The inpatient psychiatry unit at Central Vermont Medical Center in Berlin is set to close at the end of January. The hospital will stop taking new patients in mid-January and will lay off nearly 50 staff members at the end of that month, a hospital spokesperson confirmed this week.
The change is part of a series of cuts to patient care announced last month by the University of Vermont Health Network to save money and comply with budget orders from state regulators meant to control skyrocketing health care costs and insurance rate increases.
Health care workers and advocates say the closure will harm people with the highest mental health care needs across the state, and especially in central Vermont.
“We are a state with a very high suicide rate already,” said state Rep. Anne Donahue, of Northfield, and a member of the hospital’s psychiatric inpatient advisory committee. “When you reduce access to the highest level of care, you're expanding that risk.”
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The unit is the only place to get voluntary hospital-based psychiatric care in the region, and one of only five facilities that offer inpatient psychiatry in the state (not including the White River Junction VA Medical Center, which only cares for active duty service members and veterans, and the Vermont Psychiatric Care Hospital, which is only open to involuntary mental health patients).
Hospital wait times for patients in need of mental health care have gone down in recent years, but are still high. In the last year, between a third and half of adults seeking mental health care at a hospital waited more than 24 hours for placement, according to a recent report from the Vermont Association of Hospitals and Health Systems.
At times, more than half of patients in Vermont emergency departments are waiting for mental health care, according to the report (though ultimately, some do not need care in a psych unit).
The closure will only make wait times in emergency departments worse, said Karen Kurrle, who directs the intensive care program at the Washington County Mental Health Services, and works closely with Central Vermont Medical Center.
“That can absolutely exacerbate a crisis rather than be helpful to stabilize the crisis,” she said.
The psych unit at the hospital has eight beds now, down from 14 last year, after several physicians left.
"It's very difficult to run a very small inpatient psychiatry unit, and the costs were prohibitive," Anna Noonan, president of Central Vermont Medical Center, said at a press conference last month. "We understand the vulnerability of all the populations being impacted by these changes."
"None of these changes are changes we want to make," she added.
It's very difficult to run a very small inpatient psychiatry unit, and the costs were prohibitive.Anna Noonan, Central Vermont Medical Center president
The number of beds is relatively small compared to the current 175 bed capacity across the state, but they serve an important role in the region, according to Kurrle, with Washington County Mental Health Services.
“We always want to keep people in their community as much as possible,” she said. “Effective treatment is being able to discharge from a hospital setting as soon as you can to your community.”
For some people, the closure means losing somewhere they can be safe in a crisis.
“It's a place that you go to when you really, really need help and there's no other alternative,” said Lise Ewald, of Montpelier, who has gotten care there several times in the past 20 years.
Ewald is also on the psychiatric inpatient advisory committee, where she has advocated for policy changes to make care more respectful for patients. Now, she’ll have to start that work over.
"This is just crushing," she said.
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