Northeast Kingdom Human Services (NKHS) plans to launch its Front Porch program, a mental health urgent care initiative, in 2024. This final and long-awaited service completes a community-based crisis continuum of care.
The desire to create a 24/7 mental health facility started years ago through advocacy work from Betty and Chris Barrett of Newport Center, VT. Betty, a suicide attempt survivor, and a mother who lost a son to suicide, deeply understood the difference a therapeutic environment with professional supports could make for someone in mental distress.
Chris and Betty’s grassroots efforts to call attention to the need for an alternative to emergency department mental health care resonated with Kelsey Stavseth, NKHS Executive Director. NKHS and the Barretts gathered support from Northeast Kingdom community members, healthcare facilities, law enforcement agencies, community healthcare partners, legislators, and the governor’s office to bring The Front Porch to fruition.
The Front Porch aims to reshape mental health support in the NEK. Individuals experiencing a mental health crisis need access to comfortable, safe, and supportive spaces for care. Often, Vermonter’s only choice when experiencing a non-life-threatening mental health crisis is to visit their local emergency department, and law enforcement frequently becomes the community-based mental health crisis responders.
As a result, our communities experience higher rates of incarceration among individuals experiencing mental health crises, emergency department boarding, and increased utilization of more restrictive and more expensive levels of care. The Front Porch will introduce innovative hospital diversion programs that reduce the strain on hospital emergency departments and navigate the complexities of mental health care while prioritizing individual preferences and community integration in a therapeutic environment.
Incorporating the below care approaches will help to ensure The Front Porch is a welcoming, secure, and healing space for everyone.
Community-Centric Solutions: The emphasis on community integration is central. The Front Porch recognizes the importance of familiar environments and how that fosters a sense of belonging. Receiving care close to one’s community reduces anxiety and strengthens the individual’s connection to their community.
Person-Centered Care: The commitment to person-centered care allows individuals to define food, clothing, and activity preferences. Recognizing and respecting individual choices enhances treatment and contributes to a more positive experience.
Empowering Individuals: The Front Porch encourages individuals to take an active role in their recovery, empowering them to participate actively in their mental health journey. This approach strengthens the sense of agency and self-efficacy, contributing to overall wellbeing.
Hospital Diversion: Implementing hospital diversion programs aligns with the broader goal of reshaping mental health care. This approach relieves pressure on emergency services and redirects individuals toward more community-oriented and personalized support.
Diverse Treatment Options: The availability of diverse treatment options, from group therapy sessions to one-on-one counseling, ensures that individuals can access services tailored to their needs. This flexibility is essential in addressing the unique challenges that each person may face in their mental health journey.
Private Spaces for Recovery: Providing private spaces for recovery reflects a deep understanding of the need for comfort and security in the healing process. Creating a comfortable and secure environment contributes to a positive atmosphere for individuals undergoing treatment.
Supportive Community within the Center: Encouraging meaningful interactions among individuals creates a supportive community. This communal aspect enhances connection, allowing individuals to share experiences and encouragement. Peer support can be a powerful component of mental health recovery.
Each individual has unique needs that require specific solutions. The scenarios below illustrate how The Front Porch will provide specialized support to help people manage their mental health distress.
Coping with a Panic Attack
Q: I frequently experience panic attacks and need a calming space. Can the Front Porch help during these intense moments?
A: Absolutely. The Front Porch will offer a tranquil and supportive environment for managing panic attacks. Trained professionals will provide immediate assistance, ensuring a secure space for individuals grappling with heightened anxiety.
Contemplating Suicidal Ideation
Q: I’m struggling with thoughts of self-harm. Is the Front Porch equipped to handle situations involving suicidal ideation?
A: Yes. The Front Porch recognizes the urgency of such situations. The program will provide immediate intervention and a safe, confidential space for individuals. Trained staff will offer the necessary support and connect individuals with appropriate resources for long-term care.
Resolving a Home Dispute and Gaining Perspective
Q: I had a heated dispute at home and need space to think and calm down. Can the Front Porch offer a place to gain perspective?
A: Certainly. The Front Porch understands that interpersonal conflicts can be overwhelming. The program provides a space for individuals to temporarily step away from challenging situations, gain coping skills, and reflect before returning home.
Seeking Coping Skills for Daily Life
Q: I struggle with managing daily stressors. Can The Front Porch assist in developing coping skills?
A: Absolutely. The program will offer various treatment options, including one-on-one therapy and group sessions. Individuals can learn and practice coping skills in a supportive environment, gaining tools to navigate the complexities of daily life.
Needing Time Away from Stressful Environments
Q: I feel overwhelmed and need a break from my stressful environment. Can the Front Porch Crisis provide a temporary escape?
A: Yes. The Front Porch acknowledges the importance of creating a space for individuals seeking respite from overwhelming environments. It will be a place where you can take a step back, regroup, and access the support needed before reengaging with external stressors.
Beyond the Front Porch, NKHS’s Emergency Services Department has four other programs available for people in crisis, allowing them to move freely between different service levels during and pre/post-crisis. These other crisis services include 988, Vermont State Police Embedded Mental Health Crisis Specialists, Frontline Emergency Supports, and a 2 Person Co-Occurring Mobile Crisis support.
988 Suicide and Crisis Lifeline: Since June 2021, NKHS has provided 105 hours of service per week to the national suicide prevention hotline. Vermont callers who dial 988 from an 802 area code reach a lifeline call responder trained to support a person in crisis. Responders also connect with individuals through online chats and text messaging. This service gives the caller control of their communication style and the connection they need to stabilize and feel supported.
Embedded/Mental Health Crisis Specialists (MHCS): In June 2021, NKHS embedded two mental health specialists in the Debry and St. Johnsbury Vermont State Police barracks. The MHCSs help divert those experiencing a mental health crisis from utilizing the ED, decrease inpatient hospitalization, and reduce police intervention and arrests.
Mobile Crisis: A state-wide program launched in January 2024, Mobile Crisis ensures all Vermonters have access to support 24 hours a day. The program deploys a 2-person team to where and when it’s most convenient for those in crisis.
NKHS understands the value of meeting people where they are, both physically and emotionally. A broad and diverse mental health care culture ensures no gaps in coverage and the ability to deliver comprehensive care during challenging and intense times.
Founded in 1960, Northeast Kingdom Human Services is a private, nonprofit agency providing services and advocacy to adults, children, and families in Caledonia, Essex, and Orleans Counties.
NKHS aims to empower individuals, families, and communities by promoting hope, healing, and support. Our vision is to be rural health and human service leaders by offering innovative, flexible, and comprehensive programs.
In our offices and communities, NKHS professionals provide case management, community and home supports, residential care, psychiatry, medication management, therapy, vocational supports, school-based counseling, emergency care, and respite. NKHS annually serves nearly 3,000 individuals in the Northeast Kingdom communities with a staff of around 500. To learn more, visit NKHS.org.
This article is part of a series collaboratively produced by Vermont Care Partners and its members. Vermont Care Partners is a statewide network of sixteen non-profit, community based agencies providing developmental disability, mental health, and substance use services.
