Category Archives: Mental health care

I Really Don’t Think This Is News

Leave a reply

Generally speaking, VTDigger is a reliable, vital source of news, a rare oasis in an ever-expanding desert of serious media. But this one? I can’t explain how it got assigned, written, edited, approved or published.

The story in question is about a new option in mental health care for those insured by BlueCross BlueShield of Vermont, and it reads like a press release from the Blues’ comms team. The only person quoted in the story is Tom Weigel, the Blues’ chief medical officer. No other viewpoints are presented. Most of the story is just a recitation of all the supposedly wonderful features of this development.

The “news,” such as it is, concerns a deal between the Blues and Valera Health, a Brooklyn-based provider of mental health telemedicine services. The agreement will increase access to mental health services by giving patients a remote option, which is nice since Vermont doesn’t have enough mental health professionals.

But c’mon, the Blues are the fifth health insurer in Vermont to partner with Valera Health, following in the footsteps of Cigna, MVP Health, Humana, and UnitedHealthcare. This isn’t some dramatic innovation. In fact, the Blues already offer mental health care through a Boston-based telehealth firm, so this is just another iteration of an existing effort.

Continue reading →

And While We’re At It, Why Not Bring Back Eugenics?

11 Replies

Can somebody do a wellness check on Bill Schubart, prominent denizen of Vermont’s shallow, brackish pool of “public intellectuals”? Because he just published an essay that brings to mind the toxic excesses of early 20th Century liberalism — you know, the fine folks who enthusiastically took up the eugenics movement.

No, he didn’t call for sterilization of the unfit. But he did advocate a return to the Good Old Days when there were asylums to warehouse the many, many types of people deemed “unfit” for proper society.

He did his level best to craft a frame of compassion around this appalling idea, but it didn’t work. When you start talking about removing certain people from society, you are headed down a dangerous road.

Continue reading →

GMCB Adds a Dab of Lipstick, Hopes You Won’t Notice It’s Still a Pig

1 Reply

Well, that didn’t take long. In fact, it couldn’t have happened any faster.

Two weeks after public comment forced the Green Mountain Care Board to defer cancellation of a plan that might have led to a badly-needed increase in inpatient mental health beds, the Board came right back and went ahead with the deal today with minimal amendment. It stands essentially as it did before: it lets the University of Vermont Health Network off the hook for designing a new inpatient facility, thus closing the door on the best opportunity to resolve our 12-years-old-and-counting* crisis on inpatient mental health care.

*That’s the generous count, starting the clock with Tropical Storm Irene. If you want to include the dilapidated, outdated old state hospital, well, the crisis goes back a lot further.

The revised plan requires UVMHN to invest $18 million in boosting “capacity of mental health services in the state.” Not “inpatient,” mind you, but “mental health services” of any sort. The Board then punted review of UVMHN’s plan to the Department of Mental Health because, as Board member Jessica Holmes put it, “we’re not the experts” and DMH is.

It also allows the GMCB to wash its hands of the whole mess, but that’s just a bonus.

Continue reading →

Green Mountain Care Board Prepares to Punt Away an Investment in Inpatient Mental Health Care

1 Reply

Our health care guardians at the Green Mountain Care Board are trying to sneak through a bit of business that combines bad policy with questionable procedure.

Well, I guess that explains the “sneak through” part. They can’t be proud of this.

Six years ago, the GMCB ordered the University of Vermont Medical Center to take $21 million in surplus revenue and spend it on developing a plan to boost inpatient mental health care, which has been abysmally lacking since Tropical Storm Irene wiped out the old state hospital in 2011. We’re now in our twelfth year of inadequate inpatient care that has left severely mentally ill patients languishing in emergency rooms and frontline providers dealing with the consequences.

The failure to address this situation ought to be a source of embarrassment if not shame to Our Political Leaders.

Anyway, it seemed like a decent idea: Let UVMMC use the surplus to tackle a challenge that nobody else would.

Well, now the GMCB is about to let UVMMC off the hook, further delaying any meaningful response to the shortage of inpatient care. And the Board trying to rush it through with the least possible fanfare.

Continue reading →

Playing Politics With Mental Health

Leave a reply
Acting Human Services Secretary and Effusive Wireless Advocate Jenney Samuelson

As our political leaders, state and national, try to reassure us that the post-pandemic future is now, one of their favorite rhetorical devices is mental health. The danger to our physical health is nothing compared to the toll of isolation, fear, absence of normal activity, and apparently how facemasks cut off blood flow to the brain. Our leaders aren’t simply pushing us back to the assembly line of work and consumerism; they are the good guys, protecting us from Covid’s frightful toll on mental health.

