NEWS, COMMENTARY, AND ARTS BY PSYCHIATRIC SURVIVORS, MENTAL HEALTH PEERS, AND OUR FAMILIES
VOL. XXXV NO. 1
FROM THE HILLS OF VERMONT
COVID Sweeps US Psych Hospitals
Data suggests that 100 or more patients may have died of COVID-19 while in locked psychiatric hospitals around the country, with more than 40 patient deaths in New York alone. These are high-risk settings for contagion “invisible to much of the world,” said a news report in the New York Daily News on May 3. Vermont officials say there have been no patients who have tested positive in any psychiatric unit in the state, but have also confirmed that there has not been any hospitalwide testing. According to a Department of Health protocol, residents in settings with multiple occupants are tested only if one staff person or resident has a positive test and despite active screening, no suspected cases have been identified, Commissioner Sarah Squirrell said. Some states do not provide a breakdown of COVID-19 tests or deaths by facility, according to a May 17 article in the New York Times, making it impossible to identify total numbers. NBC News said in a May 13 report that it had identified 1,450 COVID-19 cases at state mental health facilities in 23 states and Washington,
D.C., “roughly double the total in the federal prison system.” It said that the numbers, provided by state health officials, “are likely an undercount since 16 states did not provide data.” Its report did not include the number of deaths.
NBC News said in a May 13 report that it had identified 1,450 COVID-19 cases at state mental health facilities in 23 states and Washington, D.C., “roughly double the total in the federal prison system.” However, in New York, the state with the highest number of deaths in the United States, the Daily News reported that more than
40 patients had died in New York state-run psychiatric hospitals as of early May. There had been 259 positive tests among the approximately 3,500 patients at 23 New York facilities as of April 23, according to an April 25 New York Gazette article. In Massachusetts, the state health data showed 17 deaths at its Tewksbury State Hospital as of June 6. Of its 308 patients, 170 had tested positive. Lemuel Shattuck Hospital in Jamacia Plain had 99 positive tests among its 211 patients, and between one and five deaths. Numbers below five are not specified to protect against patient identification. New Jersey, also particularly hard hit by the coronavirus, had 13 patient deaths as of early June, according to its state web site. New Jersey and Massachusetts are among the very few states providing a breakdown for psychiatric hospitals. Of the more than 1,000 beds at three state-run psychiatric hospitals, 270 patients and 488 staff had tested positive as of June 6, the New Jersey health data indicated. Neither New York numbers nor the Tewksbury (Continued on page 4)
Sharing of Records Is New Default By ANNE DONAHUE Counterpoint
MONTPELIER — Despite a state commitment to “produce broad awareness of the policy change and to inform people about … their rights related to the disclosure of health records,” only three of 22 people surveyed by Counterpoint in May had heard that information is now available to their health providers without their consent. The legislature authorized the state to change its health information exchange system as of March 1, but only after “creation of patient education mechanisms and processes [that will] enable patients to fully understand their rights regarding the sharing of their health information.” Counterpoint sent a survey to psychiatric survivors and consumers who have active leadership roles in the mental health system, and most said they had not heard about the change in policy that removed the patient consent requirement. Under the new law, a patient can still refuse to have records shared but must take action to have record-sharing blocked. Prior to March 1, records were kept confidential except in an
emergency unless a patient had given direct consent. Although a majority said that they generally thought it was helpful for any of their providers to be able to access their records from their other providers, 18 of the 22 did not trust either their provider, the electronic medical system, or both, to keep information confidential. The survey participants came from across the state, ranging from Brattleboro to Springfield to Barre to Burlington. Vermont’s statewide health information exchange gathers records from all health care providers into a central database, which any provider can access after certifying that they are using the information for the care of the specific patient. Until this year, however, patients were supposed to be asked by their providers whether they consented to the exchange being used for them. Except in emergencies, the system could only be accessed if there was a patient consent in the record. In 2019, the Department of Vermont Health Access reported that the system was failing in its goal to help provide better care for patients because so few people had provided consent.
10 The Arts12
10-Year Plan For a Holistic, Integrated System
It said that after aggressive outreach to get providers to ask their patients for consent, the percentage increased from 19% in 2017 to 35% in 2018, but that was still far too low a number to make the system useful. In a report to the legislature, DVHA said that it had looked at practices in 40 other states and found that most only allowed patients to block information sharing or gave patients no option against being included, and only three states required patient consent in the way Vermont did. That meant “Vermont is out of step with national trends in health data exchange policies,” the report said. DVHA said Vermont’s policy was “minimizing the health records available when clinicians provide care.” It said it should be changed so that consent is assumed unless a patient directly informs a provider that they do not want it shared, which is called an opt-out policy. The legislature passed a bill in 2019 that permitted the change in 2020, as long as DVHA developed a “robust” plan with “strategies to inform each Vermonter about the [health (Continued on page 4)
What WRAP Is Worth
2 Peer Leadership and Advocacy
Meeting Dates and Membership Information for Boards, Committees and Conferences During COVID-19 crisis restrictions, call first to check whether groups are meeting
Peer Organizations VERMONT PSYCHIATRIC SURVIVORS BOARD
A membership organization providing peer support, outreach, advocacy and education. Must be able to attend meetings monthly. Experience with boards preferred, but not necessary. For information call 802-775-6834 or email firstname.lastname@example.org.
COUNTERPOINT EDITORIAL BOARD
The advisory board for the Vermont Psychiatric Survivors newspaper. Assists with policy and editing. Contact email@example.com.
ALYSSUM Peer crisis respite. To serve on board, contact Gloria at 802-767-6000 or firstname.lastname@example.org. DISABILITY RIGHTS VERMONT PAIMI COUNCIL
Protection and advocacy for individuals with mental illness. Call 1-800-834-7890 x 101.
State Committees ADULT PROGRAM STANDING COMMITTEE
Advises the Commissioner of Mental Health on the adult mental health system. The committee is the official body for review of and recommendations for redesignation of community mental health programs (designated agencies) and monitors other aspects of the system. Members are persons with lived mental health experience, family members, and professionals. Meets monthly on 2nd Monday at the Department of Mental Health, 280 State Drive NOB 2 North, Waterbury, noon-3 p.m. For further information, contact member Daniel Towle (email@example.com) or the DMH quality team at Eva.Dayon@vermont.gov.
LOCAL PROGRAM STANDING COMMITTEES
Advisory groups required for every community mental health center. Contact your local agency for information about meetings and membership.
Advocacy Organizations DISABILITY RIGHTS VERMONT
Advocacy in dealing with abuse, neglect or other rights violations by a hospital, care home, or community mental health agency. 141 Main St, Suite 7, Montpelier VT 05602; 800-834-7890.
Hospital Advisory VERMONT PSYCHIATRIC CARE HOSPITAL
Advisory Steering Committee, Berlin, check DMH website for dates at mentalhealth.vermont.com.
Consumer Advisory Council, fourth Tuesdays, 12 - 1:30 p.m., contact Director of Patient Advocacy and Consumer Affairs at 802-258-6118 for meeting location.
RUTLAND REGIONAL MEDICAL CENTER
Community Advisory Committee, fourth Mondays, noon, conference room A.
UNIVERSITY OF VERMONT MEDICAL CENTER
Program Quality Committee, third Tuesdays, 9-10 a.m., McClure bldg, Rm 601A.
Attend Peerpocalypse Virtually
Peerpocalypse has been rescheduled for July 2023 due to COVID-19, the Mental Health and Addiction Association of Oregon, organizer of the conference, has announced. “While we hope everyone can make it to Seaside, Oregon, we do understand that these are uncertain times. So, for those who can’t make the trip, we are offering the conference virtually!” Virtual registration includes virtual access to workshops, with CEU credits; virtual access to keynote speeches; and T-shirt, conference program, and name badge. (The T-shirt, program, and name badge will be sent via mail.) To receive a T-shirt, the $200 virtual registration must be received no later than June 26. To register, go to form.jotform.com/92246365148158.
MENTAL HEALTH LAW PROJECT
Representation for rights when facing commitment to a psychiatric hospital. 802-241-3222.
ADULT PROTECTIVE SERVICES
Reporting of abuse, neglect or exploitation of vulnerable adults, 800-564-1612; also to report violations at hospitals/nursing homes.
VERMONT CENTER FOR INDEPENDENT LIVING
Peer services and advocacy for persons with disabilities. 800-639-1522.
VERMONT FAMILY NETWORK
Support for families with child or youth with mental health challenges. 800-800-4005; 802-876-5315.
VERMONT CLIENT ASSISTANCE PROGRAM
Rights when dealing with service organizations such as Vocational Rehabilitation. Box 1367, Burlington VT 05402; 800-747-5022.
HEALTH CARE ADVOCATE To report problems with any
health insurance or Medicaid/Medicare issues in Vermont 800-917-7787 or 802-241-1102.
VERMONT FEDERATION OF FAMILIES FOR CHILDREN’S MENTAL HEALTH
Statewide support for families of children, youth or young adults in transition who are experiencing or at risk of experiencing emotional, behavioral or mental health challenges. 800-639-6071, 802-876-7021.
How to Reach The Department of Mental Health:
mentalhealth.vermont.gov For DMH meetings go to web site and choose “more” at the bottom of the “Upcoming Events” column. ADDRESS: 280 State Drive NOB 2 North Waterbury, VT 05671-2010
The Service Building, 128 Merchants Row Suite 606, Rutland, VT 05701 Phone: (802) 775-6834 email: counterpoint@ vermontpsychiatricsurvivors.org MISSION STATEMENT:
Counterpoint is a voice for news and the arts by psychiatric survivors, ex-patients, and consumers of mental health services, and our families and friends. Copyright 2020, All Rights Reserved FOUNDING EDITOR Robert Crosby Loomis (1943-1994) EDITORIAL BOARD Joanne Desany, Emma Harrigan, Calvin Moen, Sara Neller, Eleanor Newton, Sarah Simoneau The Editorial Board reviews editorial policy and all materials in each issue of Counterpoint. Review does not necessarily imply support or agreement with any positions or opinions. PUBLISHER Vermont Psychiatric Survivors, Inc. The publisher has supervisory authority over all aspects of Counterpoint editing and publishing. EDITOR Anne B. Donahue News articles without a byline written by the editor. Opinions expressed by columnists and writers reflect the opinion of their authors and should not be taken as the position of Counterpoint.
Counterpoint is funded by the freedom-loving people of Vermont through their Department of Mental Health. Financial support does not imply support, agreement or endorsement of any of the positions or opinions in this newspaper; DMH does not interfere with editorial content.
Counterpoint is published by Vermont Psychiatric Survivors three times a year, distributed free of charge throughout Vermont, and also available by mail subscription. Vermont Psychiatric Survivors is an independent, statewide mutual support and civil rights advocacy organization run by and for psychiatric survivors. The mission of Vermont Psychiatric Survivors is to provide advocacy and mutual support that seeks to end psychiatric coercion, oppression and discrimination. Counterpoint does not use pseudonyms in its reporting without stating that a pseudonym is being used and without an explanation for why the person’s identity is not being disclosed. Counterpoint does not use anonymous sources under any circumstances.
Have News To Share? Send it to Counterpoint! The Service Building, 128 Merchants Row Suite 606, Rutland, VT 05701 Email: counterpoint@ vermontpsychiatricsurvivors.org
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Summer Fall 20182020
ROUND UP In the News Psych COVID-19 Deaths
In Commentary Lock-Up Practice Continues
Data suggests that 100 or more patients may have died of COVID-19 while in locked psychiatric hospitals around the country, with more than 40 patient deaths in New York alone (see Page 1).
A hospital has modified its procedures but continues to use the locked psychiatric area in its emergency department for voluntary patients (see Page 6).
Patient Records Exposed
Information is now available to health providers without patient consent, but many people are not aware of the change in law (see Page 1).
A draft decision has approved the plans for a new emergency department at Northwestern Medical Center in St. Albans despite potentially illegal locked doors and lack of a common space for psychiatric patients (see Page 7).
Budget Crisis Looms
Restraint Violations Cited
Tax revenues have plummeted as a result of business closures and job losses due to the coronavirus, and major cuts may be coming when the legislature meets in September to finish the new year’s budget (see Page 4).
Retreat Faces New Oversight
The state is investing tens of millions of dollars into the Brattleboro Retreat to keep it going, and new oversight agreements have been added as a result (see Page 5).
More Housing Needed
A significant need for expanded group homes and independent housing supports has been identified in a report that was required by the legislature last year (see Page 5).
Derailed by Coronavirus
The budget for new mental health initiatives for the 2021 fiscal year and construction of new psychiatric hospital space were derailed in March by the coronavirus pandemic (see Page 5).
Imprisoned in the ER
A man who brought his wife to the emergency room in September shares the experience of being held involuntarily (see Page 6).
ED Construction OK Likely
Central Vermont Medical Center has been cited for failing to ensure that a patient was free from restraints unless there was a risk of immediate harm and failure to prevent injury in the use of restraints for two other patients in its emergency department (see Page 7).
Failures, Bias Led to Death
In Solidarity, reflections on the death of George Floyd, page 18 The Value of WRAP, testimony to the legislature to prevent a budget cut, page 18 People Living Unhoused Deserve Better, a message from an advocate, page 19 Coercive Practices, on the use of threats as a form of duress, page 19 A Letter to Addiction, a message to an invisible enemy, page 20 Promoting a Choice for Life, the argument for listening instead of medicating, page 21 Aftermath of a Killing, the damage from witnessing a police shooting, page 22
A review commission has concluded that a 2016 killing by Burlington police was the result of a breakdown in services and communication among three agencies (see Page 8). Two commission members found that unconscious bias was an additional root cause (see Page 9).
The Trauma of Psych Incarceration, the experience of an involuntary hospital commitment, page 23
Vision 2030 Underway
Musings from a Bald Eagle, page 12 Poet Residing, book review, page 13 Poetry and graphic arts, pages 14-15
The Department of Mental Health has finalized a 10-year vison for integrating mental health into health care, and one step — a peerled work group to review credentialing for peer support staff — is getting underway this summer (see Page 10).
Profile: Moving Forward
In the span of a decade, Leslie Nelson went from being convinced she faced a lifetime of hospitalization, to leading a peer support team (see Page 11).
In the Arts Louise Wahl Writing Contest
pages 16-17 Prose, First place The Bird by Anthony Parshall Poetry, First Place You’ll Never Find a Pearl by Dennis Rivard Poetry, Second Place Trees by Natalie Frost Poetry, Third Place Seeking the Perfect Hurricane by Marla Simpson
Counterpoint Telephone Poll QUESTION: If state approval is required to be a peer support worker, does it change the peer-to-peer relationship? See news article, page 10.
VOTE “yes” or “no” by calling:
888-507-0721 (Toll-free call)
Results of the poll will be published in the next issue of Counterpoint.
Summer Fall 2018 2020
Budget Outlook Uncertain, But Grim
MONTPELIER — The state is anticipating a major loss of revenues in the year ahead, but the commissioner for the Department of Mental Health said it was unclear at this point how the DMH budget might be affected. Sarah Squirrell said she assumed the state’s budget “will be facing pressure broadly” but she has not received information from the administration’s finance office with any guidance yet for revised budgeting. The state legislature has said that current estimates indicate a $400 million shortfall in the budget for the current year. Based on that projection, Governor Phil Scott requested that the legislature reduce the overall budget by 8%. The annual state budget year begins on July 1, but because of the coronavirus pandemic and the resulting orders to close businesses and job losses, the legislature chose to create a budget from July through September only. A budget for the remaining nine months will be developed in September, when there is
COVID-19 • Continued from page 1
data appeared on the Times list of each setting in the country with 50 or more positive tests. The Times list does not include death reports. Those on the Times list in addition to New Jersey included the 200-bed St. Elizabeth’s Hospital in Washington, D.C., with 181 positive tests as of June 6. Four patient deaths had been reported there by the news media in May. An Illinois state hospital had 138 cases and one reported death in the 478-bed facility, and a Michigan state hospital has 73 positive cases among 220 patients. A private child and adolescent hospital in Nevada had 70 staff or patients test positive in its 116-bed facility, with one staff death. Nevada state data reported that as of June 6, there were two patient deaths and
better information about finances, legislative leadership has said. A first quarter budget passed by the House on June 9 kept the same funding as last year, and Squirrell said DMH “does not anticipate” any cuts to its budget during that time. The Senate had not acted prior to Counterpoint going to press. The state received $1.25 billion in federal funds to address the costs of responding to the coronavirus. Under the federal bill, however, the money cannot be used for ongoing budget expenses and must be spent by Dec. 30. DMH used some of the federal emergency funding to provide $3,034,932 to community mental health centers for $1.50 an hour in temporary added pay for staff working face-toface with clients, the same as the increase for state staff, including at the Vermont Psychiatric Care Hospital in Berlin. An additional $2,458,276 was provided to the agencies during the spring months for financial relief of pressures related to COVID-19. The funds were also the source for
emergency grants to the Brattleboro Retreat (see article, Page 5). DMH also obtained a separate federal emergency grant of $1,073,253 that it said would be used for expanded emergency and crisis services, including outreach vans and telehealth technology, and the expansion of peer outreach support. As a result of the change in the state’s financial status, proposals by DMH for new initiatives were dropped from next year’s regular budget. DMH had requested funds for a specialty mobile response team in Rutland for children and families with a goal to prevent the need for emergency room visits. It was identified as a pilot project, with a first-year cost of $600,000. A second proposal was an expansion of the Zero Suicide initiative, including funding for more capacity for national hotline calls to be answered in Vermont and for workforce training at community mental health agencies to improve care to patients with suicide risk. That was a total budget request of $575,000.
