Belfast Police Chief Mike McFadden (Photos by Brian P. D. Hannon)
Belfast Police Chief Mike McFadden (Photos by Brian P. D. Hannon)
" “Jails were never designed to be mental health institutions” "
Belfast Police Chief Mike McFadden picked up an envelope from a corner of his desk. The card inside was from a woman his officers had arrested on multiple occasions, including 16 times in a single summer.

She was a glaring example of a problem facing law enforcement officers and administrators on an almost daily basis: how to deal with people suffering from mental health issues. And in this particular case, McFadden said he took it as far as he could go.

“We brought her to the hospital, we brought her here, we worked with the courts, we tried to get her mental health treatment,” said McFadden, seated with his back to corner windows looking onto a downtown intersection. He acknowledged that nothing worked until he stepped outside of the usual chain to deal with what he considered an extraordinary case.

“I failed to get her the treatment that she needed until I called the governor’s office and I said, ‘This is where the buck stops. You are going to help me get this woman the treatment she needs,’” he said.

McFadden did not mention and was not asked for the woman’s name or the details of her condition, the same guidelines followed in interviews conducted with other law enforcement, medical and mental health professionals in the midcoast. They agreed to discuss the legal difficulties created by mental illness largely because of a shared desire to erase its social stigma and past criminalization.

“The model has changed”

McFadden began his policing career as a guard at the Waldo County jail in 1989-1990 during what he calls a transformation period, when the attitude toward involuntary detention — known as “protective custody” — was changing.

“There were jail guards who worked there who operated under the old way of doing things that were no longer acceptable,” he said. “They would bring people with significant mental health disorders into the jail for protective custody. They weren’t necessarily under arrest, they were a danger to themselves or others.”

They were brought to the jail so psychiatric evaluations could be conducted in a secure setting. “And it initially kind of made sense that that would happen,” but, he said, law enforcement professionals began questioning prevailing attitudes toward mental health.

“Why are we putting these people in jail? They didn’t do anything wrong, they’ve got an illness. They need treatment, they don’t need to be in jail. This is wrong. It sends the wrong message. It’s using a tool that we have in a wrong way,” McFadden said. “I don’t think people had really thought much about it. It seems logical. Except that we’re locking people up in a jail for being crazy, being not able to cope. That damages them further.”

“I think the whole system now better understands the complicated problem mental health issues present to us,” he said. If Belfast police take someone off the street for his or her own safety — due to a mental health crisis or what McFadden calls “extreme cases of intoxication” — they are no longer escorted directly into a cell. “We still take people under protective custody, but we take them to the hospital now.”

Those changes in commonly held perceptions have led to updated policies throughout the law enforcement community. Twenty-six miles south of McFadden’s office, Rockland Police Chief Chris Young said the training and policies that have taken hold in the past 15 to 20 years lead his officers to evaluate and converse with people acting strangely rather than moving immediately to restraint. Instead, they ask questions that can help determine the root cause of a problematic situation.

“What is going on here? Is this a person who’s having a mental health episode or is this a person who’s withdrawing from, let’s just say for example, opioids? And to be able to assess that through communication and dialogue with them,” Young said. “And then not only not force them to go one direction or the other to get treatment, but let them have a say in how we can help them and what treatment they think they need.”

“The model has changed,” Young said. Previously, the usual police tactic ran along the lines of, “‘Okay, you’re coming with me whether you want to or not.’ And then you’d take them down to the hospital and it would usually end up being an involuntary situation.”

Involuntary confinement tied up hospital resources, as well as an officer who had to remain with unwilling patients. Today, Young said, police routinely take a less authoritarian approach.

“If we’re talking about a mental health situation and a person is in crisis, ideally, and most of the time what we see is the officer on scene is able to get that person to go to the hospital with them so that they can talk to somebody at the hospital,” Young said. “We’re often dealing with the same people, and there’s a trust level there now that I think was lacking 15 years ago under the old models.”

If an officer identifies a mental health issue with potentially dangerous results, the first stop now is an examination room, not a cell. “If they say or do something that leads us to believe that they are a threat to themselves or to somebody else, they are going to the hospital,” he said. “At that point in time, even if there are underlying criminal charges, jail is not the appropriate place for them.”

Another strong advocate of that view is someone who helps oversee a jail.

