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As wait for mental help increases, suicide attempts continue rising in Maine

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As wait for mental help increases, suicide attempts continue rising in Maine


When you or somebody you recognize is affected by any of the problems raised on this story, name the Maine disaster hotline at 888-568-1112 or textual content the nationwide disaster textual content line at 741741. You too can dial 988 to be linked to the hotline.

Demand for psychological well being providers that peaked in the course of the pandemic has remained stubbornly excessive, rising waitlists and spilling sufferers into Maine’s hospital emergency rooms.

Previous to COVID-19, Mainers may wait weeks to see a behavioral well being specialist. Now waitlists are months lengthy, stated Dr. Anthony Ng, ​​medical director for group providers at Northern Gentle Acadia Hospital.

“You may put them on the waitlist however for each second they wait, weeks and months, their sickness may worsen,” Ng stated.

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Maine was shedding psychiatrists within the years resulting in the pandemic, and the numbers have continued to drop. In 2019, three counties — Franklin, Piscataquis and Sagadahoc — didn’t have any psychiatrists, in response to a statewide report launched final month.

Employees shortages in the course of the pandemic compelled outpatient packages to scale back providers regardless of rising charges of isolation, melancholy and nervousness at a time of financial uncertainty and political discontent, stated Ng, who is also a Distinguished Fellow of the American Psychiatric Affiliation.

Maine already had excessive suicide charges earlier than the pandemic: In 2019, the state suicide fee per 100,000 was 19.4, in contrast with 13.9 nationally.

COVID-19 made the state of affairs worse, and the necessity for providers has not alleviated regardless of the easing of pandemic lockdowns that brought about widespread isolation, psychological well being professionals instructed The Maine Monitor.

Linda Durst, chief medical officer with Maine Behavioral Healthcare, stated she has tracked extra suicide deaths in the course of the pandemic than within the 5 years prior. Particularly, she’s seen an “acceleration in extreme suicide makes an attempt in youth.” Durst additionally chairs the division of psychiatry at Maine Medical Middle.

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The numbers have been larger up to now 12 months, maybe as a result of because the pandemic has dragged on, “individuals have gotten much less hopeful,” Durst stated. And delayed care meant that individuals who search care had extra extreme instances.

However there are efforts to handle this. Gov. Janet Mills allotted $230 million for behavioral well being providers this fiscal 12 months, together with $15.4 million launched in June to assist cut back waitlists for community-based providers and cut back emergency division use for behavioral well being crises. And Maine Medical Middle has expanded its psychiatry residency program into rural communities.

Specialists say the pandemic is a chance to rethink the best way they ship psychological well being providers.

Emergency rooms get busier

When there aren’t sufficient remedy suppliers, individuals with extra extreme psychological well being challenges could find yourself in emergency rooms.

Behavioral well being visits to emergency rooms in Maine hospitals have remained 25 % larger than earlier than the pandemic, in response to a current survey performed by the Maine Hospital Affiliation. The size of keep within the emergency room has elevated 25 % — and in some instances as a lot as 35 % to 40 %.

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At one level final 12 months, psychiatric sufferers took up half the emergency beds in Maine’s largest hospital system, the Bangor Each day Information reported.

Protecting sufferers in emergency room beds for prolonged stays — a observe known as boarding — is without doubt one of the prime issues going through hospitals, stated Steven Michaud, president of the Maine Hospital Affiliation. It’s a foul state of affairs for everybody as a result of the affected person doesn’t obtain the long-term degree of care wanted, it places an additional pressure on employees and takes away beds from different sufferers.

Hospitals have seen rising charges of violence from sufferers towards employees in consequence.

“It doesn’t imply that each one behavioral well being sufferers are violent. By no means. However they’re disproportionately extra so, and to say in any other case is simply not going through actuality,” Michaud stated. “So when we’ve got these sufferers it’s extra harmful for our employees within the emergency room.”

Workforce shortages are a part of the issue, however the lack of an satisfactory variety of remedy facilities goes again to the nationwide motion within the Nineteen Seventies and Nineteen Eighties to shrink state psychological well being services, Michaud stated.

