Why the AMHI Consent Decree Matters

Posted on March 13, 2017

by Kevin Voyvodich, Esq.

Recently, DRM made a presentation to the Legislature’s Health and Human Services Committee about the history of the AMHI Consent Decree and where it stands today.  Signed in 1990, the Consent Decree is an agreement between residents of the Augusta Mental Health Institute and the State of Maine.  The Decree resulted from a lawsuit that was filed in response to problems at the state hospital, including the deaths of a number of patients in the summer of 1989, and problems with the lack of resources in community mental health system.  The agreement required the creation of a new comprehensive state mental health system and outlined the rights of recipients of mental health services.  Although 27 years old, the principles and goals of the decree related to the treatment of individuals with psychiatric labels both in hospitals and in the community have stood the test of time.  In order for a system to adequately meet the needs of individuals without taking away their rights and dignity, all of the principles and goals of the Consent Decree, outlined below, must be realized.



These principles and goals clearly focus on providing supports for individuals to achieve their wants, goals, needs, while moving through a system that focuses on individual support.  Fewer institutions, person-driven treatment, and least restrictive treatment environment are the common themes. People are often told what it is they need, but it is important to remember to ask the individual about the hopes and goals they have for their own lives.

There is a shift in the provider-client relationship when a client is asked about their needs. Often the provider simply asking that question creates a treatment process that focuses on the individual. Too many times I have seen a person sent to a setting based on what is available rather than what the individual or, in some cases, the provider believes would be the best treatment setting. The goals and principles of the Consent Decree remind us a system that provides treatment must focus on the individual.  They are entitled to flexible, quality, dignified treatment that works for their specific mental health needs. Too often, the need to comply with Medicaid’s complex billing requirements dictates the services an individual receives.  We must remember, however, that the Consent Decree does not depend on a specific source of funding, but rather it outlines what services are necessary in order to provide a comprehensive mental system that serves the individual needs of consumers.

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