The workers on the frontlines of Vermont’s mental health system say they’re struggling to meet increased demand for their services.
Many Vermonters probably don’t know what a designated agency is, let alone what one does. But the organizations are in many ways the keystones of Vermont’s mental health system, providing counseling and therapy for children and adults, as well as long-term care for people with disabilities.
Over the summer and fall, Senate President Pro Tem Tim Ashe has been touring designated agencies across the state, in advance of a legislative push next year to increase funding. At a stop at Lamoille County Mental Health Services this week, employees said waitlists for young children in dire need of help are emblematic of the struggles their organization faces on a daily basis.
“They have to bleeding or on fire before we can give them what they need, so how are we letting the system let them be so broken before we can help fix them?” said Robyn Daley, director of children, youth and family services at Lamoille County Mental Health Services.
Daley’s worked at Lamoille County’s designated agency — one of 11 total scattered across the state — for 16 years.
“And I think one of the things that I’ve learned being here is that you’re always going to have to do one more thing, you’re always going to figure out how to make it work — and you’re not always going to have the dollars,” Daley said.
Recently however, Daley said it’s getting harder and harder to stretch those dollars to meet the need.
Ashe said his off-session tour of the “DAs,” as they’re known in the mental health industry, was inspired by their funding woes.
Designated agencies operate almost entirely on state funds, but they aren’t technically part of state government. And while government agencies and hospitals can generally count on annual increases in their base budgets, designated agencies, according to Ashe, haven’t enjoyed the same growth.
“We’re trying to dig out of ... what has really been an unfair situation for a long time,” Ashe told about two dozen employees that had packed into a conference room for the Morrisville visit from him and Lamoille County Sen. Richard Westman.
"These are pretty severe cases of children with really high needs, and we are not able to meet the needs of these children — and believe me, we try." — Steph Beattie, Lamoille County Mental Health Services
Steph Beattie, who’s been working at the Lamoille County’s Early Childhood and Family Mental Health Program for the last five and a half years, said that while funding may be static, demand for services is not.
“We’ve seen the program explode, especially in the last two years,” Beattie told Ashe.
This past summer, Beattie said there were 40 kids in her program. At the time, she was the only person staffing it.
“These kids are being pulled from their families, put into foster care. They’re going through some major, major traumatic events, and they have one person,” Beattie said. “So these are pretty severe cases of children with really high needs, and we are not able to meet the needs of these children — and believe me, we try.”
Ashe said inadequate funding increases at the designated agencies over the years have also impaired recruitment and retention. Over the past two years, lawmakers allocated $12.5 million to the DAs, so they could increase the minimum wage to $14 an hour. Many college-educated workers, however, still make less than $15 an hour.
Beattie said the low pay makes a difficult job even tougher.
“We don’t do this job for the pay, at all. We do this because we love children, and we know that this is our way to help,” Beattie said.
But, Beattie and other employees, many of whom take second jobs to subsidize their work at the designated agencies, say they still “have to pay our bills.”
“And it’s heartbreaking," Beattie said of the work, "and we need more help."
Ashe and Westman said lawmakers will try to deliver that help during the next legislative session. Ashe said policymakers need to rectify decades of fiscal policy that have made DAs the forgotten children of a sprawling health care system.
“The truth, in my opinion, is that it’s not that we don’t spend enough in human services," Ashe said. "It’s that we have to dig ourselves out of spending it the wrong way."
Digging out, Ashe said, will take time. But he said next year, the Senate will resume the task of reallocating health care expenditures in ways that help the workers, and the mission, of designated agencies.