Time to Close VSH, Support Community Services

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(cross-posted from Vermont Watch, here)

Governor Peter Shumlin recently declared his firm commitment to replacing the embattled Vermont State Hospital (VSH) with a new version of the same old thing.

Besides building along these lines, the administration’s plan also includes providing an additional 16 to 24 beds elsewhere as well.

This all to the tune of millions and millions of state taxpayer dollars in remaining dependent on an outdated institutional treatment model surely to follow wherever the facility or such other beds would be located.

This is much like had been done in New Hampshire to the detriment of the community mental health system there and, as a result, the state came under scrutiny by the U.S. Department of Justice, which issued a scathing report earlier this year (here and, here).

Such monies, as Governor Shumlin is recommending be put aside to replace the state hospital in this fashion, could be better used to build the holistic community system needed in closing VSH and, not replacing it, save for a small forensic facility to be located somewhere within the state.

If we could close the former Brandon Training School without building a new version of the same old thing, creatively putting in place a more robust community system instead, we can indeed close VSH and, although there might be differences in such a system, do much of the same for our fellow citizens currently forced to languish at the state hospital, in prison, in homeless shelters or on the street.

Read more on the subject (via Beyond VSH blog), here.

Morgan W. Brown

Montpelier

2 thoughts on “Time to Close VSH, Support Community Services”

  1. how many states do NOT have a public facility that addresses the needs or confinement or service to citizens who are refused service by the private network???

    You seem to be saying the state hospital is incapable of providing a service to Vermonters and that there will be no opportunistic selection by private concerns, who will still be sucking from the public funding mechanism, accountable to WHOM??

    There are several components within a system, and a well run-meaning there is room for your issues with the brick and mortar to be solved-central treatment facility in Vermont.

    The Brandon reference/ comparison seres no real objective here.  Different populations and different needs.

  2. what ‘private network’ you are referring to & why it would have any significance if there is an alternative, such as what is being proposed by utilizing the services & staff of already existing facilities as options which would address the needs you are speaking of, which are state funded.

    Come on, VT is a progressive state. Just because other states institutionalize those w/mental illnesses in a centralized facility doesn’t mean Vermont has to continue in their draconian footsteps. The need of a VSH cannot be justified nor does any proof exist of its necessity. The size being proposed cannot be justified by the current population which also would negate the need for the project.

    Other facilities such as he Retreat are certainly more than able to have a section, or create one, where those who have specific needs could receive treatment preventing another bureaucratic boondoggle & saving many millions of taxpayer dollars at a time when we need to small up & simple down rather than serve the grandiose dreams of bureaucrats & the true beneficiaries of this type of system.

    Since the non-treatment services for those currently housed in the VSH are virtually nonexistant, the quality of life for this population should at least be a priority. Existing treatment facilities appear to be more likely to provide this.

    Former VSH director:

    “[..]The severely mentally ill patients are kept cloistered in what the outgoing executive director of the Vermont State Hospital calls a “prison-like” environment. The unit is small and staff and patients function in very close quarters. Patients are kept in their rooms most of the time. There is no gymnasium, no garden area, no vocational shops, and very little space for family visitation. When a patient screams or yells or slams a door the sound reverberates through the wards unabated.”

    “[..]Patients who at one time would have been separated into different units for treatment are now concentrated in a small space. Violent criminals with mental illness share space with elderly Vermonters with dementia and behavioral problems. Patients with anti-social personalities live on the unit with developmentally disabled patients and people with traumatic brain injury, patients with psychosis and people who exhibit self-harming behaviors.

    The comingling of patients who require different therapeutic treatments in separate psychiatric units into one small space has led to a spiraling series of problems that have plagued the state hospital for a decade.

    There is the added difficulty of providing patients with sufficient access to the outdoors. The Vermont State Hospital is in a very public location inside the state complex. A road cuts past the yard.

    “When I first came here the fences were open and you could see right in at the patients it was almost like a little bit of a zoo,” Rowe said. “People could stop and look at the patients behind a fence.”

    Individuals in different categories of mental illness require different therapeutic treatments. In the current physical environs of the hospital, it’s very difficult to provide discrete psychiatric therapies, according to Rowe.

    “There’s the concentration of those people who are most difficult to treat are now all assembled in one area whereas before you might have had more of those patient types with their own unit,” Rowe said.”

    http://vtdigger.org/2011/05/18…

    The primary reason for the squalid conditions seems to be a population which is concentrated & comingled due to its extremely small size. Conditions would improve & treatment may be more successful in a therapeutic environment where other basic needs are met. Ideally, more could be released, further reducing the need for institutionalization. Vermont could lead the way & this could be the goal.

    To the comment re belief that the “state hospital incapable of providing a sevice to Vermonters”, where is there any evidence that this has or will ever happen? I’m appalled that the deplorable conditions existed so long involving a vulnerable population w/no voice & still does. Where’s the outrage is my question, not why can’t it happen.

    Investing good money after bad is a well known no-no in the financial world, its import is no less meaningful in any other context.

    Losing tens of millions in funding due to this is also appalling. An about face was in order long ago, or at least signs of reform that the current miserable state of affairs which has continued forever would change. At this late date any such efforts could not be taken seriously & would ring hollow. If the most recent director had no encouraging words & in fact reported the continuing deplorable conditions which she found disturbing how could I or anyone else see it otherwise.

    Exit interview: Vermont State Hospital director says facility is No. 1 problem

    by Anne Galloway | May 18, 2011

    http://vtdigger.org/2011/05/18…

    Interesting comment from a staffer:

    “There are good hard working staff at VSH, but there are also too many staff who won’t do their jobs. The new executive director is going to have to clean house. When I worked there I had an office-mate who came in at noon every day for four years. When I reported it, the executive director and chief of services told me they had no idea it was going on. In all those years I never got a performance evaluation either. The VSH administration has been negligent.”

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