A rash of new regulatory findings detail mistreatment of psychiatric patients at Vermont hospitals, raising questions about standards in the state’s overtaxed mental health system. This story is the second in a three-part series on psychiatric treatment in Vermont hospitals. Read Part 1.
[W]hen Phoebe Sparrow Wagner thinks of hospital emergency rooms, she thinks of restraints, pain, screams and confusion.
But she doesn’t remember anything or anyone that helped her feel better.
As more Vermonters in need of psychiatric care find themselves stranded in medical hospitals because of a lack of mental health beds and other factors, Wagner is speaking out about her experiences.
Hospital officials say they’re doing the best they can to handle a situation for which they aren’t trained or equipped. But Wagner wants medical professionals and the general public to know that, for someone who’s experiencing a mental health crisis, spending any significant time in emergency rooms does more harm than good.
“Of course you scream. What do they expect you to do?” Wagner said of one incident in which she was repeatedly restrained. “You scream because you’re terrified. You’re angry. You’re everything.”
Wagner has been diagnosed with schizophrenia, and she has injured herself after hearing voices. Now in her mid-60s, the Brattleboro resident has been on antipsychotic drugs for most of her adult life and has written books about her experiences.
At this point, Wagner has no faith in the medical establishment’s ability to solve problems like those that have plagued her. Speaking about her long-term schizophrenia diagnosis, she says, “all it did was help me become more of a career mental patient, and it also gives them carte blanche to force medications on you.”
Wagner said she most recently has found effective help at Rochester-based Alyssum, which favors peer support “in a non-judgmental and safe environment.”
Before that, however, Wagner bounced around Vermont’s mental health system. Several times, she says she found herself – like hundreds of others – stuck in hospital emergency departments while waiting for an available psychiatric bed.
While declining to name specific hospitals, she said one such emergency stay in 2015 included a hospital staffer forcibly stopping and then injuring her when she tried to leave. “He grabbed me, pulled me through the doors, threw me onto the ground, jumped on top of me and mashed my cheek into the rug,” she recalled.
Restraint of her arms and legs followed, along with an involuntary dose of Haldol, an antipsychotic drug.
Wagner says she spent eight days in that emergency department – a place meant for physical ailments, not mental health crises. There was little communication with hospital staff during that stretch, which she remembers as “horrendous,” “confusing” and “terrifying.”
During a second emergency room stint in 2016, Wagner says her refusal to move to a seclusion room led to her being “forcibly dragged” there.
“Because I was resisting, they restrained me in four points with one arm above my head and one arm down,” she said. “This is incredibly painful. I’d already had shoulder injuries from hospitals and security guards manhandling me in lieu of the nurses doing anything.”
Hospital administrators say restraints are a necessary “last resort” measure to deal with patients who present a danger to themselves or others. But Wagner sees them only as a method of delivering punishment.
“It’s a horrendous thing to do to somebody – always traumatizing, always the worst possible thing you can do. It just makes everything worse,” she said. “I think they should be outlawed.”
“You can’t punish patients,” she added. “I don’t care how angry you are.”
The second emergency department stint lasted six or seven days before Wagner ended up in a psychiatric bed elsewhere.
Wagner believes her experiences have given her a valuable perspective, and she says she has offered to speak to medical professionals in an educational setting. No one has taken her up on that offer to date.
“I understand that they’re overworked, that they’re stressed … that they don’t know anything about mental health problems. But if they don’t, they certainly could learn,” she said.
Wagner also has written to state officials, urging them not to create more mental health inpatient beds in an attempt to solve the problem. What’s needed, she believes, is investment in more facilities that will treat mental health patients in a supportive, non-medical way.
“They do have the money. What they’re doing is, they’re putting it into making more hospital beds … they’re just misspending it,” Wagner said. “They’re spending it because they listen to the doctors who have a stake – a financial stake – in building more hospitals because it keeps people within the system.”
Hear more from Phoebe Sparrow Wagner in this week’s Deeper Dig podcast:
