State regulators have approved a plan to build a new 12-bed psychiatric unit for adolescents at Southwestern Vermont Medical Center in Bennington.
The Green Mountain Care Board signed off on the estimated $10 million project at a meeting on March 19, despite strong pushback from the Brattleboro Retreat, which operates the only other inpatient psychiatric facility for adolescents in the state.
Brattleboro Retreat CEO Steve Cummings said the new adolescent beds in Bennington will cut down on the number of patients who seek care at the Retreat, at a time when the hospital’s financial picture is already extremely tight.
“We track where all our patients come from, and we get quite a few from over there,” Cummings said. “And if we were to lose all or most of those patients, the round figure would be about $10 million.”
Major projects at Vermont hospitals have to be approved by the Green Mountain Care Board, and the Retreat took part in the certificate of need hearings for the Bennington psychiatric unit, which stretched out for more than a year.
Cummings said the Retreat challenged some of the data that Southwestern Vermont Medical Center and the state used to support the need to build a new adolescent psychiatric unit.
And he acknowledged the challenge in figuring out the appropriate number of beds available, while not overbuilding the system.
I think we have to work with the state and the other mental health providers to strike a balance of how much capacity can we afford to have available all the time, but not have so much that we’re overspending, if you will, to have multiple beds open that never get used.Steve Cummings, Brattleboro Retreat CEO
“I think we have to work with the state and the other mental health providers to strike a balance of how much capacity can we afford to have available all the time, but not have so much that we’re overspending, if you will, to have multiple beds open that never get used,” Cummings said.
The Retreat currently operates 23 beds for adolescents in Brattleboro, and their capacity can be increased up to 27 beds.
Southwestern Vermont Medical Center wants to build an inpatient mental health unit for adolescents between the ages 12 and 17 on the ground floor of its Bennington hospital.
The Scott administration first put out a call for a new adolescent facility in 2021, and it asked for $10.5 million to support the project.
University of Vermont Medical Center at the time said it would build the facility in Burlington, but then pulled out after facing its own financial challenges following the COVID-19 pandemic.
When the Department of Mental Health put out a new request for proposals, the Bennington hospital said it could add the adolescent beds, even though it is in the southern part of the state, only about an hour away from the Retreat.
“Certainly SVMC has not had an inpatient psychiatric unit, so that is a big change,” said Southwestern Vermont Medical Center Chief Medical Officer Trey Dobson. “And it does sound like, you know, patients from the entire state will be coming here so they can be transported, cared for, and then returned to their communities.”
SVMC is part of the Dartmouth Health network, and the New Hampshire-based medical group will provide the clinical team to operate the unit.
Dobson said that partnership with Dartmouth Hitchcock encouraged SVMC to answer the state’s call for a new adolescent facility.
Along with the $9.5 million the Legislature included in the budget for construction, the state is also supporting the new facility with $1 million to cover operational costs for the first year to ensure SVMC can get the program off the ground.
“We have seen an increase in youth experiencing symptoms of mental illness that require hospitalization,” said Vermont Mental Health Commissioner Emily Hawes. “And so we want folks to have a choice. The need is there, and I hope we can meet the need of our communities.”
The most recent Vermont Department of Health Youth Risk Behavior Survey found that many teenagers in the state are experiencing poor mental health, anxiety, sadness and suicide risk.
More than a third of the students who took part in the survey said they experienced poor mental health most of the time or always during the past month.
More from Vermont Public: Survey shows Vermont youth mental health stuck in pandemic trough
Hawes said more teenagers are waiting in emergency rooms for psychiatric care because inpatient beds are not available, though she acknowledged that it is very difficult to build and maintain a system that is balanced, and cost-effective, with enough resources to serve adolescents.
“Folks always want to know the question, ‘Do we have the right beds or not?’ Which is a valid question, and also one of the most difficult ones to answer,” Hawes said. “And so, I would say we want folks to have a choice, we want inpatient, psychiatric care vetted with physical care in a medical center. And we also want facilities like the Retreat to thrive.”
Southwestern Vermont Medical Center will apply for an Act 250 permit for the new unit, and the hospital hopes to have the addition open in 18 months or so.
