Maine's Department of Corrections (MDOC) operates one of the smaller state prison systems in the country -- approximately 2,300 people in state facilities -- and has developed a mental health care framework that in several respects stands apart from the crisis-level conditions documented in larger states in this series.
The MDOC Behavioral Health (BH) Team provides evidence-based, trauma-informed assessment, diagnosis, and treatment across all state facilities. All BH services, including Psychiatry, are provided at no cost to residents. Services are voluntary except in emergencies or when safety/security concerns require intervention. Residents are oriented to BH services upon arrival at any MDOC facility and have access to a wide array of services across all locations.
At Maine State Prison, MDOC operates the state's only Intensive Mental Health Unit (IMHU) -- a 32-bed unit providing modern, comprehensive mental health and medical care for people with acute, subacute, or chronic serious mental illness from both the county jail system and state DOC. The IMHU was authorized by the Maine Legislature in 2013 (LD 1515) and opened in 2014.
MDOC has also forged a partnership with McLean Hospital and its Deconstructing Stigma initiative to address mental health stigma among both the prisoner population and corrections staff.
Maine does not have active federal court oversight of its prison mental health system.
What Maine Prisoners Are Entitled To
Under Estelle v. Gamble (1976) and MDOC's Behavioral Health policies:
- Orientation to BH services at intake at any MDOC facility.
- Evidence-based, trauma-informed assessment, diagnosis, and treatment.
- A wide array of BH services across all MDOC facilities.
- All services free of charge, including Psychiatry.
- Voluntary participation, except in emergencies or safety/security situations.
- Residential and outpatient Substance Use Disorder (SUD) treatment.
- Access to the Intensive Mental Health Unit (IMHU) at Maine State Prison when clinically warranted.
Mental Health Screening at Intake
All incoming MDOC residents are oriented to Behavioral Health services and guided in how to access care upon arrival at any MDOC facility. This orientation at intake is the initial entry point into the BH system.
MDOC's BH Team conducts evidence-based, trauma-informed assessment to identify mental health needs. Residents with identified needs are matched to appropriate services.
If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications -- to support accurate clinical assessment.
The Behavioral Health Team: What Is Provided
MDOC's Behavioral Health Team offers a continuum of services across all MDOC facilities:
Assessment and Diagnosis: Evidence-based, trauma-informed assessment and clinical diagnosis for all residents with mental health needs.
Individualized Treatment Plans: Services are individualized, strengths-based, and trauma-responsive. The MDOC creates environments that encourage engagement in recommended treatment programs.
Individual and Group Therapy: Research-informed clinical services provided by the BH Team.
Psychiatry: Psychiatric evaluation and medication management, available at no cost to all MDOC residents.
Crisis Intervention: Emergency mental health response available when safety or security concerns require intervention.
All services are provided at no charge.
The Intensive Mental Health Unit (IMHU)
The Intensive Mental Health Unit (IMHU) at Maine State Prison (MSP) in Warren, Maine is the state's only unit designed specifically to provide intensive mental health care in a correctional setting. Key facts:
History: In the early 2000s, advocacy groups including the ACLU pressured MDOC to limit segregation of people with serious mental illness. Maine State Prison opened a Secure Mental Health Unit in 2005, but by 2009 advocates raised concerns that it functioned similarly to segregation. In 2013, the Maine Legislature (126th) passed LD 1515, providing funding and authorization for a true Intensive Mental Health Unit. MDOC partnered with CorrectCare Solutions and renovated an existing housing unit at MSP.
Opening: 2014.
Capacity: Up to 32 clients.
Population served: County jail and MDOC residents who suffer from acute, subacute, or chronic mental illness AND who are violent or otherwise unable to be managed in less intensive settings. The IMHU serves both state prisoners and county jail residents -- an unusual feature that makes it a resource for the entire Maine corrections system, not just MDOC.
Setting: A separate unit within the secure perimeter of Maine State Prison, distinct from the prison's operations and administration.
Services: Modern, comprehensive mental health and medical care in a setting separate from the general prison population.
Outcomes since opening: Decreased frequency of self-injurious behavior; reduced violence; increased medication compliance; improved transition and transfer process back to county jails, communities, or state hospitals.
The IMHU represents a meaningful investment -- legislative authorization, physical renovation, and a separate staffing model -- in the most seriously mentally ill and most difficult-to-manage correctional population in Maine.
Substance Use Disorder Treatment
MDOC places significant emphasis on Substance Use Disorder (SUD) treatment alongside mental health care. Approximately 46% of MDOC residents receive medications for substance use disorders -- among the highest rates of SUD medication treatment in the country.
