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Vermont's Mental Health Future

April 14, 2018

Last week was an important and good one for our state. We saw real and promising progress in the ongoing effort to improve Vermont’s mental health system.

The University of Vermont Health Network is stepping up in a big way to help ensure Vermont has the correct capacity to treat patients compassionately and effectively into the future. The plan is still in early stages but, as Green Mountain Care Board Member Jessica Holmes noted, it is “long on vision and far-reaching in potential impact.”

I agree. The GMCB’s vote last week for new inpatient capacity in central Vermont puts us on a path to create the system our state and its people deserve. This will not happen overnight – a great deal of collaboration, planning, milestone setting and careful evaluation lie ahead.

As we move forward as a state, it is important to keep our sights on a few things:

  • We must ensure the ongoing vitality of the Brattleboro Retreat. A critical component of our mental health system, the Retreat is a resource our state cannot afford to neglect. Due to a federal policy known as the IMD Exclusion, the Retreat will begin to lose Medicaid funding in 2021, which would be devastating for the organization, its patients and Vermont’s efforts to improve mental health access. 

    There is no easy fix, but we must come together as a provider community and a state to ensure that this unique and essential place continues to serve vulnerable people and coordinate the best possible care for them. Without the Retreat, our mental health crisis would become a catastrophe.
  • Additional capacity in central Vermont and the Retreat are still only parts of the broader need. VAHHS is developing recommendations to fortify and optimize the entire continuum of mental health care—from community-based services to secure residential facilities to acute-care beds. We will continue to engage our members and all stakeholders in this important work.
  • Vermont hospitals cannot address the mental health crisis alone. We need strong partners, working together to achieve a mental health system that provides patients and their families compassionate and effective care. The Department of Mental Health, the Legislature, the Administration, Designated Agencies, Advocates, Hospitals and other providers all have an important role to play and must bring their ideas and resources to the table.
  • Recent developments are promising, but there is a long way to go. We are still examining options for addressing long E.D. wait times for mental health patients in the near term. And we are still collecting data from hospitals around the state to understand the situation as best we can— and from there identify the best next steps.

VAHHS applauds the Green Mountain Care Board, the UVM Health Network and all our members. From outfitting emergency departments for safety to testifying in the State House to investing in staff and telehealth, hospitals are stepping up. They are defining the issues and acting to help move us through them.

Vermont is far from alone in this crisis; states from coast to coast are managing the same set of issues, often under worse conditions and with fewer stakeholders coming together in the spirit of forward progress. But I believe that here in Vermont can get this right—we must get it right.