As many of us are painfully aware, mental health service providers have not been able to keep up with demand as we navigate COVID-19. Here in Maine, our community-based mental health system is in a crisis.
The stress of the pandemic has exposed many shortcomings in our mental health system, but these problems existed long before 2020. In addition to the pandemic exacerbating mental health issues, COVID-19 has also revealed the need for increased mental health services and the inherent problems Mainers face in accessing care. Providing effective, high-quality mental health care amid the pandemic within a fractured system has proven difficult at best and at times impossible. Unfortunately, many who need care have gone without, with unfortunate results for them, their families and friends, and the community at large.
While the Department of Health and Human Services has made strides in addressing our state’s mental health needs under the Mills administration, there remain profound needs. Misunderstanding and stigma among large swaths of the population exist and pose significant challenges to implementing innovative ideas to assure that services for some of our most vulnerable are being delivered.
Much of this results from the chronic underfunding of community mental health services. According to Pathways of Maine, a provider of home-based behavioral health services to children and families, over the last 10 to 15 years there have been increases from 50% to over 200% in nearly every single cost area for providers — health insurance costs, rents and utilities, technology costs and more. As the cost of doing business continues to increase, the state has not even come close to keeping up in what we pay to providers. We are simply not adequately funding community and in-home mental health services. As a result, wait lists continue to grow, and needs become more pronounced.
These issues are particularly acute for children. Children need consistent, nurturing adults in their lives to form healthy attachments and to develop positive socio-emotional skills. Lists for children awaiting home and community-based treatment continue to grow. For example, as of February of this year, over 650 children were waiting for behavioral health care services. This includes over 70 children in need of residential treatment placed out of state, as well as those who are incarcerated, those in need of behavioral health care, those on waiting lists for home community treatment and those languishing in emergency departments, waiting for appropriate behavioral health placements, at times for weeks or longer.
The underfunding of community-based mental health services has also had severe impacts on those working in the field. Stagnant, non-competitive wages, the lack of a career ladder and having to care for too many patients has taken a toll on workers, leading to workforce shortages. In order to encourage more people to work in mental health services, we need to improve funding for these community-based programs.
We are at an incredibly opportune moment to catapult forward the availability of services and innovation within this often misunderstood and sometimes maligned sector of our health care continuum. We can take action now to examine our mental health care system and, most importantly, to adequately fund those services that work, especially those that are preventative in nature. Making sure people with mental health issues, particularly children, get the help they need in a timely manner saves money, pain and trauma in the long run.
We have been and will continue to work with mental health providers, consumers, advocates and our legislative colleagues to reduce the stigma of receiving mental health services, increase the availability of services and elevate awareness of the range of opportunities available to help people who need mental health care. We owe it to our citizens to do no less.
Lori Gramlich of Old Orchard Beach is a longtime social worker and public health advocate who is serving her second term in the Maine House. She is a member of the Taxation Committee and the Environment and Natural Resources Committee. Rep. Colleen Madigan of Waterville has worked in the field of behavioral health for over 25 years and is serving her third term in the Maine House after previously serving one term in the Maine Senate. She is a member of the Health and Human Services Committee.
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