A 19-year-old woman experiencing a mental health crisis recently spent 10 days in a Lewiston ER awaiting treatment. Though a place was finally found for her, dozens of other people who have similar issues are still waiting for care that they’re not getting – a complex challenge that won’t be resolved until Maine enables residents to seek preventive care regardless of their income.

Police brought Chyann Cahill-Hassett to the St. Mary’s Regional Medical Center ER on Sept. 1, after she had a breakdown, lashed out at a residential treatment provider and then ran away, her mother, Maureen Cahill, of New Hampshire, told The Associated Press.

While Cahill searched across five states for treatment options, her daughter, who is cognitively disabled, had to share common space with others in crisis, like a drunken man whose pants were falling down and tried to sit on the teenager’s lap. It took until Sept. 11 for a spot to open up on the psychiatric floor of St. Mary’s.

Similar scenarios play out every day, in Maine and across the country, fueled by a surge in demand and shortages of staff, beds and treatment facilities. St. Mary’s, for example, which has an ER just for those with mental health issues, sees over 400 patients a month there, the Sun Journal of Lewiston recently reported — 78 percent more than in its first year.

Though Maine has over 500 beds for mental health patients, some are set aside for specific groups, like senior citizens or children, and others are unavailable because there’s no staff to cover them. ER patients can’t move to inpatient psychiatric units because the people there are waiting for beds to open up at backlogged long-term facilities.

Recognizing and screening people for mental illness ensures they get treatment before they need inpatient or long-term care. But Maine has missed a key opportunity to intervene, repeatedly rejecting federal Medicaid expansion funds and leaving 70,000 residents without any mental health coverage at all.

Poverty is endemic in Maine, and more than a third of adults here who receive Medicaid have a diagnosable mental health condition. Opting out of Medicaid expansion will limit the ability of community mental health centers to reach community members with mental illnesses before their condition deteriorates, a recent study predicts. Meanwhile, the gap between the need for psychiatric care in Maine and the services available here will continue – and so will the crowds in the emergency rooms of hospitals around the state.