AUGUSTA – A 5-year-old program that provides early intervention to young Portland area Mainers afflicted with mental illness is getting a $12.5 million grant from the Robert Wood Johnson Foundation to develop it as a national model.
“This is something we should be doing throughout Maine,” Rep. Hannah Pingree, D-North Haven said after members of the Legislature’s Human Services Committee was given a presentation on the program Tuesday.
“I will be looking at pushing this next session, if I am re-elected,” said Pingree, who co-chairs the committee. “Here is a program in Maine being held up as a national model that works and saves money. It is so nice to have some good news.”
The PIER, or Portland Identification and Early Referral, program is operated by Maine Medical Center in Portland and Spring Harbor Hospital in Westbrook. It was started in 2001 with a $500,000 grant from the Robert Wood Johnson Foundation.
Dr. William McFarlane, director of the Center for Psychiatric Research at Maine Medical Center, told lawmakers the program has been successful in helping teens and young adults cope with mental health issues before they became so ill that they would need to be hospitalized.
“I have some doubts and some qualms whether people in – well, you name the city – will do as well as people in the Portland area have,” he said. “I don’t have any qualms that people in the rest of Maine would be able to develop these kinds of services.”
McFarlane said the key to the program’s success has been the identification of “early warning signs” in kids by people outside of the mental health community. He said training of school personnel and others who work with teens to recognize such early signs as “hearing a little voice” or “being fearful for no reason” have led to early intervention with conventional treatments including therapy and drugs.
“It’s a little hard to describe this to lay people,” he said, “but young people have described it as something they feel happening to them. And then, unfortunately, as you get further along, you lose the perspective on it and it feels natural.”
McFarlane said the key difference between the PIER program and other programs is that it works intensively with the families to educate them about what is going on with the young person and how to respond to them.
Lawmakers were impressed with Tuesday’s presentation, particularly the data that indicates the amount of hospitalization has been dramatically reduced.
McFarlane said the cost of additional therapy and training is more than offset by the avoided costs that would occur from a hospital stay.
The panel also heard from one participant in the program who said he had been dramatically helped by it. Clay Eberle of South Portland, son of Rep. Jane Eberle, D-South Portland, said he would recommend it to any other young person who asked about it.
“I would tell them it is a place to go to get out of your shell so you don’t end up in Riverview,” he said, referring to the state’s psychiatric hospital in Augusta.
Other lawmakers on the panel were as impressed as Pingree. Rep. Sarah Lewin, R-Eliot, said the data indicate the program is helping kids and can save money.
“To me this bears investigation,” she said. “This has saved a few million dollars among a small number of people in just one service center in the state. This could [lead to] significant savings across the state.”
Brenda Harvey, commissioner of the state Department of Health and Human Services, said that while the program certainly has promise, it also faces problems because most insurance programs, including Medicaid, will not pay for treatment until there is a diagnosis made of a mental illness.
“How policy supports prevention is the question at hand,” she said. “There are complications in how this would be funded and put in the mainstream.”
Harvey said some of the array of services used in the PIER program, such as supporting employment, are not covered by any insurance policy, including Medicaid. She said finding other funding sources will be difficult.
But, McFarlane said the savings over just a two year budget cycle are significant and would more than pay for the program.
“Within a biennium, you would get your money back on this,” he said. “In fact, you would get it back three times over.”
Pingree said she will support expanding the program to other areas of the state, possibly through a pilot program at first. She said a program that improves the lives of Mainers and saves them money is a program that will get broad support.
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