AUGUSTA– The beleaguered Augusta Mental Health Institute crossed an important threshold last week, as a judge signed a negotiated settlement designed to sharply reduce the number of AMHI patients while beefing up mental-health homes and services in communities around the state.
Hailed by one advocate as “a historic day” and “an extraordinary step forward” for the AMHI patients and ex-patients it covers — a number that approaches 3,000 — the settlement envisions emptying the institution of three-fourths of its nearly 300 non-forensic patients within five years.
Ambitious as that goal may seem, it may prove to be the easy part for the patients and advocates seeking to reform Maine’s mental-health system in a way that does not force people who need psychiatric help to give up precious ties to family and friends that are often essential to recovery.
The reality is that the mentally ill are often viewed with suspicion and fear by outsiders, and it’s not uncommon for proposals for group homes and similar facilities to encounter stiff opposition from neighborhood groups.
Yet, a recent survey commissioned by the Robert Wood Johnson Foundation found that one out of three Americans or someone in his or her family has sought the help of a psychiatrist or psychologist.
The telephone survey, conducted in December, found that more than half of the 1,300 respondents believed that most people who are mentally ill can recover and lead productive lives, and that maintaining a normal life in the community can help them get better. Seven out of 10 said they believed keeping patients behind locked doors is not the best approach to treatment.
Paradoxically, however, respondents expressed a dim view of having facilities for the chronically mentally ill in their neighborhoods, placing them in the same category as homeless shelters and drug-treatment centers. Prisons, shopping malls and homes for AIDS victims were less welcome. Schools, day-care centers and hospitals were among the most welcome.
The survey simply quantified what mental-health professionals in Maine have recognized for years. State Mental Health Commissioner Robert W. Glover says that reforming the mental-health system in the face of popular resistance is “one of the core dilemmas” in that field.
The professionals agree that educating the public — and energizing their clients to take part in that education — is a key to successfully implementing the AMHI settlement.
“It’s the clients themselves who have to speak before those attitudes change,” said Helen Bailey, an attorney for Maine Advocacy Services in Winthrop, one of the groups that filed the lawsuit that led to the AMHI settlement.
Catherine A. Sears, assistant executive director of the Portland Coalition for the Psychiatrically Labeled, recalled the difficulty her group encountered in developing a 45-unit housing project in that city that was divided almost equally between elderly and mentally ill people.
Initially, she said, the elderly residents were scared by the prospect of living alongside people with mental illness, but gradually those attitudes changed. Nowadays, the residents jointly celebrate birthdays, the younger people regularly read to their older neighbors, and the senior citizens are there to console the others when they are going through troubled times.
“It really comes down to people just being people,” Sears said.
At Shalom House Inc., administrative director Claire Harrison recalled how hundreds of people turned out to oppose her group’s plan to open a group home on the outskirts of Portland in 1984, citing concerns that the residents would be dangerous and that the home would drive down property values.
Ultimately, the home was established, and others have followed. Shalom now operates six facilities in Portland.
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