AUGUSTA, Maine -- With about three weeks left in the legislative session, mental-health advocates want lawmakers to increase the funding for essential MaineCare services in order to attract more badly needed staff.

Experts contended long waiting lists often mean families can't get counseling and end up in crisis.

Amy Cohan, vice president of outpatient and community services for Spurwink Services and a licensed clinical social worker, said at times there have been as many as 500 families waiting for in-home counseling, especially people who live away from the I-95 corridor.

"Insufficient rates make it really impossible for providers to travel to families' homes, particularly in rural parts of the state, in a financially sustainable way," Cohan explained.

Cohan noted during the pandemic, calls to hotlines, rates of anxiety and depression, suicidal thinking and suicides all rose sharply. In addition, opioid overdoses increased to record levels, reversing progress made in recent years.

Multiple bills, including Legislative Document 432 and Legislative Document 1173, which are intended to address the situation, are waiting to get a vote. Lawmakers need to finalize the budget before the session ends on June 16.

Opponents objected to the cost of raising providers' pay, but supporters countered it's crucial in order to attract more people to the social-services profession.

Rep. Colleen Madigan, D-Waterville, co-sponsored several bills to help alleviate some pressure.

"There needs to be more money put into put state now so that kids can stay at home," Madigan asserted. "They can be treated in their communities, and they can get the behavioral health care they need before they wind up in an emergency room or needing inpatient hospitalization or residential care."

Madigan pointed out many programs have been forced to cut services for lack of staff, leaving families no option but to send their children out of state to find a residential placement.

David McCluskey, executive director of Community Care, a nonprofit that treats people with mental illness, said the staff shortages translate into a broken system that causes real suffering for families.

"So there's people who are waiting to leave psychiatric hospitals because there's no place for them to step down to," McCluskey stressed. "And then there's also people waiting to get into hospitals. And so the system is sort of frozen."

The state's largest county has just opened the new CARE Court system, designed to get help for severely mentally ill people in Los Angeles.

CARE stands for "Community Assistance, Recovery and Empowerment," a court where families, roommates, social workers, first responders and clinicians can petition a judge to get people the assistance they need.

Samantha P. Jessner, presiding judge of the Superior Court of Los Angeles County, said a person must be 18 or older, and participation is voluntary.

"They must be diagnosed within the 'schizophrenia and others' psychotic disorders class," Jessner outlined. "They must be unlikely to survive safely in the community without support. Participation in a CARE plan must be the least restrictive alternative."

The National Alliance on Mental Illness in California supports the CARE Courts, noting people suffering from schizophrenia are sometimes unable to recognize their diagnosis, are resistant to treatment, and too often end up homeless and fighting addiction. Some disability rights groups have expressed concern people could be forced into treatment.

Janice Hahn, chair of the Los Angeles County Board of Supervisors, explained the motivation behind the program.

"Families are at the end of their ropes, and communities are frustrated," Hahn observed. "Leaders up and down the state have felt like our hands have been tied. It's a tool we will use to get people the care that they so desperately need."

People can contact their county CARE Court to start the process. CARE Courts are also now open in Glenn, Orange, Riverside, San Diego, Stanislaus, San Francisco, and Tuolumne counties. All counties are required to participate by the end of next year.

Lisa Pion-Berlin, president and CEO of Parents Anonymous, which runs the California Parent and Youth Helpline, added her organization is available to help.

"We are here to support people to deal with their underlying issue," Pion-Berlin emphasized. "There's a lot of fear of this idea of this new process called CARE Court. Will it be caring; will it be empathetic? Will they reject it? Is it punitive? Is it going to be helpful?"

People can contact the California Parent and Youth Helpline online or call or text 855-427-2736.


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A new program in Utah wants to help first responders learn to recognize and work through their traumatic life events through horsemanship. This coming Saturday, Rein in Response will be holding its first official and free kickoff event in La Verkin.

Taylor Graff, owner of Rein in Response, said sessions are set to begin early next year and added while pricing is still being finalized, participants will pay a part of the total cost while sponsors will pay the balance.

Graff said she has been working with an equine therapist to develop the curriculum, which will teach first responders skills and tools to better manage trauma. For Graff, it's personal -- her father was a police officer for years, and felt the impacts of events he experienced on the job.

"Our family dynamics changed, relationships changed, and my dad changed. It was a really big deal, and none of us knew how to deal with it," Graff said. "We did not have the emotional intelligence to figure out what was going on."

An estimated 30% of first responders and public health workers can develop depression and post traumatic stress disorder, compared with 20% in the general population, according to the Substance Abuse and Mental Health Services Administration.

Graff said it is important to note the program isn't intended to act or replace actual therapy, but rather to be an outlet where one can release and get in better tune with their emotions.

She noted people can learn a lot from horses, since they'll react based on a combination of their own personalities and human behavior toward them. She adds that participants, in partnership with a horse, will learn how to read, de-escalate and negotiate situations in the round pen.

"We teach them how to get the horse back up and just going crazy, and then bringing them back down -- and we relate it to them. Then we teach them how that works in themselves and how they can do it with their families," she continued.

Graff wants first responders to know Rein in Response is there to show support and offer help, and adds it's always important "to lift those that are lifting us."


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Research shows two in 10 Iowa youth report they have considered suicide, and to confront the crisis, doctors and social scientists are using federal grant money to expand mental health services to rural Iowa children.

Child care and mental health experts at the University of Iowa are using a $2.5 million federal grant to reach out, especially to rural schools, which often lack services.

Dr. Tom Scholz, professor of pediatrics at the University of Iowa and director of the division of child and community health, said the trend was well on its way before the pandemic, which only made things worse. He stressed making up for lost time is critical.

"The sooner we can get at those kids, the sooner we can make the diagnosis, the sooner we can initiate therapies, the better those kids are going to do in school and with interactions with their family," Scholz outlined. "And as a foundation as they launch into their post school activities, into adulthood."

Doctors will partner with schools and a dozen community health centers scattered around rural Iowa to serve more young people who need mental health care.

Scholz pointed out the grant will help provide more online psychiatric visits for children, and researchers are working with local health centers to serve as many youths as possible in person. It's help that might otherwise be unavailable, because many kids are far from urban centers.

"It would have required them traveling to Des Moines, Iowa City, maybe Omaha," Scholz explained. "But we're able to provide services in the communities nearer to where they live."

The new grant allows University of Iowa psychiatrists to continue and broaden the work they have been doing. Last year alone, mental health specialists worked with community health centers in rural Iowa to provide nearly 2,000 online psychiatry visits for children who need help.