A cross-agency working group tasked last year with providing new strategies for treating criminal defendants with severe mental illness has been unable to agree on what proposals to back.
The internal debate underlines the challenge in addressing one of the root causes of some of Vermont’s most high-profile violent crimes.
“The Legislature really wants some concrete ideas,” Karen Barber, general counsel for the Department of Mental Health, said at the working group’s Aug. 31 meeting. “We’re not going to be able to get to consensus.”
Last year, Act 57 tasked the Forensic Care Working Group with studying the gaps in the mental health and criminal justice systems “related to individuals incompetent to stand trial or who are adjudicated not guilty by reason of insanity.”
Specifically, the group was asked to investigate how the state might better handle so-called forensic patients, and the logistics associated with creating a forensic hospital — which is an inpatient psychiatric facility that treats individuals involved in the criminal justice system — or other facility.
The group was originally asked to complete its final report by Aug. 1 of this year. That has since been pushed to January 2023.
But at an Aug. 31 meeting, group leaders announced that they could not find agreement, instead choosing to present participants’ diverse views.
Meanwhile, the state judiciary has launched its own investigation into how to better treat people at the nexus of the criminal justice and mental health systems. In July, the Vermont Supreme Court created the Vermont Judiciary Commission on Mental Health and the Courts. The commission features judges, justices, mental health and criminal justice professionals — some of whom also participate in the forensic working group.
In the commission’s founding document, the justices state that “there are better ways to address” people in the justice system with mental illness, and that “other states are ahead of us.” Among the goals listed is shortening the time it takes for defendants to receive competency evaluations and hearings from “months” to “a specified number of days.”
Sen. Dick Sears, D-Bennington, who sponsored the legislation to create the forensic working group, has a clear idea of the changes he’d like to see.
“I have strong feelings about the need for a (forensic) unit,” Sears said. “It’s about opening up more beds for other folks, but it's also avoiding further criminal charges for many of these individuals who end up back in the community.”
Sears pointed to a murder that occured in Bennington last year as an example of why a forensic facility is necessary.
In January 2021, Darren Pronto of Pownal allegedly slit the throat of a woman along the Walloomsac River. Pronto previously had run-ins with police. Following the murder, Pronto’s neighbors said they had warned law enforcement that Pronto posed a danger to the public.
Pronto was intially found incompetent to stand trial in 2021. A second competency hearing was scheduled for last month, but was delayed. All the while, Pronto has been held at Southern State Correctional Facility in Springfield.
Vermont is “one of the few states” without a designated forensic facility, according to Elizabeth Sinclair Hancq, director of research at the Treatment Advocacy Center, a national nonprofit promoting better treatment for severe mental illness.
“The consequences of not having enough inpatient care capacity is already being seen throughout the state,” she said, pointing to increased wait times for psychiatric beds.
Vermont reported nine forensic patients as of June 30, according to Alexander Raeburn, spokesperson for the state Department of Mental Health. He would not specify where those patients were staying or how long they had been held, citing privacy laws.
Despite wait times, some mental health professionals are reluctant to build more beds, forensic or otherwise.
Thomas Powell, a founder of Vermont Forensic Assessment and former director of clinical services for the Vermont Department of Corrections, said that the decreased number of psychiatric beds has been a purposeful pursuit — noting the adage “if you build a bed, they’ll fill it.”
“I think Vermont has made a conscious effort not to enable that,” he said. He did not expect Vermont would create a forensic facility, unless it involved converting existing psychiatric beds.
Hancq rebuffed the notion that more inpatient treatment options would have a negative impact.
“Inpatient psychiatric care will always be an important part of the continuum of care for people with severe mental illness,” she said. “It’s often suggested by people that inpatient psychiatric care could be obsolete if you have enough community resources — that’s absolutely false.”
Superior Court Judge Katherine Hayes, who is co-chairing the judicial commission, said she hopes the group will focus on improving pretrial services, crisis services and advocating for additional mental health resources in the state. But she said the specifics of the commission will remain relatively undefined until the group convenes.
Asked about Vermont’s lack of a designated forensic facility, Hayes said she does not see it as a “particular issue.” According to Hayes, Vermont’s approach to mental illness in the criminal justice system is not so much outdated as under-resourced. Changing that would require loosening the purse strings.
“It's expensive up front. And it requires a lot of staff up front. And as we all know, mental health staff is a huge, huge problem,” she said.
Wielding the power of appropriations, the Legislature, unlike the judiciary, has the opportunity to make the most meaningful investments in mental healthcare, Hayes suggested.
“I want folks to know that the more they reach out to their legislators to let them know that services are needed, and that they would support mental health services in their community, the better,” she said. “The people who are able to make systematic change most effectively are the legislators.”
Don't miss a thing. Sign up here to get VTDigger's weekly email on Vermont hospitals, health care trends, insurance and state health care policy.