VT Mental Health Services Strained

11/13/09 8:08AM By John Dillon
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AP Photo/Toby Talbot
Vermont State Hospital, Waterbury
(Host) The Vermont State Hospital has been close to capacity this summer and fall, putting a strain on mental health services around the state.

Officials say some psychiatric patients have had to wait in emergency rooms for hours or days until hospital beds became available.

VPR's John Dillon reports:

(Dillon) Patients are sent to the Vermont State Hospital in Waterbury when local health care facilities lack the beds or the psychiatric services to take care of them.

But with the hospital operating near its 54-bed capacity this summer and fall, some extremely sick patients have had to wait too long for care. Michael Hartman is state mental health commissioner.

(Hartman) "The average wait to go to the state hospital is usually five or six hours for the whole process to occur and for the person to be on their way. ... I think what we were starting to see is that turn into 10 hours, 12 hours, next day. And in the most significant case, I think, multiple days before they were able to transfer."

(Dillon) The state hospital takes patients that no other institution wants to handle because the patients are in crisis or have a severe mental illness.

But community mental health centers and regional hospitals have also seen a surge in demand for services, Hartman says.

(Hartman) "What we've seen is a pretty significant increase. I'd say it's about 10 or 15 percent in the crisis beds, about 10 local hospitals in the local hospitals and about 20 percent at the Vermont State Hospital."

(Dillon) Mental health specialists say the poor economy is one reason more Vermonters are in psychiatric crisis. Lincoln Representative Michael Fisher is a social worker who practices in Addison County.

(Fisher) "There's a set of families out there who normally would function OK, who, with the added stress, find themselves really needing more supports. And for some families that leads to needing much more supports and the need for the kind of services that are supplied at community hospitals and our state hospital around psychiatric care."

(Dillon) Fisher is co-chair of the Legislature's Mental Health Oversight Committee, which has reviewed the state's plans to close the antiquated Vermont State Hospital. The plans include a new acute care facility in Waterbury, along with treatment centers in Rutland and Brattleboro.

But regional hospitals, meanwhile, have cut psychiatric beds. Fisher says the increased demand for mental health services may cause officials to re-think the state hospital replacement plans.

(Fisher) "The state hospital is the only place for a set of people whose behaviors are such that they can't be treated in the community hospitals. And I think it really does beg the questions as to whether we've downsized too much."

(Dillon) The state's budget cuts have compounded the difficulty for mental health providers. They've seen more demand for services, just as the state has reduced spending on programs.

Ken Libertoff is executive director of the Vermont Association for Mental Health. He worries that budget cuts will erode Vermont's system of community-based mental health care.

(Libertoff) "The community system, which was built as a way of reducing the need for a large census at the state hospital, is in a period of time where they can't offer a full range of services, and are potentially threatened with further reduction. So, not unlike the problem when a bridge collapses, our system is faced with collapse."

(Dillon) The Douglas administration says state revenues are stable, so additional cuts may be avoided.

For VPR News, I'm John Dillon in Montpelier.

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mental_health state_hospital health
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