“Jails were never designed to be mental health institutions,” said Jason Trundy, deputy chief of the Waldo County Sheriff’s Office (WCSO). “But across this country that is what many of them have become because of the fact that when someone isn’t connected with services, they don’t seek out services, or their mental health starts to slide and they go into crisis, and it leads them into contact with law enforcement.”

Trundy’s office includes a patrol division that conducts law enforcement duties in cooperation with local police departments and a division operating the Waldo County Corrections Facility in Belfast. Prisoners can be held there awaiting bail for up to 72 hours, after which they are transferred to Two Bridges Regional Jail in Wiscasset.

“The sheriff’s primary legislative duty is to maintain a county jail,” Trundy said. “That puts us in a position where, post-arrest, we have the responsibility of dealing with individuals that have mental illness. So for us it’s kind of a twofold approach.”

The WCSO patrol branch received approximately 80 calls in 2007 labeled as “mental medical,” the designation placed on situations arising from mental illness. He said that figure “doesn’t come close to capturing the real picture” of the number of daily situations involving some level of mental illness. Mental health may play a part in many more calls, he said, but symptoms are not prevalent enough for deputies to recognize them or seek a referral to a medical or counseling professional.

Trundy said that a decision to arrest is made on an individual basis, but there are procedures to ensure mental health situations are not overlooked.

“If I have probable cause to believe that you are a risk to yourself or to someone else, regardless of whether you’re arrested or not, your very first stop is at the hospital,” he said. Even for those who commit a crime and are brought to the jail following an arrest, the facility’s procedures include questions that screen for mental health issues such as suicidal thoughts.

“We can’t accept them here”

Inside a painted, concrete garage bay that serves as both a connector and barrier between Public Safety Way and the jail in Belfast, the doors slide down behind patrol vehicles that have arrived to begin the process of transferring new arrestees to the custody of jail staff. They undergo a screening process before moving through the door leading from the garage to the jail’s booking area.

Holly Castle is relatively new to the Belfast facility, but is a veteran corrections officer after four years at Two Bridges in Wiscasset. She holds a clipboard with a sheet of questions, each one a potential obstacle to the interior of the jail where arrestees become inmates.

“Do you have any broken bones, profuse bleeding, any cuts that need stitches?” Castle begins. She then asks about drugs and alcohol before proceeding to psychological screening. “Are you thinking about committing suicide right now? Have you ever thought about it in the past? Have you ever attempted it in the past?”

Any answer that suggests a mental health issue immediately sends an arrestee back out of the garage with an officer on the mile-and-a-half drive to Waldo County General Hospital. 

Any indication of mental illness or crisis, Trundy said, makes jail a secondary option. Medical personnel make an initial evaluation before a mental health professional assesses the arrestee-turned-patient. “The crisis worker would have to make a decision about whether that person needs hospitalization or not,” he said.

The screening is intended to decrease the number of inmates who should instead be receiving mental health treatment. “There are far too many people being held in our county jails and in our state jail systems that are suffering from some form of mental illness and that contributed somehow to the crimes they committed,” Trundy said.

Raymond Porter is the corrections administrator for Waldo County. Like Trundy — as well as Chief Young in Rockland and Belfast’s Chief McFadden — he has seen a change in attitudes toward mental illness among law enforcement professionals, including those within the walls of community jails.

“I believe that there’s been a culture shift in corrections, and this is probably nationwide … where it’s more of a therapeutic community,” Porter said.

Overcrowding in jails has pushed corrections officials to focus on reducing recidivism — repeat offending — not only for the “humanity” aspect, Porter said, but as a way to reduce costs; fewer jail occupants means fewer bills for taxpayers. The result has been an effort to understand the science underlying mental illness and the benefits of treatment over incarceration.

“It’s been a blessing in disguise,” Porter said. “It’s shifted this culture to … doing more evidence-based practices and seeing what works with individuals.”

The culture shift has also fostered communication and partnerships between law enforcement and family members seeking the best option for relatives suffering mental crisis. Positive results are apparent to those on both sides, and just as pleasing. 

“I love it when they get the right treatment with medication and counseling and they’re doing well,” Porter said. “That’s when you know this is working, this is what we need.”

Unfortunately, mental health does not have any easy or permanent fix. “The individuals come in and you really get to know them when they’re doing well. But then when they go off their meds and they’re not doing well, it’s tough on the staff,” Porter said.

