When she pictured her life as an adult in a recent journal entry, Mariah Bailey saw a confident woman in a black business suit and high heels, her hair tied up in a bun, busy being a CEO.

That made sense to Mariah’s mother, Kathy Bailey.

Mariah always wanted to be in charge, sometimes so badly that she struggled to accept help when she needed it. In the last few years, squaring that fierce independence with the parental need to enforce basic rules had become the biggest challenge in Kathy Bailey’s life, especially after Mariah’s mental illness intensified a few years ago, leaving the family struggling to find services.

She had always been a runner, too. Leaving home without permission, sometimes for hours, sometimes for days, was a way for Mariah to seek excitement and to rebel, but also a symptom of her deep internal struggle.

Early in the morning on May 9 as he parents slept, Mariah, 15, left in Kathy’s 2021 Toyota Highlander SUV.

About 6 a.m., two Saco police officers arrived on Kathy’s doorstep to say that Mariah, driving without a license, had lost control of the vehicle as it sped over a crest on Ricker Road. She died instantly, about 500 yards from her family’s front door, when the vehicle struck a tree.

In an extensive interview, Kathy described how she and her husband spent years trying to get Mariah help, to meet her needs and provide her with a safe, nurturing home as her mental health crisis and behavioral problems spiraled.  The family tried nearly everything, her parents said, and were frustrated by a slow, unresponsive health care system, and the lack of resources to help someone like Mariah.

Again and again, Kathy said, Mariah convincingly assured doctors that everything was fine. Doctors then downplayed her difficulties as acting out because of family relationship problems or typical teenage angst, Kathy said.

Kathy agreed to discuss her daughter’s painful, private struggles because she wants legislators, policymakers and the public to recognize the unfulfilled need for children like Mariah. As a former nurse, Kathy said, she was equipped better than most to advocate for Mariah, but the anemic safety net for mentally ill adolescents failed her. Over and over, the doctors told her that Mariah didn’t “meet the criteria” for further intervention.

Even getting a diagnosis was a battle, she said.

“(Mental health professionals) need to be educated in the difference between a child of Mariah’s age that needs serious help versus someone who needs to have family communication and parenting skills addressed, and they blur the lines between the two,” Kathy said. “There’s no reason that I had to beg to get my daughter treatment.”

Out of options, the family turned to police and the court system.

For years in Maine, mentally ill teenagers have landed in lockup because there is no other place to send them, a structural problem that legislators and corrections officials are still working to address.

The Baileys, in the end, turned to the criminal legal system, the only avenue that could mandate in-patient treatment in a locked facility, potentially out of state, from which Mariah could not flee.

Since December, they had been working with the Saco police to document Mariah’s transgressions – running away, taking her family’s vehicles, misusing credit cards without permission, assaulting her mother when she tried to stop her. It was a last-ditch strategy to use the power of the courts to mandate a more rigorous treatment plan with serious consequences.

But the effort came too late. Mariah died 10 days before her first court date.

“She knew a lot. She was a smart girl. But she was a baby,” said Kathy Bailey, 67. “The upside of that is that she was capable enough that if she were in a circumstance where she had to support herself right now, I have no doubt that she would have done it. The bad part of all that is she took away my ability to parent her.”

BEGINNINGS

Mariah’s life with Kathy and Chuck Bailey began outside Bangor in the city of Brewer. It was the early 2000s, and two of the Baileys’ three kids were students in the Brewer public schools. Their two youngest had befriended two brothers who played in the band, and whose family life was deteriorating. The boys’ stepfather had died, and their mother had complicated health problems.

The Baileys had a big house and generous hearts. Their daughter pleaded with Kathy to help. She agreed. The Baileys never officially adopted the brothers, but they quickly folded them into the family, watching over them as they finished high school and launched their adult lives.

The brothers had a younger sister – and a few years after they graduated from high school, she got pregnant at 15 and needed help.

Mariah was born in February 2007. The Baileys opened their home to her and her teenage parents for the first few months of her life. The couple and the baby eventually moved out, but the Baileys stayed closely involved for two years with Kathy as a backstop, taking Mariah every afternoon to provide her mother a measure of teenage normalcy.

“(Mariah’s biological mom) was trying to do the right thing,” Kathy said. “So the baby became my baby right from the start.”

A couple of years after Mariah was born, her biological mother ran into some trouble, made some bad choices and decided to give Mariah up for adoption. The Baileys did not hesitate.

Kathy and Mariah were inseparable. When Kathy was washing dishes, Mariah played by her side in the water of the sink’s other basin. When Kathy went back to school for her master’s degree, she strapped Mariah to her chest while she wrote papers late into the night.

Mariah was a sensitive, empathetic child. She often seemed to understand so much beyond her years. Kathy liked to say she had the soul of a 102-year-old. She was silly and funny, and from an early age felt drawn to the underdog, the defender of all who were needy, Kathy said.

She was obsessed with “The Wizard of Oz,” and when Kathy took her to see a stage version, she dressed as Dorothy, resting her ruby slippers on the balcony railing so the Dorothy on stage could see them.

