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A Growing Mental Health Crisis

February 20, 2017

A note from Jeff Tieman

Last week I was fortunate to pay my first visit to the Brattleboro Retreat. It was a profound experience. CEO Louis Josephson and his colleagues there are treating people with mental illness in a dignified, creative and compassionate way. One of the first private psychiatric hospitals in the nation, the Retreat is now an almost unparalleled place elsewhere in the U.S. There are few if any hospitals like it, and not another in the world that has a unit devoted to the effective treatment of LGBTQ patients. Physically situated on hundreds of beautiful acres that run alongside the West River, this is a special place. 

Walking the facility with Louis, I spoke with a nurse manager on the children’s floor. I thanked her for the amazing work she does, and she smiled broadly back at me. “I love it, I really love it,” she said. That means a lot from someone who manages the care for severely emotionally disturbed children. It reminded me how important it is that we get this right as we work together to make health care better for those who are living with mental illness. 

In Vermont we face a series of major stresses to our mental health system. The problems before us -- from inadequate access to staffing shortages to crowded hospital emergency departments -- amount to a system that doesn't work for patients or their caregivers. The systemic breakdowns we are encountering put a serious and unsustainable strain on patients and their families, health care providers, mental health professionals, and entire communities. 

In an effort to reignite the conversation, VAHHS started collecting data and stories from our members; we listened to psychiatrists and front-line workers; we heard the perspective of ED doctors and chief medical officers. This member-driven process culminated in a paper we hope will fuel the ongoing conversation that must take place. Our document presents the challenges as hospitals see them and lays out some steps that can help make progress. None of the work is easy but must be considered in small and then hopefully larger pieces. 

There is a growing and shared understanding that we need to move from testimonials to action, from defining the problem to adopting short and long-term solutions. Our mental health challenges did not materialize overnight and will not be solved that quickly, either. At the same time, it is critical that all the stakeholders--of which there are many, from patients and families to providers and government--work together to identify the most urgent problems and build consensus on how to address them effectively. 

We must remember that everyone coming to the table brings a heartfelt view, a personal story, an idea of something that might work to stem the crisis. Simply put, we need to hear various perspectives, build momentum, and keep at it. 

I know people can be weary of blue-ribbon commissions and other coalition-style efforts to look at a problem and develop recommendations that too often sit on a shelf. I share those concerns; I also know that if we work in silos, even with the best of intentions, we will not make meaningful progress. 

My commitment, on behalf of VAHHS and the hard-working hospitals of our state, is to bring people together and contribute in every way possible to creating the right mental health system for our state. Hospitals cannot do this alone. Nor can any other group or government entity. 

Thanks for your support, and please share your thoughts and ideas with me any time.