Remoteness and spotty internet service hinder mental health care in Aroostook

4 weeks ago

If you are experiencing a mental health crisis, call the Maine Crisis Hotline at 888-568-1112.

When Michael McCormick of Caribou sought medical help for bipolar disorder, he didn’t think he’d have to travel 175 miles to find it.

Remote Aroostook County lacks enough providers, so there are long waits for treatment. McCormick was put on waiting lists, with no results. Discouraged, he visited his primary care provider, who helped with medication and arranged successful treatment — but he had to travel to Bangor’s Northern Light Acadia Hospital. 

Pandemic aftereffects, homelessness and addiction are fueling mental health needs statewide, with calls for more crisis intervention and psychiatrists. But Aroostook County has unique roadblocks to care. Residents of its small, rural towns often have to travel to a larger community or out of the region altogether. Few providers come north. And there are gaps in internet service so online help may not be an option.

It’s tough to be told you’re six months to a year away from an appointment, said McCormick, who has dealt with being bipolar for about 10 years.

“Six months, even two months, is a long time,” he said. “[Providers] really do want to help, but I think it’s a matter of the ratio of the people who are sick and the amount of service providers that are available to help them.”

The lack of help in Aroostook County can lead to tragic outcomes, as it did for Jacob Poitraw and Jacob Wood. Both were experiencing mental health episodes when they were shot and killed by police. Poitraw’s mother blamed a broken system.

Fort Kent, Caribou and Presque Isle are “high needs” mental health professional shortage areas, according to the U.S. Department of Health and Human Services. The 2022 Maine Community Health Needs Assessment named mental health the No. 1 priority in Aroostook County, with lack of providers and long wait list topping concerns.

“The resource that’s missing is clinicians for us,” said Esther Cyr, clinical director at Northern Maine General in Eagle Lake, a nonprofit social services organization. “Many have retired and there are fewer coming in, and yet the mental health needs and referrals are increasing.”

Northern Maine General, which offers outpatient mental health and residential care, has a wait list of 60. Two to five new requests come in each week, but it can’t accept more referrals without more staff, Cyr said.

Mental illness can include depression, anxiety, bipolar disorder, post-traumatic stress and many other conditions, according to the National Alliance on Mental Illness. Nationwide, one in five adults and one in six young people ages 6-17 experience mental illness every year, and less than half of those people receive care.

In Maine, 223,000 adults had a mental health condition as of February 2021, according to alliance data. Of those, 65,000 didn’t receive care. 

Rural areas have fewer providers and internet capabilities, making telehealth appointments difficult. In fact, nearly a quarter of Aroostook households are without dependable broadband connections.  

Before providers even get involved, someone has to answer calls for help. School counselors and law enforcement officers are front-line responders and the demand on them is rising.

“I have seen at least a 50 to 75 percent increase in kids’ mental health problems in the last five years. There is definitely a mental health crisis,” said Korinne Matthews, clinical counselor at Houlton Middle-High School. 

Matthews sees 30 or more kids weekly. Five years ago, she saw maybe 15 students a week, she said. 

Students still struggle with fear and anxiety from the pandemic, and many face poverty and unstable home environments where they are unable to be successful, Matthews said. 

Pediatricians often call her to see students until wait lists clear.

“We’ve lost about half our providers just in the Houlton area. Some agencies went out of business. Some have lost clinicians,” Matthews said. “They just don’t have the manpower to meet the needs of the community.”

COVID-19 spiked students’ mental health needs, said Allison Reed, guidance director at Presque Isle’s SAD 1.

PRESQUE ISLE, Maine — March 15, 2023 — Presque Isle High School Guidance Director Allison Reed, shown in this file photo, said students in Aroostook County are still dealing with the effects of the COVID 19 pandemic. (Paul Bagnall | The Star-Herald)

Though it’s different for every student, disruption of normal routines, social isolation, family stress and adjusting to remote learning ignited anxiety and depression. Those effects aren’t over. 

“We will continue to see the impact of COVID for many years,” she said. 

The Presque Isle Police Department handled more than 1,041 mental health cases in 2023, up 20 percent from 2022 and four times more than the average before the pandemic, said Chief Chris Hayes. 

There aren’t enough providers or places in Maine to refer people to, and most have limited staff for short-term care, he said.

“We are on the front lines in law enforcement so we need to keep responding to mental health calls and offering as much assistance as we can,” Hayes said. “But we are not trained professionals in mental health, so we feel that we are not achieving anything.” 

Fort Kent Police Chief Michael DeLena reported 31 incidents in 2023 involving mental health. He attributed the influx largely to the opioid crisis and the combination of illicit drug use and mental health conditions.

“This oftentimes creates a psychosis which is difficult for law enforcement officers to manage,” DeLena said.

Fort Fairfield police saw service calls rise 50 percent, from 2,124 in 2022 to 3,383 in 2023, largely due to mental health and substance abuse incidents.


Making things better for County people with mental health issues will take a community effort, experts said.

As some midcoast police departments are doing, Presque Isle police now work with social workers on some calls. The department also acquired a therapy dog to help children and others while at the police station.  

The County must rebuild the sense of community it had before COVID isolated people and made them afraid to gather together, Cyr said.

“We need to find a way to make people feel connected again,” she said.

People need affordable housing, Houlton Middle-High School’s Matthews said. Inflation has made it hard for families to afford rent, heat and food. 

A facility like Acadia Hospital would be huge for The County, said McCormick, who has also battled addiction and lives at a Recovery Aroostook home in Caribou. He is open about his struggles and successes because he wants people to know it’s OK to ask for help.

School and community counselors should work together to help people understand that, said SAD 1’s Reed. 

“We need to reduce the stigma surrounding mental health,” she said. “The emphasis needs to be on the fact that seeking help is a sign of strength and not weakness.”

This story has been amended to reflect the total number of Fort Fairfield police service calls.