The commissioner of the Department of Mental Health is requesting a judge’s approval to move Elizabeth Teague, who was found incompetent to stand trial for a 1991 workplace shooting spree, to a less secure psychiatric facility.
A day after being fired in October 1991, Teague walked into Eveready Battery in Bennington and shot and killed her supervisor. She shot two other workers before fleeing and being captured near the Canadian border.
She spent the intervening decades in state psychiatric hospitals, first the Vermont State Hospital, and after its closure post-Irene, at the Brattleboro Retreat, which the state contracted with to care for the most acute cases of mental illness. While hospitalized, Teague was diagnosed with persecutory delusions and paranoid schizophrenia, court records show.
Bennington County State’s Attorney Erica Marthage opposes Teague’s transfer from the Retreat to a secure residential facility in Middlesex, she said.
Marthage said the transfer is being requested not because of an improvement in Teague’s condition, but because the state thinks it’s too expensive to keep her at the Retreat.
“If there was any indication that Ms. Teague’s mental health status had changed it would be a different question, but that’s not the case,” Marthage said.
In Commissioner Paul Dupre’s filing, a staff psychiatrist reports, “(Teague’s) remaining in a hospital is an inappropriate allocation of scarce resources if she can be safely managed at a lower level of care, which is the case in the opinion of this writer.”
Citing that same report, Marthage’s office argues in its filing to make the case public – which the judge granted – that Teague is still a high-risk patient.
In 2008, Teague became agitated and threatened staff by “making her finger into the shape of a gun,” and pointing at them, and continues to experience and act on delusions, according to the psychiatrist’s report.
The report also states that Teague is lucid, but has made “minimal progress” in her rehabilitation and has “no insight into her illness.” She refuses to take adequate medication for her condition, according to the report, and cannot be medicated involuntarily because her durable power of attorney gives a guardian the authority to refuse medication on her behalf.
The Middlesex Therapeutic Community Residence was opened last June. At the time, the governor and other state officials said the seven-bed facility would serve patients with acute mental illness who do not require long-term hospitalization. Officials also said Middlesex TCR would be a temporary facility while the mental health system built capacity post-Irene.
The commissioner’s request is particularly concerning, Marthage said, because of those and other public statements that high-risk patients would not be housed at the Middlesex facility.
Prior to the facilities opening, when residents were fighting its arrival, former Commissioner Patrick Flood, told VTDigger that, “By intent and by design this is really a facility for people waiting to be discharged. These folks are not in an unpredictable state. They’re pretty stable … and I want to stress that I don’t see them as a high-risk population at all.”
Calls for comment from Dupre’s office about what type of patients Middlesex TCR can appropriately treat were not returned Thursday.
Rep. Anne Donahue, R-Northfield, a member of the House Human Services Committee, said Teague’s case could be a test for the decentralized mental health system Vermont is building.
“As far as I know, she’s the first example of someone who was at the Vermont State Hospital based on a criminal charge, where this brand new program concept is being proposed for what is one of the primary intended purposes,” Donahue said.
Donahue has been involved over the past two years with the implementation of Act 79, a law meant to bolster non-hospital alternatives for treating mental illness, such as secure residential facilities – like Middlesex TCR – and other services meant to support people in their community.
It’s not unreasonable for Dupre to consider cost as one factor in a decision about where someone in state custody should receive treatment, but it shouldn’t be the primary reason, Donahue said — providing patients with safe and appropriate care should come first.
The case should be decided on a preponderance of the evidence, she added. If Teague is determined too high risk, meaning she poses an unacceptable amount of danger to herself or other people at the Middlesex facility, then she should remain at the Retreat, Donahue said.
What’s not at issue is whether patients who pose some danger can be housed at a secure residential facility, she said. By definition, patients in state custody pose some amount of danger, or they wouldn’t be confined.
The Middlesex facility was always intended to serve forensic patients, meaning those who come into the commissioner’s custody though the criminal justice system, according to Donahue.
“In many people’s minds, that was going to be its primary use,” she said.
A Windham County Superior court justice will hear the case in August, and rule on where Teague will continue to receive treatment.