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“This can be a long-standing downside, which tells you there hasn’t been sufficient providers out locally for years, if not many years,” Michaud stated. “And by the best way, this can be a nationwide phenomenon. Everyone like me is pulling their hair out about this throughout the nation.”

Along with allocating funds to suppliers, the Mills administration in January opened a close-supervision residential facility to offer a substitute for incarceration or hospitalization, opened a disaster heart in Portland and expanded disaster assist for youth based mostly on a pilot program in Aroostook County, in response to a spokesperson.

Rising funding to suppliers and rising the variety of beds for in-patient remedy will assist, however Michaud stated it’s essential to additionally begin interested by totally different strategies of offering care.

“There’s not sufficient cash in all the federal government to handle this so we’re going to need to do each: We’d like extra sources … however we additionally want alternative ways of taking a look at it by way of  fashions,” Michaud stated.

Disappearing psychiatrists

Between 2015 and 2020, the variety of training licensed psychiatrists in Maine dropped by half to 110.

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The drop-off is due largely to a wave of retirements that was hastened by the pandemic, Durst stated. The common age of a psychiatrist in Maine is 55.

However Durst added that there appears to be renewed curiosity in psychiatry and he or she’s seen spectacular candidates for coaching packages.

Maine Medical Middle runs the state’s solely psychiatric residency program, which presents 4 years of postgraduate coaching. There are 5 residents in the usual program and three in baby psychiatry. This system was expanded this 12 months to incorporate two residents in a rural observe in Rockland.

There’s a variety of proof that folks from rural areas or are educated in rural areas usually tend to keep there, stated John Gale, a senior analysis affiliate on the College of Southern Maine and the previous president of the Nationwide Rural Well being Affiliation.

Specialists stated it’s essential to have suppliers in rural areas as a result of they’ve native data and understanding of what their sufferers are experiencing, and are higher in a position to join and deal with them. As well as, it’s tough for individuals to drive hours from dwelling, spending time and gasoline cash, to obtain these providers.

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Gale stated the scarcity of workforce professionals and psychological well being providers has existed for his complete 40-year profession within the subject. There’s been some progress however it hasn’t solved the issue.

“We’re not more likely to produce sufficient psychiatrists and social employees who need to go to rural communities to fill the necessity, so I believe we’ve got to consider it in another way than we used to,” he stated.

Telehealth is a technique to enhance entry however it’s a “double edged sword,” stated Ng, with Acadia Hospital. Whereas it might bridge the hole for individuals who dwell in areas with out native psychological well being providers, telehealth additionally implies that Maine-based psychiatrists may work remotely in different places. As well as, not everybody has broadband to assist telehealth communications.

Specialists instructed The Maine Monitor that one of the vital essential options is to weave psychological well being providers into major care, school-based packages and group assist.

This can be a likelihood to be extra proactive and work on stress discount, somewhat than watch for issues to get so extreme that they should see a psychiatrist, Ng stated.

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“That is time for us to take a look at new methods to work with communities, somewhat than the old style approach of simply placing extra individuals on the market to see extra sufferers.”

Story by Rose Lundy. This story was initially revealed by The Maine Monitor. The Maine Monitor is a neighborhood journalism product revealed by The Maine Middle for Public Curiosity Reporting, a nonpartisan and nonprofit civic information group.



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Maine

Maine real estate mostly unaffected by commission changes

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Maine real estate mostly unaffected by commission changes


New rules that went into effect in August changing who pays real estate commissions have resulted in more paperwork and some anxiety for home buyers and sellers but have had little, if any, impact on home prices in the state’s hot real estate market.

The changes, which stem from a settlement in a lawsuit accusing real estate agents of conspiring to keep their commissions high, altered the way commission fees are set nationally. 

For decades, most home sales in the United States have included a commission fee, typically between 5 and 6 percent of the sale price.

The typical Maine home went for around $400,000 this fall. A 5 to 6 percent commission on a $400,000 home would be between $20,000 and $24,000, split between the agents for the buyer and the seller.

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Before the changes in August, the split for each agent was predetermined by the seller, who paid the fee for both agents. That usually resulted in fees being baked into the list price of a home.

In some states (although not in Maine) agents were able to search the multiple listing service, a catalogue of homes for sale, by the commission split, which critics said incentivized agents to steer clients toward more expensive properties with higher commissions.

