The response was as predictable as the proposal: The commissioner of mental health and mental retardation proposes reducing the size of the Bangor Mental Health Institute and alarm bells sound around the region. Rather than having its legislators dig in once again in Augusta and once again give up ground, Bangor needs a better response.
A review of patients last fall caused BMHI administrators to conclude that 80 of 140 long-term residents of the institute would be better served in a community setting, outside the hospital. That means 62 of the 400 positions at BMHI no longer would be needed. Mental Health Commissioner Melodie Peet said she hoped most of the reduction could be met through retirements or staff leaving for other reasons, but the possibility for layoffs is apparent.
Local lawmakers have gone through the usual expressions of concern and have suggested that they might not support the reductions legislatively. That, however, leaves them defending jobs for which there are no patients, unless they can persuade patients whom the department considers better off outside the institution to petition to stay.
The city has two excellent reasons to be hesitant about embracing any plans that release large numbers of patients from BMHI. The first is experience. In the 1970s, hundreds and hundreds of long-term patients were released from BMHI to inadequate services in the community. The results were shameful. Mentally ill people ended up on the streets, in homeless shelters or in prison. Services outside the hospital have been enchanced significantly since then, but the memory remains strong.
The second reason is also related to services. Staff reductions over the years at BMHI have limited the number of day programs in the community, sheltered workshops and behavioral therapy for current residents. It’s understandably hard for the region to trust the state to take a further risk with the mentally ill when services in the institution are wanting.
Commissioner Peet wants to use the approximately $1 million in savings from downsizing BMHI to buttress community services, and that’s understandable. Before the city can entirely embrace such a plan, however, it needs assurances that an improved, comprehensive acute and long-term care facility will operate in Bangor. BMHI once had a capacity for 1,200 patients; it has fewer than 200 now. Perhaps the building is no longer the right place for hospital care and a new, smaller building is needed. Or, perhaps, BMHI could be renovated to include other mental-health services, justifying and more effectively using the large complex.
Either investment would benefit patients and reassure the community that the state is serious about maintaining long-term hospital care here. For the health of the patients and the well-being of the community, the decision to make that investment should precede further downsizing.