“I don’t think it’s adequate”

Law enforcement officials stress that mental illness frequently coexists with drug abuse, including the opioid epidemic spreading misery throughout Maine. Yet McFadden said mental health incidents have become a primary concern for Belfast police.

“It consumes the majority of our time,” he said, noting that in 2018 his department had somewhere between 50 and 250 cases involving mental illness, depending on how the data is parsed. A call for a domestic disturbance, for example, may eventually be classified as a mental medical case once all the information is logged and the context is analyzed.

The necessity of dealing with mental health draws on police resources in the street and in their budgets.

“What the public should know is that we do recognize it. We are proactive in trying to address it. And it is resource driven,” Young said. “It takes a lot of our resources when we’re dealing with these situations. Even a simple mental health crisis where we transport somebody voluntarily, that could be easily an hour, hour-and-a-half, of an officer not being on the road.”

As in many other communities, mental illness has become a staple of Rockland’s workload. “We deal with it weekly,” Young said. “Absolutely weekly we have mental health calls for service.”

Asked whether relevant services in his area are sufficient, Young responded without hesitation: “No.”

“I think that the service providers we have do a great job, and they’re doing everything they can,” he said. “But I don’t think it’s adequate.”

“You need more people to be able to conduct home visits and follow up with people to make sure they’re taking their medications, to make sure that they’re doing okay. More clinicians to treat in the office environment, even if it’s only a day-treatment type of a program. And more facilities for those people that truly need to be in there until their issues can be resolved,” he said.

The Consent Decree of 1990, which settled a class-action lawsuit over overcrowding and other conditions in the Augusta Mental Health Institute, requires the state’s Department of Health and Human Services to maintain a comprehensive mental health system. Yet the person appointed to oversee the decree, retired Maine Supreme Judicial Court Chief Justice Daniel Wathen, announced in January he is preparing legislation that will end it. He informed members of the legislative Health and Human Services Committee that he intends to provide Gov. Janet Mills with a proposal before the end of the current session. Supporters say the decree has been largely ineffective due to underfunding.

Trundy believes the lack of resources statewide creates a situation in which those afflicted by mental illness are not receiving necessary services, while police are taken away from other responsibilities.

“I’ve literally seen people sit in the emergency room for days and days and days waiting for a bed somewhere to open so that they can go to it. Because the decision has been made that they’re at a point where they need hospitalization, they need care to that degree, so jail is not an appropriate place for them,” Trundy said.

“If they haven’t made it to jail, they haven’t made it to the point where we can get them to court and get them arraigned and get a bail set and get them released from custody,” he said. “So they’re still stuck in custody, but they’re sitting in the local emergency room waiting for a bed to open somewhere.” In the meantime, officers “will stay with them 24 hours a day, seven days a week.”

“There needs to be more capacity in the system for individuals that need hospitalized-level care,” he said. “When they’re in custody it makes it a little more difficult because they need that very specific type of bed. But even when they’re not in custody … even those folks struggle to find capacity in the state system for hospitalization.”

At Waldo County Jail, Porter said public involvement is key to curing the problems that bring those with mental illness into the criminal justice system. “The more we can partner with the community, family members, and stakeholders and providers, the more effective that we are,” he said.

“It’s not hard to be an advocate”

When McFadden contacted the office of former Gov. Paul LePage about the woman his officers had arrested multiple times, he demanded assistance to get her adequate treatment. “We can do a little better on the streets of Belfast than let this poor woman suffer,” he told a staffer. “I said, this is unacceptable here.”

McFadden said he doesn’t want to be “the guy who calls the governor’s office every other day” — and this was the one time he sought assistance at that level — but the effort was rewarded. “It was less than 10 hours later. She was in a high-quality mental facility. She stayed there for almost a year, and she is out and she’s successful,” he said.

The “heartbreaking” experience of intervening with both friends and strangers struggling with mental illness has reinforced McFadden’s sense of responsibility to help stricken community members achieve the quality of life he believes everyone deserves.

“When you see profound mental health issues and see how destructive they are and how they ruin the quality of life for these people, it’s not hard to be an advocate for this type of thing,” he said.

Reaching back to his desk, McFadden took hold of the Christmas card again, opened it, and read aloud from the note written by the unnamed woman:

“Thank you for helping me when I needed your help.”