Joe Pickering Jr., Mary Barker and Jennifer Johnson all know the challenges of caring for sons with severe mental illnesses. All believe help is available via a three-letter acronym: PTP.
It stands for Maine’s Progressive Treatment Program, which allows judges to order those with severe mental illnesses who are at risk of harming themselves or others to receive assisted outpatient treatment. Then-Gov. John Baldacci expanded the program in 2010 to allow police and medical providers to seek the court-ordered treatment, instead of just the state-run Dorothea Dix and Riverview psychiatric hospitals in Bangor and Augusta.
Another expansion is needed in the form of additional federal funding and awareness of the law in Maine, according to Barker, Johnson, Pickering and other advocates who have spoken up more frequently about the program since last year’s mass shooting in Lewiston.
That rampage instead led policymakers to tighten a “yellow flag” law that allows courts to temporarily remove weapons from people deemed dangerous. Skepticism of expanding the Progressive Treatment Program comes from various influential corners, including disability rights advocates and the administration of Gov. Janet Mills, a Democrat.
The debate illustrates the trickiness of finding consensus amid a complex web of mental health treatment rules. Maine and other states have struggled to build out the community supports that were intended to come on the other end of the deinstitutionalization movement that emptied out hospitals in the 1960s and 1970s.
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The Progressive Treatment Program is an example of one of those programs. Patients in the program may live in a group home and receive regular check-ins from providers and therapists on managing their medications, attending appointments and avoiding drugs.
The “National Shattering Silence Coalition” believes Maine could save lives and use the program more by seeking an exemption from a federal policy that prevents states from using Medicaid dollars to pay for patient care in institutions that have more than 16 beds.chris
Maine and 36 other states have similar waivers for substance use disorder treatment, but Maine is not among the 12 states, including New Hampshire and Vermont, with waivers for mental health treatment. A bill from Sen. Joe Baldacci, D-Bangor, whose brother approved the Progressive Treatment Program expansion as governor, directed Maine’s Department of Health and Human Services to apply for the federal waiver but was not funded in this year’s budget.
“We’re allowing tragedy before treatment instead of treatment before tragedy,” said Pickering, whose son, Chris, died in a 2020 Bangor apartment fire at the age of 46. Chris Pickering led Bangor High School to the 1993 boys state basketball championship before going in and out of treatment for schizophrenia for years.
The 16-bed cap is meant to prevent problems associated with widespread institutionalization, but advocates argued the policy discriminates against mental illness and prevents Maine from adding more beds to treat those at risk of harm. Opponents of Baldacci’s bill argued many of Maine’s 500 or so psychiatric beds are not in use.
“I talk to hospitals all the time. Some of them will say we have a physical bed, but we don’t have someone to staff it,” Disability Rights Maine managing attorney Mark Joyce said.
Margaret Longsworth, director of mental health and clinical services for OHI, a Bangor-based nonprofit that assists people with disabilities and had not taken a stance on Baldacci’s bill, said few practitioners in the community are trained in using the Progressive Treatment Program, but she added “we have seen it do some really good things for the people who are on them.”
“We don’t want anyone to be in a hospital longer than they need to be, but they can’t be in the streets,” added Johnson, whose 50-year-old son is in an OHI-run group home after spending several years at Dorothea Dix, where “his psychosis was so bad he could barely walk and talk.”
The Mills administration did not take a stance on the bill from Baldacci, who said he intends to reintroduce next year the request for the waiver that would require about $1.3 million annually in state funding while unlocking about $3.6 million in matching federal money.
Maine’s Office of MaineCare Services told lawmakers the state would also need $500,000 over five years for evaluation and data tracking and recommended aligning any application with the substance use disorder waiver expiring in late 2025.
Mills did not respond to requests for comment, but Baldacci echoed advocates who said they think the governor is “reluctant to support it because certain groups are concerned it would be a return to institutionalization.”
As the country faces billions in annual costs to treat those with schizophrenia, Maine has nothing to lose with expanding the Progressive Treatment Program and removing the federal bed limits, according to supporters who feel the program could have prevented violent acts perpetrated over the years by loved ones. About 61,000 adults in Maine have serious mental illnesses, per NAMI Maine.
“Later is better than never at all,” said former state Sen. John Nutting, a Democrat from Leeds, who co-sponsored the 2010 expansion.
In the meantime, Pickering continues to fight for his late son. Johnson and Barker feel grateful their sons are in treatment. Barker’s 26-year-old son has schizoaffective disorder and lives in a Belfast group home after spending years homeless and in jail before his mother learned in 2023 about the Progressive Treatment Program.
“He really wants a job,” Barker said. “He really wants to have peace in his life and just have a normal life.”
