Vermont's nonprofit hospitals are on the front lines of a mental health crisis. This crisis affects some of the most vulnerable individuals for whom we care. Our challenge is to ensure that we are working within the continuum of care to give patients appropriate treatment in a safe environment, and Vermont's hospitals have gone to great lengths to meet this challenge. At the same time, hospitals and others have work to do before reaching a place where the needs of Vermont's mental health patients are consistently and compassionately met.
With this report, and supporting information, Vermont's hospitals would like to recharge the conversation about the challenges and gaps facing all mental health providers and patients, as well as propose potential solutions for a more comprehensive, coordinated, and accountability-based system of care.
More on Mental Health
Over the summer of 2017, VAHHS and hospital CEOs, physicians, and nurses have participated in public meetings on an action plan to address issues in Vermont’s mental health system. Discussion included wait times in emergency departments, diversion services, data collection, barriers to discharge from hospitals, community coordination, and prevention.
Governor Signs H.133 (Act 83) into Law, June 15, 2017
Act 82 directs the the Department of Mental Health to examine mental health care and care coordination throughout Vermont. DMH's work on Act 82 is well documented on their website.
Inpatient Psychiatry Barrier Days Analysis, A Report by UVM Medical Center, May 31, 2017
The University of Vermont Medical Center produced a report on barriers to hospital discharge for patients with mental illness. They examined medical records for patients who had a hospital stay of 30 days or longer. Some of the report's findings include:
- 62% of long-stay patients experience a delay in discharge—38% of long-stay patients needed hospital-level care
- The 38% is greater than planned utilization
- There has been an increase year over year of 20%-25% of patients staying in the hospital more than 30 days
- Average length of stay is about 14 days, which is on the high end compared to other academic medical centers, however, UVM Medical Center has fewer readmission than other academic medical centers
- Removing barriers to care would provide UVM Medical Center with two additional beds per year. This, however, will not eliminate the wait times in the emergency department.
Joint Hearing on Mental Health, February 7, 2017
Legislators from House Health Care and Senate Health and Welfare heard from doctors and nurses on the front lines of the mental health crisis. The message from Vermont's hospitals was clear: We are deeply concerned about a broken mental health system that requires a strategic and collaborative effort to repair. Hospitals are and want to be part of the continued effort to solve this problem but also see the urgent need to work with government, other health care providers, and community organizations as vital partners. Read more about the hearing here.
Green Mountain Care Board Meeting on Mental Health, January 19, 2017
Watch video recording of panel discussion on mental health. Panelists include:
• Melissa Bailey, Commissioner, Department of Mental Health
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