Earlier this month, the Machias Police Department issued an urgent notice: They were looking for a 33-year-old man who fled a nearby hospital while wearing a hospital gown and no shoes.

The man had been taken into protective custody at the hospital the day before – a required step before officers can remove a person’s weapons – after claiming to have a handgun and threatening to kill his brother and then himself, according to the Maine Office of the Attorney General.

The man was found a short time later, and police got permission from a judge to take his gun, an unserialized “ghost” handgun, according to records.

Despite a growing rate of gun violence and one of the highest rates of suicide in the state, that incident was the first time a Washington County law enforcement agency successfully used the state’s yellow flag law to remove a person’s weapons.

That’s in contrast to the rest of Maine, where at least one law enforcement agency in every other county has completed two or more weapons restriction orders since the law went into effect nearly four years ago.

As of March 19, according to a compilation of state records by The Maine Monitor, a total of 62 agencies had completed 220 orders. Use of the law increased dramatically after last October’s mass shooting in Lewiston.

Maine’s yellow flag law is designed to remove weapons from those considered a danger to themselves or others. Only a law enforcement officer can initiate the process.

The first step is to take the person into protective custody – typically to a hospital – where the officer must then obtain a psychological evaluation by a licensed medical professional.

If the medical professional agrees with the officer’s risk assessment, the order goes to a judge for final approval. Only then can an officer remove a person’s weapons, including but not limited to firearms.

The link between access to guns and increased rates of suicide is well established. A Stanford study that followed 26 million people over 12 years found that men who own handguns are eight times more likely to die of gun suicides than men who don’t own handguns, and women who own handguns are 35 times more likely than women who don’t.

“Our findings confirm what virtually every study that has investigated this question over the last 30 years has concluded: Ready access to a gun is a major risk factor for suicide,” said one of the study’s lead authors, Stanford professor David Studdert, discussing the work in a Stanford news article. The study, which was published in The New England Journal of Medicine in June 2020, came out shortly before Maine passed its yellow flag law.

Washington County has the second-highest per capita rate of firearm deaths and third-highest rate of suicide deaths among all 16 Maine counties, according to the U.S. Centers for Disease Control and Prevention.

In Washington County, there were 24 firearm-related deaths from 2018 to 2021, 20 of which were ruled suicides.

Suicides account for most of the state’s firearm-related deaths. From 2018 to 2021, 653 Mainers died of a gunshot wound. Nearly 90% were ruled suicides, according to the Office of the Chief Medical Examiner.

In other words, when a Mainer died of a gunshot wound during those four years, 9 times out of 10, it was self-inflicted.

A Monitor analysis of state records found that suicide was a factor for removal in at least 70% of completed yellow flag orders.

‘THEY DON’T CALL’

The Machias Police Department, responsible for the county’s only weapons restriction order, simply doesn’t get a high volume of mental health-related calls, Chief Keith Mercier said.

“That probably explains why we don’t have high numbers” of weapons restriction orders, Mercier said.

The Eastport Police Department, about 44 miles away, similarly does not get a lot of mental health calls, Officer Donald Rice said.

Rice said his department – which as of now is just him and a few part-timers – “usually (has) a good grasp of what’s going on.” Rice said officers can “intervene” before it gets to the point of taking someone’s weapons.

Because of the way each police department and regional dispatch center codes calls and collects data, it is next to impossible to ascertain how many mental health-related calls law enforcement agencies receive.

But a previous Monitor investigation found that police statewide are taking on an increasing number, especially as a shortage of crisis workers and clinicians has left many communities without ready access to mental health care.

Mercier’s and Rice’s comments are in stark contrast to what other law enforcement officials told the Monitor.

Presque Isle police Chief Chris Hayes said his department completed more than 1,000 mental health calls last year, four times higher than the year before.

Hayes said about 70% of their calls are mental health-related.

“It pretty much dominates the daily job now,” he said.

The Aroostook County department completed its first weapons restriction order a couple of weeks after the Lewiston shooting and has had three more since. Agencies there have completed seven orders.

“Washington County, to me, is always an enigma,” said Sarah Wright, the Aroostook Mental Health Center’s director of emergency support services. “We know that there are significant struggles in Washington County, but their outreach for help for themselves is significantly low compared to what we know the data is telling us – that there’s a problem.”

Access to care and mental health were the highest priorities for Washington County residents in 2022, according to the county’s Community Health Needs Assessment.

And yet providers like Wright and Julie Redding, the clinical director at the nonprofit Community Caring Collaborative, a group of dozens of organizations aiming to help the region’s most vulnerable residents, weren’t too surprised to hear police say they’re not getting a lot of calls.

“We are rich, rich, rich, rich in relationships here,” said Redding. Washington County’s strong sense of community is an enormous resource, but it can also lead to concerns over a lack of anonymity, or fear of shame or retribution for seeking mental health help.

“That can be really at times challenging and can increase barriers for people asking for help,” Redding said.

Washington County residents are also more likely compared to the state as a whole to be uninsured, have trouble finding a primary care provider within 30 miles – if at all – and rely on emergency departments for mental health care because of a lack of providers or long waitlists, according to the assessment.

Even compared to neighboring Aroostook and Hancock counties, Washington County stands out for what Wright called a “silent need.”

During February, for example, Aroostook County residents called the Maine Crisis Line more than 1,300 times. Washington and Hancock county residents combined for 157 calls.

“They don’t call. I don’t know why,” Wright said.

Wright said she recognizes that law enforcement is not the appropriate response for a behavioral health call, but police simply have more “boots on the ground” than organizations like hers.

There are just over 80 crisis workers in all of Maine, Wright said. But until the state’s mental and behavioral health care workforce grows significantly, police “are going to continue to be on the frontline of crisis response because we can’t possibly cover as much geography as they do,” especially in vast, rural areas like Down East and Aroostook County.

FEW OFFICERS, DEPARTMENTS ‘IN LIMBO’

But Washington County law enforcement agencies also are facing severe staffing challenges. And because only a law enforcement officer can initiate a weapons restriction order, there are limited legal avenues to remove firearms from a person at risk of harming themselves or others.

As of 2022, there were just 33 law enforcement officers to cover Washington County, or 1.1 officers per 1,000 residents – one of the lowest ratios of officers to residents in the state – according to the Maine Department of Public Safety.

Some departments, including Eastport and Milbridge, have just a single full-time officer. In Milbridge, Chief Lewis Pinkham also serves as town manager, and has struggled for years to hire more officers.

The Maine State Police, which technically cover the entire state, significantly scaled back coverage in Washington County last year.

Officials from the Washington County Sheriff’s Office, Baileyville Police Department, Calais Police Department, Pleasant Point Police Department and Indian Township Police Department did not respond to multiple calls and emails.

The Pleasant Point and Indian Township police departments serve the two Passamaquoddy Tribe communities near Perry and Princeton, respectively. A public safety employee at the local dispatch center for Indian Township said that, since the police chief left a few years ago, the department has been in “limbo” and unsure of who was even in charge.

Amid all those challenges, Redding and Wright see an opportunity to capitalize on the deep relationships in small, rural communities.

“Sometimes, the relationship is what’s key when seeking behavioral health help, especially in places like Aroostook or Washington counties,” Wright said.

This story was originally published by The Maine Monitor. The Maine Monitor is a local journalism product published by The Maine Center for Public Interest Reporting, a nonpartisan and nonprofit civic news organization.