November 1st, 2012

Flood may have silver lining

When Hurricane Irene tore through Vermont in the summer of 2011, it took with it the 120-year-old state hospital in Waterbury. The 52 beds lost in the flooding caused by the storm constituted the backbone of the state’s mental health care system, a system that is being re-created as a result.

In the immediate aftermath of the hospital’s closing, acute care patients were shifted to the Fletcher Allen Health Care facility and to the Brattleboro Retreat.

“The first couple of months were rocky,” says Jeffrey McKee, Psy.D., director of inpatient psychiatry at Rutland Regional Medical Center and southwest regional representative for the Vermont Psychological Association. “A lot of people stepped up, though, and the way that the staff at the hospitals responded was remarkable and positive. The staff of the State Hospital helped us bridge the gap. They worked with us until Feb. until we were able to staff up at a higher level.”

While the crisis that Vermont is facing has been difficult, the situation may have some positive results.

“I wouldn’t say a ‘blessing in disguise,’” says Patrick Flood, commissioner of the Department of Mental Health (DMH), “maybe a silver lining. The crisis of the flood forced us to take some actions and created an additional surge of energy to address some things that hadn’t been dealt with for a long time.”

In addition to an update of antiquated building infrastructure, the new plan will encompass a more forward-looking, de-centralized system of care. The state legislature has mandated a new management system to coordinate care, peer services and housing subsidies. Signed by the governor in April, the legislation includes the authorization of short-term crisis beds, intensive residential recovery beds in three facilities and two new units in existing hospitals. A 25-bed, state-owned and operated acute inpatient hospital, to replace the VSH, is on schedule to open in January of 2014.

Although they are on track for the renovation process, the professionals on the “front line” are still seeing this situation as a crisis. Even with the quick response from the DMH and close attention being paid by the state’s legislature and governor’s office, it can be easy to forget that there are patients who are currently being treated with less than adequate services.

“We are still in crisis a year out and we need to remind people of that,” says McKee. “The current situation is still unacceptable in terms of access to appropriate care. We have people who need in-hospital care and they can’t get it. It is not uncommon to have patients in the ED waiting for a bed for 24 or 48 hours.”

The wait is not going unnoticed, however. The DMH has been keeping the legislature and governor’s office up-to-date on the situation.

“We do reporting to two committees every other month,” says Flood. “They get updated on the status and want to learn more, to better understand. It is both an updating process and an educational process.”

The crisis situation should improve this month with the opening of three new facilities – a temporary eight-bed hospital, a secure residential facility and a community step-down facility.

“The impact will be helpful, freeing up beds,” says Flood. “There are not enough acute inpatient beds and we continue to have people sitting in ERs. We had a surge in late September and, in a small state it doesn’t take much, six to eight people.”

With everything on track Vermont should see a new system rising from the ashes or soggy wreckage, of the old one.

“We are replacing antiquated infrastructure with state-of-the-art infrastructure,” says McKee. “A lot of the things we’ve been working on for years are on the table and in active planning so that gives us a lot of hope that the outcome will be positive.”

By Catherine Robertson Souter

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