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Ex-girlfriend says the mental health system failed a Poland man accused of killing his brother

The ex-girlfriend of a man accused of murdering his brother on Thanksgiving Day is among those who say Maine hospitals and the state are not doing enough to treat people battling schizophrenia and other mental health disorders.

Justin Butterfield.PNG
Androscoggin County Jail
via BDN
Justin Butterfield

Yaicha Provencher said Monday that the past four years have been a nightmare as she sought help from police and hospitals for her ex-boyfriend's increasingly severe psychosis. Provencher said that over the last three years, Justin Butterfield has been hospitalized at least eight times after paranoid and sometimes violent behavior, only to be released within days. Yet even after Butterfield reportedly set a building on fire and put his own life in danger, Provencher said hospitals never tried to involuntarily commit him or seek court-order treatment.

"So what does it take? It has taken a man, who was a loving family man, brutally killing his brother, who he took in from homelessness because he loved him,” said Provencher, who has one child with Butterfield and is caring for a second. “And is it enough yet? I ask you: is it enough yet? Does he finally get his right to treatment? Or does he get thrown in prison, prosecuted and punished because of others' negligence?"

It’s been about a week and a half since police arrested her former boyfriend on charges that he killed his older brother in the home that they shared. Butterfield reportedly told police that he had been battling "The Terminator” in an apparent reference to the character from a 1980s Arnold Schwarzenegger action film.

Speaking at a State House news conference, Provencher said she was never informed about Maine's law that allows hospitals or medical professionals to ask a judge to order someone into a "progressive treatment program." Under the law, people seeking to avoid being re-committed involuntarily must stick with a treatment plan involving regular interactions with psychiatric workers or other professionals and may have to live in a supervised setting.

"And yet there are still many medical professionals in Maine who don't know the law exists because the department has not told them and not promoted it,” said John Nutting, a former state lawmaker from Leeds who sponsored the 2010 law that created the progressive treatment program. Nutting estimated that about 80 people in Maine are under PTP orders, which is much lower than in other, similar-sized states. Still, he says that under-utilization is representative of a "fundamental misunderstanding and mismanagement of people" who need court-ordered, long-term treatment because they no longer recognize and can manage their own severe, biological brain disorder.

"The whole system is bound up,” Nutting said. “People are waiting weeks in emergency rooms for a hospital bed. And the Mr. Butterfields of the world are sent home because the hospital is totally full of people who have been there over and over again and probably have already committed violent acts. And yet they keep releasing them over and over again."

Nutting and others said the Maine Department of Health and Human Services isn't promoting use of the program, despite an increase in state funding. He also says the state hasn't applied for federal funds that would help pay for the teams of psychiatrists, nurses and other support staff needed to help keep people in the program and out of crisis.

In a written statement, DHHS spokeswoman Jackie Farwell said the Mills administration has invested historically large amounts into mental and behavioral health as well as substance abuse treatment and prevention. Farwell said that includes $15 million to address immediate needs exacerbated by the COVID-19 pandemic, to reduce utilization of hospital emergency departments for behavioral health crises, meet increased demand due to the long-term mental health effects of the pandemic, and to reduce wait lists for community-based services.

“The Department has implemented the Progressive Treatment Program in accordance with the law and continues to support alternatives to involuntary commitment, which remains a last resort for Maine people facing mental health challenges,” Farwell said. “We will continue to examine options to further strengthen Maine’s behavioral health system into the future.”

But the group Disability Rights Maine has opposed the progressive treatment program. As executive director Kim Moody explained, the nonprofit is charged by Congress with making sure that disabled people have advocates and lawyers to ensure their rights are protected.

"So of course we are against coercion and forced treatment. I mean, for one thing we have never seen any literature that really shows that forcing someone into treatment works,” Moody said. “People need to seek treatment when they are ready for treatment."

Moody said it's natural to look for a target or explanations after violent tragedies. But she doesn't blame the hospitals or the state for any under-utilization of a model that relies on forced treatment.

"I would say though that perhaps it is under-utilized because it really just does not work,” Moody said. “Maybe it can work for a few select people. But I think what we have found across this nation is that it has serious problems – again related to mental health treatment not working when it is forced or when people are coerced into treatment.”

But Yaicha Provencher said the system clearly failed Justin Butterfield, his two children and his late brother despite everything that she, his family and friends have done to try to get him help.

"We need to be more educated,” Provencher said. “We need to do better for those who cannot help themselves – and not help themselves by choice because their brain disorders do not allow them to."

A judge has ordered a review of Butterfield's competency to stand trial.