Maine ignoring legal settlement in handling mentally ill.

Sun Journal -In 1989, after 10 patients died from deficiencies in the care provided to them at the Augusta Mental Health Institute, patient advocates sued the state and the following year achieved a sweeping legal settlement known as the “consent decree.” This 99-page document ordered what is now named the Department of Health and Human Services to create a decent, robust system to care for Maine’s seriously mentally ill citizens — and to do it within five years. The Department agreed.

But 27 years later, law enforcement officials, mental health experts and patient advocates agree that the state is still far from meeting the consent decree’s mandates. Despite the decree’s strict requirements, the shortcomings of the state’s mental health system include: 

• Potentially tens of thousands of seriously mentally ill adults in Maine, many of whom wander the streets of the state’s cities or languish in the jails and prisons, may have had insufficient care or have had little or even no contact with the state’s mental health treatment system. 
• Treatment is critical — but lacking in Maine. While seriously mentally ill people are no more dangerous than other people if they get proper treatment, the untreated are three to four times more likely to commit violent acts than members of the general population. This is why law-enforcement officials have been so upset with — and for so long — the inadequacy of the care the mentally ill receive. 
• The consent decree is essentially an unfunded mandate. It doesn’t require the Legislature to appropriate money for mental health care, and advocates generally agree that state government’s refusal to provide enough funding underlies many problems in the treatment of Maine’s mentally ill. Exacerbating insufficient funding by previous administrations, Gov. Paul LePage has cut 13,000 patients from mental health care in the last five years. 
• Treatment facilities are insufficient. Officials admit that Riverview Psychiatric Center in Augusta, the county jails, and the Maine State Prison’s mental health unit are unable to treat or even control especially violent patients. Instead, the institutions tend to transfer them from one to another in a “diagnosis game.” 
• Solutions are inadequate. Special courts keep up to 250 mentally ill people out of jail and prison, but they only serve those already in trouble with the law. And critics claim that the major mental health care advocacy groups, which get considerable funding from the state and federal governments, have an inherent conflict of interest and don’t aggressively work to increase and improve community care or change the way institutions like Riverview administer services.