But Squirrell, currently the executive director of Building Bright Futures, says she is up to the challenge of improving Vermont’s overburdened mental health treatment system when she becomes the state’s next mental health commissioner on Jan. 1.
Among Squirrell’s top priorities include increasing treatment capacity; boosting training and workforce development for mental health staff; and focusing on early intervention for children who’ve had traumatic experiences.
“I have this incredible opportunity to contribute in a powerful way to meaningful change for our most vulnerable Vermonters,” Squirrell said.
TheDepartment of Mental Health’s leadership has been in transition since the October departure of former Commissioner Melissa Bailey, who took a job out of state. Bailey’s deputy, Mourning Fox, took over on an interim basis while officials searched for a replacement.
On Thursday, Gov. Phil Scott announced Squirrell’s appointment to the commissioner’s job. Fox, who has been the department’s deputy for about two years, will return to that role.
In his announcement, Scott praised Squirrell’s dedication to helping the vulnerable and “her ability to think about creative solutions.”
State Human Services Secretary Al Gobeille acknowledged that the state “continues to see major challenges in our overall system of care for delivering mental health services.”
“I am thrilled that Sarah has agreed to lead the incredible team we have at the Department of Mental Health to continue to make improvements,” Gobeille said in a statement released by the governor’s office. “I look forward to working with her.”
The system’s biggest challenge is an increasing number of patients with increasingly acute treatment needs. Vermont doesn’t have enough capacity to handle that influx, leaving many psychiatric patients stuck in hospital emergency departments that are not designed for mental health treatment.
Building more inpatient treatment capacity is one potential solution. Projects are in the works, but they are expensive and take time.
Squirrell has her work cut out for her. But she said she is aware of the challenges and has spent most of her career in human services, including work in the mental health field.
She has a master’s degree in community mental health and clinical counseling as well as a bachelor’s degree in psychology. Before taking the reins at Building Bright Futures, she was director of school-based mental health services for Laraway Youth and Family Services in Johnson.
While Building Bright Futures is focused on early childhood issues, Squirrell said there are clear links to her future work as mental health commissioner. For example, both jobs involve working with a variety of groups toward a common goal.
“Collaboration and partnership are just critical to advancing our mental health system of care,” Squirrell said in an interview Friday. “Vermont has a huge opportunity right now to strengthen our existing mental health delivery system in a more proactive, integrated and coordinated direction.”
Another link between her current and future jobs is an increasing focus on childhood trauma and the long-term impact that can have, both for physical and mental health. Addressing such issues earlier, she said, can help prevent larger problems later on.
“Another area that we need to focus on in our mental health system of care is the importance of early intervention – really going upstream, building capacity for more trauma-informed care and resilience and not forgetting the importance of family supports,” Squirrell said.
Earlier intervention will be one of her priorities as mental health commissioner, as will expanding the state’s ability to treat mental health patients in a variety of settings.
“We absolutely need to focus on increasing our inpatient capacity. That is urgently important,” Squirrell said. “(But) it’s not the only answer. We also need to focus on continuing to build and improve our community supports.”
Training and workforce development is another priority, and that includes offering help to emergency room staffs that are struggling to handle psychiatric patients.
Another priority goes beyond staffing, facilities and treatment programs: Squirrell said too many people still aren’t getting help due to the “fear of being labeled and judged” for mental illness.
“We still need to be thinking about stigma, and how stigma around mental health care is really and truly a barrier to accessing care,” she said.
Funding will be a barrier to any large-scale mental health initiatives. But Squirrell said she believes the state “has the opportunity to make significant changes.”
“I certainly don’t have all the answers yet,” she said. “But I am very excited to get to work and truly honored by this opportunity.”