35 other positive cases in psychiatric facilities. Advocates in several states have spoken out about the dangers of contagion in large psychiatric hospitals, and an ex-patient group in Massachusetts launched a campaign to have more patients released, according to an article in Mad in America on May 25. “One of the primary areas of concern revolved around the isolation and distancing policies that may be necessary for the public’s health but are particularly worrisome for individuals’ human rights,” the article said. “These measures include the cessation of all outside visitation, including lack of access to outside peer support workers and other non-hospital affiliated advocates who are in a position to monitor conditions,” it said.
Those restrictions are all in place in Vermont under the state’s emergency orders. DMH began plans to open a separate psychiatric facility in Vermont in April in order to segregate any patients with symptoms or positive tests to prevent spread in an inpatient unit, but it had not yet opened by early June. Renovations were underway at the Windham Center in Bellows Falls at a cost of $587,335 to make the existing unit safer, DMH said. The Vermont planning originally envisioned temporary use of the Woodside youth treatment center as the coronavirus isolation unit but DMH said it found that Woodside could not be renovated adequately for inpatient use, and leased the Windham Center instead.
RECORDS SHARING • Continued from page 1 information exchange], the consent policy, and their ability to opt out of having their health information shared.” DVHA reported back on its plan in early 2020 and said that “consent discussions with patients including the presentation of opportunities to make informed consent decisions will continue to occur where individuals interact with the health care system [and] will still be about consent for treatment and the subsequent access to information.” “The difference now is the decision to allow access to information in the [exchange] will change from opt-in to opt-out,” meaning that instead of consent being required, a patient will need to specifically say they do not want to allow access. The DVHA report said that the steps it was taking included to “provide all participating health care organizations with [a] sample script and handout to use at check-in” along with language that could be inserted into existing notices of privacy practices. That information, under the requirements of the new law, was to include a clear explanation of the health information exchange, the way the information is collected and how it is shared, and how patients can choose to not have their information shared. Of the three people who told Counterpoint that they had heard about the policy change in the past six months, none said they learned about it from a health care provider. Concerns about security were significant.
Only two people said they trust both their providers and the system itself. Two said they trust the system technology but do not trust their providers to use information in the right way; six said they trust their provider but not the system; and 10 said they trust neither. “A good hacker could break into the system on the type of databases they use. Some of my information is outdated or, worse, incorrect,” one person commented. Although only seven people said they do not think that it is generally helpful to have information accessible among their providers, six others said it is helpful only if it is limited by consent and to specific information. “Not mental health, too much stigma and prejudice,” one wrote in a comment. Another said, “Sometimes, yes. Other times, it is harmful. Especially when I am looking for a fresh start, and trying to escape the bias and prejudgment that comes from new providers who only take what they see on paper for face value and NOT getting to know their actual patient.” Current federal law provides special protection regarding substance use treatment but not any other type. The result of the federal restriction does mean that agencies that deliver substance use treatment are often restricted in whole from sharing any patient information without specific patient consent. The Vermont health exchange is subject to that federal law, and as a result, some community mental health agencies do not share patient records with the state exchange.
The exchange “does not currently receive information from designated 42 CFR Part 2 programs,” the DVHA report noted, and therefore, “any patient who does not opt-out of health information sharing will know that information from designated 42 CFR Part 2 programs (related to substance use disorder and treatment) is not being transmitted.” Of the 22 participants in the survey, 17 responded that they wanted the information about how to opt out of having their records accessible. Only one had previously filed to revoke consent; the other two who said they knew about the change in policy said they did not know how to opt out of the system.
How To Opt Out Of Information Sharing
The Department of Vermont Health Access has created three ways for patients to opt out of the health information exchange, so that their information is no longer automatically accessible to providers without their direct consent: 1. Go to the Vermont Health Information Exchange website (www.vthie.net) for an overview of your choices, and follow the steps to fill out a secure online form. 2. Call the Consent Hotline at 888-9801243. 3. Print out and mail in the form: vthealthinfo.com/sites/default/files/2020-01/ VHIE-Consent-Opt-Out-Form-01-2020.pdf.
NEWS . NEWS
Fall 20182020 Summer
State Seeks $10.2 M More for Retreat
MONTPELIER – The Agency of Human Services has requested an additional $10.2 million of state funds be provided to the Brattleboro Retreat to keep it afloat financially, on top of more than $10 million already added earlier this year. The funding is tied to planning for “more residential capacity, both short term and long term, and prioritizes maintaining capacity for Vermonters with the highest acuity of mental health needs,” the plan states. The legislature is separately considering new quality oversight measures for the Retreat. The money would come from the emergency funding the federal government has given the state to respond to health provider needs resulting from the coronavirus pandemic. The agency identified it as an urgent need in early June, saying the money for the Retreat should be authorized before other hospitals or health care providers get any further emergency funding. The legislature was on the verge of a decision on approving the money when Counterpoint went to press. The request came as part of release of a ninepoint action plan that also holds the Retreat accountable for cost saving measures through greater efficiency and improved business operations, according to testimony from Department of Mental Health Commissioner
Sarah Squirrell in front of the legislature’s joint fiscal committee on June 8. She said it would be tied to plans for the Retreat to shift to providing more levels of residential care to “lead in the state’s efforts to enhance community-based care while positioning itself for continued sustainability into the future,” which she said was in line with the department’s 10-year vision for integration of mental health services within the broader health care system. Three current Retreat youth group homes would be converted to a more intensive and more secure residential program in the Osgood Building, which is currently an inpatient building, she said. The group homes would then be able to become adult programs that would help meet needs identified earlier in the year in a report from DMH for group homes and supported housing for people to be able to be discharged from hospital, Squirrell said. The Retreat was facing financial pressures from a low census already last fall, and received a rate increase for payments by the state at that time, as well as an additional $5.2 million in rate increases in January, she said. In April it was under even more pressure because it lost revenue because of fewer patients after the pandemic struck, she said, and the state use federal emergency funds to provide $7.3
million in addition direct grants and payments. The state also added $1.5 million to the state’s construction program to pay the Retreat for cost overruns on the new, 12-bed acute inpatient unit being renovated in the current Linden Lodge building. On June 9, the House passed a bill that linked increased funding to oversight to protect the state’s “significant interest in the quality of care” at the Retreat. As Counterpoint went to press, that bill awaited action by the Senate. It set out new requirements that voluntary patients, as well as involuntary, have access to the patient representative funded by DMH and contracted to Vermont Psychiatric Survivors. It also requires that the patient representative participate in new staff orientation. The bill requires that DMH hold regular meeting with the Retreat, VPS and Disability Rights Vermont to discuss patient experiences of care, and requires DMH and the Retreat clinical teams to meet at least monthly to review quality issues, “including service delivery, clinical practices, practice improvement and training, case review, admission and discharge coordination, and other patient care and safety topics.” DMH would be required under the bill to report to the legislature next February on patient experience of care.
New Housing Omitted Despite Report
MONTPELIER — The Department of Mental Health identified a significant need for expanded group homes and independent housing supports in a report that was required by the legislature last year to assess “the mental health bed needs for residential programs.” However, no new initiatives were proposed in response to the report, and legislative committees had not yet responded to it when the legislature suspended regular activities in March. DMH indicated its priority remained a new locked residential program with 16 beds to replace the current seven-bed Middlesex secure recovery residence. It began a public planning process for the building design in May, and is seeking to build it on the site of the Woodside youth center in Colchester. The report reviewed gaps that presented barriers to patients being discharged from involuntary inpatient psychiatric hospital units. Among the report’s conclusions was that
“further investment in group homes and other independent living situations are indicated.” It noted that Rutland County Mental Health and Northeast Kingdom Human Services do not have group home beds. The report said that if the state had more ability to access independent living situations, it would free up space in intensive residential programs, which are experiencing longer lengths of stay and thus unable to admit as many patients who are ready to leave a hospital. If there were more housing opportunities, “we would then see a decrease in their [intensive residences] average lengths of stays and an increase in their ability to admit more individuals who could benefit from that level of care.” It found that “return to former independent housing,” rather than more restrictive settings, “stands out as consistently being one of the most common discharge dispositions” for patients leaving involuntary inpatient hospitalization. In addition, the report said the data “show the occupancy rate for group homes are extremely
high and unfortunately, are frequently not an option for individuals as a step down from the hospital.” The report also said, however, that there were six to 10 individuals at any given time with lengthy stays in high-security units who could be referred to a locked residential program if it had the capacity to perform emergency involuntary procedures like restraint and seclusion. That supports the state plan to expand to 16 beds for the replacement locked residential program, the report said, as it will “provide critical capacity within the mental health system of care and contribute to reducing barriers to discharge from Level 1 inpatient beds across the state.” The report also identified that the need is “on the rise” for special funding for high-intensity services “which allows for certain individuals to live in a setting outside of an inpatient psychiatric hospital.” But it suggested that in the future, those individuals might be served instead in the new locked residential program.
Initiatives Derailed by Coronavirus
MONTPELIER — The budget for new mental health initiatives for the 2021 fiscal year and construction of new psychiatric hospital space were among state discussions that were derailed in March after the coronavirus pandemic reached Vermont and redirected the state’s focus.
UVM Hospital Space
The University of Vermont Health Network was in the second year of a design process for a 25-bed addition to its psychiatric inpatient capacity at its central Vermont campus. In January, the network announced that a preliminary design, which included a new emergency room as a base floor with three new inpatient units above it, was too expensive to develop further. Those units would have
included the existing 15 psychiatric beds at Central Vermont Medical Center in Berlin, for a total of 40.The hospital had worked extensively with psychiatric survivor and peer support advocates to ensure that voluntary psychiatric patients in the emergency room had options for rooms in unlocked, general care areas. After that plan was mothballed, stakeholders who worked on it were to regroup and focus on the new inpatient bed project alone, network representatives said. In March, the network announced that planning had been suspended while its hospital directed all its resources toward preparation for a potential unprecedented surge in patients requiring intensive treatment due to COVID-19.
Retreat Level 1 Beds
By March, the Brattleboro Retreat was near completion of a 12-bed unit for highest security inpatient care, a renovation project largely funded by the state. An additional $1.5 million in construction funds for cost overrides were included in the state’s capital bill. Retreat officials had said staff recruitment would be a challenge but projected opening the unit in stages beginning in late summer. That process was suspended in March when the governor’s COVID-19 state of emergency stayat-home orders include a ban on construction work. According to the Department of Mental Health, a new timeline pushes the opening date to December.
NEWS 6 NEWS
Summer Fall 2018 2020
Imprisoned in the ER:
A Patient’s Experience
BERLIN — When Jordan White* brought his wife to the Central Vermont Medical Center emergency room in September, he believed he was helping her with a brief visit to get a medication adjustment after they could not get access to a same-day psychiatrist. Instead, he and his wife found themselves “locked up and ostracized” in a special section of the ED designated for psychiatric patients that he later described as “exactly like a prison with a guard house” and “completely non-therapeutic, stressful, and damaging.” CVMC calls the 3-patient suite of rooms its Transitional Care Area. White went on to file grievances with the hospital and with the attorney general’s office, not knowing that at the same time, advocates were working to change the hospital’s approach to those in a mental health crisis and to block a hospital in St. Albans from its own emergency room renovation design for a locked psychiatric care area. White said he decided to share their story with Counterpoint in the hope that it would help in accomplishing changes to the way psychiatric patients are treated in the emergency room. He asked that his name not be used in order to protect his wife’s medical confidentiality. He was stunned, he said, when he accompanied his “calm, non-dangerous elderly family member to the ER” and they were both immediately locked up with no warning. His wife is a “70-year-old lady who would not hurt a bug,” he said. “In my opinion, the emergency department of Central Vermont Medical Center is guilty of violating the civil rights of Vermonters,” White said. “They do this by tricking the unsuspecting
Vermonter into entering a locked room (TCA) without any warning that, once the door slams shut, you are imprisoned and cannot leave.” They were told that “the door could not be unlocked until discharge papers were signed,” making “the whole experience of seeking medical help from the local hospital a trauma, which itself is damaging and can take months of recovery.” The experience was so traumatic that, a few months later, his wife delayed going to the emergency room when she was experiencing severe pain. She waited a day to go to a different hospital, where she required emergency surgery for a life-threatening condition, White said. “The unnecessary and illegal incarceration … of mental health patients has the direct effect that they will not return to the ER even when a health emergency dictates that they should be seen immediately,” he said. “Picture the TCA, a main room with no windows and a single table and bathroom adjoining, with three locked doors into individual rooms on one side and on the other side a glassed-in, locked office from which the staff peer at you while they hide in there along with their uniformed security guard, locking and unlocking the door whenever they come into the main room,” he said. “Just like a jail, they make the patient undress and search through everything. They even confiscated my briefcase with my notes to talk to the doctor.” White said it took well over an hour for a psychiatrist to show up. “Of course, the psychiatrist concluded we were not dangerous and authorized letting us go — which took another half-hour of stressful waiting while they slowly did the paperwork.” White said he felt a transitional care area
might be appropriate for someone who has been seen by a psychiatrist and is being admitted, while waiting for an inpatient bed. At CVMC, however, it was “used as a convenient place to lock away all persons presenting with a mental health question, before they had been admitted or even seen a doctor.” White said that after his grievance, he was told the hospital was no longer automatically putting everyone with a mental health issue in the TCA. However, he said an ED charge nurse confirmed to him in November that the triage nurse “can still make the judgement to trick someone into the TCA before they have even seen a doctor.” He said the practice constitutes fraud because patients sign a consent form that says, “I understand I can terminate my treatment at any time,” but “even when there was no danger of harm to self or others, they held us against our will and did not allow us to terminate treatment by leaving the TCA.” “The TCA is not a nice place, and CVMC knows this,” White said, “yet they have abused elders and others by locking them in there for years when there is no need, without making any improvements to the facility.” He pointed out a report published in 2017 evaluating the new unit that included statements that “TCA makes people feel closed in, like a jaillike environment; the TCA is a non-therapeutic environment.” It described a need for an expansion of the space and improvement to the therapeutic environment, “including access for fresh air, windows, innovative electronic programs.” *Jordan White is a fictitious name used by Counterpoint in order to protect the medical confidentiality of the individual’s wife.
