There has been mixed reaction to Vermont Gov. Peter Shumlin’s (D) plan to permanently shutter the state’s sole mental hospital. Many have applauded the closing of the antiquated facility, which was plagued by safety and quality-of-care concerns for years prior to the massive flooding from Hurricane Irene that forced the emergency evacuation of 51 patients in August (Psychiatric News, October 7). But mental health advocates have taken issue with the governor’s interim plans for the three to five years he said it may take to develop a new facility.

In the meantime, state officials have been scrambling to identify alternative placement for patients put out by the recent flood. While local hospitals such as Fletcher Allen and Rutland Regional Medical Center have provided temporary beds for some of the displaced, these facilities lack the proper staffing and equipment to effectively serve the needs of severely mentally ill individuals, according to a recent article in the New York Times.

“This crisis is an opportunity to rebuild our mental health services to make them better than before,” said Shumlin in an October 20 press release announcing his approach to ensuring continued services for the state’s acutely mentally ill residents.

Included in Shumlin’s proposal is a planned expansion of community-based mental health services such as in-home care, transitional facilities, and group housing. He acknowledged that such a move has been “long overdue” in the state.

Shumlin also announced his intention to establish a long-term agreement securing 14 acute-care beds at the Brattleboro Retreat, a private mental health care facility. The governor noted that Brattleboro has provided up to 15 beds for patients following evacuation of the state hospital and will undergo state-supported renovations allowing for the future care of individuals with serious psychiatric illness.

The state is trying to secure another 15 beds for those in need of acute care at a separate facility, added Shumlin. Currently under consideration is a now-closed boarding school for dyslexic students in Williston or a site near the Central Vermont Medical Center.

Lastly, the governor described plans to fund two additional “step-down” facilities for those patients ready to transition from an acute-care setting back into the community. This would help ensure that beds at psychiatric hospitals are available for those with the greatest need, said Shumlin.

Speaking with the New York Times, state representative and longtime mental health advocate Anne Donahue expressed concern that the state may be unable to secure sufficient funding to fulfill the governor’s ambitious interim goals. And making key policy decisions in the face of a crisis could lead to a situation in which imperfect temporary solutions become permanent ones, she said.

Vermont Psychiatric Association President Alice Hershey Silverman, M.D., echoed Donahue’s concerns in a November 10 letter to Shumlin. Silver man urged the governor to focus on the development of one main inpatient facility for those with acute needs, preferably on the campus of the Central Vermont Medical Center.

“We believe that a single location will help Vermont recruit and retain the staff with the expertise necessary to ensure the success of such a program,” Silverman wrote. “While we also support the development of smaller, less intensive inpatient programs at the Brattleboro Retreat and/or Rutland Hospital, we do not see such facilities as a replacement for a more intensive, centralized program.”

Shumlin’s press release is posted at <http://www.vermont.gov/portal/government/article.php?news=3133>.