By Ramona du Houx

Photo of Maine state capitol by Ramona du Houx

February 5, 2021 a new landmark agreement was announced that charts a path toward ending the Augusta Mental Health Institute (AMHI) Consent Decree. For more than three decades, the Consent Decree has required the State to build and maintain a comprehensive mental health system that meets the needs of Maine people due to historic failures to do so.  

The Consent Decree is the result of a 1990 class action lawsuit brought on behalf of residents of the former AMHI following the deaths of 10 hospital residents. The legally binding agreement required the State to rectify problems at AMHI and over time establish and maintain a community mental health system responsive to the needs and rights of individual consumers. 

A lot of work has been done to repair the damage caused but needs oversight to ensure DHHS is on the current course. To that end, the Maine Department of Health and Human Services (DHHS); Office of the Maine Attorney General; counsel for the Consent Decree plaintiffs, Disability Rights Maine; and Court Master Daniel Wathen have agreed to a set of evidence-based, measurable performance standards that support timely access to mental health care, protect client rights, and establish compliance requirements that, if met, could potentially end the Consent Decree within two years.  

“The creation of the AMHI consent decree three decades ago marked the beginning of a long and necessary process to improve Maine’s mental health system. It has touched the lives of countless Maine people, from the original plaintiffs and their loved ones to those in need of compassionate and effective care over the subsequent decades,” said Governor Janet Mills. “With this landmark agreement, the resolution of the consent decree is within sight. I look forward to the remaining work that must be done and applaud DHHS, the Maine Attorney General’s Office, Disability Rights Maine, and Court Master Judge Wathen on reaching this milestone.” 

The agreement also includes expansion of advocacy through Disability Rights Maine, protection of funding for the Consumer Council System of Maine, and designated resources within the DHHS Office of Behavioral Health to assist clients facing challenges accessing services.  

Under the new agreement, the parties will be able to request the Superior Court’s dismissal of the lawsuit  after the State meets the 17 performance standards in four out of six consecutive quarters. The first quarter will begin after DHHS concludes MaineCare rule making now underway to ensure individuals with serious mental illness receive and maintain access to core community mental health services.  

“The Office of the Attorney General appreciates the extensive and collaborative efforts of the parties to reach this agreement,” said Attorney General Aaron M. Frey. “The OAG is optimistic that the Department is on the right path to demonstrating substantial compliance with the new standards and successfully meeting the goals of the consent decree in the foreseeable future.” 

In addition to rule making, DHHS has strengthened enforcement of its contracts with mental health providers to ensure patients receive the services they need. The Department has also worked with Disability Rights Maine to support its advocacy of mental health clients.  

“Since 2019, DHHS has demonstrated a willingness and a commitment to hold providers accountable for their performance obligations and improved data to mark its progress,” said Court Master Daniel Wathen. “I commend the parties for reaching this agreement, which sets forth a reasonable and meaningful definition of substantial compliance and provides the tools needed to achieve it.”