Vt. Sees Growing Use Of Emergency Rooms For Psychiatric Patients

09/11/12 5:50PM By John Dillon
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The state says it's making progress on many levels as it overhauls Vermont's system of mental health care.

But officials are troubled by one disturbing sign: an increasing number of people are waiting in emergency rooms because there aren't enough mental health beds available.

Mental Health Commissioner Patrick Flood appeared before an oversight committee and painted a generally positive portrait of the state's mental health system.

A year ago, Tropical Storm Irene closed the antiquated Waterbury State Hospital, forcing the evacuation of 51 patients. The legislature this winter decided not to re-open the facility. Instead, lawmakers passed a bill that emphasized more community-based treatment.

But Flood says there still aren't enough beds to meet all the needs of people in acute mental health crisis.

"The number of people waiting in emergency rooms is actually going the wrong direction, if you ask me," Flood says.

Flood told the panel that cases in which patients were held in hospital emergency departments grew from 15 in June to 22 in July to 24 in August. Some patients waited three or four days for a placement, he said. The worst case involved a patient with a physical as well as a mental health condition that waited five days at the emergency room of a small hospital before a mental health bed was found.  Flood would not name the hospital.

But he says the situation will improve as new hospital units come on line. Flood says his staff talks every day with hospitals and local non-profit providers to find placements.

"The resources, the availability of beds, is still a significant problem. I think how we as a system are dealing with it is much better than it ever used to be," he says. "So we don't see people falling through the cracks."

Flood is confident new beds will soon be available. His department is negotiating with the Rutland Regional Medical Center to open a new unit. And the state plans to open an eight-bed facility in Morrisville in November.

"We're hard at work in terms of staffing it, and putting together the policies that we need to have and talking to the Department of Health about getting it licensed," he says. "All of that is on schedule. And I'll just say it probably for my own benefit: We'll really feel the difference when that tiny little eight-bed facility opens up."

Mental health advocates applauded the state's efforts. But Wendy Beinner, director of the Vermont Chapter of the National Alliance on Mental Illness, says she remains concerned about the ongoing pressures on the system.

"I would say almost daily I'm getting calls from family members, and also some from people who are themselves seeking services, who are not getting sufficient services in the community," she says.

State officials are still assessing the financial impact of the re-designed mental health system. Commissioner Flood says lawmakers may need to bolster the budget by $1.5 million next year to make up for a projected shortfall.


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