Residential SUD Treatment: Available at Maine State Prison and Mountain View Correctional Facility through a 6 to 9 month evidence-based, intensive treatment program.
Outpatient SUD Treatment: Both high-intensity and moderate-intensity outpatient SUD treatment is available at all MDOC sites.
Medication for Substance Use Disorder (MSUD): Available to residents who want to be considered. A resident can submit a sick call slip to the "MSUD Program" expressing interest.
Recovery Coaches: Available at MDOC facilities to provide peer-based support.
For residents with co-occurring mental illness and substance use disorders -- a very common combination in correctional settings -- MDOC's integrated approach addresses both conditions within the same BH framework.
Maine's State Hospital System
Maine's state hospitals do not distinguish between civil and forensic patients -- unlike most states in this series. This means the same facilities serve both people voluntarily or involuntarily committed through civil processes and people referred from the criminal justice system for competency evaluation or treatment.
Riverview Psychiatric Center in Augusta is Maine's primary state psychiatric hospital. It serves both civil commitment patients and people referred from the criminal justice system (incompetent to stand trial, not criminally responsible). When an MDOC prisoner requires inpatient hospital-level psychiatric care beyond what the IMHU or facility-level BH Team can provide, Riverview is the primary referral destination.
The McLean Hospital Partnership
MDOC has partnered with McLean Hospital (a Harvard Medical School affiliate) and its Deconstructing Stigma initiative to address mental health stigma in the correctional setting. The partnership works with both the prisoner/resident population and corrections staff:
- Addressing mental health stigma among those incarcerated: helping residents understand and seek mental health treatment without fear of judgment or retaliation.
- Addressing mental health stigma among corrections staff: 34% of corrections officers develop PTSD, one-third are diagnosed with depression, and corrections staff are more likely to die by suicide than to be killed in the line of duty.
This dual focus -- prisoner and staff mental health -- is relatively unusual in the series and reflects an understanding that the institutional culture of corrections affects the delivery of mental health care.
Release and Reentry
MDOC's BH Team provides discharge planning as part of the continuum of care through release. For residents approaching release with mental health needs:
- Maine's community mental health services are administered through the Maine Department of Health and Human Services (DHHS), Office of Behavioral Health (OBH).
- Community mental health services are provided regionally through contracted providers.
- Medicaid (MaineCare) enrollment or reinstatement before release is essential for community mental health access.
- MSUD medication continuity at release is an active focus given Maine's high rates of SUD medication treatment.
What Families Can Do
If your person is in MDOC custody and has a mental illness:
Know BH services are available at all facilities. MDOC's BH Team provides services across all state facilities -- your person does not need to be at a specific facility to access mental health care. Remind them to complete a sick call slip or BH services request.
Know services are free and voluntary. All BH services, including Psychiatry, are provided at no charge. Participation is voluntary except in emergencies. Your person cannot be forced into non-emergency mental health treatment.
Know the IMHU at Maine State Prison. If your person has serious mental illness AND has been difficult to manage due to violent behavior or acute psychiatric symptoms, ask whether a referral to the IMHU at Maine State Prison has been considered. The IMHU is the most intensive mental health resource in the MDOC system and serves both state prisoners and county jail residents.
Know the MSUD option. If your person has a substance use disorder and wants medication treatment (Medication for Substance Use Disorder), they can submit a sick call slip to the "MSUD Program" at their facility.
Know the Riverview pathway. If your person's psychiatric condition requires inpatient hospital-level care beyond what MDOC can provide in-house, Riverview Psychiatric Center in Augusta is the state hospital referral destination. Maine's state hospitals do not separate civil and forensic patients.
Ask about discharge planning. If your person is approaching release and has a mental illness, ask what community mental health providers and supports have been identified, whether MaineCare has been enrolled or reinstated, and whether any MSUD medication continuity has been arranged.
File a grievance. MDOC has an administrative grievance process. File formal grievances for: failure to orient to BH services at intake, denial of mental health care, failure to provide Psychiatry services when needed, medication interruption, and failure to initiate discharge planning.
Contact Disability Rights Maine. DRM (drme.org) is the federally mandated Protection and Advocacy organization for Maine and monitors conditions for people with mental illness and disabilities in MDOC facilities.
Seek legal help. If your person's mental health needs are severe and they are not receiving appropriate care, if IMHU referral has been denied when clinically warranted, or if medication has been discontinued without clinical justification, consult a prisoner rights attorney with experience in Maine's federal courts (District of Maine).
Frequently asked questions
How does Maine screen prisoners for mental illness?