Voluntary Patients Still Get Locked In
BERLIN — Central Vermont Medical Center has modified its procedures but continues to use the locked psychiatric area in its emergency department for voluntary patients, according to hospital administrators. Questions arose about practices there after recent events drew attention to locked EDs. A patient told Counterpoint about a grievance he had filed against CVMC. (See article above), and Northwestern Medical Center revised its emergency department renovation plans after being challenged about locked doors by the Green Mountain Care Board, the Department of Mental Health, and advocates. (See article, Page 7.) CVMC was cited in February by the state’s Division of Licensing and Protection for failure to meet requirements in the use of restraints. One of the citations said the hospital had told a patient they could not leave when “there was no indication in the medical record that the patient was under arrest and/or was obligated to stay in the ED.” The report itself made no reference to any authority to use locked treatment room areas. The three-room suite, which includes an enclosed nursing station and a patient shower, is called a transitional care area, or TCA, at CVMC. According to Terri Lynn Graham, director of emergency services, inpatient psychiatry, and nursing resources, the guiding principle for use of the locked rooms is keeping patients safe —
those with psychiatric symptoms and others in the ED — and keeping staff safe. The nurse at the triage desk conducts a review when patients come into the ED, and if there are indications of suicidality or a desire to hurt oneself, of being a “run risk,” or a risk of violence, “the safest place is the TCA,” Graham said. The hospital has made a change to include informed consent by telling a patient where they are going when being brought to the TCA, she said. “My goal is to keep the patient safe. We explain this to people,” she said. All patients used to receive information about the right to refuse treatment when they signed in, but new ED processes now prioritize getting patients into treatment rooms and then signing consent, Graham said. As a result, patients no longer provide informed consent before entering the ED, she said. If a voluntary psychiatric patient objected and said they wanted to leave after learning they were being required to stay in a locked area, “it does involve some grey areas,” said Dr. Justin Knapp, the hospital’s medical director for psychiatry. Patients are told they need to wait for a screener or the psychiatrist to assess whether they will be permitted to leave, “but a lot of it is a conversation,” Graham said. If a patient insisted on leaving immediately, an ED physician would be called to review
whether there should be a “first certification” to legally hold the person, she said. Knapp said that the state’s focus on maximizing voluntary care means “there is sort of a limbo that exists” in “sorting out where [patients] fall” in terms of risk. “Vermont has put a lot of responsibility on front line staff” for those decisions, while in other states, more patients would simply be held involuntary, he said. During the fall and winter of 2019, CVMC was engaged with a broad group of stakeholders in the design of a new emergency department which would have included a new transitional care unit. The planning group included several psychiatric survivors and peer supporters, including two who described recent past negative experiences in the existing TCA. The project was shelved after it was determined by the University of Vermont Health Network to be too expensive to include in the same plan with a planned new inpatient mental health unit. Graham said the message was heard that it was “not a warm and inviting place,” particularly in terms of the paint. It has been repainted “with nice, warm earth tones,” she said. The design of the area itself is “something we could consider” as well, said Anna Noonan, the hospital’s executive director, but “we are constrained by the physical layout” of the entire existing ED.
NEWS . NEWS
Summer Fall 20182020
ED Renovation Gets Draft Approval MONTPELIER — A draft decision by the Green Mountain Care Board has approved the plans for a new emergency department at Northwestern Medical Center in St. Albans despite saying the board agreed with mental health advocates that voluntary psychiatric patients cannot be held against their will in locked areas. The board’s preliminary decision rejected a request that a common area be included in the section of the emergency department designated for mental health patient rooms. The board’s draft decision said that “if the new locking capabilities of the unit are used to illegally detain patients in need of mental health services” it would not meet the criteria for approval of construction. “We are also concerned with statements NMC has made that suggest it may employ the new locking capabilities of the unit to seclude patients experiencing mental health issues without appropriate legal process,” it said. “At the same time,” the board said, “we do not believe it is appropriate for us to review and approve NMC’s policies governing use of restraint and seclusion.” It added, “We are not experts in this area and the questions are quite nuanced.” The board said it would therefore include a requirement that NMC seek input from the Department of Mental Health on its restraint and seclusion policies. The board also said it intended to “ensure that NMC makes good on its commitment to meet with advocacy organizations” about “maintaining an environment that is as unrestricted as possible.” Under the process for approval of new hospital construction, the board shares its draft findings and conclusions publicly and parties can file objections before it becomes final. The deadline for a final decision is August 3. A broad range of advocates and psychiatric survivor organizations filed objections to the NMC plans based on two concerns: the likelihood that voluntary patients would be locked into a section of the emergency room
designated for psychiatric emergencies, and the lack of a common area for peer support, social interaction and meetings with advocates.
Locked Doors Questioned
In terms of locked doors, the draft opinion said that “while there are positive aspects to the flexible design of the new mental health unit that NMC has proposed creating, this design also gives NMC the ability to lock doors and areas within the unit and this has raised difficult questions as to whether, and under what circumstances, these capabilities will be used.” It said that it agreed with advocates and the Department of Mental Health that “there is no legal basis to detain persons against their will if they are not in the custody of the State” and that “even when NMC is legally justified in locking a patient in a room or an area of the unit … the flexible design of the space raises questions as to how NMC can ensure other patients are not improperly restricted in their ability to leave.”
“... there is no legal basis to detain persons against their will if they are not in the custody of the State” However, it said that DMH, rather than the board, was “uniquely situated to review the policy that will govern how the new locking capabilities of the unit are used” and “we will require that, prior to construction, NMC seek input from DMH on its restraint and seclusion policy and give serious consideration to any recommendations DMH provides.” After challenges by advocates, NMC had told the board in April that “any use of seclusion by locking rooms or hallways will be ordered only after steps set forth” in its emergency restraint and seclusion policy.
Common Area Not Required
In rejecting a requirement for a common area,
the board said that although the decision was “a difficult one for us,” it was “not persuaded that an ED without such a space denies patients equal access to appropriate mental health care that meets standards of quality, access, and affordability equivalent to other components of health care.” The “equal access” standard is required for approval under a new criterion established by the legislature in 2018. The board went on to say, “While we will not require that NMC create a common space as part of this project, we strongly encourage NMC to explore opportunities to use existing spaces for this purpose.” One of the five board members dissented on that point. Robin Lunge said that the approval should require a dedicated space outside of patient rooms that would allow for interaction with “visitors, peer advocates, mental health professionals, legal advocates, and others.” Vermont Legal Aid’s Office of the Health Care Advocate had exercised its right to become a legal interested party, and Disability Rights Vermont was granted status as an intervenor to speak on the rights of people with psychiatric disabilities. A broad coalition of mental health organizations, including Vermont Psychiatric Survivors, co-signed a letter of opposition drafted by three people who described themselves as “individuals who have direct lived experience with psychiatric hospitalization.” Those three — Ward Nial, Dan Towle and Anne Donahue — wrote additional public comment letters in January and April to rebut responses by NMC. DMH submitted comments twice to support the need for a common area outside of patient rooms and to state that psychiatric patients should not be held in locked spaces in emergency departments. It provided data showing that the vast majority of patients coming to the emergency department for a mental health crisis are voluntarily seeking help.
Hospital Cited for Improper Restraint BERLIN — The state’s Division of Licensing and Protection found in February that Central Vermont Medical Center had failed to ensure that a patient was free from restraints unless there was a risk of immediate harm and failed to prevent injury in the use of restraints for two other patients in its emergency department. Dr. Justin Knapp, CVMC’s medical director for psychiatry, said in May that the finding by regulators that the rights of eight patients were violated were primarily issues of documentation.
He said his impression was that “adequate if not very good or excellent care was given,” but given the “complexity” of documentation requirements, DLP found the hospital out of compliance. One patient hit their head on the floor after being forced down to be given involuntary medication. The patient had initially resisted going to the hospital’s locked psychiatric crisis area, and then after agreeing to go, became “inappropriate” and “aggressive verbally” there,
Readers Oppose Locked ERs The winter Counterpoint poll question was: Should psych areas in emergency rooms be locked to prevent patients No from 100% leaving?
Those responding to last winter’s Counterpoint poll were unanimous in opposition to having hospitals use locked areas to prevent mental health patients from leaving an emergency department. The question was asked in light of practices in several hospitals and a plan at Northwestern Medical Center in St. Albans to renovate its ED to include mental health rooms with locking doors. The new poll question for this issue asks, “If state approval is required to be a peer support worker, does it change the peer-to-peer relationship?” See Page 3.
flushing the toilet repeatedly to flood the area, the report said. The injury, which resulted in swelling around the eye, was not assessed until 17 hours later, it said. The second patient suffered a wrist injury after being “taken to the floor” while being manually restrained after attempts to hit staff, the report said. A third patient was being “aggressive towards staff” by making “threatening statements” and then became agitated when staff “went hands on” to prevent the patient from leaving. The patient was then involuntarily medicated and put in four-point restraints. Staff said the patient was intoxicated and “not legally allowed to leave,” but the DLP report said that “there was no indication in the medical record that the patient was under arrest and/or was obligated to stay in the ED.” In those three cases, and in five more, a failure to conduct a face-to-face assessment after initiation of restraints was cited. The incidents took place between October 2019 and February 2020. The hospital’s plan of improvement included revision to policies and staff training and was accepted by DLP in March.
NEWS 8 NEWS
Summer Fall 2018 2020
Agencies Faulted in Death By ANNE DONAHUE Counterpoint
MONTPELIER — A review commission has concluded that the 2016 killing of Ralph “Phil” Grenon by Burlington police was “the result of a breakdown in services and communication” between the Howard Center, the Burlington Housing Authority and the police department. Two commission members added an independent opinion that “an unconscious bias against people with mental illnesses” on the part of the city of Burlington, including the police, “was a root cause of Mr. Grenon’s death.” (See article, Page 9) The Mental Health Crisis Response Commission’s report focused extensively on Grenon’s long treatment history with the Howard Center. It made 10 detailed recommendations, many of which related to specific inadequacies it identified in that agency’s record of treatment planning with Grenon, although they were offered as general recommendations for “community mental health centers.” The legislature created the commission in 2017 after Grenon’s death prompted a group of citizens to call for a review of interactions between police and individuals in an apparent mental health crisis that result in serious bodily injury. One of its purposes is to make recommendations for improving the outcomes of such encounters. Grenon’s death was the first to be reviewed by the commission. The 62-page report, completed after two years of gathering testimony and documents, was presented by Wilda L. White. She holds the designated seat of “an individual who has a personal experience of living with a mental condition or psychiatric disability, appointed by Vermont Psychiatric Survivors” and was elected the commission’s chair. Grenon was killed when police responded to complaints about disruptive behavior at his apartment building, and he met them at his door with two kitchen knives. After almost four hours of negotiation with him, police entered the apartment and found that he had retreated to his shower. When police charged at him, he moved forward with the knives. After a Taser failed to stop him, an officer shot him four times. The Howard Center’s executive director, Bob Bick, said he felt that the commission’s report was an “unfortunate missed opportunity for learning and created a process that instead seemed designed to assign blame.” “One of the recommendations made, consistent with legislative intent, was to improve communications among community partners,” Bick noted. However, he said, “We believe that the way the investigation was conducted hampered rather than helped this process.”
The report said that Grenon’s mental health “began to deteriorate at least one year before his death” following the loss of his longtime Howard Center case manager. Three months before his death, he had stopped refilling his prescription for antipsychotic medication. Grenon’s neighbors complained to his landlord — the housing authority — and the police that he was “disturbing them by talking to himself and screaming at the walls of his apartment.” He was “likely experiencing psychosis” at the time, the report said. The report said that the Howard Center never informed the police about Grenon’s fears and his statements that he “believed that
people, including the police, were coming to his apartment to kill him” and that he “planned to defend himself with knives.” The Howard Center “did not use any of the avenues available to it to treat Mr. Grenon involuntarily after it determined that he posed a serious risk of danger to others,” the report said. The agency’s medical records did not indicate a treatment strategy to address that risk, nor did it “have an adequate plan … during the vacation of his treating psychiatrist,” who was away when the death occurred, it said. Along with a list of recommended treatment practices, the commission said that community mental health centers should have training programs to educate crisis clinicians “how best to work with law enforcement during a crisis … including how clinicians can best support law enforcement during interactions with people in extreme states.” “If a client/patient will not attend appointments or respond to visits to his apartment, and emergency examination is appropriate, [the agency should] coordinate with law enforcement to intercept the client/ patient when he is in public rather than in his home,” the report said.
Although Grenon had received an eviction notice “because of escalating conflicts with his neighbors,” the commission said it did not believe that the notice was the cause for his behavior. The report said the housing authority “recognized the deterioration in Mr. Grenon’s mental health months before he died and communicated with the Howard Center,” but the communications “lacked the sense of urgency that the Commission believes the circumstances required.” When the housing authority received no reply, “no one followed up.” The report included recommendations for public housing authorities to create protocols for collaborating with community providers to meet the needs of tenants if their behaviors or mental states disturb the rights of other tenants.
The police had both “false and incomplete information” as well as inadequate resources, the commission said. They “did not take into account how Mr. Grenon’s mental illness affected his ability to comply with their commands or how his mental state might affect his reaction to pepper balls or Tasers.” The report included a number of recommendations for enhanced training for police, as well as development of an arrest and detention protocol that “accommodates an individual’s known mental illness during arrests and detentions,” developed with input from community partners, including “people with lived experience of law enforcement interactions during extreme mental states.” Ralph ‘Phil’ Grenon S o m e
Wilda L. White recommendations were directed at actions that the report found had contributed to Grenon’s shooting. The report said that police should have equipment that allows officers to maintain distance from and control over the individual in crisis and “use as few officers as is safe” when confronting someone in a small, enclosed space. The report found that the number of officers in Grenon’s apartment led to four officers becoming trapped when he “advanced into the bedroom, wielding the two kitchen knives,” meaning an officer then “was compelled to use lethal force to protect his fellow officers and himself.”
A Lost Opportunity
Responding to the report, Bick said that he believed the commission was intended to “function in a manner similar to how hospitals offer protected but open communications after there are bad outcomes from a procedure or process. It was intended as a way to learn and improve in a shared and collaborative process.” He said the commission instead took separate, individual testimony in its closed meetings. “Each party was interviewed alone and they had no opportunity to talk together, to clarify disparate perceptions and recollections, to identify the sources of those disparities and then, together, develop plans to minimize them in the future. “Ironically, the process resulted in a lost opportunity to improve in the one area in which we agree improvement can always happen, namely, communication between different and complex systems when they are dealing with acute crisis circumstances.” The commission’s report described new training in the police department and the housing authority’s new policy on handling evictions, but said, “There was no evidence before the commission that the Howard Center made any changes in policies, practices and procedures as a result of Mr. Grenon’s death.” Bick said that statement reflected a misunderstanding of the agency’s role. “Regardless of the skill and life experiences of our staff, it was and remains an ongoing challenge to know how best to be of help to any individual who does not want our help,” Bick said. He challenged the report’s conclusion that Howard Center staff should have evaluated Grenon for an emergency examination, citing a “belief in an individual’s right to define their world, even if they act in ways that may appear strange or alarming to others.” “If we had gone into his apartment earlier, this tragedy might still have occurred and we would (Continued on page 9)
Fall Summer 2018 2020
LEAD-UP TO A TRAGEDY — A still shot from a police body camera shows the convergence of police officers stacked outside the bedroom in Grenon’s small apartment. “The police response ... was a textbook case in technology, force and failure — with Phil shot dead in his bathroom and several young police officers traumatized by the experience and circumstances they never should have found themselves in,” said Jim Leddy, who organized the group that lobbied to create the commission.
AGENCIES FAULTED IN DEATH • Continued from page 8 have been accused of being overly aggressive in violating his civil liberties,” Bick said. Jim Leddy, who pulled together the original ad hoc group that proposed creation of the commission, said what impressed him about the report “was its thoroughness, thoughtful analysis and comprehensive recommendations.” “I do think the overall impact of an otherwise solid report may be somewhat limited because it took so long to complete,” he said. “Following such a tragedy, timeliness of the investigation can influence w h e t h e r c h a n g e happens.” Leddy is a previous executive director at the Howard Center who said he “knew Phil for more than 60 years, went to school with him, worked a couple summers Jim Leddy speaks at Phil Grenon’s with him at a funeral in 2016. summer camp
for boys, and often visited with him when seeing him on the street. We were always friends.” He said his most critical concern was “a lack of follow-up by relevant agencies at the state and local level.” He said there was no clear or fixed point of accountability and leadership. “In simple terms for the future, I believe the keys are leadership, teamwork and accountability that transcend the personal connections and become imbedded institutionally,” Leddy said. “Absent leadership and clarity in this area, we await the next Phil Grenon tragedy.”
