A recent presidential executive order demands a throwback to institutionalization of the homeless over housing. Such a draconian and costly shift would swing the pendulum back to inhumane policies predating the 1980s, when people with mental health needs were given no right to self-determination, often spending their lives locked away in mental institutions.

The order ignores the tremendous success that housing with support offers to most individuals, at lower cost and with compassion and humanity over institutionalization.

Almost as bad, the order fails to address our real present-day challenge: society’s refusal to require treatment, including medication, for the small population of people with brain disorders who commit significant and/or persistent criminal conduct in the absence of these requirements.

Almost two years ago, I chose to become the prosecutor for all defendants on Cumberland County’s Mental Health docket. This docket centers around questions of competency to stand trial. My main motivation was to understand how mentally ill individuals with repeated criminal conduct could be repeatedly sent back into the community, untreated, frequently returning to the conduct that brought them into the court system.

These cases represent a very small percentage of the total criminal cases we prosecute, but are a root cause of significant community and family frustration and concern. Resolving them well with our current tools is extraordinarily difficult.

Maine’s disjointed statutes give significant scrutiny and a high level of expertise to questions of competency, followed by more limited efforts to restore a defendant’s mental health. What the public does not realize is that the criminal cases of people who are found by the court to be incompetent to stand trial and not restorable to competency must — almost always — be dismissed by law.

The frustration of communities and law enforcement officers hosting these individuals is palpable, as calls to the police turn into another tour of jail, forensic evaluation, mental hospital, then back to the community. As DA, among the challenges I get most frequently is, “What are you doing about people who are living on the streets with deteriorating mental illness, acting out, placing the community in fear?”

Heartbreakingly, this often comes from family members desperate to help a loved one with untreated mental health, who is often self-medicating and struggling with addiction, as they fall away from wellness. How can we stand by while people with often treatable conditions live out their lives removed from interventions that would secure a pathway to wellness and recovery?

I apply the leverage that I have within a system not designed to solve complex social problems. We’ve asked officers to use their encounters on the street to urge people in need to go to homeless service facilities, leveraging no-complaints for minor criminal violations when appropriate in exchange for agreeing to get help.

Often this approach works. Housing and support happen at remarkable numbers from Portland’s Homeless Services Center, in stark contrast to virtually no moves to permanent housing reported from the 2023 encampments.

I’ve used the Mental Health docket to develop a greater understanding of what individual defendants’ diagnoses and treatment needs are, then worked to secure bail or probation conditions to require treatment, including anti-psychotic medication and/or addiction recovery help.

We’ve partnered with Cumberland County’s social service providers to coordinate care when someone is going to be released back into the community, to try to keep them well. We’re taking uncharted paths in the civil code to keep people with persistent or very serious criminal conduct on their medication, when that is their proven pathway to keeping themselves and others safe.

We don’t need to swing the public policy pendulum back to an unjust past. We need to recalibrate. We must factor in impacts on communities, families and individuals themselves when we allow those with treatable brain disorders to choose to remain untreated. To keep individuals and the public safe, we will need required pathways to wellness.

Jackie Sartoris is the district attorney of Cumberland County.