Take, for example, Edjamacation Secretary Dan French implying that those of us still worried about the pandemic are pushing our kids into the abyss. At this week’s Gubernatorial Agenda Promotion Event, he talked of reducing the anxiety level in schools by getting everything back to normal. In other words, if you’re still concerned about prevention, if you’re constantly badgering kids to wash up or stay home if they’re sick or — horrors — force them to wear a mask or do so yourself, you’re complicit in fostering a pandemic of mental illness.

Nowhere in any of this do we hear about the mental and emotional toll of living with the pandemic, of the continuing vigilance that many of us feel compelled to maintain even as French and Gov. Phil Scott pretend that those stresses don’t exist.

Masking is a two-way street. I wear a mask in public spaces, but it’s much less effective if other people are unmasked. Meanwhile, our leaders are practically tearing the masks off our faces. Oh well, the concerns of marginal Vermonters like the old, the immunocompromised, the disabled, and anyone at elevated risk are absent from the administration’s equation.

Continue reading →

Hey Hey, We’re the Veepies!

Leave a reply

This being midsummer in a non-election year, things are a little bit show in #vtpoliland. Or maybe there’s stuff going on, but since there are practically no reporters on the #vtpoli beat right now, we’d never find out about it.

As a result of this lack of news, this edition of the Veepies (our awards for stupidity and/or obtuseness in the public sphere) roams far afield into the realms of journalistic conflicts of interest, conservatives panicking over nothing, and even sports talk radio.

That’s where we begin. The Please Stop Talking About Something You Know Nothing About Award goes to Rich and Arnie, co-hosts of the afternoon talk show on Burlington’s 101.3 The Game. On Tuesday afternoon, the day Simone Biles withdrew from the team gymnastics competition, the boys pulled down their pants and showed their asses for all to see. (The show is archived on the station’s website and podcast.)

Arnie repeatedly referred to BIles’ mental health crisis as “having a bad day,” and accused Biles of costing her team the gold medal. Rich questioned “the timing” of her withdrawal, and asked, “Was she having a bad day first, or was she having a bad day after she messed up the vault?” (She withdrew after a subpar performance on the vault.)

This happens every time a societal or political issue intrudes on the Toy Department of Life. Sports talk radio is suddenly, horribly out of its depth.

Look, guys. You can’t schedule a mental health crisis. You don’t know what’s going to set it off. When it happens, it can be like a tsunami dragging you down. We know that Biles felt unable to compete safely, so withdrawing was the responsible thing — for her well-being and for the team’s prospects in the competition. So just shut up about issues that you can’t be bothered to learn about, and stop making fools of yourselves.

After the jump: Two cases of conservative hysteria, and a veteran reporter steps in it.

Continue reading →

Here’s Half of a Good Article on a Proposed Mental Health Facility

2 Replies
Not An Artist’s Rendering of the New Psychiatric Facility, Though Some Would Say So

Earlier this week, VTDigger ran a story that explored the opposition to a proposed replacement for the “temporary” psychiatric treatment center in Middlesex. You know, the one that opened eight years ago and is entirely inadequate?

The story quoted people opposed to the replacement plan because it would be “too institutional.” The story didn’t quote anyone who favors the plan, aside from an official of the Department of Mental Health.

And the article framed those opposing the plan as if they represented the entire spectrum of psychiatric care. And used the language of opponents as if it was objective.

Before I go on, I must say that VTDigger is a fine organization that provides an invaluable service in our age of diminished traditional media. I’m a financial supporter. The vast majority of its coverage is thorough and fair. But when it falls short, I will point out the failure.

The trouble begins in the third paragraph, which says the plan “has sparked an outcry from mental health providers and advocates.”

The phrase “mental health providers” is very broad. It can include social workers, nurses, technicians, therapists with a variety of degrees, psychologists and psychiatrists. The article does not quote any psychologists or psychiatrists — the latter being the only mental health providers with a medical degree and specialized postgraduate training.

Those quoted include a former patient at the defunct Waterbury State Hospital, “a psychiatric survivor and mental health worker,” and a self-described psychotherapist whose training is in dance and movement therapy.

Continue reading →

Maybe We’re Finally On Our Way to a Functioning Mental Health System

Leave a reply
“Temporary facility,” well beyond its sell-by date.

