AMHI chief wants acute care moved to local centers

AUGUSTA — Linda Breslin, the new superintendent of the Augusta Mental Health Institute, said Monday that eventually she would like to end AMHI’s role as a provider of acute psychiatric care and turn that responsibility over to local hospitals and mental-health centers.

Breslin, speaking at an introductory news conference as she began her second week on the job, said the pending settlement of a lawsuit filed on behalf of AMHI patients presents “an opportunity” to achieve that goal.

The former New York state official said family involvement is critical to the effective treatment of acute patients, particularly those who are being admitted to hospitals for the first time, but that such involvement is often impractical because AMHI is so far away from many parts of the state.

“AMHI draws its population from a very broad geographic region” and acute psychiatric services would be more effective if they were provided closer to the patients’ homes, she said.

Shifting responsibility for acute patients to local facilities would allow AMHI to concentrate on rehabilitating patients who require longer periods of institutionalization, she said.

“This facility for too long has been all things to all people,” she said.

AMHI, a 150-year-old complex that in recent years has been plagued by clusters of patient deaths and unfavorable reviews by federal monitors, is licensed to hold 208 patients and had a census of 164 patients Monday. Breslin said she expects a Superior Court judge to sign the proposed lawsuit settlement sometime in August. The settlement calls for expanding the range of services for the mentally ill in Maine. It would set minimum staffing levels for AMHI while also placing “an enormous burden” on community programs, she said.

“It should work here,” she said.

Breslin said she and her boss, Mental Health Commissioner Robert W. Glover share the goal of ending acute services at AMHI, and that the proposed consent decree settling the lawsuit “certainly has this as one of its goals.”

The class-action lawsuit, filed by four advocacy groups in February 1989, alleges that AMHI patients are denied adequate medical care, given too many drugs and unnecessarily locked in seclusion.

Breslin, describing her first week on the job, said ensuring patient safety is “my priority for this month.”

She said exposed pipes in areas where patients are allowed without supervision have all been enclosed since a patient hanged himself from a pipe last May, but that the presence of asbestos has delayed similar precautions from being taken in some other areas.

Also being reviewed is whether AMHI staff members have received adequate training to recognize and respond to patients with self-destructive tendencies, she said.

The superintendent said the state has not yet applied to regain the Medicare certification for AMHI that was revoked two years ago, but was working with the review agency to correct any lingering problems before an application is submitted.

“You don’t apply unless you think you’re going to get it,” she said.

Breslin said she intends to stay at AMHI for the long haul, stressing her family’s longstanding ties to central Maine. The Breslins own a home in Liberty and have visited Maine frequently for two decades.