MONTPELIER – With at least 47 new faces entering the Vermont House of Representatives and nine freshman senators, the 2023-2024 legislative biennium looks more than usual like a blank canvas. Mental health advocates will be watching closely to see how it fills up.
The governor typically submits his executive budget recommendations about two weeks after the start of the session. At that point, legislators – and the public – will hear about the Department of Mental Health’s funding priorities for fiscal year 2024, which begins in July of 2023.
Among potential areas for attention, DMH policy director Nicole DiStasio pointed to workforce shortages “at all levels of service delivery, particularly for psychiatry;” the 988 Suicide & Crisis Lifeline, where efforts to increase in-state call center capacity continue; and mobile crisis response services.
Following the start of a pilot program for a youth-oriented mobile crisis team in Rutland, the legislature instructed DMH last spring to develop a model for statewide mobile services. DMH issued a request on Nov. 1 for proposals from “qualified providers that could include, but are not limited to, Vermont Department of Mental Health Designated and Specialized Service Agencies.”
The vendor or vendors will provide “rapid community crisis response, screening and assessment, stabilization and de-escalation services, coordination with and referrals to health, social, other services and supports, and follow-up services as needed” to Vermonters of all ages.
DMH will consider “a range of staffing models,” though the RFP notes that “best practices include incorporating trained peers.” A report on the Rutland pilot is due to arrive on legislators’ desks by Jan. 15. DMH sees mobile crisis services as one way to keep Vermonters with mental health needs out of emergency departments.
According to Senator Ginny Lyons, the presumptive chair of the Senate Committee on Health and Welfare, mobile crisis teams won’t be enough on their own to solve the problem.
Lyons praised the Vermont Blueprint for Health, a healthcare reform initiative that has supported several programs for “whole-person care” since 2006, calling it “a model for the country,” but said that it could do more for mental health.
“I’ve been in conversation with folks about expanding Blueprint to cover mental health,” she revealed, “so that we have in place comprehensive primary care for folks with mental health needs and make it as important as any other area of primary care.”
An upcoming report by the state’s Mental Health Integration Council, also due by Jan. 15, could offer related recommendations.
The intersection of criminal justice and mental health is also likely to be a major topic among legislators. A Forensic Working Group studied the issue for a year and will soon issue a report of its own, but philosophical divisions appeared to prevent its members from arriving at a unified recommendation for how Vermont’s psychiatric facilities should deal with patients who’ve faced criminal charges.
“They didn’t provide any resolution to that issue. It just threw it back on our table,” Lyons said.
Lyons anticipates working on a bill that would propose a forensic hospital – a locked facility that would treat arrestees deemed incompetent to stand trial or adjudicated not guilty by reason of insanity.
By Lyons’s account, it could also house some convicted criminals who have mental health needs.
“The thinking is, well, we need to have something for people who have committed these crimes,” she said. “I don’t want to put them in Corrections, but how do we handle this? That continues to be a huge question. And so having a secure facility is the direction, I think, that some folks are going.”
“Right now, there are funds for a facility,” she added.
It absolutely boggles the mind how Vermont legislators and health care providers struggle with common sense solutions that the rest of the civilized world seems to have accomplished decades ago. My mental health care in 2 countries and 3 USA states over the last 44 years has ranged from adequate to excellent. But since moving to Vermont the “care” has been extraordinarily ignorant, abusive and untrained at best. At worst I have experienced criminal behavior by mental “health care workers” who have manipulated and coerced expensive items and money from me (case managers). There are so many simple and pragmatic solutions, and suggestions could easily be obtained from other states/country’s stellar mental health care systems…..nd from patients who can offer feedback. But the toxic hubris in the DMH and elected representatives has the health care in this state stuck in a dangerous quagmire. The extreme misogyny is beyond belief. Norm McCart at the DMH actually demanded to speak with my husband before he would consider speaking with a female mental health care consumer. It is simply unacceptable to tell a sexual assault survivor, particularly one with conclusive court documents/witnesses/video footage, that their assaults and/or harassment is “delusional” and then to force drugs upon them. But even when PROVEN wrong, the psychiatric providers will not back track their ignorance/ego or even apologize. Look at the statistics here for violence against women compared to the national average and all surrounding northeastern states. And yet it is still the norm here to drug sexual assault survivors or domestic violence victims into a vulnerable stupor so they cannot work, drive, run, or even defend themselves. This state has ZERO standards that require health care providers to have a semblance of trauma training. And yet it is widely known that trauma is the #1 reason that people seek mental health care. But the Dunning-Kruger afflicted run this state, so I have little hope that anything will change. The Janssen marketing team has moved to VT in a rush last May, just prior to the elections. Because even though VT ranks #6 in the nation for doping clients (like vulnerable sexual abuse survivors) into an even more vulnerable stupor with antipsychotics, they want to squeeze every last penny out of the tax payers with our incredible pliable and uneducated legislators. Because shwing emotion after being raped is considered a dangerous mental illness. Soon this tiny serene farm state will rank #1 in doping our traumatized citizens into a shuffling, drooling, zombie-like stupor. It seems they want to enable the sexual predators, or that they are proud of the fact that the #1 reason for homicide in VT is men murdering women. Has anyone even bothered to LOOK at the rape, murder and domestic violence statistics here before they gas light survivors? The APA considers that psychiatric abuse. The insane abuse I have endured from VT providers has been far more traumatizing than the original assaults, amazingly. It has nearly cost me my life and they have destroyed everything I ever loved and work to build in my once very productive life. This state would be better off defunding all state run “mental health” programs and the DMH. In addition, anyone who comes to any VT citizens home (case managers, constables, police, emergency workers etc) should be required to wear a body cam at all times. It protects the workers but it even more importantly protects citizens from the corruption, harassment, criminal behavior and abuse that is so common in this state. Also, every single psychiatric, ADHD and any potentially adddicting medication should be closely tracked to make sure certain demographics (race, gender, LGBTQ, ethnicity, religion etc) are not being abused nor favored. Not only the patients should be tracked but the doctors/prescribers should also be closely monitored and regularly reviewed. If any prescriber goes about the national average in prescribing anything, they should be called in for a review by a state panel including 50% peers. Phamaceuticals should be the absolute last resort, not the knee jerk response as soon as someone enters the facility. They need to LISTEN to their patients!