Mariah’s best friend as a child was the family dog, Dewey, a chocolate lab who was her protector and who always was glued to her side. When it came time to put Dewey to sleep, the veterinarian came to their home. The family surrounded Dewey in the living room. As the injection was administered, Mariah, who was then about 11 years old, knelt down whispering soothing words into the dog’s ear.

She wanted to talk Dewey into heaven, she told her mother. By then, that’s what she called Kathy.

One day, when Mariah was 4, she suddenly called Kathy “mom,” and it startled her. “Can I call you mom?” she asked Kathy.

“She said, ‘You do all the things like a mom does, and my mom can’t do that stuff. And sometimes I can call her mom, but you’re my mom,’” Kathy said. “This girl was a deep thinker from day one.”

FISSURES

Mariah also was deeply traumatized.

Kathy and Chuck Bailey were open with Mariah about her adoption and talked about it in age-appropriate ways, they said. Mariah knew she was loved, but questions nagged at her.

“In kindergarten she asked, ‘What kind of mother gives up her child?’” said Kathy. “Mariah was a kid, but she was never really a kid.”

Mariah’s strong will emerged early, too. In the third grade, she marched into the principal’s office and demanded to be put into a different class, Kathy said. Mariah did not get her way – and the teacher, undeterred, went toe to toe with her. After a few classroom skirmishes, Mariah relented, and the teacher became a favorite adult in her life.

Still, sometimes she would stand up in class, declare that she was done with school for the day and demand to be sent home.

When Mariah was 7, Kathy found her on the internet. She was still learning to read, but she was taking a self-administered mental health assessment. As she grew up, it became clear that she was highly attuned to people’s emotions and showed deep empathy for others, but often struggled to mediate her own feelings, Kathy said.

Mariah was about 12 or 13, in middle school, when her more serious behavioral problems began. She didn’t want to listen to teachers or, if it didn’t suit her, transition from one subject to the next.

Friction emerged in her relationships with her peers, Kathy said. Mariah was both bullied and a bully herself. The dramas that ensued were supercharged by the casual cruelty of social media.

Her parents knew Mariah’s angst was outside the norm by the time she was 13. One day at home, she exploded in an anxious fit, scaring both Kathy and Chuck.

“I ended up grabbing her and holding her for four hours. She fell asleep in my arms,” Kathy said. “And when she woke up, the crisis was over. But it wasn’t too long after that that she had another one, and then another one.”

Within months, a pattern had emerged. When Mariah couldn’t regulate her emotions or became manic and upset, she ran.

Kathy and Chuck would track her down and take her to the hospital, where doctors would perform a crisis mental health assessment, giving Mariah space and time to de-escalate. Mariah would successfully assure medical staff that she was actually fine, redirecting their attention to her relationship with Kathy.

“She said, ‘Oh my gosh, I just went out last night and had some fun, it’s not a big deal,'” Kathy said, choosing to omit details about the risks she had taken or the danger they put her in.

It frustrated Kathy, who recognized the signs of a deeper problem. But Mariah was convincing, Kathy said, and it made it more difficult to get her into the kind of intense, long-term treatment that she needed.

Early on, in the second or third grade, Mariah was diagnosed with anxiety and depression, along with oppositional defiance and a mood disorder.

Eventually doctors diagnosed reactive attachment disorder, which can affect children who do not have enough time to bond with their parents or caregivers as infants, altering their ability to form healthy relationships later in life.

Kathy, drawing on her training as a nurse, saw signs of borderline personality disorder or bipolar disorder, but Mariah still was too young to be diagnosed for those conditions, she said.

For the last two years Mariah’s defiant behavior intensified, with her family scrambling to find ways to address her spiral.

RUNNING

During the summer of 2020, Mariah ran away day after day, sometimes three or four times a week, Kathy said. It was a grinding routine. Kathy stopped sleeping, always on. The strain upended their lives.

During one of countless post-crisis hospital visits, a nurse saw Kathy’s exhaustion and burnout and agreed: Mariah needed more help. The family checked her into a crisis services unit in Rockport, where she stayed for two weeks to stabilize.

At first Mariah was upset and resistant. But she soon thrived in treatment, benefiting the most from dialectical behavioral therapy, an evidence-based approach that mixes coping strategies with mindfulness techniques and meditation, teaching people how to regulate their emotions and self-soothe.

“As she got deeper into a particular kind of therapy, she actually thrived on it and did really well with it,” Kathy said. “That’s why we were trying to get her hospitalized – so that they could do some intensive work. And I think it would have made all the difference, at least for a while to get her maybe a little bit older, a little bit more mature.”

But the relief after the in-patient crisis visit was short-lived, Kathy said. About 10 days after Mariah came home, she ran again, triggering another hospital visit. The cycle had restarted, bringing on more emergency room visits, another week in the Rockport unit, two stints at Spring Harbor Hospital, a nonprofit psychiatric facility in Westbrook. 

The family learned that they couldn’t always rely on crisis hotlines, especially around holidays, when staffing was thin or nonexistent. They began calling police, who would look for Mariah and return her to her parents, who would again drive her to the hospital for another temporary de-escalation.

