Community Forum, Mike Smith: Mental health crisis requires attention

This week’s Community Forum is by Mike Smith, a regular media columnist, and host of the radio program “Open Mike with Mike Smith” on WDEV. He was the secretary of administration and secretary of human services under former Gov. Jim Douglas.
It’s a helpless feeling, some say. Like spiraling down a deep, dark hole. You try to stop your fall, but you can’t. And the farther you fall down that hole, the darker it becomes until ultimately darkness surrounds you.
It’s difficult to describe what a person suffering from mental illness is going through. Each experience is probably unique. However, the end result is likely the same — you become a different person, a person you and others don’t recognize. And without help, chances are you’ll remain that different person, trapped in a world you can’t escape or explain.
Vermont officials and health care professionals agree we have an escalating mental health crisis in our state. But a consensus on what to do about it has proven elusive. The result — when we do act, we move forward in small incremental steps that may temporarily relieve some pressure points but don’t permanently address larger problems.
For example, hospitals — overwhelmed with people seeking urgent help for mental illnesses — have provided more beds in their emergency rooms for these patients. Health care professionals will readily admit this is not a permanent solution because ERs are meant to evaluate and stabilize patients before moving them elsewhere. But few beds are available elsewhere for those suffering from mental illness, so they remain stuck in emergency rooms or are eventually released without more extensive treatment. As a result, we sometimes witness tragic events, including Vermonters’ harming themselves, loved ones or the public.
The fact is we’re only inching forward toward solving this problem. Some have likened our current approach to putting a Band-Aid on a gaping wound. Others have said (off the record) that our response to this crisis is shameful. Clearly it’s time for all stakeholders to accept responsibility for what’s happening, declare that it’s unacceptable and move forward with urgency toward a comprehensive solution.
So, what needs to be done to solve our mental health crisis?
The first key is that state officials and the Legislature can’t dither. The governor, the House Speaker and the Senate President pro tempore need to come together and make it a priority to address this crisis — and fast. They need to devise a comprehensive action plan and quickly pass legislation to enact it in the upcoming legislative session.
This plan may include more psychiatric beds; perhaps even different and faster processes to meet the needs of those in crisis. Chances are there won’t be universal agreement on a direction, but seeking unanimous consent is what has stifled significant action in the past, especially in the Legislature. Rather, bold leadership requires achieving sufficient consensus, but not necessarily unanimity.
Some of the solutions, such as increased inpatient capacity, will take time to implement, especially if construction is involved, so the sooner lawmakers act, the sooner we’ll see progress.
Second, state agencies and departments must do more to educate Vermonters about mental illness to lessen and eventually eliminate any stigma that prevents too many from seeking treatment. This includes finding ways to dispel misperceptions about mental health that may affect one’s job, reputation or even relationships.
Third, there’s a need for better coordination between state agencies and departments, local human service agencies and health care providers. This seems to be lacking among some state entities, especially the judiciary, corrections and mental health.
In one recent case, a woman experiencing a psychiatric crisis clashed with law enforcement and ended up in the corrections system, not in our mental health system, because there were no psychiatric beds available. She was sent to a correctional facility, where her condition grew worse, before finally being transferred to the Vermont Psychiatric Care Hospital eight days later. The Vermont Human Rights Commission found that the state discriminated against this patient.
Above all, we need to give hope to Vermonters who are living with mental illness. We need to come together and provide a lighted path so they can escape that dark place they have fallen into.
To do all this, we need political leadership at all levels willing to prioritize this issue and take bold steps.
No more half measures, no more dithering.

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