Sarah Squirrell
Sarah Squirrell is the commissioner of the Vermont Department of Mental Health. File photo by Mike Dougherty/VTDigger

Vermont’s Department of Mental Health is preparing to unveil a plan for the next decade that aims to more closely integrate mental and physical health care

The plan, expected to be submitted to the Legislature next month, lays out a vision to guide policymaking over the next 10 years. While officials and advocates are setting out broad goals in the blueprint, the plan is not closely focused on specifics.

Health care professionals and officials met Wednesday at the Waterbury state office complex for a “think tank” discussion as they finalized the report, which envisions eliminating stigma around mental health and expanding community-based treatment programs.

However, multiple attendees raised concerns that the final draft does not have a specific action plan to address the mental and health needs of Vermont’s correctional systems. Some recommended that the department should add an action plan to address the health care needs of those in Vermont’s jails. 

While Vermont is consistently ranked one of the healthiest states in the nation, it’s been hit hard by the opioid crisis and saw a small increase in overdoses last year despite progressing prevention efforts. Suicide is the second leading cause of death among Vermonters between ages 15 and 34, and 13% of Vermonters experience frequent mental distress, according to the department. 

A report submitted to the Legislature last January found that Vermonters have more mental health needs compared to those in other states and that they also want more mental health services. It also found that emergency department lengths of stay increased drastically over the previous year, meaning that people had to wait longer to be admitted to mental health treatment facilities. Three percent of visits to emergency departments accounted for about 40% of bed utilization. Consequently, that report recommended expanding community-based programs could offset the burden on inpatient providers.

Mental health treatment capacity has been an ongoing concern in Vermont. State officials and UVM Health Network have collaborated on plans to build a new psychiatric hospital in Berlin to address needs. Earlier this year, lawmakers approved some funding to begin building a new secure residential mental health facility. Since Tropical Storm Irene flooded the Vermont State Hospital in Waterbury in 2011, the state has used a temporary facility consisting of seven beds in two fenced-in mobile homes in Middlesex.

A key element of the forthcoming 10-year plan is expanding services in the community. The plan has multiple goals, but at its center, it proposes that Vermont’s health care system become more community-oriented and integrated. 

Department of Mental Health Commissioner Sarah Squirrell said progress has been made to destigmatize mental health support and to integrate mental and physical treatment in Vermont’s health care systems. But more remains to be done. 

“Can we continue to strengthen … and emphasize the significance of mental health?” Squirrell said. “Absolutely. There is more work to do.” 

Beyond strengthening Vermont’s health care systems, Squirrel said this plan also allows the Department of Mental Health to feasibly set a vision and pursue it. 

“We know that mental health and physical health can’t stand apart. They need to be integrated,” Squirrell said. “The more we can do to articulate, design and implement an integrated, holistic health care system, it’s going to better meet the whole health needs of all Vermonters.” 

The 10-year plan aims to eliminate stigma against patients in Vermont’s health care systems. The report proposes this can be addressed through training for mental health providers and the creation of public campaigns that raise awareness about mental health stigmatization. 

Another aims to expand peer-to-peer support services. The report will recommend support for programs that can connect people who may be in a mental health crisis with those who can be a mentor.

The 10-year plan, which will be sent to the Legislature this January, does not have a proposed budget attached to the decade-long vision. 

Officials and mental health care providers went through the report, which is still being finalized, this week. The report had previously gone through four other “think tank” meetings, and drafters took input from the public in meetings last summer.

Jill Maynard, director of Emergency Services at Southwestern Vermont Medical Center in Bennington, said she was concerned about some of the language in the report that suggested the department add and expand resources. She said the department should look more closely at whether some programs could be streamlined before deciding to expand.

“We’re not going to be able to wave our magic wand and come up with millions of dollars that we think we need,” Maynard said. 

Others raised concerns about the accessibility of health and wellness programming that the report also recommends expanding around the state. Rep. Lucy Rogers, D-Waterville, said that if the department wants to holistically serve the state of Vermont, it needs to make its wellness offerings inclusive of people with various lifestyles. 

“A dairy farmer may not choose to go to a yoga class even if a yoga class is available,” Rogers said. 

Grace Elletson is VTDigger's government accountability reporter, covering politics, state agencies and the Legislature. She is part of the BOLD Women's Leadership Network and a recent graduate of Ithaca...

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