Now, fees are negotiated sale-by-sale. Buyers and sellers are now each responsible for paying their own agents, meaning a buyer may have to come with more cash up front if a seller doesn’t want to pay the commission fee for a buyer’s agent. Sellers are also no longer allowed to include commission fees in their listings.

Tacy Ridlon, a listing agent with Better Homes and Gardens Real Estate The Masiello Group in Ellsworth, who has been in real estate for 32 years, said it is a bit jarring to have a conversation with buyers about whether they are willing to pay part of their agent’s commission. 

Once the commission is established and the agreement signed, she said, the buyer’s agent then approaches the seller’s agent to see what part of their commission the seller is willing to cover, if any.

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Ridlon said 3 percent for the buyer’s agent is a typical starting point. 

“We have to start high. If the seller is willing to offer 2 percent for the buyer’s agent, then our buyer only has to pay one percent… If the seller is not offering anything, then we ask the buyer to pay a certain amount. Some can pay and some can’t. For some it’s very difficult because they don’t have a lot of money to play around with.”

The change has resulted in some confusion for many buyers and even some agents around the country, as rules differ from state-to-state. Photo by Kate Cough.

Some agents said they found the changes minimal; others find the paperwork and negotiating with buyers daunting. One agency owner said the ruling has done little to bring prices down.

“This ruling has done nothing to save buyers or sellers any money,” said Billy Milliken, a designated broker and owner of Bold Coast Properties, LLC, in Jonesport. “If anything, it’s made the cost of buying a home even more expensive.”

Milliken said his sellers have had no problem agreeing to pay both buyers’ and sellers’ commissions. The cost has been embedded in the price of the property. 

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“The real loser is first time home buyers who are not educated in buying a home and also have limited cash resources,” said Milliken. “It puts them at a disadvantage.”

The change has resulted in some confusion for many buyers and even some agents around the country, as rules differ from state-to-state. 

People are slowly getting used to the changes, said Monet Yarnell, president of the Midcoast Board of Realtors, who owns her own agency, Sell 207 in Belfast, adding that Maine’s real estate practices were already more transparent than many other areas of the country. 

“I think it was a little confusing in the beginning, more doom and gloom,” said Yarnell. But sellers are still incentivized to offer something to the buyers’ agents, she said. And the changes have increased the level of communication between agents and their clients.

“It’s more how the money flows rather than the actual dollars.”

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Ridlon, in Ellsworth, said she has been fortunate that most sellers have offered some compensation toward the buyer’s agent commission. “I have not had a buyer who can’t do the 3 percent.”

Ridlon had one seller who was not willing to pay any part of the buyer’s agent’s commission. The property had a lot of showings, but many of the buyers asked for closing costs to be covered or for concessions in lieu of picking up part of the commission.

“That didn’t really work for my seller either,” she said. “Then he relented and said he would pay one percent.” 

The property sold.

Debbie Walter sold her condominium in Stockton Springs via Yarnell and then bought another condominium in New London, N.H., with another real estate agent. 

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“We’re kind of guinea pigs,” said Walter. “We were very concerned about that whole piece, both as sellers and buyers.”

Fearful the sale of their house might not proceed smoothly the couple readily agreed to pay a 3 percent commission for the buyer’s agent.

When they made their offer to buy the condominium in N.H., they offered as buyers to cover their buyer’s agent’s commission as well. But the seller in that case took an equally cautious approach and offered to cover 2.5 percent of the buyer’s agent’s commission, which Walters’ agent accepted.

“It was very stressful,” Walter said. Offering to cover their buyer’s agent’s commission, she said, created “one less headache for the whole closing procedure.”

Tom McKee, president of the Maine Realtors Association, said the settlement and new rules have had little impact.

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“It hasn’t changed anything for me,” said McKee, who is with Keller Williams in Portland. Now that the commission split is no longer listed in the M.L.S., said McKee, “there are just more questions in the transaction.”

McKee said there is no set percentage, that everything is negotiable.

“If we do our job right and are meeting with the client first, they already understand.”



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Maine’s highest court proposes barring justices from disciplining peers

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Maine’s highest court proposes barring justices from disciplining peers


The Maine Supreme Judicial Court has proposed new rules governing judicial conduct complaints that would keep members of the high court from having to discipline their peers.

