New figures reported this week suggest Vermont’s capacity for inpatient psychiatric care began to recover slowly last year, but is still well below pre-pandemic levels.
Meanwhile, the total number of days spent in emergency departments statewide by patients seeking mental health care reached new heights. That number of over 10,500 days appears to be more than triple what was found in a similar analysis as the 2015 baseline.
The results come as no surprise to Ben Smith, medical director of the emergency department at Berlin’s Central Vermont Medical Center. According to his department’s internal statistics, he has at least doubled the number of hospital stays awaiting critical psychiatric care in the last five years. The impact on all kinds of patients seeking care and his staff will be severe, he said.
Smith said the increase has reduced his department’s ability to respond to emergencies of any kind, with both beds and staff occupied. Also, “It’s terrible for these patients,” he said.
“It’s not because our staff aren’t doing a heroic job of keeping these people stable and comfortable,” he added.
The stress and frustration of the situation has caused people to retire to work elsewhere, making it more difficult to recruit new staff for the emergency department, which needs to provide treatment to all visitors. We’re the only ones who can’t say no, and staff have to, even though they know they can’t provide the right amount of care,” Smith said.
Representatives from both the State Hospital Association, who created the new statewide data, and the Vermont Department of Mental Health, who published it. annual report He warned legislatures that psychiatric care capacity and emergency department stays are related, but that they interact in complex ways.
Emma Harrigan, director of policy analysis for the Vermont Hospital and Health System Association, which represents the state’s 14 hospitals, said: Brattleboro Retreat and Veterans Hospital at White River Junction. “But we also recognize that there are other challenges that may be contributing to that.”
A new report shows that the number of people discharged from inpatient psychiatric facilities across the state has increased by about 10% year-over-year. But a VTDigger review of the same report dating back to 2019 shows that hospital discharges remain more than a third lower than they were before the Covid-19 pandemic.
Overall days spent by patients receiving inpatient mental health care followed a similar trend, falling by more than half between the year before the pandemic and 2020 and 2021, when the pandemic had the greatest impact. Did. Data released this week still show a 30% reduction in hospital care days provided in the period from 1 October 2021 to 30 September 2022 compared to the pre-pandemic era.
Recent reports and presentations to Congress by Department of Mental Health staff say the inpatient system is still struggling to return to its former capacity due to local labor shortages.
At the Vermont Psychiatric Hospital in Berlin, about 60% of each shift is staffed. itinerant nurseMental Health Commissioner Emily Hawes said earlier this month she was relying on itinerant psychiatrists to keep the facility running at 21 beds, about 85% of capacity. said there is.The Brattleboro Retreat hope to return By the end of March 2023, we had increased our pre-pandemic bed capacity to 100, but now we can only treat 84 inpatients.
Meanwhile, the report found that patients requiring mental health care were admitted to hospital emergency departments for more than 10,500 days between October 1, 2021 and September 30, 2022, a record high. showed that it did That number is only a 5.6% increase year-on-year, but overall, he is almost 40% more than his pre-pandemic days tallied in the 2018-19 period.
Emergency department visits for patients requiring mental health care were approximately 7,500 at baseline, already reflecting the system’s underperformance in Vermont’s needs. The hospital association has been collecting and analyzing data for over a decade and has found significant increases each year.
“Even at our pre-pandemic capacity, we had people boarding the emergency room,” Halligan said.
2018, organization reported There were just under 3,140 emergency room patient days in 2015, an increase of nearly 30% per calendar year until 2017, when more than 5,200 were reached. While the timeframes cannot be directly compared, this suggests that the number of days a patient seeking mental health care spends in Vermont’s emergency department has more than tripled in her seven years.
Health regulators and state medical administrators have focused on increasing hospital bed capacity for both adults and adolescents since Vermont State Hospital closed after flooding from Tropical Storm Irene in 2011. . the year before the pandemic, push in progress Have additional facilities added to the University of Vermont Health Network growing needs.
At this session, those plans have now been scrapped, and Governor Phil Scott’s proposed adjustment to this year’s budget calls for about $9.3 million for development. Youth Inpatient Facility at a medical center.
Management has acknowledged that there are fewer available beds due to staffing shortages and says they are working to reopen them and add more. I warn you that you are wrong. The slow movement of Vermonters requiring inpatient care from the emergency department is a complex series of events, including the lack of alternative housing to support long-term stays so patients can leave the inpatient facility. It is due to factors.
“In the mental health system, we often say ‘a bed is not a bed’. There may be beds that are not full, but for a variety of reasons the placement is not adequate to meet the needs of the individual. Nicole Distacio, director of policy at the Department of Mental Health, said in an email.
Another focus was creating avenues for seeking mental health care outside hospital emergency departments and making sure Vermonters knew about them. There is now a statewide crisis telephone hotline — 988 — A contract is coming soon to connect mental health crisis support provided by designated social service agencies and provide statewide community-based mobile crisis response.
But more inpatient beds would help the sickest patients. Those are the people who have been in the emergency department the longest, compared to people who have had heart attacks and can’t be sent to intensive care, Smith said. It’s a humanitarian crisis happening in South Africa,” he said.
do not miss it. Sign up here to receive VTDigger’s weekly emails about Vermont hospitals, healthcare trends, insurance and state healthcare policies.
