King and mental health

Gov. Angus King, who in his budget address was direct on the amount of revenue to be invested in mental-health programs, but vague on the specifics of how it would be spent, this week dropped the second shoe.

He recommends eliminating 430 jobs in the department as it moves to downsize the Augusta Mental Health Institue and the Pineland Center. The state employs a total of more than 900 people at the two facilities to care for approximately 250 patients.

Reducing AMHI by half and Pineland by two-thirds is only the beginning, a first step in shaping a policy that moves the state to community-based care while making maximum use of existing facilities.

The latter implies shutting down what doesn’t work and hasn’t worked. The governor and the Legislature can see a prime candidate across the river, AMHI, a facility that has been allowed to decay beyond the point at which it can be salvaged. It lumbered into the ’90s for one reason only: it is located at the source of political power and lobbying influence in Maine. The state could save a significant amount of money by eliminating costly duplication of facilities at AMHI that exist at Bangor Mental Health Institute, which is accredited and has an excellent program for geriatric patients.

Historically, funds from cutbacks in mental-health programs were diverted to sop up red ink elsewhere in the budget, leaving deinstitutionalized patients on the street, without services. In the future, savings from facility downsizing and employee attrition or layoffs should be invested in community programs, allowing the state to improve the department without a massive infusion of new spending.

King says during his administration reinvestment in mental-health services will take place. He will reallocate $12 million to outpatient care during the biennium, while AMHI shrinks and Pineland Center all but disappears. For the good of Maine’s mentally ill, it has been a long time coming. For some, too long and too late.

Moving to a responsible policy for care of the state’s mentally ill will not be inexpensive, either in financial terms or in job reductions, but, if done properly, it can produce something Maine can be proud of: a system to care for the mentally ill that is humane and affordable.