The print headline of an editorial in this newspaper has preyed on our minds since we read it (“Our View: Failing system fuels violence in hospitals,” July 24, Page D2).

Repealing a federal law that bars states from using Medicaid to pay for care in psychiatric facilities with more than 16 beds could prevent up to 50 percent of mass killings, 29 percent of family homicides, 10 percent of all homicides, 20 percent of law enforcement fatalities and more than 40,000 suicides annually. weeranuch/

We respectfully disagree.

Through years of inaction and discrimination, our society fuels the violence. The true “heart of the problem” is that too many Mainers with psychiatric disorders are in crisis in the first place. They need, and rarely get, non-stressful care settings, which hospital emergency rooms cannot provide. Why does our society continuously fail these Mainers by inadequately or not providing these services at all?

Public policy based on outdated and discriminatory thinking is a major factor fragmenting our health care system and harming our nation. People with serious brain disorders such as schizophrenia, bipolar disorder and major depressive disorder suffer the most. These illnesses are understood the least.

Science is slowly concluding that the human body is one system, not two parts. Our society has not caught up with those scientific findings. As a result, too many with brain disorders are on the streets or in hospital emergency rooms, jails or, worse, cemetery plots.

If you want to end hospital violence in Maine and America and violence in general, start by ending the Medicaid Institutes for Mental Diseases law, an outdated, discriminatory federal law created in 1965.


Under this law, no federal funding can be used to finance mental or substance-use disorder care for Medicaid beneficiaries aged between 21 and 64. The law applies to public or private psychiatric facilities with more than 16 beds, even residential psychiatric services in the community.

The main intent of the “institutes for mental diseases” exclusion was to discourage states from using federal money to pay for psychiatric inpatient care. Unfortunately, the federal government succeeded. Many state hospitals across the nation have closed, and community psychiatric inpatient services have not developed because of the exclusion.

We’re advocates for some reasonable level of psychiatric inpatient care in Maine and across America. Prisons and homeless encampments aren’t the answer, Neither are hospital emergency rooms. By keeping in place this outdated law, the federal government thwarts the development of more comprehensive services, including psychiatric inpatient care.

We taxpayers have been footing this bill for inpatient care for 57 years. Why shouldn’t the federal government pay its fair share? Why hasn’t our state government done its part by implementing a waiver for mental illness? It has one for substance abuse. Aren’t both co-occurring brain disorders?

Five members of the Maine Legislature – Sen. Joseph Baldacci and Reps. Lynn Copeland, Margaret Craven, Barbara Cardone and Anne Perry – are profiles in courage. By letter, they urged Sens. Susan Collins and Angus King and Rep. Jared Golden to repeal the “institutes for mental diseases” exclusion law.

The National Shattering Silence Coalition, which is based here in Maine, calls upon all of us to “shatter the silence” about serious brain disorders. By eliminating the exclusion law, the Treatment Advocacy Center estimates the country could eliminate up to 50 percent of mass killings, 29 percent of family homicides, 10 percent of all homicides, 20 percent of law enforcement fatalities and more than 40,000 suicides annually.

Our federal government must pay its fair share of all the services required for those with serious brain disorders. In doing so, it could save itself and us taxpayers billions of dollars.

But ending this deeply outdated law isn’t just about the money. It’s for the health and safety of both Maine and America.

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