Maine to be freed from court oversight
The state of Maine will soon be free from a consent decree that has shaped the way the state treats mentally ill patients.
A court appointed specialist, or “Court Master,” was put in place to ensure the state met certain standards. That specialist was retired Chief Justice Daniel Wathen of Maine’s Supreme Judicial Court who determined Maine is now in “substantial compliance” with legal guidelines updated three years ago.
He told Maine Public Broadcasting Network there is now a working mental health system.
“It didn’t require that they be able to meet every need, but that they have a system for responding reasonably to needs,” Wathen said. “And they have such a system now.”
The back story on the court oversight started nearly 35 years ago. In the summer of 1990, a Supreme Court Justice approved an agreement that settled a class action lawsuit against Augusta Mental Health Institute (AMHI) following the death of 10 residents in 1988.
The agreement terms were a part of a consent decree by the court. (AMHI closed in 2004 and was replaced by the Riverview Psychiatric Center in the same location.) This decree detailed a set of principles the state should follow when treating mentally ill patients, which aimed to improve mental health services by prioritizing patients’ rights in both state-run hospitals and the community.
By 2007, the Maine Court Law determined that the consent decree applied to all adults with serious mental illnesses and not just the original plaintiffs in the case.
Defining principles were further outlined in 2021. Based on those guidelines, Maine could petition to dissolve court oversight if it showed substantial compliance in 17 performance areas for at least four out of six consecutive quarters.
It took 14 quarters to reach that goal.
In an email, Sara Gagné-Holmes, commissioner of the Department of Health and Human Services (DHHS), referred to the long-awaited resolution to three decades under the decree.
“The department welcomes the Court Master’s recognition that the state of Maine is in substantial compliance with the 1990 consent decree, thanks in large part to the investments of the Mills administration. The department has been working hard to strengthen Maine’s adult community mental health system of care to ensure timely access to high quality services over the past six years, and we are pleased that our systemic improvements are making a difference,” she said.
She said a notice of substantial compliance was filed with the court on October 20, 2024, reflecting Maine’s “ongoing commitment to a strong and robust system of care in Maine.”
Gagne-Homes added the hope is “a long-awaited resolution to the consent decree after nearly 35 years.
According to the DHHS website, the principles were set on several standards to be met that included timely access to services for adults experiencing serious mental illness, contract management and enforcement of rules, effective use of inpatient capacity at Riverview Psychiatric Center, and timely reporting.
The state made other improvements by creating a community health clinic model to be implemented in January 2025, establishing a 988-crisis hot line to be manned 24/7, improving medication management, and solidifying its working relationship with such advocacy organizations as Disability Rights Maine and the Consumer Council System of Maine. (Neither Disability Rights Maine nor Consumer Council chose to comment for this article, with DRM referring to https://drme.org/drm-statement-on-the-dismissal-of-the-amhi-consent-decree/ for information.)
According to NAMI Maine, more than 200,000 adults in the state have a mental health condition, which is about 11 times the population of Augusta, and 61,000 have a serious mental illness.
More than 200,000 Mainers live in a community that does not have enough mental health professionals. And about 65,000 Mainers did not receive needed mental health care, many of them because of cost.
In an October 16 article, the Portland Press Herald reported further problems with staffing and safety concerns at two of the state’s psychiatric hospitals—Dorthea Dix in Bangor as well as Riverview in Augusta.
Lawmakers who met with several employees at both facilities said the staff shortage and turnover rates created unsafe working conditions. Wathen, however, stated that those concerns were outside of the consent decree and separate from the state’s compliance set by the 2021 standards.