AUGUSTA — The urgent need for additional behavioral health resources was the focus of Tuesday’s second meeting of the Legislative Working Group to study the process of filing criminal charges against perpetrators of violence in medical settings.
Task force members and invited speakers portrayed the state of Maine’s behavioral health system. Hospitals, residential facilities, outpatient facilities, and prisons are understaffed and lack adequate resources to handle violent individuals and those with possible mental illness.
Then the question is to find a suitable place for those people – if there is one available – and whether they should be held accountable through the criminal justice system.
Mallory Shaughnessy, executive director of the Alliance for Addiction and Mental Health Services, said the task force “needs to think very carefully about not criminalizing mental health.”
Health care facilities cannot use mental or behavioral health examinations to screen for violent behavior, nor do they indicate that a person will act violently.
At the same time, “staff at these facilities cannot be expected to be subjected to these attacks just because they have a diagnosis.”
However, as noted by Shaughnessy et al., many organizations lack the staff and capacity to make the specific capital investments that would make facilities safer for patients and staff.
“I feel like this is set up as an issue between hospitals and behavioral health facilities. Betsy Sweet, an advocate for the Behavioral Health Community Collaborative, said.
“If we can manage people and their behavior without adding resources (and) criminalizing it, that is very important to this commission,” Shaughnessy said.
Cumberland County Sheriff Kevin Joyce said that as it stands, law enforcement is “the default social service provider after hours and on weekends.”
What is lacking in Maine’s mental health system, “the reality is that prisons are being used to make up for it.”
“We are trying to mitigate the mental health crisis,” Joyce said. “Until February, at least in Cumberland County, the emergency department was the only option.”
Joyce said Sperwink’s Living Room Crisis Center in Portland has relieved some of the pressure from local law enforcement, but “my colleagues in other parts of the state have had similar situations.” There are no luxuries.”
Dr. Michael Kelley, Behavioral Health Officer at St. Mary’s Health, agrees that “we don’t want to criminalize mental health” about individuals with certain mental disorders beating staff. I said I will.
But “if you don’t draw the line somewhere, unfortunately it sends the message that people can do whatever they want,” he says. I said I would send a message saying it wasn’t. of a person as someone else.
It also sends a message to staff that they don’t deserve protection, he said.
As a physician, he thinks about the patient’s mental capacity to understand the choices they are making, whether they understand good or bad as a result of those choices.
“It’s not an easy decision,” said Kelley, when it comes to deciding what that patient capacity is and whether to involve law enforcement. “As healthcare providers, we want very much to protect our patients … but we have to protect people.”
But when it comes to the judicial system, the burden is on the state to prove beyond reasonable doubt that a person acted to the fullest extent of his or her ability, said Maine District Court Judge Andrew Robinson.
“All of these protections and standards reflect the importance of convicted outcomes,” he said.
The weight of the burden of proof and other factors such as an individual’s mental state make prosecuting these cases difficult, or at least incredibly complex.
Robinson said she wanted to outline the process because “it’s important that people know what challenges exist for prosecutors making these decisions.”
Kennebec and Somerset County Assistant District Attorneys and task force member Freyla Turpinian understands why health care providers and employers are frustrated as they approach the cases they bring “thoughtfully and carefully.” is doing.
“When they’re not charged, they look like we don’t care about them,” she said.
Prosecutorial decisions are unique and vary from case to case and from office to office.
“You’re in very interesting territory when you talk about prosecutions, because it’s up to the DA to prosecute or not,” Turpinian said.
As she did at the first task force meeting in August, the DA assistant questioned the “effectiveness” of using the criminal justice system to deter violence in medical settings.
“I really want to fight the idea that if we prosecute more of these people, we can stop the violence,” she said.
The task force is scheduled to meet at 9:00 am on September 27th. The hybrid meeting will be held directly at the Augusta State Capitol and streamed online. This is the first time the Task Force has heard public testimony.
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