The report said that the commission sought “to determine the root cause(s) of Mr. Grenon’s death and how it could have been prevented.” During its investigation, the commission “requested and reviewed documentary evidence, took sworn testimony from witnesses, and studied Vermont’s mental health laws and police use of force policies,” it said. The law that established the commission set out six duties, beginning with conducting reviews of police interactions “with persons acting in a manner that created reason to believe a mental health crisis was occurring and resulted in a fatality or serious bodily injury.” The commission is “to identify where increased or alternative supports or strategic investments within law enforcement, designated agencies, or other community service systems could improve
outcomes” and “educate the public, service providers, and policymakers about strategies for intervention in and prevention of mental health crises.” It is also directed “to recommend policies, practices, and services that will encourage collaboration and increase successful interventions,” to recommend training strategies, and “to make recommendations based on the review of cases before the commission.” Besides White, members of the commissioner include a vice chair — Cindy Taylor-Patch, the training director of the Vermont Criminal Justice Training Council — and representatives from the Department of Mental Health, community mental health agencies, law enforcement agencies, an assistant attorney general, NAMI Vermont, Disability Rights Vermont and two atlarge members. The report said that, “while not unanimous,” the report’s conclusions reflected a majority of the commission and that “all commissioners participated in the drafting and review of this report” and “accepted the report as the report of the commission.” Since the commission was created in 2017, there have been five new deaths involving use of force by police in Vermont, which led White to speculate last fall that the commission’s workload could become greater than it can handle.
Two Find Bias Tied to Grenon Shooting
MONTPELIER — Two members of the Mental Health Crisis Response Commission found that an additional root cause of Phil Grenon’s death was “unconscious bias against people with mental illnesses on the part of the city of Burlington, including the Burlington police department.” The commission’s chair Wilda White, joined by Ed Paquin of Disability Rights Vermont, said their conclusion was based on a series of facts: Grenon’s killing was the second of a person with a mental illness in fewer than three years, and both were directly related to the Burlington police’s failure to follow its own policies. Its officers and leadership “made disparaging and/or stereotypical statements about people with mental illnesses, in general, and/or Mr. Grenon, in particular.” Changes adopted after Grenon’s death “are heavily focused on investment in equipment to extract people in emotional crisis rather than engage with them.”
There was no credible explanation as to why its own policies were not followed “to protect Mr. Grenon, accommodate his mental illness as the law requires and avoid putting BPD officers in harm’s way.” The city has “rebuffed attempts by people with a history of mental illness to participate in activities to improve relations with the Burlington police.” And finally, despite the two killings, the city “did not see fit to include people with a history of mental illness on its recently created use-offorce committee and when the omission was pointed out to the City Council, it took no action to rectify the omission.” White and Paquin made recommendations that the city revoke its policy that “prohibits people who disclose a history of mental illness from participating in police ride-alongs” and that it amend the resolution that formed a committee to review community policing practices “to include at least two members with
a history of mental illness and an interest in improving community policing practices.” They also recommended an audit of police department policies pertaining to encounters with people in mental or emotional crisis to ensure that they comply with the Americans with Disabilities Act. They said the department should “develop and train officers in a wider array of options to avoid use of force involving people in mental or emotional crisis, including useful and effective alternatives to repeatedly shouting ‘drop the knife,’ at people who are not complying” and should “refrain from using tools on the recently purchased, $150,000 emergency response vehicle for forcible extraction before all peaceful resolution options have been exhausted.” The supplemental report by the two members stated, “It is not the case that other commissioners disagree with all the facts or conclusions it contains. It is the case that it has not been edited and approved by the full commission.”
NEWS 10 NEWS
Fall 2018 2020 Summer The Department of Mental Health presented “Vision 2030” in January as a 10-year plan to achieve “a coordinated, holistic and integrated system of care for Vermont.” A listening tour around the state gathered input, and a 25-member think tank, including five who self-identified as psychiatric survivors, consumers or peers, met last fall to help draft the report. The plan said that “an essential element of this vision is to shift the balance between mental health services provided in the hospital to services delivered in the community,” that “prevention and health promotion activities” are key and that “we must also address the stigma and discrimination that is often hidden deep within the [health care system] structures.” It said first steps would include asking the legislature to create a council “with authority to oversee and guide strategies,” and that DMH would “initiate short-term actions in the plan that can be supported within existing resources.” Eight action areas were identified and are summarized below.
“Health and wellness promotion must lead any long-term planning for population health and requires partnerships across a broad range of stakeholders and safety-net providers. It must … equally support children, youth, the middleaged and elders while building connections between all ages” and “must address social justice issues with anti-racism as a foundational principle.”
Vermont must provide “clear, consistent information and support for people in crisis,” implement “practices that improve an individual’s experience while in a crisis,” train providers in “trauma-informed, person-led care,” strengthen “prevention, care coordination, and hospital diversion programs” and develop “alternative options to utilization of emergency departments.”
“Vermont communities must have the resources necessary to ensure their residents can meet their most basic needs if we are to build and sustain healthy communities.” These include “food stability; housing; transportation; affordable, accessible childcare; employment; a community responsive to their needs; a medical home; access to mental health services” which include “a strong peer network.”
Key steps include a peer-led work group to make recommendations about credentialing and Medicaid reimbursement, expansion of models “such as 2-bed peer respite programs and making peer supports accessible in the emergency department and in inpatient settings” and exploration of models such as peer navigators.
“Stigma is a significant barrier in accessing quality care and prevents many people in need from seeking help; it also stops many from acknowledging they may be experiencing symptoms” and “can result in poor or harmful treatment if providers stigmatize [them].” Many individuals choose not to seek services “because of labeling, prejudice and judgement.”
“A critically important area … is building a culture of care that treats those seeking care with respect and dignity” and supporting them in “development of their own treatment plan and recovery goals.” This requires “holding the person’s individual needs, values and interests as the guiding beacon of our system of care.” Critical first steps include reshaping practices to “include advance directives so that individuals can take the lead in their care from a position of wellness, rather than at the point of a mental health crisis.”
Vermont has elements of a robust community-based care system, but they “are inconsistently available … and are often supported by short-term or insufficient funding.” Some first steps will be to “assess gaps in our care continuum,” “improve client navigation supports” and “increase outreach and education.”
“We must equip our direct care staff, care managers, supervisors and peers with the opportunities, resources and tools they need” to “meet the urgent health needs of our vulnerable populations.”
Peer Action Area Will Assess Credentialing
WATERBURY — One action step in the Vision 2030 plan — to have a peer-led work group to “make recommendations about whether and how credentialing and Medicaid reimbursement should be considered or implemented” — is getting underway this summer. Pathways Vermont was selected for the peer workforce development grant this year, and it has been charged with the task. The workforce initiative is convening a steering committee for the purpose, according to Hilary Melton, executive director of the Burlington-based agency. There has been debate in Vermont about credentialing for peer support workers out of concern that it impairs the core value of mutual relationships between equals, yet recognition that it is a key to expansion of funding and access (See Counterpoint, “Is Peer Support at Risk as It Grows?” Fall, 2018). Melton said, “Vermont has a long and rich history of peer support. What we don’t have is adequate funding for what many other states have already made a part of their systems of care.” She said that peer services are currently less than 1% of the Department of Mental Health budget. The Vision 2030 plan states a goal of
“continuous expansion of peer-based services” into all levels of care. One of the short-term strategies includes exploring “actionable areas for peers to inform planning of programs and their delivery,” including through peer-run wellness centers, crisis settings, and designated agencies and hospitals. Melton noted that four peer-led organizations, including Pathways, recently collaborated on a white paper outlining a plan to increase peerrun community centers and respites around the state. “I believe with an investment in peer services we can actually bring the costs down for all Vermonters. Peer services are proven to be effective and can support people in their communities before there is ever a need to access emergency rooms,” she said. The peer workforce development initiative was created as a grant program under Act 79 in 2012, which required DMH to contract with a program to “improve the quality, infrastructure and workforce development of peer services.” It was run as the Wellness Workforce Coalition by the Vermont Center for Independent Living until last year. In the first year of the grant to Pathways, startup work has included development of a
website, outreach about the project, adapting Intentional Peer Support training to an online platform and commissioning research about the certification and Medicaid billing question, Melton said. The $89,000 annual grant also covers statewide IPS training four times a year and monthly IPS co-reflections, she said. Melton said that beyond the effective support they offer, peer services “have the added benefit of providing employment opportunities to people with lived experience.” “Having a sense of purpose is one of the most fundamental blocks of mental health, right after housing,” she said. Pathways Vermont runs a number of peer-led or peer-supported programs, including Housing First, the Vermont Support Line, a community center in Burlington, and Soteria, which is a recovery residence focused on options for non-medication alternatives.
Start-Up Status Still Uncertain
A bill to create a task force to implement the DMH 10-year vision plan was passed by committees in the House and Senate, but had not yet received final approval in early June. The group included broad representation from partners across all of health care to address the recommendations that came from mental health system representatives.
Fall 2018 2020 Summer
Connection Seen as Key to New Start By WENDY M. LEVY Counterpoint
BURLINGTON — Leslie Nelson says she firmly believes that “losing my mind was one of my best career moves.” In the span of barely a decade, Nelson says she went from feeling profoundly hopeless, convinced that a lifetime of hospitalization was her fate, to leading a peer-support team. Last fall, she appeared as a keynote speaker at an international conference on community mental health. The difference between Nelson’s story and that of many others who faltered — and often didn’t survive — in the mental health system is connection, she said in an interview with Counterpoint. Step by step, through interactions with peers, clinicians and others she encountered in hospitals and training centers, Nelson realized her strengths and experiences could take her far and help her to help others. It all began with an offhand remark from a therapist. From there, Nelson said she found a community of mental health survivors and advocates who helped her change her story from a false narrative of unavoidable destiny to an inspiring account of resilience and service. In 2017, Nelson began working at Burlington’s Howard Center, a state-designated agency offering “supports and services to address mental health, substance use and developmental needs.” Nelson is the peer community recovery specialist and supervisor for the START (Stabilization, Treatment and Recovery Team) program, which “provides community-based peer support services to adults in Chittenden County.” But only a decade ago, while living in New York City, Nelson found herself experiencing five hospitalizations in nine months for mental health-related issues. Doing intense family-of-origin work led to the first of those hospitalizations in 2008. “I was floridly psychotic,” she said. “I was on disability, thinking I’d never be able to work again,” said Nelson, who added, “I was brokenhearted. Angry.” When asked how she began emerging from that state, Nelson said it was a helpful message from a mental health worker at the hospital. “I remember banging my hands on the desk, saying I was nothing but a compliant mental patient, and I’m [still] totally cracking up!” she said. The mental health worker countered with, “You’re having an adverse reaction to therapy.” “For me, that was the change in thinking,” said Nelson, who explained that this new way of looking at her situation helped her see that her condition “was a reaction to life. It’s not me being stark raving mad.” She felt a little less hopeless, she said, because this version of her story “was a little spark I could hang on to.” While she was receiving services at a clinic, Nelson said her therapist told her, “I think you’d be a really good peer specialist.” Until then, Nelson had never considered that line of work, she said. In the clinic, Nelson noticed a flyer for a peer support training seminar. “Maybe I could try that,” she thought. Her partner, whom Nelson described as “very supportive,” drove her to and from the training sessions because at that point she had a hard time riding the subway, she explained. She soon learned about another opportunity:
the Howie the Harp Advocacy Center in Harlem, part of the Community Access organization, which provides supportive housing and social services in New York City. Named for its founder, the late Howard “Howie the Harp” Geld, an early mental health patients’ rights activist, HTH describes itself as providing an intensive, supportive training program — including job placement in the human services field — for people with mental health diagnoses. The trainers are people with lived experience in the mental health system. According to the center, in envisioning positive change, Geld saw the lack of peers in the treatment system as a deficit, and by including those with lived experience, it could transform the culture. Nelson described the HTH program as very intense and supportive, with encouragement coming from HTH staff, classroom trainers, and the other participants, some of whom had a history of incarceration and racial oppression. “For me, personally, if I had not gone to a place like Howie the Harp, I wouldn’t have been able to return to work,” she said. “I didn’t quite need hand-holding, but I almost needed hand-holding. That’s who they support.” Nelson noted that prior to her studies at HTH, she often felt extremely isolated. “I was inside a lot,” she said. “But when I got there, I felt at home,” said Nelson. HTH was “my first introduction to this world of people who had these experiences who were doing something with these experiences that was meaningful,” she said. While at HTH, Nelson said she began to deeply consider her story — and how it fit into a larger family and cultural system — as she learned different views of mental health. She discovered the works of such mental health recovery advocates as Mary Ellen Copeland, Pat Deegan and Shery Mead, the founder of Intentional Peer Support. While she does not “over-identify with a diagnosis,” Nelson is aware she was “born into a lot of trauma.” From an early age, she gained an awareness that she “saw things other people weren’t seeing,” and “I responded to life around me in a very strong way,” especially when experiencing emotions like fear. During her childhood games, she had difficulty “discerning fantasy from reality.” “I grew up,” said Nelson, “with a narrative [that] women in my family get to a certain age, and go crazy, and get hospitalized.” From an early age, she was convinced that was her fate, too. At HTH, Nelson said she learned to draw upon her experiences as proof of her resiliency. In the program, “we think about what’s strong, rather than what’s wrong. Those simple ideas hooked me.” While studying in the HTH program, Nelson said she had a conversation with the director of Community Access, the umbrella organization that runs HTH. Open Dialogue came up. Developed in Western Lapland in the 1980s, Open Dialogue emerged from clinicians trying to find a better way to treat people experiencing acute mental illness, including psychosis. The practice includes the family and friends of the person in the treatment and has evolved to incorporate peer support. The Community Access director gave her a job referral. As a result, Nelson began a fouryear career as a peer specialist in the Manhattan division of the Parachute Project’s Mobile Treatment Team. This program sends full-time peer workers into the community to provide
Leslie Nelson services in the public mental health system. “People with lived experience were the experts, and we were the most important people in the room,” she said. Doing this work was another boost to Nelson’s feelings of confidence and self-worth, she said. “I think I grew three inches. I came in all shrunk down in my seat. But then I sat up straight and thought, ‘I am somebody!’” Through Parachute Nelson met Dr. Sandra Steingard, the Howard Center’s chief medical officer. In early 2017, when the START team leader position opened up, Nelson said Steingard contacted her to encourage her to apply. After arriving in Vermont, Nelson said she felt like the new kid on the block. “There’s a long history of psychiatric survivor activism” in Vermont, she said, “and I’m acutely conscious of being a newer person.” She said her goal is for the peer support world to “balance hard-core activism with full-on cooptation. Can activism be in the system but not of the system? How can we push for changes?” One way, Nelson said, is by sparking change from within. She noted that the Howard Center recently completed a two-day Intentional Peer Support training, which she co-facilitated with Chris Hansen, director of IPS. “It’s really significant that a designated agency” like the Howard Center “is hosting IPS,” said Nelson. “I’m really pleased with this development. I initiated it, and I was ready for a fight,” she said, but noted, “There was no fight at all!” “There’s a long way to go, but I’ve felt very supported [at the Howard Center] with my ideas and thoughts for moving peer support forward,” said Nelson. Nelson’s influence extends beyond her work at the Howard Center. She was recently featured on Vermont Public Radio’s “They Are Us” series, which explores mental health in Vermont. She is one of the subjects of Ben Wolf’s documentary, “Daniel, Debra, Leslie (And You?)” about people who hear voices. Last fall, she was a keynote speaker at a symposium in Taiwan about community services for people with mental health issues, where she joined other esteemed leaders in the peer support movement. And in November, Nelson began a three-year training in Open Dialogue at the Institute for Dialogic Practice, sponsored by Yale University. Nelson said she has found her home not just professionally but geographically. She and her partner “are thrilled to be in Vermont. We don’t have any plans to go anywhere.”