All MDOC residents are oriented to Behavioral Health (BH) services and guided in how to access care upon arrival at any MDOC facility. The BH Team conducts evidence-based, trauma-informed assessment to identify mental health needs. If your person has a psychiatric history, provide documentation at intake -- prior hospitalizations, diagnoses, and active medications. MDOC assigns residents to appropriate services based on assessed needs, with access to the full BH continuum across all facilities.
What mental health services does Maine DOC provide?
MDOC's Behavioral Health Team provides: evidence-based, trauma-informed assessment and diagnosis; individualized treatment plans; individual and group therapy; Psychiatry (evaluation and medication management); crisis intervention; Substance Use Disorder residential treatment (at Maine State Prison and Mountain View) and outpatient treatment at all sites; Medication for Substance Use Disorder (MSUD); Recovery Coaches; and discharge planning. Services are available across all MDOC facilities.
Is mental health care free in Maine prisons?
Yes. MDOC explicitly states that all Behavioral Health services, including Psychiatry, are provided at no cost to residents. This covers the full continuum -- assessment, therapy, psychiatric medication management, SUD treatment, and crisis intervention. There are no co-pays or fees for mental health care in MDOC facilities.
What is the IMHU at Maine State Prison?
The Intensive Mental Health Unit (IMHU) at Maine State Prison in Warren is Maine's only unit providing intensive mental health and medical care for people with acute, subacute, or chronic serious mental illness who are violent or otherwise difficult to manage in less intensive settings. Capacity: up to 32 clients. Population: county jail residents and MDOC state prisoners (it serves both systems). Authorized by LD 1515 (2013 Legislature); opened 2014. Since opening: decreased self-injurious behavior, reduced violence, improved medication compliance, and better transition outcomes.
Who qualifies for the IMHU at Maine State Prison?
The IMHU serves county jail and MDOC state prison residents who have acute, subacute, or chronic mental illness AND who are violent or unable to be safely managed in less intensive correctional mental health settings. It provides a level of care between general population outpatient services and state psychiatric hospital admission. If your person meets these criteria, ask whether a referral to the IMHU has been considered.
What is the McLean Hospital partnership with MDOC?
McLean Hospital (a Harvard Medical School affiliate) and its Deconstructing Stigma initiative have partnered with MDOC to address mental health stigma in the correctional setting. The partnership focuses on both the prisoner/resident population (reducing stigma that prevents people from seeking treatment) and corrections staff (addressing PTSD, depression, and suicide risk among officers). This dual focus recognizes that corrections staff mental health directly affects the institutional environment in which prisoners receive care.
What substance use disorder treatment does Maine DOC offer?
MDOC offers residential SUD treatment at Maine State Prison and Mountain View Correctional Facility (6-9 month evidence-based intensive programs); outpatient SUD treatment (high and moderate intensity) at all MDOC sites; Medication for Substance Use Disorder (MSUD) via sick call request to the "MSUD Program"; and Recovery Coaches at facilities. Approximately 46% of MDOC residents receive medications for substance use disorders -- among the highest SUD medication treatment rates in the country. Co-occurring mental illness and SUD are addressed within the integrated BH framework.
How does Maine handle mental health care at release?
MDOC's BH Team provides discharge planning as part of the continuum of care. Community mental health services in Maine are administered through the DHHS Office of Behavioral Health (OBH) via contracted regional providers. Steps for release: identify community mental health providers in the person's return county; reinstate or enroll MaineCare (Medicaid) before release; arrange medication continuity (especially for MSUD medications given Maine's high treatment rates). Riverview Psychiatric Center in Augusta is the primary state hospital referral for those needing inpatient psychiatric care after release.
What can families do if mental health care is denied in ME?
Remind your person that BH services are available at all MDOC facilities and are free -- they can request services via sick call slip at any time. If serious mental illness combined with difficult behaviors is present, ask about IMHU referral at Maine State Prison. If inpatient psychiatric care is needed, ask about Riverview Psychiatric Center referral. Ask about MSUD medication options if substance use disorder is co-occurring. File MDOC grievances for BH orientation failures, service denials, medication interruptions, and discharge planning failures. Contact Disability Rights Maine (drme.org) for legal advocacy.
Who oversees mental health care in Maine prisons?
MDOC's Behavioral Health Team manages mental health care system-wide under MDOC policy. The IMHU at Maine State Prison operates as a separate unit within that system. Maine DHHS Office of Behavioral Health (OBH) oversees community mental health and the state hospital system, including Riverview Psychiatric Center. Disability Rights Maine (DRM, drme.org) is the federally mandated Protection and Advocacy organization monitoring conditions for people with mental illness and disabilities in MDOC. No active federal court oversight of MDOC mental health has been identified. ---