AUGUSTA — A decision to send a mentally ill man found not criminally responsible for assaults on mental health workers to South Carolina to the only privately operated “detention healthcare facility” in the United States has prompted concerns that Maine has no place where such potentially dangerous patients can be treated effectively, safely, and legally.

Mental health advocates say sending Anthony Reed, 40, to the Columbia Regional Care Center in South Carolina, where they believe he will be kept in a correctional, not hospital, setting, is “criminalizing mental illness.”

“When you’re found not criminally responsible, it means you’re not guilty,” said Jenna Mehnert, executive director of the National Alliance on Mental Illness, Maine. “Yet here we are, taking someone found not criminally responsible, who is supposed to go to a mental health hospital for treatment, and sending him to a prison. From our perspective this is the most blatant example of criminalizing mental illness you could possibly imagine.”

State mental health officials agree sending a mental health patient to a privately run facility out of state is not an ideal solution, but said Maine currently has no facility where potentially violent patients found not criminally responsible can be treated safely without violating Maine law.

Riverview clinical director Brendan Kirby said, in a Monday court proceeding in which Reed was placed in the custody of the commissioner of the state Department of Health & Human Services, “I think it is outrageous he does not have access to a secure unit in Maine that can meet his needs.”

Riverview Superintendent Jay Harper, noting he could not discuss any specific patients, said Friday a special mental health unit at Maine State Prison is capable of treating patients found not criminally responsible for violent acts, but state law does not allow patients found not criminally responsible to be treated there.

He said there is no difference in the mental health treatment offered at the Columbia Regional Care Center and that offered at the mental health unit at Maine State Prison. He noted both operations are by the same privately operated firm, Correct Care Solutions.

He said such facilities are capable of treating mentally ill, not criminally responsible patients without them being stigmatized just because the facilities are secure and also treat patients who have been accused of a crime in the same location.

“They’re not corrections programs, they are run by psychiatrists and psychologists, that’s how they do it, the same as we do,” Harper said. “They are treatment focused, not corrections. But they are also not hospitals. The issue being raised, by advocates, that if someone goes to a treatment program located (in a secure, non-hospital setting) has the appearance of criminalizing mental illness, I don’t believe that argument. There is no difference in treatment.”

Harper said state mental health officials have had internal discussions about changing the state law that prevents patients found not criminally responsible from being sent to the mental health unit at Maine State Prison.

Mehnert acknowledges mental health treatment can be offered within a correctional setting but maintains there is a difference between the treatment received in such a setting, to people convicted of crimes, and the treatment that should be provided to people with mental illness who have been found not criminally responsible for crimes.

“The correctional level of (mental health) care is to maintain function, and prevent someone from causing trouble, to keep them functional,” she said. “It’s not to restore their mental health and attempt to find recovery. The correctional system’s mission is punishment, versus a hospital where it is to get people well. A hospital, not a prison. That’s what we want.”

Reed was convicted of three assaults in Cumberland County in 2004 and in 2010 was convicted of aggravated assault after badly injuring a Riverview chaplain in what prosecutors said was an attack motivated by “virulent racism.” In a separate incident in 2012, Reed reportedly attacked four staff members at Riverview, including a female mental health worker who was sent to the hospital for injuries that did not threaten her life.

In 2013, he was found not criminally responsible because of his mental illness.

Jim Cheney, a spokesman for Correct Care Solutions, noting he could not discuss specific patients, said in an email in response to questions about Columbia Regional Care Center, that it is a maximum security treatment facility with seven units providing “a broad spectrum of healthcare and treatment services to patients touched by the justice system,” including patients with mental illness related conditions.

It is described on its website as the only privately run detention healthcare facility in the country.

Asked if the facility is a detention facility or a treatment center, Cheney said it was a treatment facility.

He said staff there are equipped and trained to address aggressive behavior but, “More importantly, we make a concerted effort to be proactive in our treatment to reduce incidents of violence.”

He said available psychiatric and mental health treatment there includes psychotropic medications, group counseling, case management, individual counseling, crisis intervention, and behavior management plans. Individual’s group schedules are dependent on the acuity of their psychiatric symptoms and risk of harm to themselves or others.

Mehnert said she understands there is a need for a facility, different than those now available at Riverview or Dorothea Dix in Bangor, where people with mental illness who are also potentially violent can be treated in a secure setting.

She believes the Lower Saco Unit at Riverview could be operated as a forensic unit for such patients. She believes the state could create a secure mental health unit, either there or elsewhere, “for the small group of people with serious and persistent mental illness, and who are aggressive, which is a very small percentage,” of patients.

Harper, Friday, echoed statements Kirby made in court Monday that Riverview lost its certification from the federal Centers for Medicaid and Medicare Services, which oversees Riverview funding, because an audit by the agency found, among other issues, corrections officers on-site and restraints being used to control difficult patients, and other security measures.

Mary Mayhew, commissioner of the Department of Health and Human Services, said in August that the LePage administration still seeks a solution to satisfy the Centers for Medicaid and Medicare Services and that creating a new facility for so-called forensic patients — those who have killed, assaulted or committed other offenses but been found criminally insane — is the only certain way to obtain certification.

Mehnert said her organization has long felt the Lower Saco Unit at Riverview could be operated as a forensic unit, without impacting the facility’s certification, as long as that unit were operated separately from the rest of Riverview, where civil patients are also treated.

Mehnert and Harper agreed a patient from Maine being treated far away in South Carolina could make it more difficult for them to maintain contact with family, and that, in general, being able to stay in contact with family is better for a patient’s treatment.

But Harper said there is currently not a facility in Maine, due to the law preventing patients found not criminally responsible from being housed at the mental health unit at Maine State Prison, where patients found to be violent can be housed and treated in Maine.

“The advantage of being able to stay in a Maine program is the ability to stay closer to family,” Harper said. “From a treatment perspective, it’d be better (for a patient sent to an out of state, secure treatment facility) to be at the Maine State Prison. We love to have (family) involved, but the law doesn’t provide for a situation where we can do that.”

He noted Maine officials ensured a patient sent to the South Carolina facility will be able to communicate with family. He said they will be able to do so, through Skype and by phone.

Mehnert said Reed is close to his family and, in previous court appearances, turned to talk to his dad to inquire about other members of his family.

Cheney said Correct Care Solutions officials believe communicating with family is an integral component of a successful treatment program and patients at the Columbia Regional Care Center have the ability to maintain contact with family by phone and mail. He said provisions are also made so patients there can communicate with their lawyers.

The facility typically has about 290 patients, about 220 of which are from the state of South Carolina. The remaining 70 patients are from other states, sent there either by the federal government or other states which have agreements with the company to take patients.

Correct Care Solutions has operations in Maine, providing healthcare workers for Maine correctional facilities including Long Creek Youth Development Center in Portland and Maine State Prison.

Keith Edwards — 621-5647

[email protected]

Twitter: @kedwardskj


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