Sweetser, a Maine behavioral health nonprofit, will establish the state’s first secure residential program for children with severe mental health conditions in 2026 after it was the only organization to apply for a state grant to help with start-up costs.
The Maine Department of Health and Human Services awarded the $2 million contract on March 20, marking a major advancement in the state’s yearslong effort to create a psychiatric residential treatment facility in Maine, which began in 2018. In the years since, the state has struggled to attract a provider due to the cost to create and run such a program.
Mental health providers have decried the lack of in-state options for adolescents who require intensive supervision due to the severity of their psychiatric issues, especially for children prone to violence or running away. Developing a locked, long-term program for them will prevent as many children from languishing in hospital emergency rooms or seeking residential care in other states, they have argued.
But developing a locked-door program in Maine hasn’t been without criticism from some advocates who are wary of the model and would prefer that state officials prioritize rebuilding its network of community-based services.
Sweetser — the only provider to bid for start-up money that state health officials made available in December — plans to use the funds to renovate an existing unit of its Saco campus to upgrade security and safety requirements, such as adding furniture that is fastened to the ground. It anticipates accepting referrals in the spring of 2026, according to documents submitted in its application to the state.
“Sweetser is proud to lead the effort to bring our kids home from expensive, out-of-state care,” said Sweetser CEO Jayne Van Bramer. “Our goal over the next year will be to create a therapeutic space in Saco that families can be proud of. With this decision, the state has taken a significant step toward filling a critical gap in the continuum of care and ultimately strengthening our youth behavioral health system.”
The program will serve 12 to 16 children at a time in MaineCare, the state’s Medicaid program. Slots will be prioritized for Maine kids, according to the application. A combination of clinical and social work staff will treat adolescents with a variety of psychiatric and behavioral health disorders, including problematic sexual behavior and substance use. They will use “an array” of individual, group and family therapies, according to the 29-page application containing detailed descriptions of how the nonprofit will oversee treatment and staffing.
Sweester expects the program will be financially sustainable under the proposed MaineCare rate, the application said, and the nonprofit’s board and leadership are committed to making up for any funding deficits as it gradually takes on clients and gets the program off the ground.
The program will expand the state’s range of intensive-care options for adolescents at a time when Maine is also required to beef up the community-based end of the behavioral health system.
Late last year, the U.S. Department of Justice reached an agreement with the state in court to strengthen Maine’s beleaguered network of community-based children’s behavioral health services. The federal government had sued Maine in September for violating the Americans with Disabilities Act by failing to sustain an adequate number of community-based services for kids with disabilities, forcing them to become unnecessarily institutionalized in hospital emergency departments, psychiatric hospitals, residential programs and the state’s youth prison.
A stakeholder group that met last fall to discuss the hundreds of kids bottlenecking in hospital emergency departments acknowledged that Maine desperately needed more in-home and community-based services. Still, a majority of members believed the state needed a secure residential program to ease the pressure on the system’s deep end, according to a January report.
Hospitals across Maine have become increasingly vocal about the worsening crisis: Young psychiatric patients can spend days, weeks — even months — in chaotic, windowless emergency departments because staff cannot find long-term placements that will accept them.
Maine’s existing youth residential treatment programs are unlocked, have long waiting lists and are often reluctant to accept youth prone to aggression, dangerous behavior or elopement due to understaffing. There are also dramatically fewer treatment beds available than there were five years ago, before the onset of the pandemic made it even harder to attract staff.
Representatives from Disability Rights Maine, a legal advocacy group, broke from the stakeholder group’s majority opinion, reiterating a long-held position that the state’s scarce resources should first go to services that prevent psychiatric conditions from worsening to the point where kids require hospitalization or residential treatment. The agency has also raised concerns that secure programs, which are more institutional and restrictive, undermine the therapeutic goals of treatment and put kids at greater risk of abuse.
Reporter Callie Ferguson may be reached at cferguson@bangordailynews.com.
