Tag Archives: Brattleboro Retreat

Our mental health sandcastle, part 1

And every one that heareth these sayings of mine, and doeth them not, shall be likened unto a foolish man, which built his house upon the sand:

— Matthew 7:26

Here’s something that close observers won’t find surprising at all: fresh signs of trouble in Vermont’s mental health care system. In my next post: staffing shortages and other troubles in the system’s crown jewel, the Vermont Psychiatric Care Hospital. This time: Again with the Brattleboro Retreat.

The Vermont attorney general’s office is conducting a criminal investigation into the Brattleboro Retreat following a whistleblower’s complaints about alleged Medicaid fraud at the private psychiatric hospital, The Associated Press has learned.

Ruh-roh. The AP’s Dave Gram quotes AG Bill Sorrell as characterizing the probe as “not narrow in scope,” and that it goes beyond the whistleblower’s complaint into other areas.

As for that complaint:

[Former Retreat staffer Thomas] Joseph alleged a yearslong pattern of instances in which, if overcharges showed up in patient accounts, Retreat staff would not make refunds but instead would change the account to reflect a balance of zero.

If the accusations are true, the Retreat would be in deep shit with Medicaid, which (according to Gram) supplies the Retreat with roughly one-fourth of its total funding.

Yeah, that’s not an enemy you want to make.

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Let’s hope nothing else goes sideways at the Retreat

Thanks to Governor Shumlin, this is a fact:

The [Brattleboro] Retreat is home to the Tyler 3 unit, the only child and adolescent inpatient psychiatric unit in Vermont.

It was Shumlin who wanted to decentralize inpatient services, despite his own experts’ call for a new improved Vermont State Hospital after Tropical Storm Irene. Now, any time we have a child or teen with severe mental illness, they’re off to Brattleboro.

The place where three teens have attempted suicide — two of whom died as a result — in the past 14 months. This comes to mind today because the family of one of those teens is suing the Retreat for negligence.

The patient in question tried to kill herself on May 5 of last year, by hanging herself over a door with a pair of jeans. The brief remainder of her life?

The teen suffered “serious, painful and permanent injuries” including strangulation, unconsciousness, cardiorespiratory arrest, lack of oxygen to the brain, prolonged coma, physical pain and suffering and eventual death, according to the family’s lawsuit.

These days, inpatient psychiatric facilities are carefully designed to eliminate ways for a patient to harm him/herself or others, which is always a high risk. Furniture is soft and rounded, large items are built-in or bolted down, no sharp edges or blunt implements or long ropey things allowed, doors are angled downward so you can’t, say, hang yourself over one of them. Every possible precaution is taken.

The Retreat has, to put it mildly, a checkered history for diligence in patient care. Not to mention financial and administrative competence. And every time there’s a screwup, we hear the same refrain: We’re making improvements, we’ve got a plan, we’ll make things better.

On behalf of every troubled child or teen in Vermont, I sure as Hell hope so. Every tragedy is another black mark on the Retreat’s record — and on the Governor’s.

Now, I know the old VSH had its own troubled history, but its problems were largely in the past. A new State Hospital could have provided a state-of-the-art facility and an expert staff, almost certainly for a lower cost than the current multi-site system. The Governor wanted a decentralized system and ignored the advice of his own people in the field. Now he, and we, are stuck with the Brattleboro Retreat. Let’s hope they make it work from now on.