The trailers that make up the seven-bed state psychiatric facility in Middlesex were meant to last two years at most. As a stopgap measure that opened in 2013, the beds were part of the state’s new regional mental health infrastructure meant to replace the 54 inpatient beds at the old psychiatric hospital in Waterbury. Tropical Storm Irene destroyed the Waterbury complex two years earlier.
The Middlesex trailers, which some mental health advocates call “jail-like,” remain in use. But their tenure will soon come to an end, state leaders said Friday at a groundbreaking event for a permanent 16-bed facility in Essex.
“To be quite honest, it’s been long overdue,” said Rep. William Lippert Jr., D-Hinesburg, who chairs the House Committee on Health Care. “We’ve known that. We acknowledge that and we need to acknowledge that on behalf of the Vermonters whose lives are touched and impacted by mental illness.”
At 17,000 square feet, the new facility in Essex is expected to cost $15.4 million. Construction is slated to finish in December 2022, and the first patients are expected to arrive the following spring.
The recovery facility for adults is being built on the grounds of the now-closed Woodside Juvenile Rehabilitation Center. The dilapidated Woodside building will be demolished in the process, and state officials have proposed replacing the juvenile facility with a new complex in Newbury. However, that plan has run into local opposition.
Construction of the recovery facility comes as the coronavirus pandemic has strained nearly every part of Vermont’s mental health infrastructure. A rise in unaddressed depression, anxiety and other disorders caused a spike in demand for inpatient mental health beds at a time when health care workers are in short supply.
With few open inpatient psychiatric beds in Vermont, many patients in crisis are stuck at hospital emergency departments across the state until a bed opens. Alison Krompf, deputy commissioner of the Vermont Department of Mental Health, said last month that all but five of the state’s 138 adult psychiatric beds were occupied. Since then, the department has worked to bring more beds online, but psychiatric patients continue to wait at emergency departments across the state.
The recovery facility in Essex would ease the pressure by supporting adults who have completed the type of intense care offered by the Brattleboro Retreat or the state psychiatric hospital in Berlin, but aren’t yet ready to go home. The facility would feature natural light, access to nature, and communal activities such as cooking and gardening, said Emily Hawes, the state mental health commissioner.
“We know today that care facilities that feel more like a home than an institution and that allow easy access to nature help residents feel safe, which in turn helps with recovery,” she said.
The Essex center won’t be exactly like home, however. Residents would receive 24/7 medical supervision. As with the trailers in Middlesex, the new facility would be surrounded by a fence to contain patients who have been hospitalized involuntarily. Hawes said patients would stay there eight to 10 months on average before returning to their communities.
“If you want people to be able to go outside and not run off, you have to have that,” said Connie Stabler, of South Burlington, an advocate whose loved one has schizophrenia. It may sound strange or even archaic to some, Stabler said, but it can be hard to keep a person safe in the grips of some types of mental health episodes. Her relative, for example, has been known to run out of buildings screaming in the middle of the night.
Mental health department leaders had intended to seek approval for involuntary medication and seclusion at the facility, which state law allows only in hospital settings. They scrapped the idea after an outcry from advocates and elected officials, Hawes said.
That change in strategy was a relief for Stabler and other people whose relatives have been hospitalized. Stabler, who also volunteers with the Vermont chapter of the National Alliance On Mental Health, said the use of restraints would have changed the dynamic of the new facility.
“It would have made it just another hospital,” she said.
