The state wants to replace a temporary psychiatric facility in Middlesex with a permanent structure twice the size, officials told lawmakers last week. The location of the facility has not yet been determined.
The secure Middlesex Therapeutic Community Residence houses psychiatric patients, among them forensic patients. The seven-bed structure, which was opened in June 2013 as a temporary facility, is located on the grounds of a Vermont State Police barracks.
The Middlesex residence is a temporary facility for forensic patients after Tropical Storm Irene damaged the Vermont State Hospital in Waterbury.
The Vermont Department of Mental Health opened the secure residence to provide additional capacity for Vermont’s new decentralized mental health system. Instead of building a 50-bed psychiatric facility to replace the state hospital, the Shumlin administration opted to build a smaller, 25-bed hospital in Berlin and offer decentralized services at Rutland Regional Medical Center and the Brattleboro Retreat, a private psychiatric hospital.
The department wants to build a permanent secure facility with 14 beds at an estimated cost of $11.4 million to free up capacity in the mental health system of care, specifically inpatient beds at hospitals, Paul Dupre, commissioner of the Department of Mental Health. The total amount does not include the cost of purchasing land for the facility.
Dupre characterized the secure residential facility as a longterm project. At this time, the department is not requesting funds, and merely submitted the report to satisfy a request from lawmakers, Dupre said in testimony to the House Appropriations Committee.
Last June Vermont opened the doors of the Vermont Psychiatric Care Hospital in Berlin, but the system still lacks the capacity to keep people with acute psychiatric needs out of emergency departments.
Frequently patients who no longer need treatment in a hospital setting are not discharged back to the community or corrections because they lack competency or are still considered a danger to the public, Dupre said.
“If someone doesn’t belong in corrections, they’ll put them in a state hospital if they think they’re dangerous, even if they don’t always meet the need for that,” Dupre said.
Treating forensic patients at the Vermont Psychiatric Care Hospital or one of three private hospitals in the state that provide inpatient care for psychiatric patients in state custody is costly and restricts access to beds for people seeking voluntary hospitalization or those in state custody waiting in emergency departments, he said.
The secure 14-bed facility would use seclusion and restraints for dangerous patients and would provide a lower cost alternative for those who can’t return to the community, but don’t belong in corrections.
CORRECTION: The location for the state’s planned secure residential facility for forensic patients has not yet been determined. The original story incorrectly stated that the facility would be located in Middlesex. This story was also updated with additional information from Dupre.
