrast to the continuing fight across the Kennebec River at the Statehouse about how to fix problems at the state’s current hospital.

On Monday, legislators on the Appropriations Committee sparred with Department of Health and Human Services Commissioner Mary Mayhew, trading blame for the failures that have led to Riverview losing its federal certification and reimbursements.

Mayhew listed a litany of legislative failures in an eight-page statement she read to the committee. She argued that the Legislature had failed to grant their requests to fund a separate facility for court-ordered patients, as far back as 2012. Mayhew seeks funds for a small facility to house the court-ordered, or forensic, patients apart from the civil patients, saying that move would restore the federal funding in the main hospital.

Democrats on the committee were offended by Mayhew’s criticism, and one legislator objected to Mayhew’s reading her entire eight pages of prepared testimony.

But she continued to read, and it was a tense afternoon with legislators reminding Mayhew that they had frequently supplied emergency funding for the hospital, and Mayhew warning that she would not listen to attacks against her.

The tone at the hearing did not bode well for any large-scale solutions to improve care as we head into a session where the legislative leaders and the governor are already at loggerheads in lawsuits and potential impeachment proceedings.

The continuing lack of treatment was also highlighted recently in news reports that a young woman stayed in a Lewiston emergency room for 10 days due to the lack of an inpatient bed. According to press reports, an official at Saint Mary’s Hospital blamed a lack of beds statewide partly stemming from limits on available non-forensic beds at Riverview.

With our modern medications and increased community support, it’s hard even to imagine the conditions in the distant past that caused people to end up in the state hospital, and the rough conditions they faced there. There simply was no treatment, and no medication to treat mania, or to support families in providing care for someone with terminal dementia.

Fortunately our treatments have improved, as has the ability of people to live in their communities. We can only hope that the political logjam will not prevent the progress that is still needed to build a truly first-class system of care.

Portland resident Marian McCue is the former editor and publisher of The Forecaster.