It made Mariah resent her mother, Kathy said. And it put Kathy in dual roles, of loving mother and mental health nurse, that often conflicted and made it difficult for her to maintain a closeness with her daughter.

“Our relationship had just become all about dealing with this,” Kathy said. “It’s so hard for a parent and a child to solve these problems without mediation. We didn’t have the tools or the education to be able to do any of this stuff, you know?”

The family relied on a committed team of social workers and case managers at Spurwink, a provider of behavioral health and education services, but they ran into familiar systemic problems: There were too few placement options for teens who needed intensive treatment.

An inflection point came in November 2020, when Mariah ran away with a 17-year-old she had met online. They were gone for eight days.

Kathy drove in circles around Portland, looking for her daughter. Finally, after the young man abandoned her, Mariah called her mother and agreed to come home so she could shower and change clothes. While her daughter washed up, police arrived and took Mariah to a hospital.

LAST RESORT

In therapy and counseling, Mariah complained about the restrictions Kathy had placed on her access to the internet and social media because she couldn’t connect with her peers. To Kathy, social media was a toxic pool that exposed her daughter to endless risky situations and bad influences.

Again and again, Kathy was frustrated by the lack of resources for Mariah. There seemed to be no program designed for young people like her. Although there are group homes, crisis centers and in-patient treatment facilities, there are not enough of them and staff often struggle to keep control of residents who are not much younger than they are, Kathy said. She knew just how easily Mariah would be able to charm staff, and use her good rapport to bend rules or break them.

After the lengthy disappearance, Mariah was placed again at the crisis unit in Rockport, and then at Sweetser, a Scarborough residential program for youth that included an on-site school.

Mariah thrived in the school setting, Kathy said, but the Sweetser staff struggled to keep her in check, and she defied their rules, roamed the campus without permission and refused to take on the responsibilities Sweetser required of her. She also was not making progress in therapy to work on her underlying problems, Kathy said.

“Unfortunately, most of the work with Mariah was not  preventative therapy but rather rehashing the problem that happened the night before,” Kathy said.

To her,  the focus was on putting out small fires while the whole forest was burning.

After 10 months, Kathy said, Sweetser gave up.

While the original plan had been to transition Mariah out of the program, her actual exit occurred without warning about three weeks early. A Sweetser manager called Kathy the  Monday after Thanksgiving last year, and asked, ‘How soon can you pick up your daughter?’ They had already packed Mariah’s things, and she went home that day.

Mariah had fled one too many times, caused too many disruptions, Kathy was told. She was expelled from the program without discharge planning to continue her therapy or medication.

The plan Sweetser had discussed with the family was gone.

She was supposed to have an outside therapist in place, a new psychiatrist to review and renew her medication, and home therapy program twice a week – pieces the family scrambled to put in place themselves.

“I said, ‘How dare you discharge this girl for running away, when the reason why she came to Sweetser was because she was running away? That doesn’t make any sense to me.’ I said, ‘You’re punishing her twice.’”

Representatives for Sweetser and Spurwink and Saco Police Chief Jack Clements declined to discuss Mariah’s case or her history, citing confidentiality laws.

“The loss of any life is a tragedy, but the loss of a child or teenager is unthinkable,” said Jayne Van Bramer, president & CEO of Sweetser, in a written statement. Van Bramer did not answer specific questions about why the agency discharged Mariah without more planning and preparation. “Our thoughts and sympathies are with her family at this extremely difficult time.”

In January, the family, seeing nowhere else to turn, began making plans with the Saco Police Department to bring Mariah into the court system. A clinician from Sweetser and case managers from Spurwink were helping the family make this happen. Kathy is grateful to the case workers and those clinical therapists who recognized Mariah’s urgent need for help, as well as the Saco police, whose officers visited their home countless times when Mariah ran away. But they were all working within an under-resourced mental health system, she said.

No amount of determination and commitment can conjure treatment options that simply do not exist, she said.

In the last few months before Mariah’s death, the family had begun the slow process of proving to MaineCare so that she could seek better treatment outside Maine. To make that happen, they had to apply to and receive rejections from the in-state programs they already knew would not meet Mariah’s needs.

As they worked to make plans, the warning signs grew more dire.

Mariah had begun to shut down. She spent all day in bed, sometimes asleep for long stretches, emerging occasionally to eat or use the bathroom. She was barely on speaking terms with Kathy, and hurled nasty insults at her when Kathy tried to engage. She was running away almost every day, too – so often that the Baileys kept a prepared missing person’s form on their computer. They needed only to change the date and print it out before handing it over to police.

They were so close to making a breakthrough, Kathy said. Mariah’s big court date was May 19, when a judge would address the more than a dozen accumulated charges against her and potentially lay out better treatment options.

Instead, Kathy spent that day sifting through photos of her daughter and reading through her journals to decide what to display at her memorial service, looking for messages Mariah left behind.

In one of them, Mariah wrote:  “You keep a lot to yourself because it’s difficult to find people who understand.”

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