Musings From A Bald Eagle When I lose my hair, I have decided to become a bald eagle. I will spread my wings and let the wind carry me wherever it may. I will not resist, for the wind already knows where I am meant to go. This must be what it truly means to let go. ... This is what it means to be free. “Is this the same as dying?” I ask. My spirit voice inside tells me: “I am a bald eagle — Strong, Brave, Majestic and Alive!” When I fly with an open heart, I will soar. There is a certain kind of peace when I soar above the earth, above it all. I am in a state of grace. To be alive on this beautiful earth, swaddled in love by so many. There is only gratitude flowing inside my blood. I bend into the wind and it lifts me up! I am not afraid of its power or its currents. The wind and I make a pact to trust in each other. There is harmony in this. From high above I can see everything. The trees, the rivers, the mountains. A field mouse. A blade of grass. They are all one now. And as the wind suddenly shifts direction, my eyes turn and everything has vanished. I keep my heart open, with wings outstretched. I am flying with my eyes closed. Fearless. ~ Amy Wales~
Author’s preface In early January, I was diagnosed with a rare form of cancer. As frightening as this was, I found that I was becoming more distressed about the image of me losing my hair than the fact I had cancer! Instinctively I knew that in order for me to survive this journey, I could not allow any negativity to take over my thoughts; I needed to remain positive. So I created an affirmation (injected with a bit of humor), to counter the dark energy. My affirmation is: When I lose my hair, I have decided to become a bald eagle. Several days later, the affirmation bloomed into this poem. Amy Wales, Montpelier
Fall 2018 Summer 2020
Poet Residing by Anne Donahue Michael Alter’s new book is aptly called “A Work Journal with Poems” because He peppers the pages with one-liners that range from the the journaling is the greater art than practical — “Take frequent breaks, save your feet” — to the more the poetry. He takes us on a profound: journey of ordinary work “It took me 38 years and gardening over to learn to be the course of a month friendly with with a daily jounal people. Soon, I June 13: that pulls beauty and will learn to be already ready. It And the mop was humor out of simple friends.” head or flush. The mop flo e th d he is sw acts. While Alter nd around and arou reeled and reeled All “A pot or pan clean — such shine! does intersperse y. rr hu easy, and I had no d an ht lig in — is gold! Especially with nothing lusted, some poems, ngy heat a plished, despite di m co e ac crusted on,” he proclaims in the opening many of them have oo shortness of th ed room, the oh-t os cl entry. less vivid imagery g to do. task, and nothin Alter’s job, cleanup in his men’s residential and flow than the in the morning. I had arrived late as home, takes on new meaning in his reflections on the ordinary. journal entries and work, and that w No one told me to ng with He makes it seem rarely boring and often uses a simple turn of are not the strength freedom of worki e th it, of n fu e th , being hat I wanted to do words to bring a sense of beauty to the mundane: of his book. my will, doing w . ad ng more than le “The cool ebb of the morning breathes pulse into the work of The illustrations led with somethi task. y ourselves to the life. Coffee in a can percolates the air with slow suspense.” in the book by Alter’s We all must carr arrive morrow, and not to e or m It is in gardening, however, that Alter expresses some of his self-described friend do ill w I deeper joys and insights. and neighbor, Tom late. “I don’t do windows,” Merwin, are pleasing he notes at one point. “It images that add to is better to plant flowers.” the text. : June 19 en rd ga rk da e He describes the act of Taken as a whole, Working in th ith w y, da e th planting: Poet Residing is sometimes repetitive but more often brings a of ol in the co s, ee tr e th in ng di “The five-petaled red smile and a new perspective on how the simple tasks of making sparrows hi n floating in lle po e th k in of the begonia, to nestle one’s way in life can be both a steadying influence and a source of th d you’ to make gh ou en e er w ze in the cupped palm, slip beauty and happiness. the bree doesn’t. Our into the dark loamy soil, In one of the closing journal entries, June 29, he reflects, “The me sneeze, but it the gardener es id gu od G ly nt cover in a ge days are brilliant warm and the leaves in finding the to excise practice hole with a nestle under them. Shadows vast fill , ul of the weeds multitudinous So rich, round the lawn, and soon July will be drunk the night. Their hobgoblin before mound, is with them. Bloom on, flowers, bloom ut be alone. B the melody leafiness asks to soothing.” on.” lergic to their the gardener is al am I His June Bloom on, indeed. k in y , I th the melod solitude. Somehow ds ee w 11 journal ter as the is the fire plucking by an al . Michael Alter is a long-time e n t r y et ck on the wind go plunk in the bu ke resident of Forty-Seven Main Street o p e n s , on the la y music in Castleton. Poet Residing is his “Watering making strawberr und so t ou ith w e tr ea second volume and was published plants in the cool of the yard, a th ve in the trees hummingbird lo by MacGregor House Publishing in the restful sun licking my shoulders, the immaculate rk in the night? da ce fa y m is Castleton. His books are available plants begging for a bath,” and then reflects, “Civilization on Amazon. was founded by one, small squirting, cherry tomato.”
A Message from Inclusive Arts Vermont
With the world upended by yet another outrageously unjust racially motivated killing, and ensuing protests, we at Inclusive Arts Vermont are reflecting on how we as an organization can do better. We are feeling a full range of emotions alongside you. We are mourning the loss of George Floyd and countless others who have been the victims of violent racism. We are saddened by the losses of lives caused by COVID-19, which are disproportionately higher in the disability and POC communities. Our organization was a creation of the disability rights movement. We were made to ensure that, through the arts, the voices of people with disabilities are celebrated and heard. We work towards that end every day, but can do so much more. As our friends at Vermont Arts Council said, arts organizations “have a deep responsibility in the present moment, to stand against hatred and racial injustice. We often say that the arts promote empathy, that a great painting, sculpture, or poem has the power to lift us above our divisions and inspire us to transcend our personal point of view, to stand in the shoes of another. Now is the time to be true to those values.” Disability does not discriminate. It affects all populations regardless of income, sexual orientation, location, or skin color. We recognize that people of
color are particularly underrepresented in the arts, and within our own organization. We own this lacking and want you to know that we are committed to changing it throughout all of our systems: programming, messaging, staff, and board alike. We believe that all people are whole and perfect exactly as they are – and that includes the color of someone’s skin. Our organization often says that the creative process creates space for bravery, authenticity, connection, and joy. We also talk a lot about making magic. Right now, the world needs bravery and connection and change more than ever, but it won’t happen through magic. Change happens through intentional action and work. Inclusive Arts Vermont sees the need for change. We know that we cannot change the entire world, but we can affect our circle. We can do more, do better, and while we should have acted sooner, we’re going to now. What that exactly looks like yet we aren’t sure, but know that our staff will do everything we can to make sure that all voices are truly included in our programming and messaging. We want to use our platform to celebrate and amplify the voices and creativity of artists of color with disabilities. If you have resources or thoughts to share, please don’t hesitate to reach out to us at firstname.lastname@example.org. We would love to listen to and learn from you. Katie Miller, Executive Director
Fall 2018 2020 Summer
Waiting at “Uno” Waiting Those minutes I don’t know How to convert into meaningful time As my time is only waiting For the bus. Inside it’s warm and pretty Polished wood tables with Tiffany lamps above. On my left is the bar With hanging wine glasses On my right are two bowls of apples — Green Granny Smiths and Golden Delicious. I don’t know if it’s just a display Or if they are meant to be free gifts For the customers but I ask For one apple anyway.
by LINDA A. WALSH St. Johnsbury
I Hope You Have Bipolar So we can talk. Shhh ... keep it quiet. That’s what the world wants. Ha. As if. I don’t know about you but for me mania hides itself as well as that new red Mazda MX-5. Depression is another thing. You can keep that on the low down. It’s a sly, miserable distemper isn’t it? But we have bipolar disorder. Not the socially acceptable depression. Who changed manic-depression to bipolar? Quite brilliantly non-descriptive those psychiatrists. Anyway, are you out? or in? Do they know at work? (They’d know if you had diabetes or some such, we were just unlucky enough to be born with sick brains.) I used to hide. let people talk smack about us and not say a thing. I used to feel shame. Is there a worse way to treat yourself? I say to myself: I should have gotten that degree, that job, that vacation house. “They” have those things. What I have left after the indignities, the near dying, the hospitals, the embarrassments, the self-imposed solitary confinements, the failed elixirs, the strapped down shocks to the brain, the letting your kids down. You know the drill. What I have left is me. It doesn’t matter if society judges me as lacking. I’ve walked through the storm and if you’re in this match too, I’ve got your back. And if you’re with me I’m going after this beast. And yes, I’m writing this in the year 2020, not 1950.
by Lise Ewald Montpelier
Share Your Art! Email to counterpoint @ vermontpsychiatricsurvivors.org or mail to Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701 Please include name and town
It’s 5 p.m., the traffic is a Nightmare On Shelburne Road. I think about the baby I take care of part-time, His mother a doctor from Balarus, twenty years my junior. What have I done with my life — No profession, no husband, no kids? What have I done with my time All those years in America Writing silly poems and stories Taking classes in Mist and Nebulosis Swimming every day at local pools — Occasional trips overseas? Looking at my apple I am suddenly reminded Of that summer of ’86 in England When I lived on a farm in Kent. We, the apple pickers, baked apple pies And apple crisps every night — I was happy to be a temporary farmer. I wish now for the time To move backwards Give me another chance To do it all over again. What would I choose? Maybe all the choices Would prove to be wrong choices A few years later. People start arriving for dinner And I have my apple for the road. Some leaves are already on the ground The others are resisting the wind. I see my Special Services bus Turning the corner. I exit the door With a broad smile on my broad Slavic face. Years after the Kent apple picking I am still the same girl — Enjoying every moment Even if I don’t always know How to productively use it. I am number one — Never giving up, always prepared For that trip into the Unknown Future Holding in my hands That precious golden apple.
by Vesna Dye Burlington
The Arts . 15
Summer 2020 beautifully fallen tree, splayed upon the forest floor, in quiet abeyance, without any fanfare, yet still rather beloved, quite nicely done thou.
By Morgan Brown Montpelier
The Brightest Light
by Michael Sabourin Groten
Dedicated to my Rainbow Baby, Cassidy Skye Streeter, who was born to Heaven on May 7, 2018 I’ll never see your precious face. You’ll never feel my loving embrace. I’ll never hear your first cries, yet here I am, having to say my good-byes. I felt the flutters and heard your heartbeat I day-dreamed about the day when we would first meet. I got a few toys, some clothes, a little bed … I couldn’t wait to kiss your sweet little head. I don’t want to let go of my dreams of you, but, you’re no longer here … your time on Earth is already through. You were my baby and always will be. My heart is so broken, but no one can see. This isn’t fair! I just want you back! My heart now has a deep hole, for it’s you that I lack. This love I have for you is so terribly strong. You may not be here, but your memory will live on. I may not have met you, but I’ll never forget my little one. And when I take my final breath, and my life is all done, I’ll finally see your face in Heaven and grasp your hand in mine, And the brightest light up there will be my love for you that shines.
by Anna Bernier Newport
Dylann Storm Roof Dylann Storm Roof — going down. A single voice cannot be found To say a word and ask the state To reconsider his sad fate. Did he kill them? Yes indeed. Was it senseless? That’s agreed. Does he have a price to pay? “Yes he does.” is what I say. But someone please explain to me The basis of this odd theory That killing Dylann somehow will Teach others that it’s wrong to kill.
by Christopher Hayden Burlington
“A Study in Introspection” (polymer clay on glass) by Colby Lynch, Montpelier
The Bird by Anthony Parshall
There was nothing to do today. Jane had already completed everything that she had to do for the day. She had gone to work in the morning, and she had gone home at 5, after work was over, and now she was sitting at the kitchen table in her one-bedroom apartment, when it suddenly hit her, there’s nothing more for me to do, ever. This was extremely disconcerting to her, because she had made it almost one of the principles of her life to always have something to do, whether it was knitting or reading or going to a party. It seemed at the moment as if there would never be anything for her to do ever again. She wasn’t exactly depressed, but the feeling was as if she had no future, as if there would never again appear in her life anything that was satisfying. She thought that she could go to her room and turn oﬀ the lights and meditate, but then she thought again and decided that she didn’t want to do that. Perhaps she should have a cup of tea. But, no, that wouldn’t get her out of the malaise. There was nothing. She sat there and thought about it, and it seemed there was no reason to ever get up again. But eventually, she did, and went to her room and lay in bed with the lights oﬀ. It was sort of peaceful, though there was also a sense of dread that went with the peacefulness. She didn’t want anything, but at the same time there was something that she desperately needed, some sort of event that she had the idea would give her a reason to go on living. She wasn’t suicidal, but it felt kind of like she had already committed suicide, lying there in bed. It was as if there were nothing, that everything was an illusion and that she was in hell, all by herself. She tried to imagine what this event might be that she needed so badly; perhaps it was a big party on Christmas, when everyone was friendly and full of holiday spirit and the whole point was to lift everyone’s spirits individually and collectively. That might be it. And then she began to imagine that she was already at that party, perhaps lying in bed in some acquaintance’s bedroom and pretending she was ill or maybe it was just that she was tired and had to lie down for a while, and she would soon make her big reappearance at the party. Then she realized that the party was right here, right in this room, and that everything was just the way she wanted it to be, despite the fact that there was no Christmas tree and it wasn’t Christmas. This made her glad, and she began to forget about the malaise. Everything was already exactly as she wanted it. The next day, she got up and went to work at the magazine where she worked in the layout department. It was a winter day in February, and it was snowing when she went out, and she sometimes turned from her desk to watch the snow falling outside the window. Not much happened: She worked at her computer. That evening, she had been planning to have dinner with a friend, a professor of religion at New York University. He was an old friend and had been a mentor to her when she had studied religion at that university some time ago. Since then, she had almost entirely forgotten about religion, and she had fully entered the world of materialism, leaving behind with her
Summer Fall 2018 2020
Louise Wahl Memorial Writing Contest
studies the world of the spirit. She had never gone to church, except for a few times with her parents, when she was young, particularly on holidays, and, though she had maintained a meditation practice during her college years and for some time after, she had long since dropped it. Religion seemed to be something of the past for her, but whenever she was in the company of professor Reynolds, there was a certain reminiscing about the time when she had been involved in the study of religion. He, respectful of the fact that she was no longer interested in religion, didn’t insist on discussing it, and they usually talked about their daily lives and sometimes had philosophical conversations which, in the circumstances, necessarily contained references to religion. Jane was feeling a little bit down after work; she went home by subway and up into her apartment and changed clothes, putting on a dress, and sat down in her living room with a glass of club soda. She felt like she didn’t really want anything at the moment, that just sitting there was enough; and the feeling she had had the day before, the feeling that there would never again be anything for her to do, she found, had been replaced by a feeling that everything was suﬃcient. It was as if everything around her ran by itself, and that she didn’t have to know how to use it but maybe she did. It was all right. Everything was ﬁne.
She looked him in the eye. He looked back at her. In a moment, she ﬁnished her club soda and put on her winter coat and hat and mittens and then put on her boots, and she went outside into the evening, which was rather cold. Almost immediately, she saw a homeless man in a dirty green coat, panhandling and looking cold and miserable. She approached him and said, “Hello. Are you all right?” He looked at her in surprise and said, “Yes, ma’am. I’m all right. Kind of cold out here, though.” He chuckled. She gave him a ﬁve dollar bill and said, “Take care.” “Thank you very much.” It was nice for Jane that she could be helpful. She liked to feel useful in some way or other. At the restaurant, professor Reynolds was waiting for her at a corner table. It was a French bistro, a rather small place, but the food was very good. It was their usual place. He said, “Jane. How nice to see you.” “You, too, Sam.” She thought to herself that if he was younger, she might have fallen in love with him, but as it was their relationship was platonic. They sat and chatted and ordered food and wine, and it was all very pleasant. It seemed to Jane, under the inﬂuence of the wine, in this cozy hole in the wall, that if she could preserve this moment then everything would be all right. This was precisely what she wanted: It was a form of comfort, and it was a form of memory that was made before she even had the chance to remember it, and it was entirely good.
