The tearful mom testified that her son chose to live under a bridge rather than be forced to live in an institutional setting where he would receive all the services that he needed.

The young man suffered from a very serious and persistent mental illness and had tried to commit suicide a number of times. He felt that he could not live in the only setting that would provide for his needs, so he lived out in the open while the weather was fair enough for him to do that.

I am a social worker who has worked with families with members who have severe and persistent mental illness and know first-hand the devastating effects that these illnesses have on the individual and their family.

I was, therefore, shocked when attending a recent legislative hearing and heard the testimony regarding the requirements of mentally ill citizens of Maine who want to receive services in their own home. That is not a possibility for all services.

In 2009, the state of Maine began to require that adults with severe and persistent mental illness live in a private, non-medical institute if they wish to receive the full spectrum of medically necessary, community-based rehabilitation services.

Let me be clear about that. That is a group home or other institution setting. Yes, sometimes that is the best place for someone in need of oversight and support, but it should not be a requirement in order to receive the services they need.

An individual should be able to live in their own home, where they can feel comfortable and, hopefully, make progress toward rehabilitation and wellness. Institutional settings should not be the only option available as a place of residence.

People with medical illnesses and disabilities live in their choice of settings and receive their services and treatments where they live. If I have multiple sclerosis, cancer or diabetes, I do not have to live in a medical setting to get my treatments. Why, then, is it acceptable for the state to force someone with a mental illness to live in a specified institution (and sometimes in a specific bed) in order to receive the services that will best serve their medical and rehabilitation needs?

Following the deinstitutionalization of the Augusta Mental Health Institute, a class action lawsuit resulted in the development of the AMHI Consent Decree. That consent decree was developed to protect the rights of those patients that came through the doors of the hospital.

The principles of the consent decree also inform the mental health services and practices provided to adult patients receiving mental health services in Maine. These principles state that independence is to be reinforced and that a service must be based on the needs of the individual patient in the least restrictive appropriate setting. The requirement of the state to have an individual live in an institutional setting flies in the face of those principles.

Sen. Margaret Craven is sponsoring LD 87. It is important for the Legislature to support that bill. It would send a message to the mother of the mentally ill son that the citizens of Maine do not want to force anyone to live in a setting that is not conducive to their best health and well-being.

Cindy Pooler of Chelsea is a social worker and a member of the National Association of Social Workers.


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