AUGUSTA — I am a registered nurse working at Riverview Psychiatric Center, writing in response to the outrageous and, frankly, defaming assertions that have been made by the Portland Press Herald.

It is inexcusable to smear the reputations of hundreds of dedicated people. To assert that we have substituted “punishment for treatment,” as the Press Herald declared in a Sept. 24 editorial (“Our View: Full state investigation necessary to address Riverview woes”), is a grotesque lie.

Before writing his news articles about Riverview, Press Herald reporter Joe Lawlor had never set foot here. We deal with a wide variety of clients from all walks of life – and that includes murderers, rapists and arsonists who have been found not criminally responsible because of mental illness.

When someone has been declared not criminally responsible, it does not mean that they aren’t extremely dangerous. The hope is that with treatment and medication, the client can live successfully outside of prison. When they arrive at Riverview, the forensic clients (those sent here after criminal charges) are every bit as dangerous as any convict behind bars. The fact that most of the forensic clients have spent some time in prison makes them all the more hardened, manipulative and difficult to trust.

Statistically, the mentally ill are less violent than the average citizen. However, we at Riverview deal with a small subset of that population that has proven to be dangerous to themselves and others.

Let’s explore that “dangerous to themselves” part. The use of restraints is primarily for the purpose of preventing a client from harming themselves. Even locked in a padded room, self-harming clients will claw their wrists, beat their head against the windows, pull out their nails and hair, bite themselves, strangle themselves with sheets or clothing, smear feces, etc. For their own well-being, these clients must be restrained until they can be safe.

Medication, sometimes against their active resistance, can help. Time and talking can help, too. Once restrained, I remind them that it is only for their protection. I have told many clients, “I wouldn’t let my own children do this. And I hold the same standards for you. You are in my care and I will not let you be harmed by anyone, not even yourself.” The vast majority of clients understand this, in that moment and afterward.

The most difficult clients will use their self-harm to force protective staff to come close enough for the client to assault them. This is a common tactic among some of the clients.

So, let’s not forget “dangerous to others.” Imagine waking from a nightmare in which you had hurt or even killed people. You lie in bed, heart racing, thinking – “Relax, it was just a bad dream.” Now imagine that you wake up at home, in jail or in the hospital – and it wasn’t a dream: “Oh, dear God, not again. What have I done?”

I have stood toe to toe with screaming psychotic clients threatening do to horrible things. And I assure them, “I won’t let you hurt anyone. And I won’t let anyone hurt you.” It would amaze you how quickly after a violent outburst a client will turn to me and say, “I’m so sorry. Did I hurt anyone?”

At Riverview, that client is reassured that keeping everyone safe is our No. 1 job and we’re proud to do it. When someone is hurt, it is usually the staff. We all come to work every day knowing that we will be cursed, spat upon, sometimes assaulted with fists, feet and furniture. We accept that this is part of what we do.

What is not acceptable is for people who know nothing about this difficult and dangerous work to call us abusive. I have never “punished” a client. In 25 years specializing in the care of potentially violent psychiatric clients, I have been punched, kicked, bitten, scratched, spat upon, choked, urinated upon, smeared with feces and attacked with improvised weapons. But I have never struck a client.

Gov. LePage and the Legislature opened a mental health unit at the Maine State Prison to help Riverview. More help is needed.

Legislation is needed to address dangerous psychotic patients who refuse to take the medication that could help them be less of a threat to staff here and society when they are discharged. Assaults committed at Riverview need to be prosecuted rather than ignored by a district attorney who is unwilling to do the job.

We need more staff. We need the tools and support to do what is necessary to maintain a safe environment in which treatment can take place.

I am proud to work at Riverview and even prouder of the staff with whom I work. They deserve your thanks.

— Special to the Press Herald