Like proposals before it, the state’s new three-year plan for reducing the long-term population at Bangor Mental Health Institute and improving community mental-health services makes sense to just about everyone. And like those earlier plans, its success depends on the state’s ability to adequately care for patients outside the hospital setting, which Maine has not always done well.

Unlike earlier proposals, however, the state mental health department this time appears ready to provide the essential services and willing to downsize BMHI at a rate that will not force this community to relive the patient dumping of the early ’80s. The department’s plan released last week is a relief, a sign that the conflicts of the past two decades between the state and patient advocates may be over and evidence that department officials have been listening closely to patients and their supporters.

BMHI will close three of its seven wards during the next three years under the plan. More telling, however, is that approximately 60 long-term patients will be moved into the community, and the hospital will recommit its focus to acute care, lasting 30 days or less. The evidence that more acute-care beds are needed is less than a mile away at the private, nonprofit Acadia Hospital, which has been full and occasionally forced to redirect patients to other facilities almost since it opened six years ago.

What awaits the patients leaving BMHI? The first 10 are scheduled to be tranferred by the end of March 1999 and already the department has identified 20 appropriate beds in the community, which would serve both these patients and 10 more scheduled to leave BMHI by June 1. BMHI already offers the loan of its staff to advise community facilities on how best to help patients make the transition and, as important, has left the option of having patients return to BMHI if the transition doesn’t work out. More community outreach, including two day hospitals and a medication clinic at the former Pooler Pavilion help expand services. It is encouraging that the department has gone further than ever to put in place a safety net to help everyone in this process.

Some people in Region III, the five counties in Northeast Maine affected by the plan, will remain skeptical. That’s understandable. Downsizing nightmares in the past did little but fill homeless shelters with Mainers too ill to care for themselves but not dangerous enough to qualify for hospitalization. To many are still there, but at least now the state is taking steps to avoid adding to the problem.

Ultimately, comprehensive community and outpatient services have the potential to serve patients better than hospitalization. The trick always has been to get the services into the community. Maine seems to have gotten it right this time.