NEWS, COMMENTARY, AND ARTS BY PSYCHIATRIC SURVIVORS, MENTAL HEALTH PEERS, AND OUR FAMILIES
VOL. XXXIV NO. 2
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FROM THE HILLS OF VERMONT
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SINCE 1985
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FALL 2019
State Could Be Sued Over Discharge Delays MONTPELIER — The state and others could face a federal lawsuit on behalf of patients who remain in hospital psychiatric units for lack of appropriate discharge options, based on the constitutional right to care in the least restrictive setting. Disability Rights Vermont has announced an initiative to identify such patients, and that it will pursue “systemic remedies” — including the option of a lawsuit — if structural obstacles to a return to the community are not then addressed. Delays in discharges have often been cited as one reason for long delays in emergency departments for people who are waiting for admission. If the facts gathered demonstrate a broad-based problem with access to community resources for those in the hospital, there are two potential groups with liability, according to Supervising Attorney AJ Ruben. They include private community facilities that refuse to admit people with a psychiatric disability, and state government, which “has the duty to ensure the capacity” for people to leave institutional settings and be integrated in the community, he said. Ruben said that, in the course of its fact-finding, if individuals are found who are being held inappropriately in a hospital, they will be told about the rights of people with disabilities to be free from unnecessary institutionalization and that “you may have a federal cause of action,” even if there is not a more widespread problem. The agency referenced both the 1999 Supreme Court case in Olmstead v L.C. and the Americans with Disabilities Act in citing potential rights violations. It said that many Vermonters with disabilities are being harmed by being held “long after their doctors (Continued on page 5)
One Forgotten Group: Elders Rejected by Homes By TRACY BRANNSTROM Elderly patients who are unable to find a place to live to leave the hospital — a contributor to lack of access to inpatient care for others and long emergency department waits — represents one of the groups identified in the Disability Rights Vermont initiatives that has not always received as much public scrutiny. People in the hospital who need psychiatric care combined with a high level of nursing care sometimes remain in inpatient settings long after they are ready to be discharged, according to professionals and state officials. “It’s not rare,” said Robert Pierattini, MD, chief of psychiatry at the University of Vermont Medical Center. He said that he sees such patients waiting weeks or months for a place to live with the supports they need, adding, “At any one time, there is always somebody.” When those who do not need to be in the hospital stay there, it blocks access to that level of care for someone waiting in an emergency room, mental health officials have said; the frequently cited examples have been inpatient stays due to lack of space at the state-run locked residence or supported housing. A study conducted by UVMMC found that, over a 30-month period in 2015-2017, 22 people faced delays of 30 days or more in finding a place available in a nursing home or assisted living residence. These individuals remained in (Continued on page 4)
REARING UGLY HEADS — Two dinosaurs were prominent participants in this year’s Mad Pride march and rally held in Brattleboro in July. For more pictures and full coverage, see pages 1213. (Counterpoint Photo: Anne Donahue)
Deaths from Use of Force Skyrocket By ANNE DONAHUE
MONTPELIER — When police shot and killed a man in August on the Spring Street bridge, he became the fifth person in Vermont in less than two years to die from police use of force while appearing to be experiencing a mental health crisis. The five deaths equal the number of deaths over the previous 16 years, from 2001 to 2016. Mark Johnson, 62, was described by family in his obituary as “a gentle giant, kind and caring.” Police said that he raised a gun towards them after having been told repeatedly to drop it. It
was later determined to have been a pellet gun, the police report said. The sharp increase in deaths could increase the workload of a new statewide review committee to the point that it may not be able to accomplish its intended purpose, according to its chair, Wilda White. The Mental Health Crisis Review Commission, created by the legislature in 2017 after the 2016 shooting of Ralph “Phil” Grenon in Burlington, is required to “conduct reviews of law enforcement interactions with persons acting in a manner that created reason to believe a mental health
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Building a Vision for the Future of Health Care
crisis was occurring and resulted in a fatality or serious bodily injury.” Its purpose is to “identify where increased or alternative supports or strategic investments within law enforcement … [or] community service systems could improve outcomes” and make policy recommendations, rather than to assess for blame, which is the role of the attorney general and local state’s attorney’s offices. White said that it currently has received a referral for only one death since 2017, and none for serious bodily injuries. It does not (Continued on page 5)
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Why I Take Drugs