Professor Reynolds asked her a question about the state of her spirit; he asked if she still maintained a place in her life for the life of the spirit. Jane didn’t really know how to answer him. She thought to herself that it was neither to her credit nor discredit that she had taken to the life of the material. So she said, “You know, I think I left all of that behind sometime after I graduated from college. There seems to be no reason to have a spiritual life. I have everything that I need as it is.” Professor Reynolds smiled broadly and said, “Well, maybe you should resume your studies. By which I mean maybe I can oﬀer you a book suggestion or something of that nature.” She said, “OK. Why not? I’ve only been reading ﬁction and nonﬁction for the longest time. Maybe it would be good to read a book about spirituality.” He suggested a book and she wrote it down on her cell phone, and in a moment it was time for dessert. That night, she slept peacefully, and the next day she was back at work. The thing about her life was that nothing ever changed. There were moments of uncertainty, and there were moments of joy, but everything remained more or less the same, as if everything in life had the ﬂavor of a certain spice, vanilla for example. She wanted to have a certain kind of life, but she wasn’t sure exactly what it would look like. It wasn’t exactly fun she was after, but rather a combination of fulﬁllment and fun, like taking a tropical vacation and meeting her husband at the same time. She didn’t really care about being productive, but there were, of course, certain things she had to do in order to keep her job. So she did them, and tried to work busily along, without any real interest in the work, except that it kept her occupied and, which mattered slightly less, provided her with the money she needed to survive. Jane never questioned whether there was more out there than she already had. The only thing that she really wanted was to meet a man whom she wanted to marry. It didn’t have to be true love, but she would have to be sure that she wanted to marry him. It was almost an obsession with her, a variety of mania, and she could never ﬁnd the right person. She hadn’t had a boyfriend in three years, despite the fact that she was good-looking and young. She avoided most men, turning them down when they asked her out on dates, preferring to wait until she found Mr. Right. She had no idea whether he would actually turn up one day, but she was willing to wait. After work that day, she went to a bookstore, where she went to the ﬁction section and browsed for a while, until she found what seemed like a suitable work of postmodern ﬁction that she could focus her attention on. The clerk behind the counter was about her age, thirtysomething, apple-cheeked, and she immediately knew that he was the one. She didn’t care that he worked in a bookstore, or that he was merely a clerk there. He probably read a lot; there were probably other things to recommend him. She looked him in the eye. He looked back at (Continued on page 17
The Arts 17
Fall 20182020 Summer THE BIRD • Continued from page 16 her. She said, as she was taking her book in its bag adorned with the store’s logo, “Do you want to do something sometime?” He smiled and said, “Yes,” and she gave him her number. “Just be sure to call me.” She was already thinking about what it would be like to marry him and have children. For three days, she waited for his call. She hadn’t even asked his name. But he did call, on the third day. The number was unfamiliar to her. “Hello? Is this Jane?” He said. “Yes. Oh, hello, is it you?” “It’s me. Sorry I’ve taken so long to call you. I’ve been thinking about you.” He wanted to take her on a cruise on the East River, and she agreed. They would meet at the bookstore in a week’s time. During that week, not much happened. She had no dinner dates. She spent her nights watching television or movies and reading and enjoying a glass of wine near bedtime. She lived a simple life. At some point, she picked up the book on comparative religion that professor Reynolds had suggested. When she opened it, she was immediately back in college, when within her had been this mania to know, to understand the deepest mysteries of the human experience, and ﬂooding back to her came the philosophies and mythologies of love, and how some said the love between two people was the highest good. There were so many stories about solitary seekers and prophets who remained alone, always alone, and then there were ideas about love between two people. She saw that the outcome of her studies of religion had been a search for love. When she met Ben at the store on the day they were to go for their winter cruise, he was wearing a tweed coat and felt gloves. She fell in love with him when she saw him, and immediately took his arm and said, “Do you think we’ll get married one day?” He laughed and said, “But I don’t even know you yet.” They took a taxi to the pier and got on the boat, and as they sailed away from the dock, Jane broke away from him and looked back, sweetly, not boldly, at the cityscape that was now behind them. Anthony Parshall is from Essex Junction.
You’ll Never Find a Pearl Any time at all, you can spot a diver or two, out diving for pearls. Or for anything precious still present and alive in this land. In the present age. You’ll see them diving into bodies of water, going after precious things. Bodies of every kind of water there is, exotic or otherwise. You’ll be out driving your car and one diver or another will catch your eye. Maybe you’ll wonder why the search goes on for pearls in things like sad old reservoirs and stagnant lakes. And even in polluted pools, for crying out loud. You’ll be thinking, “Those people are fools, weird and desperate.” And you will drive off smirking and scratching your well looked after head, one hundred percent sure you wouldn’t be caught dead being desperate. And you never will find a pearl.
by Natalie Frost
(home town confidential by request)
Seeking the Perfect Hurricane
When one searches for imperfection, it can be found When one searches for perfection it will be found To float would mean support from all the imperfections Don’t put too much weight on the lilies or you will fall through To be dazzled, free from worry Your love is like a hurricane I want to love you but I am blown away
by Dennis Rivard
White River Junction
Trees around me As I scream, cry, and wail Trees surround me As I toss, turn and flail Trees implacable witness To my anguish.
Unstoppable decay to inside and out, Be wary of what you seek, for when it is found ... You are my hurricane the eye of my storm, beware of what you seek, the imperfections I have found.
by Marla Simpson
Louise Wahl Memorial Writing Contest Prose First Place The Bird
Anthony Parshall Essex Junction
Poetry First Place - You’ll Never Find a Pearl - Dennis Rivard - White River Junction - $50 Second Place - Trees - Natalie Frost - $25 Third Place - Seeking the Perfect Hurricane - Marla Simpson - Randolph - $25
Named for a former Vermont activist to encourage creative writing by psychiatric survivors, mental health consumers and peers. One entry per category (prose or poetry); 3,000 word preferred maximum. Repeat entrants limited to two First Place awards. Entries are judged by an independent panel. Winners will be published in the winter 2020 Counterpoint.
Enter This Year’s Contest: Deadline October 15 Send submissions to:
Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701 or by email to: email@example.com
Include name and address.
EDITORIAL PAGE 18 COMMENTARY
Fall 2018 2020 Summer
Opinions What WRAP Is Worth
This testimony was presented to the legislature after the disclosure that the Department of Mental Health did not intend to restore funding for WRAP (Wellness Recovery Action Plan) program support in its fiscal year 2021 budget. After an outcry by psychiatric survivors and advocates, the funding was restored.
By AMY WALES
In Solidarity Those of us with psychiatric labels, who know the meaning of prejudice and the pain of discrimination, must stand in close solidarity with our black and brown family members at this time of grief over yet another murder of a man of color at the hands of the police. And although we can be aligned with their pain, there will always be a fundamental difference that we who were born with white skin need to recognize and understand. Our labels are not something we are born with. Our labels are not worn on our skin. We can usually hide them. It may be wrong that we need to hide them, but the fact is that we can. We need to reflect on what our lives would be like if we had to worry every moment about our safety — or that of a child or spouse — because of the color of our skin. What can we do in solidarity? These suggestions come from testimonials on how to be an ally: 1. Listen more; talk less. 2. Being an ally is different than simply wanting not to be racist. Being an ally requires you to educate yourself about systemic racism in this country. There are many great books and articles that illuminate oppression and structures of white supremacy and white privilege. 3. Ask when you don’t know — but do the work first. 4. Privilege means that you owe a debt. You were born with it. You didn’t ask for it. Being a citizen of a society requires work from everyone within that society. It is up to you whether you choose to acknowledge the work that is yours to do. It is up to you whether you choose to pay this debt and how you choose to do so. 5. Don’t pretend you don’t have prejudice, bias or blind spots. We all do. No one is calling you racist. But ask yourself, are you intentionally and actively against racism? There is a difference. Outrage fades; we can’t sustain it and move ahead with our lives. That’s why it matters to actually make a personal plan of response. We each need to decide what we will do with our outrage. Don’t worry that it’s not the right thing. There are many things that need to be made right. Much of this sounds similar to what we ask of others, in confronting sanism. That is why we have such a powerful opportunity to be strong allies.
Send your comments or reactions to editorials or commentaries to: Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701, or to firstname.lastname@example.org.
f I were to ask every member of this committee assembled here today the question: “What dollar amount would you be willing to pay in order to save your life or the life of someone you love?” I imagine that most of you would find this question to be absurd if not impossible to answer because I suspect we all inherently hold to the belief that the cost of life is priceless. But let’s just say you were forced to assign a dollar amount to this price tag of life. What figure would you start at? Ten million? Twenty million? Maybe even more? Now, how would you react if I were to tell you that WRAP has literally saved my life? Would you say it would be worth $60,000? Because this is the exact amount of money now on the chopping block that would eliminate the funding of WRAP initiatives throughout the state of Vermont. A little over a month ago, I was diagnosed with a rare form of cancer. This sudden and unexpected news was both jolting and terrifying. When I learned my diagnosis, my life was turned completely upside down in a matter of seconds. My PTSD returned, and I became panic-stricken, severely depressed and even suicidal. However, by utilizing the wellness tools contained in my WRAP, I was able to thwart urges and acts of self-harm, which ultimately kept me from being admitted to the hospital. Because of my WRAP, I was able to reach out to friends, family members, mental health professionals and my church community — all of whom I had identified in my WRAP as people on my support team. And guess what? Every one of them came through for me. Furthermore, one of the most fundamental teachings of WRAP that became vital to my survival was taking personal responsibility for the future of my health care needs and strongly advocating for myself. Initially, I encountered delay after delay with the first health care provider I was referred to. First my pathology results would have to wait an additional week to come in. Next, my PET scan couldn’t be scheduled for another five weeks — a test that would detect if my cancer had spread to any other parts of my body. Only after the PET scan would I then be assigned to a team of oncologists to take on my case. Now we’re talking six weeks or longer. I was running out of time and no one seemed to care. All the waiting and not-knowing became excruciating. Believing I had the power to act and change things on my own, I made a few phone calls to another care facility and, lo and behold, I was able to schedule a PET scan all by myself for less than a week later. I had taken back control of my body and the direction of my care, feeling hope for the first time since my diagnosis. Because there are no guarantees when it comes to cancer, I took quick action to make sure I had all of my end-of-life paperwork and documents in order. This was no fun chore to be sure, but it was crucial. I can now rest assured that my loved ones will know exactly what my wishes are and what to do should my life come to an end sooner than expected. Having completed this task is a huge relief to me and my family. Again, this is another component of WRAP. I have even established a website where my support network can sign up online to offer me rides to and from my future radiation treatments, which are expected to begin in several months and last Monday through Friday for six weeks straight. Already I have over 30 volunteers signed up and ready to go. On Tuesday, February 18, I will begin my first round of chemotherapy, surrounded by an excellent team of oncologists, an empathetic medical staff and so many family and friends cheering me on. Although my journey ahead will be arduous and long, I have hope for a bright, even joyful future full of meaning and purpose. You see, I am a WRAP facilitator and I need to get back to work! I need to demonstrate to countless other Vermonters that WRAP really works! So, when you think about spending $60,000, it doesn’t simply go to pay for one person’s recovery, it goes to pay for multitudes of Vermonters’ wellbeing. And that, my friends, is not only a bargain, it is priceless! Amy Wales is a resident of Montpelier, a WRAP facilitator, and a member of the staff at Vermont Psychiatric Survivors.
COMMENTARY COMMENTARY. .
Fall 20182020 Summer
Forsaken and Forgotten:
People Living Unhoused Deserve Better By MORGAN W. BROWN
t is obvious to me that except for those times when they become much more visible within public view than is socially acceptable or desired by those who appear to mainly have only their own financial or other self-interests in mind, people living unhoused (aka living homeless) have essentially been forsaken and forgotten by both government and society in general. They are cast away and left adrift, to simply rot and perish, as if they were merely trash. If this seems like a rather harsh rebuke, the fact is that the reality endured by people living unhoused is actually much harsher, particularly when coupled with deliberate indifference, not to mention outright scorn (read: contempt) on an ongoing basis. Until I became permanently housed again in mid-August 2009 (after 12 lengthy and extremely grueling years living without permanent housing during the last go-around) homelessness was something I experienced in one form or another, off and on, more or less over nearly 36 years. Despite these countless experiences, I was never able to get very good at coping with living homeless. It always took a lot out of me when living without permanent, safe, warm, dry
shelter. By the way, for those who might have assumed otherwise, although recreational camping might usually be a rather enjoyable experience, when one has nowhere else to live, having to camp out in the rough with few — if any — available resources, it is quite an entirely different matter. I know. There have been many times when these experiences, or something that happened to me during them, have made me feel utterly defeated, helpless, hopeless and worthless. If it were not for all the support and assistance I received, especially when it was most needed, things would certainly have become much worse for me than was already the case. The fact is that homelessness can happen to most anyone, at any time, for a variety of reasons. To my way of thinking, our society was built on the premise that it is better to share with others than it is to dictate and hold something over them. This is what I understand the Vermont motto, “Freedom and Unity,” to mean, anyway. Based on personal experience, along with my observations of others over the years, I remain convinced that it is extremely crucial to provide hope, opportunity, shelter, support and services to people when they need such assistance. It is as crucial, however, to do this in a manner that does not force a person or family to choose between having access to these or having to give up certain freedoms and responsibilities — along with the independence and self-respect that goes with them — that people who are housed may take for granted, yet still prize for themselves. Rather than attempting to manage,
control or coerce people in ways that we may want to believe is for their own good, our efforts are best served when they are positively focused. This provides people with a better working role model for building faith and trust in themselves and between others. No matter why or how many times or ways a person or family is in need, everyone deserves to be believed in and offered the assistance they may seek and require toward helping themselves meet their needs. In this way, people are not only helped toward becoming housed again, but they are more easily and freely encouraged to learn or enhance skills, strengths and abilities of their own that anyone needs to be independent members of the community. Time and time again, I have seen that what can make a difference in the circumstances and well-being of a person or family who is either living homeless or at risk of becoming homeless is when they receive quality contact, support, encouragement, services and shelter when needed. Our communities will be enriched and strengthened when each individual and family living within them has permanent, safe, decent and affordable housing, along with other basic opportunities and resources, from which to thrive and grow. Morgan W. Brown lived houseless (aka homeless) off and on over numerous years in many of its various forms since his initial experience with homelessness at the age of 17. He currently resides, permanently housed, in Central Vermont.
On Specific Coercive Practices These comments were submitted as testimony to the Vermont legislature.
By ISAAC JOSE LEZCANO
n my time as a patient advocate in Vermont, two consistent and disturbing practices involving involuntary status have stood out to me as particularly problematic. The first is the possibility of involuntary status being used inappropriately as a threat to coerce patients into or out of behaviors. The second is the possibility of involuntary medication being used inappropriately as a threat in order to coerce patients into taking medications. I think it’s fair to say that any action taken under duress is not a truly voluntary action. If I’m told at gunpoint, “Get in the car or we’ll force you into the car,” most reasonable observers would perceive my subsequent entering of the car as involuntary, regardless of whether I’m being manhandled in. This false choice is presented to patients in the psychiatric system every day. “If you don’t
take the medication, they’ll get a court order and make you,” “If you don’t go to X facility voluntarily, you’ll have to go involuntarily,” etc. I think it’s obvious that these practices violate Vermont’s stated directive of having a mental health system free of coercion. This should be sufficient reason for us to consider legislation restricting how patients can be spoken to. In addition to the moral and legal problems associated with coercing patients with threats, these practices also shroud the realities of our mental health system in darkness. We have no idea how many patients in our state’s hospitals are actually inpatient on a truly voluntary basis, and this lack of surety contaminates any conclusions we draw from data on patient voluntary or involuntary status. The same applies to conclusions we draw about medication practices. On top of all of this, the confusion and terror reported to me by patients I’ve worked with has convinced me that these practices are traumatic and hinder recovery. Patients often feel that they are trapped in a capricious system that operates in a fashion inconsistent with its publicly stated rules and procedures. My first week on the job as an advocate, a patient tearfully explained to me the difference between being actually voluntary and being technically voluntary. Her explanation of the logic of the threats and conditions she was
presented with required circuitous and absurd language. Another patient told me he felt invisible, trapped between gears in a sealed machine. Were these not conversations that took place in real life, they would be at home in a pitch-black political farce. A few months into this job, I wrote a friendly set of guidelines that I proposed be used by nurses at the Retreat when talking to patients. I wrote them under the mistaken assumption that coercive threats result from a lack of training. The administration showed no interest in them. I have since realized that the misuse of involuntary status and forced medication orders as threats is seen by some as a feature (not a bug) in the current system of care. Regardless of whether this is intended to be allowed, it currently is, and is widespread in its application. I am not a legislator, and I don’t know what specific course needs to be taken to rectify this, but I plead that the legislature consider some measure that directly forbids threatening patients with involuntary status or forced medication orders. I believe it is too convenient a tool for frustrated nurses, mental health workers and doctors for it to be eliminated in a less direct fashion. .Isaac Jose Lezcano is the Brattleboro-area patient representative for Vermont Psychiatric Survivors.
