Capitol Notebook: The Statehouse and the hospital

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My earliest memory of the Maine Statehouse is a sixth-grade field trip, crowding into the office of Gov. John Reed sometime in the mid-1960s. I’m not sure if that initial visit stoked my fascination with Maine politics and especially the Legislature, but it may have helped.

So decades later, I’m starting a column that will cover the stories of the Maine Legislature. Capitol Notebook will focus on the Legislative activity that doesn’t always make the daily newspaper front pages, which focus on the most controversial proposals and the random musings of Gov. Paul LePage.

We will report on the many proposals that will be considered in this six-month session of the Legislature. And we will also cover the work of legislators from The Forecaster’s coverage area, from Bath to Scarborough.

An initial disclaimer: Since leaving the post of Forecaster editor in 2006, I have been involved in various political campaigns, mostly with Democrats. To take on this column, I’ve stopped any support of political campaigns and advocacy groups to return to an observer role. I am not writing this column to push one party line or the other, but will cover both sides.

The legislators who inhabit the Capitol building can look across the Kennebec to the grounds of the former state hospital, the Augusta Mental Health Institute, a fact that some say means they should not forget the state’s job to take care of the mentally ill.

The historic problems at AMHI resulted in a lawsuit in the 1980s, settled by a consent decree that requires the state to improve the patient care in the hospital as well as the community.

Riverview, the successor hospital to AMHI, has also been plagued with problems, and has lost federal certification due to its use of armed police officers to control patients.

The challenges at Riverview took center stage at a legislative hearing last week, as two committees heard testimony from the man who oversees the consent decree. Former Maine Chief Justice Daniel Wathen told a joint meeting of the Appropriations and Human Services committees that Riverview had improved, but stiff challenges remain.

Wathen reported that the use of armed police officers to subdue patients had been reduced, but not eliminated, adding that cops had been called three times in the last two months to deal with the same patient. Many of the problems result from the increasing number of forensic patients who have been placed in Riverview by the courts, and are treated in the same facilities that house the civil patients.

He praised many of the proposals put forward in the new budget for the Department of Health and Human Services, which had been presented to the committees earlier by Commissioner Mary Mayhew. That budget includes increased funding for important community programs.

In order to make real permanent improvement at the hospital, Wathen said it must hire the “best of the best.”

Legislators pressed Mayhew about the need for a broader initiative to provide treatment for forensic patients. While the new budget calls for hiring four staff psychiatrists to replace contract workers, those jobs, like many in the hospital, will be tough to fill. It’s hard to find the “best of the best” to work in the sometimes dangerous atmosphere at Riverview. The hospital’s problems, like the challenges of community care, are tough ones to solve, and often result from the inability to find enough staff.

If the state is going to meet its central responsibility to provide quality care for the mentally ill, it needs to develop a large-scale plan and pay for expanded facilities and staffing. Mayhew acknowledged that Riverview at this time cannot support the long-term needs of the civil patients.

Until there is a broader plan to do that, the state will likely fail at its mission to care for the mentally ill.

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

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