Sweetser to open residential facility for youth

Advocate questions it is best use of funding 

This past spring, nonprofit Sweetser was awarded $2 million from the state of Maine to develop its first psychiatric residential facility for youth with severe mental health needs.

Construction began in April.

Kristie Worster, Sweetser’s chief program officer, noted the funding will rehab an existing 8,000 square foot building on their Saco campus.

Worster said the construction will continue this year with a goal to open in 2026.

Sweetser has been serving children and families since the 1800s and is one of Maine’s largest behavioral health nonprofits.

The psychiatric residential treatment facility (PRTF) will be a 16-bed specialized locked residential facility that provides intensive, 24-hour psychiatric care in a structured and trauma-informed environment.

“It’s a little less restrictive than a hospital setting,” Worster said. “It’s a locked, structured clinical setting where active treatment is used daily.”

The facility will include medical supervision, prescribers, clinicians, and therapy in a secure setting, she said.

Worster said as many as 35 other states have PRTFs and that Maine “has been an outlier” until now. The result has been separating children from families by sending them to out-of-state facilities.

“Without this higher level of treatment, Maine youth also have been languishing in emergency rooms, which is not a therapeutic environment nor the proper care for behavioral health,” Worster said.

When the program becomes operational, Worster said it will be a significant step toward filling “a critical gap” in the continuum of care and ultimately strengthen the youth behavioral health system.

Although patients will include children and at-risk youth with serious emotional disorders and highest-level needs, Worster said the facility is not intended as a long-term treatment program.

She said the goal is to have these children and youth step down into other residential placements or return home for community-based treatment within a year or less.

She reported that around 422 children in Maine await mental health services. Approximately $32 million is spent annually to send more than 70 youth to out-of-state care.

“Sweetser is proud to lead the effort to bring our kids home from expensive, out-of-state care,” Worster added.

Nancy Cronin, Maine Developmental Disabilities Council executive director, said she does not think this type of facility it is the best use of funds.

Cronin said the facility is not a long-term solution because it will not serve youth with disabilities who have complex health disorders.

“It is primarily a setting for people with behavioral disorders. That is limiting and the youth with autism, seizure disorder, who is incontinent, still has nowhere to get help,” she said.

She questioned, for example, whether youth with intellectual disability, but not medical needs, will get necessary treatment alongside patients with schizophrenia or oppositional defiant disorder.

“Is this the right milieu for all youth who have a high level of need? I don’t think so,” Cronin said.

Cronin argued that funds would be better spent on improving the community system—allowing more people to get help more quickly.

“This is a very expensive setting that will become an institution for a small number of youth while everyone else gets nothing,” she said.

Cronin joined the Maine Developmental Disabilities Council in 2008 and became the executive director in 2012. She said the rise in mental health issues, particularly in youth, is “a serious problem that we only treat through the behavioral lens.”

Assuming youth with a range or combination of disorders require the same type of treatment “is akin to treating breast cancer and diabetes the same way.”

Cronin said children and youth with developmental disabilities need a developmental approach to treatment first. Without getting that, many youths exhibit challenging behaviors—either psychiatric in nature or because they have not learned more functional ways of communicating.