(Oct. 22, 2015) A hospital in rural Vermont that was cited this summer for poor treatment of psychiatric patients is calling on the state to improve its inadequate mental health system in order to better serve Vermonters suffering with severe mental illness (“Gifford medical center asks state to improve its mental health system,” VT Digger, Oct. 20).
The Division of Licensing and Protection in late August determined that the rural hospital – which has 25 beds total and six beds in its emergency department – didn’t comply with federal standards for treating psychiatric patients.
In their review, regulators found that staff involuntarily medicated a patient with Haldol, an antipsychotic medication, in the emergency department. In another case, regulators say staff improperly restrained a person in his bed.
The hospital has responded by implementing changes to better treat psychiatric patients, but hospital officials argue that their emergency room remains taxed because it is taking in psychiatric patients while they wait to be placed in psychiatric hospitals.
“Once they reach our emergency department, it really is a failure of the system,” said Alison White, the vice president of patient care services at the hospital. “Once they’ve reached our ER doors, the system’s already failed them, and then we have them for anything between four hours and 10 days.”
Between June and September, 526 people who were discharged from the emergency room had some form of psychiatric condition, according to a spokesperson for the hospital.
Dr. Martin Johns, the chief medical officer at the hospital, said his staff cares about the community, and are learning how to treat severely ill psychiatric patients. But he has his doubts about the system.
“We strive very hard to do the best we possibly can, Dr. Johns said. “I think this particular [situation] illustrated the prototype of patient that’s very difficult for a small hospital like us to absorb.”
Many of the patients in question have been issued involuntary hospitalization orders and are in the custody of the Department of Mental Health. They are awaiting so-called “Level 1” beds for people who are at risk of hurting themselves or someone else. Vermont has 45 of those beds, down from 54 five years ago, and psychiatrists across the state have criticized the state for not having more. We agree.
It comes as no surprise that Vermont hospitals and emergency rooms are being inundated with patients suffering acute psychiatric crisis. With just 8.3 public psychiatric beds per 100,000 people, Vermont fails to meet the 50 bed minimum standard required to provide adequate treatment for individuals with severe mental illness.
The state of Vermont must stop passing the buck and take responsibility for its inadequate mental health system, and we must hold state governors and mental health officials accountable for the public psychiatric bed shortage and demand that they create the number of beds needed to meet the minimum standards of treatment.
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