AUGUSTA — The skin had already started to flex around the knife tip when Greg Smith got to the door.

The man had called police, threatening to hurt himself. Now, the knife pressed against his stomach, and he was a whisper away from carrying out the threat.

Additional Photos

Greg Smith, the department's intensive case manager, sits in the passenger side of an Augusta police cruiser driven by Officer Nathan Walker on Wednesday afternoon. Staff photo by Joe Phelan

Smith had talked to the man before, so when he said he wanted to talk, the man agreed. He even complied with Smith’s first request: to put the knife on a nearby table.

“Ultimately the individual walked out, got in the (police) car on his own and thanked us for a ride to the hospital,” Smith said. “It was one of those best-case scenarios.”

Smith, 40, has worked with the Augusta Police Department as a Intensive Case Manager more than 13 years. During that time, he has dealt with countless people, almost all suffering from a mental health condition, who are in crisis.

Sometimes he’s a trusted voice arranging for friends or families to stay with someone experiencing feelings of depression. Other times, Smith’s intervention has helped someone decide against taking his of her own life.

Maine’s Department of Health and Human Services is scheduled to cut funding for Smith’s position at the end of the month. There are efforts afoot to save the position; but even if those attempts are successful, there is no guarantee Smith will continue to work with the department.

“We have a lot of experience and knowledge we’re going to lose if the state or someone else doesn’t maintain Greg’s position in Augusta,” said Augusta police Chief Robert Gregoire.

Police say that experience is critical in Maine’s capital city, which is also home to the Riverview Psychiatric Center for mentally ill patients, including those found not criminally responsible for violent crimes.

Funding for Smith’s position, which costs about $50,000 including benefits, was eliminated earlier this year as part of the DHHS restructuring. The department will privatize more than half of the roughly 40 intensive case management positions statewide. Meanwhile, the department has opted to keep on the state payroll 17 managers who work with the mentally ill at county jails and state prisons.

About 24 jobs — managers who currently work in the community — will be put out for bids by nonprofit or for-profit agencies.

However, there is no guarantee that all the services Smith provided will be specified in a private contract, Gregoire said. More importantly, there is no guarantee that Smith, who already has started applying for different positions, would be hired to fill the contract.

Public safety at issue

The Augusta City Council on Thursday unanimously approved a resolution that, in part, asks the state Department of Health and Human Services or Motivational Services to restore funding for an intensive case manager to help Augusta police deal with mentally ill people in distress.

Councilor Cecil Munson said he planned to urge legislation aimed at maintaining state funding for the intensive case management workers.

“This is a public safety issue,” he said. “It’s a very useful position and a helpful position for the police to have in their resource drawer.”

The city was notified of the state’s decision about Smith’s position around the same time that the state-run Riverview Psychiatric Center also disclosed plans to shutter three group homes on the former Augusta Mental Health Institute campus and move the 16 patients who live there — many of whom have been deemed not criminally responsible for crimes ranging from assault to murder — into homes on Green Street and Glenridge Drive. The move is a result of a decision by the Office of Adult Mental Health to stop funding those group homes because they are state-owned property.

City councilors have decried the move as a public health risk, but they also are frustrated by what they see as another move by the state to shift costs to the city. Meanwhile, councilors have eliminated funding from the Police Department as part of their effort to balance the budget.

City Manager William Bridgeo said Smith fills an important position in the city, and his work consistently has earned high praise; but there is no money for the city to keep Smith on the payroll without assistance.

“I don’t have the funds to backfill the state,” Bridgeo said. “There’s no money available in the city budget to fund the position — nor should it be a city responsibility.”

More than case management

Smith, who works 40 hours per week, spends his shifts riding with a patrol officer. Smith has taken the Law Enforcement Officer Pre-Service Training Program, sometimes called the “100-hour course,” but his is a civilian position. Smith responds to all calls with the officer, and both he and the officer go to the site of any call involving someone suffering from a mental health problem.

Smith lends a hand on any case. That might mean talking to someone during a domestic-violence call or consoling a family member whose loved one has been involved in a serious accident.

“It’s much more than case management,” Gregoire said. “He’s there to deal with all kinds of crisis.”

Smith said about the only instance he wouldn’t get out of the car for would be a routine traffic stop.

Gregoire said connecting people suffering from mental health problems with proper services is challenging because of the maze of public and private case managers and service providers. Smith has been effective in connecting the department with those outside agencies to ensure such people — referred to as consumers — have their needs met.

“I’ve been doing this for 24 years,” Gregoire said. “I don’t know how the mental health system works.”

Gregoire said Smith has developed trust among many of those who suffer from mental health conditions, and with whom police interact. Smith also has gained the trust of Gregoire’s officers.

“He has a genuine concern and interest in providing a service,” Gregoire said. “He wants to make those consumers are better prepared to live in the community.”

Smith, who is married and has a young child, hopes he gets to stay on the job he says he still loves, even as he is filling out résumés in case the position cannot be saved.

Gregoire knows they are working against the clock to save his position.

“Unfortunately, if this doesn’t get remedied, Greg will be elsewhere and we’ll be at a loss; because Greg still has to take care of his family,” Gregoire said. “We don’t want to lose any of the resources we have that benefit our community.”

Staff Writer Keith Edwards contributed to this report.

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