Deep concerns are being voiced about the potential return of some patients to the flooded-out Vermont State Hospital in Waterbury as the state struggles to cope with a crisis in the mental health system.
Mental Health Commissioner Christine Oliver Friday said the state has not ruled out other options for treating patients who were evacuated from the Brooks building at the Vermont State Hospital (VSH) after tropical storm Irene struck Aug. 28. A total of 51 patients were evacuated Aug. 29 and were dispersed to mental health treatment facilities around the state.
Oliver on Thursday indicated that the quickest and least costly solution appeared to be to try and reopen some beds at the red-brick facility, which was built in 1890.
It is a solution no one, including Oliver, thinks is anything but a stopgap emergency measure. However, some mental health advocates remain adamantly opposed, and others worry that temporary use will become more long term or forestall movement to better treatment models.
“I am of the belief that we could get some of these other options set up and going a lot quicker, and it would be more affordable to do,” said mental health blogger Morgan Brown, who says he knows others feel the same way.
“It’s not a fit facility any longer. Why would we want to invest more money to go back?” he asked.
Oliver’s comments, backtracking on a firm commitment to renovate and return patients to a scaled-down VSH, come the same day Oliver and other mental health officials had a teleconference with a group of mental health organizations in Montpelier to brief them on the treatment crisis and the Department of Mental Health’s efforts to deal with it.
He said he was confident the state is trying hard to find other alternatives to moving some of the patients with the most acute need back into the VSH.
“They are flipping over stones looking for answers. They deserve a lot of credit for the hard job they’re doing,” he said.
But after talking with Oliver in the teleconference Friday, he said he also understood the state remains in an emergency situation with patients who are in inappropriate treatment settings.
“There are decisions being made daily between bad placements and less bad placements,” he said. The state has a valid concern that something could go wrong in the current situation, and a patient could endanger him or herself or others.
“What they know is they need to make a decision as soon as possible, because they are afraid that something tragic might happen,” he said.
In her comments Thursday, Oliver said efforts to create a scaled-down hospital unit, with housing for 40 patients or less, might be the best scenario and it was possible that it could be up and running by late November.
Friday, Oliver said that may still end up being the case but has a person working full-time trying to find any “congregated type of setting” that could be “made safe and meet the needs of patient care.”
She agreed with Nease that reopening the Brooks hospital facility “was nobody’s first option.”
Oliver said that with so many of the 240 state hospital employees located in the Washington County area around Waterbury, that area was the main focus for efforts to find some alternative treatment options.
There is virtual unanimity in the mental health community that the antiquated state hospital building, built in 1890, was not an ideal facility for treatment of the severely mentally ill before the flood — and would be even worse one now, considering the building’s condition, the muddy grounds and reconstruction there that would make therapeutic treatment difficult.
The VSH flooding that displaced patients also forced closure of the state office complex where 1,586 state employees worked. It caused extensive damage to all the infrastructure and ground floors of many buildings.
Julie Tessler, executive director of the Vermont Council of Developmental and Mental Health Services, said she had hoped a plan floated to use modular hospital units might pan out. But Oliver Thursday said those proved unfeasible and ruled that option out of the mix.
Tessler said she was “very proud” of how the mental health agencies she represents responded in taking in state hospital patients but that those placements remain problematic.
“Those placements, many of them cannot go beyond a week or two,” she said.
Oliver said an additional issue is the stress on state hospital staff, who cannot be asked long-term to travel by van around the state to treat VSH patients in other facilities.
While saying no options have been ruled out, she said Friday it’s also clear that soon the state will have to make a decision one way or the other soon.
I don’t believe the state hospital should be on the table. If it was taken off, they would be open to other options.”
– Morgan Brown
One thing almost everyone agrees on is that the situation pretty much defines being between a rock and a hard place. Nick Emlen, a coordinator who works with Tessler and also attended the teleconference, called the meeting “mutual, open and frank” but added that the Department of Mental Health is in an unenviable position.
“They’re exploring all possible options, but they have very few at the moment,” he said.
For his part, Brown is convinced the state is leaning toward going back to the state hospital, which he says is unfortunate. He said the state is missing the boat by overlooking other less restrictive care models that could be designed piecemeal.
“I don’t believe the state hospital should be on the table. If it was taken off, they would be open to other options,” he said.
Despite disagreements, Mental Health Commissioner Oliver drew considerable sympathy from those at the teleconference.
“They’ve been asked to run a 100 meters as fast as they possibly can, and their legs are tied together, and they have one hand tied behind their back,” joked Nease.
He noted Oliver until Friday didn’t even have an office to work out of and only got a desk and phone number Friday.
Actually, Oliver said, it’s not even a desk — it’s a card table.
Her office has been set up in the historic Redstone building in Montpelier.