A Letter to Addiction
Dear Addiction, You are no stranger to me. My entire life has been spent in the throes of coping with loved ones who suffer through your existence. In the past, I watched you destroy lives in one fell swoop, watched rich men become poor, happiness turned sour. Turned honest men into liars and cheaters, turned them into thieves and manipulative beings. You’ve taken every aspect of life and turned it upside down. In an instant, you can kill, your murderous ways seeping into my loved ones’ lives, destroying them from the inside out. I’ve watched you kill without a second thought, leaving behind scars and tears that devastate for a lifetime. After I watched a loved one die from your choking grip, I prepared myself. I armed myself with knowledge and worked the Naranon program. I vowed never to let you infect my life ever again. I thought I was ready for you this time, addiction. You creeped into my home unknowingly. Evil black ooze that shape-shifted and made its way into my home, my family, my life. I didn’t recognize you; you blended in quickly without a word. How deviant you are, addiction! Masquerading around like you belonged here. Taking my loved one and demanding his attention. He fought you, I know he did. He knew you were here, but he tried to protect us from you. Thought he could slay you alone and rid you from our home. Your battle with him went unnoticed, yet I am sure my love felt the pain and anguish you caused him inside his soul. A week ago, you stared me in the face and challenged me to battle. In my shock and anger, I fought you hard. You took my loved one and strangled him until he turned blue. Tried to choke the life out of him on my bathroom floor. Angrily I screamed and yelled, “Why are you doing this to us?” in vain as I tried to revive my love. I breathed for him as I cursed you, pounded on his chest to will his heart to keep beating until help arrived. And at the same time, I was pissed. I was pissed that you thought this was ok! You thought you could enter my home and take up residence here. How dare you! My home was supposed to be a safe haven! Addiction doesn’t belong here! And yet, I invited you in, unknowingly. I saved my loved one’s life from your death grip. I shouldn’t have had to! You placed my children at risk more than anything. You tried to destroy the very best love I had ever experienced in my life. You tore it all to shreds, laughing menacingly as you swallowed us up. I kept screaming, “You destroyed us!” as I tried to drag my love to an open area, so that I might be able to keep him alive. Everything had come crashing down in an instant. In my mind, my kids flashed before me, the house, finances, and my true love … all gone in an instant. How could you do this! I was so angry. So very, very angry. How could you think this was right? You controlled his brain, urging him to bring it home. Bring it home, you said, she won’t know. Bring it home, you said, just a little and you’ll feel fine. Just a little, and all your pain evaporates.
Come on, just a little and life will be grand. Bringing it into my home was the ultimate deceitful act and it angered me, saddened me and ripped my heart to shreds. But addiction doesn’t care, does it? Sucks up lives and moves on to the next. I saved his life! I could feel his life slipping away between my fingers, like sand. There was nothing I could do! What am I going to do? I thought, during the agonizing torture of trying desperately to save him and begging for you not to take his life. But I am only human; I cannot bring back the dead. Please save him, I begged of myself, begged of the paramedics. Watching his blue lips and swollen eyes, hearing the gasping and rattling of lungs becoming edematous, and finally, listening with my stethoscope to the thud-thud-thud of a heart threating to fail. I could barely hear his heart. You were in there, twisting and choking his beautiful and loving heart into black ooze. I wouldn’t take the stethoscope out of my ears. I felt if I did, he would surely die. I had to keep listening and then perform CPR. And then listen some more. Please baby, stay with me. What an awful thing to have to endure. When he had been revived, all the anger I had felt when I first saw him slumped over in the bathroom dying reared its ugly head.
You creeped into my home unknowingly. Evil black ooze that shape-shifted and made its way into my home, my family, my life. I didn’t recognize you; you blended in quickly without a word. All I could do was scream at him and cry. “Get that shit out of my house!” I screamed, and then, “I saved your fucking life!” Over and over, I screamed. I had to take myself away, as I was being consumed by the ill effects of your grasp. I would have kept screaming and shaking. I walked away. I couldn’t stand to be there despite the deep love I have for my loved one. I couldn’t be there; the anger took me to a place I didn’t want to be. Addiction, you made me act in ways I have never acted before. I screamed, I threw things, punched walls, kicked chairs, yelled — and yes, you made me want to drink that night to soothe my seething soul. You fucker, you thought you could get me, too. And for a moment, I almost let you. The night this happened, I woke up after 30 minutes of dozing to my own coughing and choking, my own heartbeat in my ears. And for a delirious moment I thought he was dying again and I sat up, hysterical. I thought I was dying, too. The rage I felt — how could this happen to us? How could I have let this happen to me again? Why didn’t I see you coming, addiction? How could you destroy the very best love I have ever felt in my life? I know you will continue to destroy us if we let you. I will continue to shake with fear and cry
with uncertainty if we do not work our program. We will arrest you, though we may not be able to cure you. I will not be angry any longer. I am loving and hopeful. You tried to destroy my family and the very things I worked painstakingly for. Everything I have did not come easy; neither will recovery from your death grip. I only hope for recovery and hope for the life that my love and I started to create together. We have a solid and strong foundation, and I am hoping to rebuild what we lost. For now, I focus on today and I am grateful we have our lives, our home, and my children. Though I am scared, I will be strong and use my resources wisely to keep your ooze from infecting my family again. What a fucked-up thing addiction is. Although I understand how you work in the brain chemically, I don’t understand how you can take the addict’s mind and twist it so they are unaware of what risks they are taking. How can their mind turn from loving, honest and true to lying, cheating and deceitful? They know they are lying to us! But why can’t it be stopped? Why can’t the addict admit they are powerless before their life is almost snuffed out? The night before this happened, I felt something was wrong. I felt addiction in my home. I asked my loved one tearfully if he was using something because he was acting differently. With love in his eyes, he promised me he wasn’t using drugs. I cried to him that I was afraid if he did use drugs, I would lose him and he would die. My love held onto me and promised me that I would never lose him to drugs. That’s what hurts the most. He knew he was lying to me, with love in his eyes. He was trying to protect me from you, addiction. He was fighting this battle alone, didn’t want me to be hurt by you. He honestly thought he could fight you alone, but you are too massive and entangled yourself into every neuron in his brain, infecting him with desire for more. Infecting those around him. Without you, addiction, he is a sweet and caring individual who is respectful and compassionate. He doesn’t want to hurt anyone but will fight for his loved ones if pushed to it. No one wants you, but you slither into people’s lives slowly and, before they know it, you crush them in an instant. My loved one is not a bad person. He is wonderful, and I was blissfully unaware of the massive elephant in the room. We had so much together! We had the beginning of a wonderful life. We had friendship, the best kind of friendship you can have. The kind where you can feel free to be yourself and do what makes you happy and then share that happiness with each other. The kind of love where you can joke around and play, be silly and have fun with the kids. I want to say I am done with you, addiction. However, too many in my life suffer from your deviant ways. I must learn new ways of thinking so that you do not drag me down under as well. I love my partner, my best friend, my lover. I have hope he will recover. Barbara
Barbara is from Bennington. She requested that her last name be withheld for privacy.
Promoting a Choice for Life By BEATRICE BIRCH
uicide is the 10th leading cause of death in the United States. While antidepressants and other psychotropic, mind altering medications are designed to decrease symptoms, they often have the opposite effect and are known to increase suicidal thoughts and actions for people of all walks of life and all ages. The impact suicide has on the lives of family members, friends, co-workers and the community is devastating. The loss of human potential is enormous. “But will we wake for pity’s sake?” In Christopher Fry’s play, A Sleep of Prisoners, he writes, “Thank God our time is now when wrong comes up to face us everywhere, never to leave us ‘til we take the longest stride of soul men ever took. Affairs are now soul size ... it takes so many thousand years to wake, but will you wake for pity’s sake?” I have met too many young, thoughtful, sensitive and intelligent people who hated being medicated by the psychotropic medications. They were not aware that there was a choice, and being told they would have to be on these the rest of their lives, they chose suicide. They were not prepared to live in a fog of pain, disconnected from insightful thinking, heartfelt feeling and creative initiatives: the essential qualities of being-human. Not many people know that indeed there is a choice. There are legitimate ways to work through, understand and digest the debilitating and traumatic challenges that come with simply being human. But one needs to be proactive, humble and willing to break old patterns including unhelpful self-images. With the best of intentions and in trust, parents and individuals seek professional advice when wrestling with life challenges for themselves or for their children. Of course there are exceptions, but typically, due to “big pharma” prioritizing profits and insurance restrictions, within a few minutes and without really being listened to or offered supportive, empowering alternatives, struggling individuals are stigmatized with a mental health disorder, told the chemistry in their brain is out of balance and given a psychotropic medication which they will be dependent upon for the rest of their lives. Wouldn’t we all agree that human beings are dynamic and complicated? One honest psychiatrist, Dr. Peter Breggin, stated, “You think we understand the brain? It is more complicated than the universe!” Isn’t it time we look deeper? Some experience that the state of soul, the seat of our emotions and habits which is influenced by life situations, actually informs the brain. Could it be that the medications are actually what significantly disrupt the chemistry in the brain which naturally is flexible and forgiving? For some people, these addictive medications keep us in the victim mold. They disconnect us from life challenges which need to be dealt with in order for us to continue to grow and to evolve. Challenges are opportunities for growth, they are not meant to hold us down! Looking through the DSM (Diagnostic and Statistical Manual of Mental Disorders), one would imagine simply being human is an illness. For example, if you mourn the loss of a loved one for over a certain amount of time, you may be labeled as depressed and then medicated ...
so that you will no longer feel. Why? Don’t we, men and women, all have tear ducts? Tears are a reflection of the soul breathing out, of letting go. Imagine how it would be if we could be reassured that we will cry for as long as we need to, and when we have worked through the loss and the need is no longer there, we will simply stop crying. Perhaps we could choose to see tears as enablers, assisting the soul’s recovery and digesting process. As human beings we are creators, but, at times, we certainly can feel like victims. In my experience, we more or less consciously seek out challenges, which stretch us to go beyond “our box.” We are surrounded by, and certainly history is filled with, inspiring individuals who have made their way through unenviable and unbelievable hardship guided by the resilience of their Spirit. A remarkable English doctor-colleague referred to “us doctors” as “the pushers.” Look at all the people addicted to pain, sleeping and other medications.
Will we remember that a human being has a body, soul and spirit with an innate wisdom and, despite challenges, is always in the process of healing? Will we take the time to listen and support rather than shut up and medicate? Any addictive substance we take disempowers us at the expense of cultivating our own inner strength. The subliminal message is, “You are a victim of life circumstances ... and need me or this pill to fix you.” Well, this fixing is not working! We are not machines! These psychotropic medications are turning too many of us into zombies. We are experiencing an addiction epidemic. Opioids, alcohol, sugar, and the prescribing of mind-altering, psychotropic medications are causing chaos in our society. The spiritual essence of the human being is being eclipsed. I’m reminded of Henry David Thoreau’s quote, “The mass of men lead lives of quiet desperation.” Ask anyone wrestling under the influence of their medications how they feel. When we do not feel, then incredibly awful things can happen. What are we doing to our people? Never before in the history of the world have so many people been so intensively medicated, via both legal and illegal drugs, as they are in the U.S. today. The United States accounts for about 4.4% of the global population and yet consumes more than 30% of the prescription opiate drugs in the world. Some estimate U.S. prescription opiate consumption to be as much as 80% of global demand. What life have we created for our youth? Are we listening to them and helping them to connect with their divine, creative, resilient self? How else will they develop the confidence to take on the challenges life presents?
A n elderly, wise friend stated once, “ W h a t sensitive, thoughtful p e r s o n today would not be depressed?” We have so much to transform: We have schools which are like prisons where our children do not thrive, our prison system is punitive and has little belief or interest in transformation. We can feel paralyzed by the overwhelming challenges, but the secret, I believe, is to get involved with whatever you feel needs transforming. Find your colleagues and try as best you can to “walk the talk.” Remember, you never know when you might save a life simply by taking the time to be interested and to listen with your heart. Please do not underestimate your efforts and your positive thoughts ... they are more powerful than you might imagine. I want to believe that those struggling individuals for whom life became unbearable under the influence of medication cocktails have not died in vain. I have chosen to see their action as both a sacrifice and statement to all of us: “But will we wake, for pity’s sake?” Will we remember that a human being has a body, soul and spirit with an innate wisdom and, despite challenges, is always in the process of healing? Will we take the time to listen and support rather than shut up and medicate? Will we allow people to feel and work through challenges which belong to them? Can we be motivated and catalyzed to bring deep and lasting change, enhancing what is respectfully humane? Beatrice Birch is founder and executive director of Inner Fire, Inc., a healing community in Brookline which offers the choice to recover from debilitating and traumatic life experiences, which typically lead to addiction and mental (soul) health challenges, without the use of psychotropic medications. Birch has worked in U.K. clinics, rehabilitation centers in Holland, in Taiwan and in her private practice in the U.S. This commentary first appeared in Mad in America December 7, 2018.
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By PÄTRICK KIERNAN
Summer2020 2020 Summer
Aftermath of a Killing
y life changed on the morning of July 12, 2012. My husband (Caleb) was away on a trip with friends, leaving me home alone with our dogs and cat. We were at the beginning of a clean-eating journey, and as I was testing a new recipe, I heard a police siren close to our apartment fade to muffled screaming. I walked over to our living room window with an orange mixing bowl in hand. Through the window, I saw a man walking down the shoulder of the highway and a parked state police vehicle with an officer on the blacktop. I watched as the officer pulled out his gun and shot the walking man. The man fell forward at an angle to his knees and collapsed on the highway. A few more shots rang out up the hill to our apartment. I froze in front of the window at first. Then I dropped the ceramic orange mixing bowl, scattering its pieces and the oatmeal in it everywhere. Our food-driven coonhound, Tobi, ignored the opportunity for human food and hid behind the bed in our room, shaking and drooling. Internally, I was doing the same. I was not sure what to do. My non-reaction was the reaction. I just watched a man be murdered out of my window ... by an officer. Who was I to call for help ... another officer? No ... that didn’t feel safe. As more police, emergency and news vehicles flooded in, they parked chaotically — blocking the exit of the parking lot. I sat on the floor of my living room frantically searching the internet for news of what was going on outside my window. I couldn’t turn my mind off. I wanted to call someone, but the only person who would understand the proximity of the event was my husband, and I didn’t want to bog down his fun time with friends. I felt I needed to know more before I could say anything. 2 a.m. rolled around, and I finally got ahold of Caleb. Hearing of his day distracted me from mine. Eventually, I blurted out a vague description of what I saw, oddly emphasizing the blocked driveway making me unable to leave as the main issue. He told me it was “going to be okay” and was “sure it’s nothing.” I didn’t know where else to bring those feelings. There was nothing I could do about the event, but the event also wasn’t nothing to me. Through that weekend and beyond, I kept reading any new article that came out. I learned that the man walking on the shoulder was someone with a history of mental health struggles. He had a knife with him. The officer asked him to get off the highway.
When the man ignored him and kept walking, he pulled back his vehicle, asked again, and then shot him. The officer felt threatened. Witnesses’ reports conflicted with what I saw: “The man was within lunging distance,” “He was welding the knife,” “He jumped over the patrol car,” etc. From my stadium-like view, the man had his arms to his sides, was steadily walking down the shoulder, and at least 100 meters from the trooper. Narratives in the reports made for an all-too-frequent scapegoat messaging of “person with mental illness is dangerous at large.” In hindsight, it further escalated the intensity of my internalized fear of police. I had picked up the uncomfortable feeling around police at an earlier age. This event made it inherently worse. I eventually shifted to distracting myself by planning our anniversary weekend that month as a getaway trip. Everything over the following two weeks was about leaving town.
Selfishly, I do not want another person to experience a police-related event and walk away with invisible new damage to their health. We spent the weekend in Vermont camping, hiking mountains, exploring waterfalls, and kayaking with our dogs. The weekend was a temporary helpful distraction by positive and loving experiences. I grappled with the decision to offer my perception of what I saw. I ended up not adding my own statement. Walking into a station to share information about the potential improper use of a weapon by one of their peers felt too unsafe. I wish I knew what I could have done better in that situation. I still struggle immensely with the police. Most immediately, I assume they will not understand a behavior (like pacing), see it as a threat, and use their gun to murder me as I have seen firsthand in years past. As a workaround, my reaction has evolved to avoid and blend in when I see an officer in public. It feels like a “do or die” experience. This has progressed from avoiding places where police could be to isolating myself in the safety of my own property and limiting my community engagement. So many missed positive experiences have come from this behavior.
