Capitol Notebook: Life after LePage: Searching for a better mental health system

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It should not be surprising that former Gov. Paul LePage has left behind a mess.

And not content to hang by the pool in Florida, he continues to influence Maine politics as honorary chairman of a conservative political organization, and by phoning in to a Maine talk show every Monday to critique the new governor. He has one toe in the pool in Florida, and one dipped into Maine politics and has threatened to run again in 2022.

LePage was behind the scenes in the selection of the new officers of Maine Republicans (new chairman same as the old chairman) who blame their stunning loss in November everywhere but where it should be: a widespread rejection of the intransigent style and divisive bullying of LePage.

But one important area where he has potentially tied the new governor’s hands is in mental health services, which was a constant flash point between LePage and the Legislature.

The Bangor Daily News reported last week that the LePage administration used a series of stealth moves to tie the state to a $11.3 million, 30-year contract to lease a facility for psychiatric patients in Bangor, after repeatedly promising it would cost only $2 million to $3 million.

This is the last skirmish in a long-running battle with the Legislature over the building of a so-called “step-down” facility to house patients committed to state care, but no longer in need of intensive services provided at the state’s major facility, Riverview in Augusta.

Legislators had wanted the new facility built in Augusta, where patients could be closer to Riverview. But LePage resisted, and authorized a lease for a new building that commits the state to maintain a residential facility in Bangor.

This revelation highlights the long-running failures in the state’s mental health system. The lack of a comprehensive system contributes to many other issues, including the opioid epidemic. The jails, including Long Creek, are filled with untreated mental illness.

One bill currently before the Legislature offers a good first step in building this system. Sponsored by Rep. Charlotte Warren, D-Hallowell, the bill would create four treatment centers as the first point of contact, to avoid the use of hospital emergency rooms. This legislation should be part of a comprehensive strategy for reform in the state’s system of care.

Former Gov. Angus King was the most successful at improving the state’s mental health care. He confronted issues that plagued the former Augusta Mental Health Institute, which ultimately led to it being closed and the building of Riverview, which opened in 2004.

The new facility was initially successful, but problems worsened under LePage, with sheriffs using stun guns, handcuffs and pepper spray to subdue patients. Those conditions, which have reportedly improved somewhat, led to the hospital’s decertification by federal health officials. The recent improvements have led the state to consider ending the AMHI consent decree, which was established in 1990 to protect patients and bind the state to its obligations in this area.

The original AMHI was built in 1840, across the Kennebec River from the Capitol building so state officials would not forget their obligations to care for Maine’s sickest residents. Providing that care has been a continuing failure going back many decades and governors. Let’s hope the new legislators and governor step up to that mandate.

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

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