Congratulations to the Scott administration for finally making a long-overdue commitment to the state’s mental health system. Its FY22 capital budget includes $11.6 million to build a replacement to the rattletrap pictured above. That, in all its prefab glory, is the Middlesex Therapeutic Community Residence, which houses people who are transitioning from psychiatric hospitalization to independent living.

The MTCR was built in the aftermath of Tropical Storm Irene, which flooded the old state psychiatric hospital in Waterbury. It was thrown up quickly using a pair of modular units, and opened in 2013 as a stopgap. Its time has come and gone.

It’s also too small for demand. Its seven beds are almost always full. The new digs would have 16 beds. The idea is that a larger step-down facility would allow more patients to be discharged from hospitals sooner, freeing up those beds and (hopefully) eliminating the constant issue of severely ill patients being parked in emergency rooms for lack of psychiatric beds.

This all sends me down Memory Lane. I’ve been following the state’s woeful efforts to rebuild the system since 2011. In the wake of Irene, the Shumlin administration announced plans to craft a new, much more community-oriented system. Such a system would theoretically require fewer inpatient beds because more people would get treatment sooner, before they got really sick.

Shumlin’s original plan for a new psychiatric hospital called for 16 beds. At the same time, embarrassingly, the then-medical director for the mental health department Dr. Jay Batra was saying the new hospital should be at least as large as Waterbury’s 50-plus beds.

At the time, administration officials pooh-poohed Batra.

Continue reading →

When Pigs Fly

2 Replies

In the wake of George Floyd’s murder and the wave of ensuing protests, Vermont’s political leadership is united in calling for criminal justice reform.

They are also united in minimizing expectations for actual, y’know, results.

This shouldn’t be surprising. Law enforcement has always gotten a full, respectful, sometimes dreamy-eyed reception in legislative committees. Police chiefs, sheriffs and state’s attorneys always wield strong influence when it comes to any issue that touches on their work, from criminal justice to substance abuse to cannabis to the deadly perils of Happy Hour.

(This post concerns our top Democratic and Progressive leaders, not Republican Gov. Phil Scott. He has made all the right noises, and I’m sure he will endorse modest reforms. But the expectations ought to be higher for the D’s and P’s.)

No surprise then, that Dem/Prog Senate President Pro Tem Tim Ashe and Dem House Speaker Mitzi Johnson have already put the kibosh on any talk of cutting the Vermont State Police budget. Ashe, who believes it’s time for him to move up the ladder to the lieutenant governorship, offered this in lieu of leadership: “It’s one thing to say that, to communicate as part of this national discussion, but how you actually implement such a proposal is not a one size fits all.”

Spoken like a politician fleeing a hot-button issue.

Johnson asserted that Vermont has “a very different law enforcement structure than a lot of other states,” so those notorious one-size-fits-all solutions just won’t work here.

Well, I’d like to know more about how Vermont’s structure of state police, county sheriffs and municipal police departments, whose officers are armed with lethal weapons and who are primarily responsible for responding to a variety of public safety situations, is so dramatically different from the police structure elsewhere.

And whose officers have a track record of disproportionately stopping or arresting people of color and of using deadly force in dealing with the mentally ill.

Eh, I don’t think out “structure” is so different. Johnson is simply making another meaningless callout to Vermont exceptionalism.

As for Attorney General T.J. Donovan, he has tweeted that America’s criminal justice system is “broken,” and the time to fix it is “now.” But his proposed fixes are from the lipstick-on-a-pig bargain bin.

Continue reading →

Let’s Not Fix the Mental Health System and Say We Did

1 Reply

Oh, great. The state’s Department of Mental Health is finalizing a ten-year plan to improve the state’s inadequate mental health care system. The highlights, errrrr lowlights, include:

  • It doesn’t appear to address the system’s biggest shortfall, i.e. the lack of resources for the worst cases.
  • It echoes the approach promulgated by the Shumlin administration and legislature after Tropical Storm Irene. Which, for those just joining us, failed to do what it promised.
  • There seems to be nothing about the lack of resources in the prison system.
  • There’s nothing about providing more funding to put the plan into action.

So there’s that.

The report focuses on linking treatment of mental and physical illness, “eliminating stigma around mental health and expanding community-based treatment programs.” That’s nice. But meanwhile, people with profound mental illnesses continue to be stuck in hospital emergency rooms in greater numbers and for longer periods.

That has nothing to do with “stigma” or “community-based treatment programs.” It has everything to do with Vermont’s lack of capacity to treat our severely mentally ill. That’s been a problem since Irene damaged the state hospital at Waterbury.

Continue reading →