State hospital filling up

Three weeks after the doors opened at the Vermont Psychiatric Care Hospital in Berlin, the facility has eight available beds and all are in use, according to Jeff Rothenberg, CEO of the new facility. The hospital should be fully staffed and have all 25 beds available for use by Aug. 15, Rothenberg said.

After Tropical Storm Irene damaged the Vermont State Hospital in Waterbury in 2011, the state opened the Green Mountain Psychiatric Care Center, an eight-bed temporary facility in Morrisville, as it waited for a new facility to come online.

Gov. Peter Shumlin this month cut the ribbon on the $28.5 million facility in Berlin, and all patients were transferred from the Morrisville facility by the following day.

Rothenberg said the new hospital has hired all of its permanent staff, but has had difficulty hiring nurses, who, “as anticipated, have been hard to recruit.”

Rothenberg attributed the recruitment issue to an overall shortage of psychiatric nurses, a lower salary for state medical employees and “some hesitancy to come work for the state at Berlin before they see that it’s up and running.”

In the interim, Rothenberg said, the Berlin facility is in the process of training 20 traveling nurses, who commit to a three-month minimum stay.

Four hospitals across the state provide level one mental health care. The Berlin psychiatric hospital has 25 beds, Brattleboro Retreat has 14, Rutland Regional Medical Center has six and Fletcher Allen Health Care has 14.

Depending on the facility, patients average between two and four months in intensive psychiatric level-one care.

To qualify for level-one treatment, patients must have a serious mental illness and require substantial resources. Many patients resist treatment or for various medical reasons don’t respond well to typical methods of treatment, Geoffrey Sinner, a medical director for Brattleboro Retreat, told the committee.

Other psychiatric directors who testified by phone told lawmakers that they have not yet seen a reduction in the emergency room wait times and full occupancy levels since the state’s new hospital opened. That isn’t surprising they said, as so far it doesn’t have any more beds than the number previously available in Morrisville.

The Department of Mental Health expects to fill the new hospital’s beds, though in terms of funding and staffing, 80 percent occupancy is optimal, according to Jay Batra, medical director for the Department of Mental Health.

Roughly 40,000 Vermonters have some degree of mental illness, and in January the state housed 52 involuntarily committed patients.

Representatives from level-one facilities urged the oversight committee to focus legislative efforts on outpatient services in the upcoming 2015 session.

W. Gordon Frankle, chief of psychiatry at Rutland Regional Medical Center, told the committee that for many patients, level-one mental health treatment has become a revolving door. Often, he said, a patient will leave Rutland Regional and be admitted to another state facility after just a month or two. And after a few more months, he said, they’ll show up in Rutland again.

When not in the hospital, some patients stop taking their medication and regress. Others are discharged and have no place to go.

“With more resources, I think the system could do better in identifying those patients and providing a higher level of care in the outpatient world,” Frankle said.

At the Berlin facility, Rothenberg said he did not have any specific plans to change the outpatient transition process.

“We will continue to work with community providers on discharging patients when they’re ready,” he said.