AUGUSTA — Gone are the cargo pants and rolled-up shirtsleeves from when he was a patient advocate at Riverview Psychiatric Center.

Jay Harper arrives for work as the hospital’s acting superintendent in a tie and suit.

“I went from being an advocate in the back room reading the record to the superintendent’s role,” Harper said Thursday as he talked about his vision for helping patients and for bringing the hospital back into compliance with federal regulators. It was his second day on the job. Even as his computer, phone and email was getting set up, Harper was in the office and walking the halls, talking to people and setting priorities.

“I think of myself as an advocate,” Harper said. “The best clinicians, the best doctors, advocate for the tools that they need so they get the best outcome for their patients.”

He wants to make the whole organization “inclusionary and transparent” and work with educators, the business community and others to help patients.

“There’s probably no groups we can’t figure out how to use resources from,” he said.


He also said the patients that do the best have family and community support.

His approach includes cooperating with NAMI Maine, formerly the Maine chapter of the National Alliance for Mental Illness, which works to help build “better lives for the one in four Mainers who are affected by mental illness,” as well as the Disability Rights Center, which provides advocacy services to Maine residents with disabilities.

Harper had to resign his post on the board of NAMI Maine when he came out of retirement to become acting superintendent. Now 64, he retired on Dec. 31 as a patient advocate at Riverview.

He figures he spent 70 days away from Riverview as a retiree and added that the length of his tenure in the new role has not yet been discussed. The announcement of the leadership change at Riverview came Wednesday from Department of Heath and Human Services Commissioner Mary Mayhew. Last week, Mayhew ousted Mary Louise McEwen from the superintenden’s job, saying a change in leadership was needed.

Harper said the entire Riverview staff, including the mental health workers who spend large parts of each day with the hospital’s patients, can provide good ideas for success that can be incorporated into the hospital’s response to the Centers for Medicare and Medicaid Services, which pulled federal funding — estimated at $20 million annually — last September.

Harper also wants to address the high staff turnover rate and exceed federal minimum standards for operation to show “what a first class psychiatric center is going to look like.”


The hospital employs about 300 people, all but 30 of whom work in the Augusta building. The hospital census Thursday showed 83 patients, 45 of them civil patients and 38 forensic patients, those who are in because of crime-related issues.

He also spoke of making the hospital safer for patients and for staff.

A spate of staff injuries caused by patients — including a particularly horrific attack on one mental health worker a year ago that left her beaten and with a pen point embedded in her hand — resulted in the hospital bringing in corrections officers to watch individual patients. Those officers were armed with stun guns for the first few months.

Now the hospital has added four specially trained acuity specialists to help handle the most aggressive patients.

Harper said his immediate plan is to proceed with getting federal recertification for three of the hospital’s four units — two of them civil and one forensic, and then work toward certification of the fourth unit. The fourth unit is known as Lower Saco and houses the patients with the most severe mental illness and behavioral problems and which has the most incidents of trouble.

“My desire is to do the three and the one as close together as possible,” Harper said. He said that is important from the perspective of fairness to the patients.


Riverview admits about 300 people a year — some of them for short periods for evaluation or stabilization — and it also has an outpatient unit. The hospital is licensed by the state and was recently certified by the Joint Commission, a nonprofit organization which “accredits and certifies more than 20,000 health care organizations and programs in the United States,” according to its website.

Now it’s back to the federal regulators, who will come in to the hospital to do their assessment. “They determine whether the quality of service is such that they’re willing to reimburse you for it,” he said.

He said another big issue for the hospital is to find the best placement for forensic patients found not criminally responsible for offenses or incompetent to stand trial but who might suffer from other medical and physical maladies. He said any changes there will require working with legislators, judges, the district attorney’s office, the State Forensic Service and others.

Harper said patients with traumatic brain injuries, for instance, might need a different type of hospital than the state forensic hospital as might those suffering from Alzheimer’s disease along with severe and persistent mental illness.

“Other patients in the milieu suffer because you’re managing behavioral issues,” Harper said.

He said the search for appropriate placement might have to be widened to out-of-state hospitals.


“It’s a process that will not happen overnight, but it’s in the best interests of patients and the taxpayers,” he said.

In 1988, Harper came to Maine from Massachusetts to become director of the Bureau of Mental Health, and most recently worked as a patient advocate for the Disability Rights Center of Maine.

Betty Adams — 621-5631

[email protected]

Twitter: @betadams

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