The proposed rules would establish a panel of eight judges — the four most senior active Superior Court justices and the four most senior active District Court judges who are available to serve — to weigh complaints against a justice of the Maine Supreme Judicial Court. Members of the high court would not participate.

The rule changes come just weeks after the Committee on Judicial Conduct recommended the first sanction against a justice on the Maine Supreme Judicial Court in state history.

The committee said Justice Catherine Connors should be publicly reprimanded, the lowest level of sanction, for failing to recuse herself in two foreclosure cases last year that weakened protections for homeowners in Maine, despite a history of representing banks that created a possible conflict of interest. Connors represented or filed on behalf of banks in two precedent-setting cases that were overturned by the 2024 decisions.

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In Maine, it’s up to the Supreme Judicial Court to decide the outcome of judicial disciplinary cases. But because in this case one of the high court’s justices is accused of wrongdoing, the committee recommended following the lead of several other states by bringing in a panel of outside judges, either from other levels of the court or from out of state.

Connors, however, believes the case should be heard by her colleagues on the court, according to a response filed late last month by her attorney, James Bowie.

Bowie argued that the outcome of the case will ultimately provide guidance for the lower courts — a power that belongs exclusively to the state supreme court.

It should not, he wrote, be delegated “to some other ad hoc grouping of inferior judicial officers.”

The court is accepting comments on the proposal until Jan. 23. The changes, if adopted, would be effective immediately and would apply to pending matters, including the Connors complaint.

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Maine’s marine resources chief has profane exchange with lobstermen

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Maine’s marine resources chief has profane exchange with lobstermen


Maine Department of Marine Resources Commissioner Patrick Keliher said “f— you” to a man during a Thursday meeting at which fishermen assailed him for a state plan to raise the size limit for lobster.

The heated exchange came on the same day that Keliher withdrew the proposal, which came in response to limits from regional regulators concerned with data showing a 35 percent decrease in lobster population in the state’s biggest fishing area.

It comes on the heels of fights between the storied fishery and the federal government over proposed restrictions on fishing gear that are intended to preserve the population of endangered whales off the East Coast. It was alleviated by a six-year pause on new whale rules negotiated in 2022 by Gov. Janet Mills and the state’s congressional delegation.

“I think this is the right thing to do because the future of the industry is at stake for a lot of different reasons,” Keliher told the fishermen of his now-withdrawn change at a meeting in Augusta on Thursday evening, according to a video posted on Facebook.

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After crosstalk from the crowd, Keliher implored them to listen to him. Then, a man yelled that they don’t have to listen to him because the commission “sold out” to federal regulators and Canada.

“F— you, I sold out,” Keliher yelled, prompting an angry response from the fishermen.

“That’s nice. Foul language in the meeting. Good for you. That’s our commissioner,” a man shouted back.

Keliher apologized to the crowd shortly after making the remark and will try to talk with the man he directed the profanity to, department spokesperson Jeff Nichols said. The commissioner issued a Friday statement saying the remarks came as a result of his passion for the industry and criticisms of his motives that he deemed unfair, he said.

“I remain dedicated to working in support of this industry and will continue to strengthen the relationships and build the trust necessary to address the difficult and complex tasks that lay ahead,” Keliher said.

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Spokespeople for Gov. Janet Mills did not immediately respond to a request for comment on whether she has spoken to Keliher about his remarks.

Lobstermen pushed back in recent meetings against the state’s plan, challenging the underlying data. Now, fishermen can keep lobsters that measure 3.25 inches from eye socket to tail. The proposal would have raised that limit by 1/16 of an inch and would have been the first time the limit was raised in decades.

The department pulled the limit pending a new stock survey, a move that U.S. Rep. Jared Golden, a Democrat from Maine’s 2nd District, hailed in a news release that called the initial proposal “an unnecessary overreaction to questionable stock data.”

Keliher is Maine’s longest-serving commissioner. He has held his job since former Gov. Paul LePage hired him in 2012. Mills, a Democrat, reappointed the Gardiner native after she took office in 2019. Before that, he was a hunting guide, charter boat captain and ran the Coastal Conservation Association of Maine and the Maine Atlantic Salmon Commission.



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