LEWISTON — The panicked calls come about once a night to Lewiston police.

A dad, a daughter, a roommate or neighbor is acting strange. Medications may be skipped. The person may be alone, afraid, anxious or depressed. 

Lt. Mark Cornelio doesn’t mind those calls. The Lewiston police officer — like officers and deputies throughout the Lewiston-Auburn area — have been given crisis intervention training. They know how to help. 

But it’s the calls that never get made that frighten Cornelio.

“Sometimes people snap,” he said. “Sometimes nobody knows.”

They should. That’s the message circulating in the wake of last week’s shooting in Arizona.

Jared Loughner, accused of killing six people on Jan. 8 in Tuscon, had been frightening people with his behavior for a while, according to numerous news reports.  He’d been kicked out of community college and arrested. He had received counseling, but he had never been treated for mental illness.

“Our society has to change,” said Carol Carothers, executive director of the Maine Chapter of the National Alliance on Mental Illnesses. “If we see someone with a mental illness on the sidewalk, we cross the street. It can’t continue.”

People must help, she said.

There are numbers to call, local experts say. There are people who can help.

One starting place may be the crisis hot line begun by Tri-County Mental Health in Lewiston. Its phone service, at 1-888-568-1112, is staffed 24 hours a day.

The people who answer the phones can dispatch immediate help, Executive Director Chris Copeland said.

“Someone also can call the number if they need advice about what to do,” Copeland said. “It’s not easy.”

And cases like the shooting are incredibly rare.

The vast majority of people with mental illnesses are neither a danger to themselves or others. Most are folks enduring mood problems and depression.

Dr. Michael Kelley, chief medical officer of behavioral health at St. Mary’s Regional Medical Center, figures that fewer than 1 percent of the 1,000 patients he meets every year are dangerous.

Even the severely ill people — those hearing voices or enduring chronic depression — rarely pose a danger.

“If they’re hearing voices, they’re just voices,” he said. If they’re getting angry, they may be getting angry at the dishes in the sink.

Kelley has followed some of the news coverage of the Arizona shooting, he said.

“Everybody’s like, ‘Why didn’t they do something?’ because everybody knew he was weird?” Kelley said.

It’s not that simple, he said. But the line is there if you know where to look.

“You have to watch the behavior,” he said. “Are they screaming at people? Are they physically menacing toward people? Are they saying things or posting things on their blogs that they want to hurt people?

“Anytime somebody says the words, ‘I’m going to kill myself’ or ‘I’m going to kill somebody else,’ that crosses the line,” he said.

At that point, seek help fast, he said.

“If somebody is acting dangerous, if someone is threatening suicide or threatening to harm people, you absolutely want to start with 911 because sometimes speed is of the essence,” Kelley said.

At that point, police can take someone into custody and take them to the hospital.

Locally, St. Mary’s is a kind of hub. It has a dedicated psychiatric emergency room.

“It’s a whole ER that is for nothing but behavioral health, which is one of a kind in our area,” Kelley said.

There, a full psychiatric screening and safety exam can be administered. The long-term health of the patient remains up to the patient, however.

“In Maine, all you can force is hospitalization, not treatment,” Kelley said.

Carothers believes the worst cases could be avoided with more compassion and community involvement.

Maybe the Arizona tragedy could have been avoided if a friend, teacher or family member had been more stubborn about getting help to a young man who was showing signs that he was sick, she said.

There is no law in Maine that requires teachers or others to alert authorities if they believe someone is mentally ill and potentially violent. Mental health workers have a legal obligation to alert someone if they believe a person is in imminent danger.

But Carothers believes the obligation belongs to everyone.

“If you saw someone have a heart attack, you’d rush to their aid,” she said. “You’d try to help.”

The impulse has to be the same when someone is mentally ill, she said.

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