Remoteness and spotty Internet service hinder mental health care in Aroostook

Remoteness and spotty Internet service hinder mental health care in Aroostook
Remoteness and spotty Internet service hinder mental health care in Aroostook

If you are experiencing a mental health crisis, call the Maine Crisis Hotline at 888-568-1112.

When Michael McCormick of Caribou sought medical help for bipolar disorder, he didn’t think he’d have to travel 275 miles to find it.

Remote Aroostook County lacks enough providers, resulting in long waits for treatment. McCormick was placed on waiting lists, but to no avail. Discouraged, he visited his doctor, who helped him with medication and arranged for successful treatment, but he had to travel to Northern Light Acadia Hospital in Bangor.

The effects of the pandemic, homelessness and addiction are fueling mental health needs across the country, with calls for more crisis intervention and psychiatrists. But Aroostook County has unique obstacles to take care of. Residents of its small rural towns often have to travel to a larger community or out of the region altogether. Few suppliers come north. And there are gaps in internet service, so online help may not be an option.

It’s hard to be told you’re six months to a year away from dating, said McCormick, who has struggled with bipolar disorder for about 10 years.

«Six months, even two months, is a long time,» he said. «[Providers] I really want to help, but I think it’s a matter of the ratio of people who are sick and the amount of service providers available to help them.’

Lack of help in Aroostook County can lead to tragic results, as it did for Jacob Poitrau and Jacob Wood. Both were having mental health episodes when they were shot and killed by police. Poitrau’s mother blamed a broken system.

According to the U.S. Department of Health and Human Services, Fort Kent, Caribou and Presque Isle are «high-need» mental health professional shortage areas. The 2022 Maine Community Health Needs Assessment identified mental health as the No. 1 priority in Aroostook County, with a lack of providers and long waiting lists leading concerns.

«The missing resource is the clinicians for us,» said Esther Cyr, clinical director at Northern Maine General in Eagle Lake, a nonprofit social services organization. «Many have retired and fewer are coming, yet mental health needs and referrals are increasing.»

Northern Maine General, which offers outpatient psychiatric and residential care, has a waiting list of 60. Two to five new requests come in each week, but they can’t accept more referrals without more staff, Cyr said.

Mental illness can include depression, anxiety, bipolar disorder, post-traumatic stress disorder and many other conditions, according to the National Alliance on Mental Illness. Nationally, one in five adults and one in six young people aged 6-17 experience a mental illness each year, and less than half of these people receive care.

In Maine, 223,000 adults had a mental illness as of February 2021, according to the alliance. Of these, 65,000 received no care.

Rural areas have fewer providers and Internet capabilities, making telehealth appointments difficult. In fact, nearly a quarter of Aroostook households are without reliable broadband connections.

Before the providers even get involved, someone has to answer the calls for help. School counselors and law enforcement officers are frontline responders, and the demand for them is growing.

“I’ve seen at least a 50 to 75 percent increase in mental health issues in children in the last five years. There is definitely a mental health crisis,” said Corinne Matthews, a clinical counselor at Houlton Middle-High School.

Matthews sees 30 or more children a week. Five years ago, she was seeing maybe 15 students a week, she said.

Students still struggle with fear and anxiety from the pandemic, and many face poverty and unstable home environments where they can’t be successful, Matthews said.

Pediatricians often call her to see students until waiting lists are cleared.

“We lost about half of our suppliers in the Houlton area alone. Some agencies went bankrupt. Some have lost clinicians,” Matthews said. «They just don’t have the manpower to meet the needs of the community.»

COVID-19 has increased students’ mental health needs, said Allison Reed, director of guidance at Presque Isle’s SAD 1.

PRESQUE ISLE, Maine — March 15, 2023 — Presque Isle High School Guidance Director Alison Reed, shown in this photo, said students in Aroostook County are still dealing with the effects of the COVID 19 pandemic. (Paul Bagnall | The Star-Herald)

Although it is different for each student, the disruption of normal routines, social isolation, family stress, and adjusting to distance learning all cause anxiety and depression. These effects are not over.

«We will continue to see the impact of COVID for many years,» she said.

The Presque Isle Police Department handled more than 1,041 mental health cases in 2023, up 20 percent from 2022 and four times the pre-pandemic average, Chief Chris Hayes said.

There aren’t enough providers or places to refer people to in Maine, and most have limited staff for short-term care, he said.

«We’re on the front lines in law enforcement, so we need to continue to respond to mental health calls and offer as much help as we can,» Hayes said. «But we’re not trained mental health professionals, so we don’t think we’re accomplishing anything.»

Fort Kent Police Chief Michael DeLena reported 31 incidents in 2023 involving mental health. He attributed the influx largely to the opioid crisis and the combination of illicit drug use and mental illness.

«This often creates a psychosis that is difficult for law enforcement officers to manage,» DeLena said.

Fort Fairfield police noted that mental health cases increased 50 percent, from 2,124 in 2022 to 3,383 in 2023. Too few providers, rising substance use disorders and homelessness are factors.

Making things better for people in the county with mental health issues will require a community effort, experts said.

As some Midcoast police departments do, Presque Isle police now work with social workers on some calls. The department also acquired a therapy dog ​​to help children and others while at the police station.

The county needs to restore the sense of community it had before COVID isolated people and made them afraid to gather together, Cyr said.

«We have to find a way to make people feel connected again,» she said.

People need affordable housing, said Matthews of Houlton Middle-High School. Inflation has made it harder for families to afford rent, heating and food.

A facility like Acadia Hospital would be huge for The County, said McCormick, who has also struggled with addiction and lives at Recovery Aroostook Home in Caribou. He’s open about his struggles and successes because he wants people to know it’s okay to ask for help.

School and community counselors need to work together to help people understand this, SAD 1’s Reid said.

«We need to reduce the stigma around mental health,» she said. «The emphasis should be on the fact that seeking help is a sign of strength, not weakness.»

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