EDITORIAL: Inexplicably, unnecessarily, Maine endangers critical mental health services for young people

Sept. 12--First came the news that the Maine Department of Health and Human Services was turning away the last three years of a five-year federal grant it had applied for and won.

Then came the department's attempt to explain its decision to reject the $3 million in federal funds meant to help the state improve its ability to serve teens and young adults with mental health challenges.

"We found these services can continue uninterrupted by folding them into current state spending within the Mental Health Block Grant, Medicaid program and other funding sources," DHHS said in a statement issued Friday morning. "Whether we are utilizing Federal or State dollars, we have a responsibility to manage those dollars with utmost frugality and integrity -- it would be irresponsible to continue drawing down these grant dollars when other funding sources exist."

We're happy to see DHHS say it values the services that young adults with mental health services need so they can transition into productive adults, and not people debilitated by mental illness.

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But we have our doubts that the picture is as rosy as the department makes it out to be and fail to understand how returning federal funds and paying for these services with state and other federal funds already allocated to other purposes adds up to "frugality and integrity."

Three-quarters of mental health conditions have emerged by age 24, according to the National Institute of Mental Health, and decades of research have shown convincingly the value of early treatment of mental illness. Yet it's notoriously difficult for young adults to access the mental health services they need -- whether the reason is no or limited insurance coverage, a shortage of specialists in adolescent mental health, or a general reluctance among young adults to seek help.

Fewer than half of U.S. adolescents with psychiatric disorders receive treatment for those conditions -- a reality that explains the federal government's emphasis in recent years on developing the needed network of support services for young adults who typically aren't well served by mental health service structures geared toward young children or older adults.

The development of that young adult support network was the intent behind the five-year, $1 million-per-year federal grant that Maine applied for and received in 2014. It funded training so caseworkers could more effectively work with adolescents instead of applying practices used with older adults. It funded the development of a network of peer mentors who could draw on their own experiences with mental health challenges to help fellow young adults with similar challenges. And when it came to treatment, the funding filled in the gaps that insurance wouldn't cover.

Now, the work to develop and sustain a statewide infrastructure to support adolescents with mental health challenges is in doubt.

Maine DHHS says it can draw on funds from another federal funding stream -- the Community Mental Health Services Block Grant, which brings about $1.8 million to Maine each year -- to provide services to the current young adult participants. But the state has already planned out a budget for spending this block grant. If the department reallocates the funding, what other function or service will go unfunded or have its funding reduced as a result?

The department says that Medicaid -- a combined state and federal expenditure -- can pick up some of the slack. But Medicaid coverage is nonexistent for some parts of the grant-funded initiative, such as peer-to-peer mentoring. And since the LePage administration refused to expand Medicaid, many young adults don't have coverage.

And when the Department of Health and Human Services says services for all current young adult participants in the grant-funded initiative will continue "uninterrupted," that says nothing of the young adult who will need help next month or next year. The point of developing a mental health service network for young adults is to serve young adults now and in the future.

"This is about returning federal money the state does not need because we cannot create a dependency on funding that could be gone tomorrow based on federal decisions," Maine DHHS said toward the end of its Friday news release.

Yes, a federal funding source is disappearing abruptly. But the unilateral, opaque decision ending it -- which injected unneeded uncertainty into a fragile service network -- is fully the responsibility of the state of Maine, not the federal government.

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