Judy Sandler is a writer and educator who lives in Lincolnville.
In Maine, more than 37,000 people live with severe mental illness.
Fewer than half receive treatment in a given year. Severe mental illness is often accompanied by anosognosia — a neurological condition that prevents a person from recognizing that they are ill. In those cases, waiting for someone to seek help on their own is not just unrealistic; it is dangerous.
On Nov. 29, 2022, Mayor Eric Adams announced a directive allowing police and outreach workers in New York City to bring individuals with severe, untreated mental illness to hospitals for evaluation — even if they did not pose an “imminent” threat.
Ten years ago, I would have protested such a policy. I would have argued that it infringed on civil liberties. Ten years ago, I had no experience with severe mental illness. My son was in college, playing soccer, majoring in recreational therapy and preparing to graduate. “Involuntary hospitalization” was not a phrase mentioned at our dinner table.
Today, I understand the issue differently — not because I value civil liberties any less, but because I have seen what happens in the gap between no intervention and too late.
When my son was 25, he called me one morning and told me he had remembered killing someone years earlier in a drunk driving accident — an event that had never happened. His girlfriend, recognizing something was terribly wrong, brought him to St. Mary’s Hospital in Lewiston. He was diagnosed with bipolar disorder, stabilized and released three weeks later.
For a time, he returned to the life we knew. Then he stopped taking his medication.
What followed is painfully familiar to many families: lost jobs, broken relationships, periods of instability and fear. We worried when he came to our door, but we worried more when he didn’t— when he was alone, unmedicated and unraveling.
We did what families are told to do. We called the police. We called the sheriff. We explained that our son was manic, not making sense, possibly using drugs, driving on a suspended license, and in desperate need of psychiatric care.
We were told the same thing, over and over: He was not an “imminent danger” to himself or others. There was nothing they could do.
What I did not know at the time is that Maine does have crisis intervention resources — teams designed specifically to respond to mental health emergencies. Yet despite many, many calls to police departments in various counties in Maine, no one redirected us to clinicians trained to handle psychiatric crises. If such a system exists but cannot be accessed by the families who need it most, then for all practical purposes, it does not exist.
That standard — imminent danger — sounds reasonable. In practice, it often means waiting until a crisis becomes undeniable. Families can see the trajectory. The system requires proof.
A few days later, the crisis came. Instead of being taken to a hospital, my son was arrested. Then arrested again. And again. Charges included disturbing the peace and violations tied to his car. Despite repeated calls to law enforcement and attempts to reach the district attorney to explain that he was in a psychiatric crisis, not a criminal one, he spent 10 days in the Cumberland County Jail.
Our experience is not unusual. Twenty percent of the U.S. prison population lives with severe mental illness. Law enforcement officers spend a disproportionate amount of their time responding to psychiatric crises. As Elyn Saks, an expert in mental health law, has observed, the largest mental health facilities in the country are jails.
In jail, my son did receive medication — but in a form that left him barely able to function. That is not treatment. That is containment.
It is tempting to look at policies like the one advanced in New York City and conclude that Maine simply needs to give police more authority to intervene earlier. But that is only part of the answer — and not the most important part.
The deeper problem is this: we are asking police to manage medical crises without giving them the tools, partners or pathways to do so — and without ensuring that the systems that do exist are actually accessible.
Maine already has key pieces of a better system. The statewide 988 crisis line connects callers to trained specialists who can assess a situation and dispatch mobile crisis teams — clinicians who can respond in person, de-escalate and connect individuals to care.
None of that helped my family because we were never connected.
Dr. Saks was correct; my son was more likely to get treated in jail than in a hospital. At the time of his arrest, only 11.5 beds were available in Maine per 100,000 people. Maybe that’s why the police prefer to press criminal charges against people who live with severe mental illness.
What might have changed the outcome is something more fundamental.
First, Maine should require that 911 dispatch systems formally integrate with the 988 crisis system, so that mental health calls are triaged in real time and routed to mobile crisis teams whenever appropriate — not left to chance or individual officer discretion.
Second, Maine should establish a formal mechanism for family-initiated crisis escalation — a way for parents or guardians to provide documented history and trigger a psychiatric evaluation before behavior becomes criminal. Families are often the first to recognize a crisis, and their knowledge should be treated as clinical evidence, not anecdotal.
My son was fortunate in that we were able to pay for private treatment after his release. Many families cannot. The consequences — for individuals, for communities and for public resources — are enormous.
Maine can and should do better. Because the question is not whether we intervene; it is whether we intervene in a way that leads to effective, long lasting care — or to a jail cell.