Last year it was brought to my attention that some Vermont precincts have trained mental health liaisons embedded within their units. Very briefly put, they are there to help debrief both officers in their mental health needs as well as accompany them in the field to connect with civilians with mental health needs who are interacting with law enforcement. I then brought this information up in many arenas in my life, gauging others’ awareness of the program. It turns out, I have yet to meet a person who knew about it before I informed them. Why is that? Upon further digging, I have learned that these liaisons tend to be funded for only one per barracks, not covering all the operating hours the officers are staffed for. It is my opinion, with our state’s current mental health crisis, that we should be better staffing an on-hand resource rather than on-call management. Liaisons benefit both our officers and the civilians in need. With more mental health incidents statistically happening during the night and weekend hours, it is clear we have to bridge the gap of second- to third-shift hours and provide full coverage seven days a week. Had I known there was a person at the precinct who would be able to hear and understand my struggle for mental digestion of what I saw in July 2012, I could have moved forward more easily. There are incidents occurring daily that a trained mental health liaison can help mitigate for both our officers and the members of the public they serve. We should constantly be looking for more ways to expand the means of support to address our mental health crisis. Acute triage or talktherapy models should not be the sole ways we address our community health needs. Selfishly, I do not want another person to experience a police-related event and walk away with invisible new damage to their health. We, as a community, need to call our legislators and ask for support in its expansion of coverage within the law enforcement structure as well as a means to educate the public of its existence and functionality. Pätrick Kiernan of Harmonyville, Vermont, is a small homesteader and blogs about the intersections of mental health and the self, marriage and health care systems at patrickundcalebk.com.
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The Trauma of Psych Incarceration By SUSANNA JAEGER
ver the l a s t 19 or more months, I have been trying to advocate not only for myself but also for others who may not have a voice, against destroying many innocent people’s lives by inappropriately sending them to be incarcerated in an archaic mental health system. My rights were taken away through an invalid, wrongful involuntary commitment by Northwestern Counseling and Support Services and Northwest Medical Center in collusion with a psychiatrist who was working for Vermont Psychiatric Care Hospital at the time. The so-called “professional staff” working at NCSS and NMC placed me on a petition for involuntary commitment without transparency, without professional demeanor, without due process and with critical errors and/or wrongdoing by NCSS staff including the crisis team staff and NCSS psychiatrist. There was no transparency, no initial evaluation and no 12-hour evaluations to make sure I still fit the criteria for involuntary commitment over the seven days I was held in the emergency room. No one ever told me why I was being held. I had gone to the hospital of my own free will with the promise of an NCSS staff member that I could get a ride home with a colleague of his who lived near me. When I got to the hospital — not one I regularly visit — I was slapped with the petition by another NCSS staff person who made seven critical errors on it. This really felt like entrapment. They wrote on a board, “suicide ideation.” This was never true. I needed help with my anxiety due to a low-dose medication that I did not want to be taking because of the increased risk of cardiac arrest and tardive dyskinesia in women over 65. The NMC physician stated I was medically cleared, even though he never spoke with me about any medical problems or called my providers. I have long QT syndrome, a heart condition which can cause arrhythmias and cardiac arrest if I am given the wrong medication. He asked only two basic conversational questions: “How are you?” to which I answered, “I am fine,” and then, “What do you want to do?” to which I answered, “I want to go home.” That is what the original NCSS staff member
said was going to happen if I went to the hospital. However, after this two-minute conversation that was apparently his evaluation, he wrote in his report in support of the petition, “uncooperative,” and then “refer to NCSS notes.” No one in any professional position followed Vermont state laws or questioned any of the wrong information that NCSS’s crisis team staff member wrote — not one person — and I was never given the chance to say I had high anxiety. The petition said a sheriff stopped me from going off a bridge, which never happened. It used a seven-year-old NCSS diagnosis. About 20 hours after my arrival at NMC, a second NCSS crisis clinician briefly came into my room offering me the option to be admitted voluntarily. Although I did not believe I belonged there in the first place, when he started to leave, I said directly, “I will go voluntary,” but he continued walking out and never included it in the petition. I found I could not trust the NMC nurses, either. They took my phone, and when they let me use the NMC ED phone, they illegally sat beside me or stood by the doorway and listened in. My room was open for all who came through the NMC emergency department to see me (violating HIPPA). The sealing decision to hospitalize me involuntarily was made via a short and inadequate cell phone conversation with the psychiatrist at the Vermont Psychiatric Care Hospital. It was evident to me due to her unprofessional demeanor and her interrogation that she’d already made up her mind to just follow what NCSS wanted.
There was no transparency, no initial evaluation and no 12-hour evaluations to make sure I still fit the criteria for involuntary commitment over the seven days I was held in the emergency room. This was a doctor who says she has a special interest in PTSD yet never recognized that I had complex PTSD since she never bothered to find out who I was. The other psychiatrist involved, from NCSS, only came into my ED room to tell me rudely and loudly to “sit down!” and proceeded to ream me out for calling NCSS crisis so many times, and then left. I was guarded by armed Lamoille County sheriff deputies over most of my seven days at Northwest Medical Center and then transported in heavy metal shackles (which are illegal to use), wrists bound to ankles in the back of a cold cruiser, to Tyler 2 at the Brattleboro Retreat. The deputies in the ED told me continuously they did not know why I was being held or why I was being sent involuntarily to the Retreat, and
so did the nurses there, despite having all my records from the hospital and NCSS. After seven days, I was told I could be released, but it took five more days to get into a transitional support program. They gave me a diagnosis of depression and anxiety. I could have told them that. That was an excruciatingly painful time because I was required to give up my shoes at night and walk in socks. I have a lift in one shoe because I have one leg shorter than the other. My new knee replacement has never healed from the physical trauma of NMC and the Retreat. And yet my insurance and I had to pay for all services, and I continue to pay for services to combat the trauma I suffered at the hands of the untrained and uncaring NCSS team members, the untrained doctors and nurses of Northwest Medical Center’s emergency department and the psychiatrist at VPCH. The conditions at the Brattleboro Retreat are horrendous, and the hospital is now caring for patients who may have been exposed to the coronavirus. The state is not doing enough to get the vulnerable populations out of the old, dirty, contaminated floors of the Tyler building, which are riper for COVID-19 to spread like wildfire through the dilapidated facility than even our prison system. Hospitals and organizations such as these are dangerous to the health, welfare and well-being of many Vermonters. We have lost so much, including our lives in the way of time: years of recovery from the trauma suffered. Rural organizations and hospitals are out there running outlaw operations and causing further trauma to those already traumatized. Howard Center is providing my services now, and they’re great. Yet I’m in CRT services because my life has gone downhill so much after the trauma I suffered. I’ve been in Howard’s START peer support program for more than a year. I have been able to do some advocacy, and there have been small pieces of change at NMC, including some basic training of nurses and physicians. I was also able to speak on Mental Health Day at the legislature. I still don’t have my life back. I am struggling severely under the trauma of the involuntary commitment. I’ve had multiple safety checks from first responders and eight trips to UVMMC. Losing my rights and being re-traumatized has diminished my capacity to see the future and to have positive plans. It has made my life miserable, and it feels not worth living. I want my story told and I want to advocate, and I want these people and hospitals and organizations to be held accountable. Please come to our aid.
Susanna Jaeger of South Hero reports that she worked a total of nearly 20 years in health and social services in Alaska before coming to Vermont, including four years coordinating Women in Crisis for Domestic Violence & Sexual Assault and 13 years in community mental health, serving as acting coordinator numerous times.
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24 Resources Directory SURVIVOR PEER SERVICES Vermont Psychiatric Survivors Peer Support Groups During COVID-19 crisis restrictions, call first to check whether groups are meeting
NATIONAL SUICIDE PREVENTION LIFELINE 800-273-TALK (8255) 24/7 confidential support
BRATTLEBORO: Changing Tides, Brattleboro Mem.
Hosp, 17 Belmont Ave., Brattleboro; every Wednesday, 7-8:30 p.m. Call John at 802-258-0782 BENNINGTON/UCS: United Counseling Service, 316 Dewey St., Bennington; Mondays and Wednesdays, noon-1 p.m. Call Barbara at 802-442-5491 RUTLAND: Wellness Group, VPS Office, 128 Merchants Row, Suite 606; every Wednesday, 5-7 p.m. Call Beth at 802-353-4365
VPS is a membership organization providing peer support, outreach, advocacy and education 128 Merchants Row, Suite 606, Rutland, VT 05701 802-775-6834
www.vermontpsychiatricsurvivors.org Peer Support WARM LINES VERMONT SUPPORT LINE (STATEWIDE): 833-888-2557; 24 hours, 365 days [833-VT-TALKS] By call or text
PEER PLUS (STATEWIDE):
802-595-0588; 7 days/wk, 6-9 p.m.
MUTUAL SUPPORT NETWORK THE HIVE: firstname.lastname@example.org www.hivemutualsupport.org 802-43-BUZZ-3 (802-432-8993)
Alyssum, 802-767-6000; www.alyssum.org; email@example.com
VERMONT PSYCHIATRIC SURVIVORS OUTREACH AND PATIENT REPRESENTATIVES 802-775-6834 F: 802-775-6823 firstname.lastname@example.org
Soteria House, information and online application at www.pathwaysvermont.org/what-we-do/ our-programs/soteria/ or call Pathways Vermont Intake Line, 888-492-8212, ext. 140
Vermont Federation of Families for Children’s Mental Health Statewide support for families of children, youth or young adults in transition who are experiencing or at risk to experience emotional, behavioral or mental health challenges. 800-639-6071, 802-876-7021
Pride Center of Vermont
LGBTQ Individuals with Disabilities Social and Support Groups: Connections and support around coming out, socializing, employment challenges, safe sex, self-advocacy, and anything else! Burlington, Wednesdays, 4:30 p.m. at Pride Center, 255 S. Champlain St.
Brain Injury Association
Support Group locations on web: www.biavt.org; or email: email@example.com; Toll Free Line: 877-856-1772
DBT Peer Group
Peer-run skills group. Sundays, 4 p.m.; 1 Mineral St, Springfield (The Whitcomb Building). tinyurl.com/PeerDBTVT
Trans Crisis Hotline
The Trans Lifeline (dedicated to the trans population) can be reached at 877-565-8860.
Peer Centers & Employment Support 0920; firstname.lastname@example.org; www.anotherwayvt. org; see website for events calendar.
PATHWAYS VERMONT COMMUNITY CENTER, 279 North
Winooski Avenue, Burlington, 888-492-8218 ext 300; www.facebook.com/PathwaysVTCommunityCenter; www.pathwaysvermont.org/what-we-do/ our-programs/pvcc
Vermont Recovery Centers WWW.VTRECOVERYNETWORK.ORG BARRE, Turning Point Center of Central Vermont, 489 N. Main St.; 479-7373; email@example.com
BENNINGTON, Turning Point Center, 465 Main St; 802-
Public Community Mental Health COUNSELING SERVICE OF ADDISON COUNTY, 89 Main St.,
Middlebury, 05753; 802-388-6751
UNITED COUNSELING SERVICE OF BENNINGTON COUNTY,
PO Box 588, Ledge Hill Dr., Bennington, 05201; 802-4425491
CHITTENDEN COUNTY: HOWARD CENTER, 300 Flynn Ave., Burlington, 05401; 802-488-6200
FRANKLIN & GRAND ISLE: NORTHWESTERN COUNSELING AND SUPPORT SERVICES, 107 Fisher Pond Road, St. Albans, 05478; 802-524-6554
LAMOILLE COUNTY MENTAL HEALTH SERVICES, 72 Harrel
Street, Morrisville, 05661; 802-888-5026
NORTHEAST KINGDOM HUMAN SERVICES, 181 Crawford
Road, Derby; 802-334-6744; 800-696-4979, 2225 Portland St., St. Johnsbury; 802-748-3181; 800-649-0118
ORANGE COUNTY: CLARA MARTIN CENTER, 11 Main St.,
Randolph, 05060-0167; 802-728-4466
RUTLAND MENTAL HEALTH SERVICES, 78 So. Main St., Rutland, 05701; 802-775-2381
WASHINGTON COUNTY MENTAL HEALTH SERVICES, 9 Heaton
St., Montpelier, 05601; 802-229-6328
WINDHAM AND WINDSOR COUNTIES: HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT,
Crisis Text Line
390 River Street, Springfield, 05156; 886-4500; 51 Fairview St., Brattleboro, 05301, 802-254-6028; 49 School St., Hartford, 05047, 802-295-3031
LGBTQ Youth Crisis Hotline:
24-Hour Crisis Lines: Involuntary Custody Screening
Around-the-clock help via text: 741741 for a reply explaining the ground rules; message routed to a trained counselor.
The Trevor Lifeline now at 866-488-7386. TrevorText Available on Fridays (4-8 p.m.). Text the word “Trevor” to 1-202-304-1200. Standard text messaging rates.
NAMI Connections Support Groups
BENNINGTON: Every Tuesday 12-1:30 pm; United Counsel-
ANOTHER WAY, 125 Barre St, Montpelier, 802-229-
Counterpoint publishes this resource directory to allow readers to seek out choices for support. Counterpoint has not reviewed or evaluated the quality or biases of these resources, and makes no representation about their value for any individual.
ing Service, 316 Dewey Street, CRT Center
BURLINGTON: Every Thursday 3-4:30 pm; St. Paul’s Episcopal Cathedral, 2 Cherry Street (enter from parking lot into lower level)
ADDISON COUNTY: Counseling Services of Addison County 802-388-7641
BENNINGTON COUNTY: United Counseling Service, 802-
442-5491; (Manchester) 802-362-3950
CHITTENDEN COUNTY: Howard Center 802-488-7777 FRANKLIN AND GRAND ISLE COUNTIES: Northwestern Counseling and Support Services, 802-524-6554; 800-834-7793
LAMOILLE COUNTY: Lamoille County Mental Health, Week-
BERLIN: Second Thursdays each month, 4-5:30 pm; Central
days 8 a.m.-4 p.m. 802-888-4914; Nights and weekends 802-888-4231
RUTLAND: First and third Sundays 4:30-6:30 pm; Well-
Human Services 800-696-4979
NATIONAL ALLIANCE ON MENTAL ILLNESS-VT (NAMI-VT)
ORANGE COUNTY: Clara Martin, 800-639-6360 RUTLAND: Mental Health Services, 802-775-1000 WASHINGTON COUNTY: Mental Health Services, 802-229-0591 WINDHAM,WINDSOR COUNTIES: Health Care and Rehabili-
Vermont Medical Center Board Room, 130 Fisher Road.
ness Center (Rutland Mental Health) 78 South Main Street (parking/entrance off Engrem Avenue)
802-876-7949 x101, or 800-639-6480; 600 Blair Park Road, Suite 301, Williston, 05495; www.namivt.org; info@ namivt.org
ESSEX, CALEDONIA AND ORLEANS: Northeast Kingdom
tation Services, 800-622-4235
Please contact us if your organization’s information changes: firstname.lastname@example.org
BRATTLEBORO, Turning Point Center of Windham Coun-
ty, 39 Elm St.; 802-257-5600; email@example.com BURLINGTON, Turning Point Center of Chittenden County, 191 Bank St, 2nd floor; 802-861-3150; www.turning pointcentervt.org or GaryD@turningpointcentervt.org
MIDDLEBURY, Turning Point Center of Addison Coun-
ty, 228 Maple St, Space 31B; 802-388-4249; tcacvt@ yahoo.com
MORRISVILLE, North Central Vermont Recovery Center, 275 Brooklyn St., 802-851-8120; firstname.lastname@example.org
RUTLAND, Turning Point Center, 141 State St; 802-7736010; email@example.com
SPRINGFIELD, Turning Point Recovery Center of Springfield, 7 Morgan St., 802-885-4668; spfldturningpoint@ gmail.com
ST. ALBANS, Turning Point of Franklin County, 182 Lake St; 802-782-8454; firstname.lastname@example.org ST. JOHNSBURY, Kingdom Recovery Center, 297 Fall St;
802-751-8520; email@example.com; j.keough@stjkrc. org; www.kingdomrecoverycenter.com
WHITE RIVER JUNCTION, Upper Valley Turning Point,
200 Olcott Dr; 802-295-5206; secondwindfound.org; firstname.lastname@example.org
Vermont Veterans Outreach
BENNINGTON AREA: 802-442-2980; cell: 802-310-5391 BERLIN AREA: 802-224-7108; cell: 802-399-6135 BRADFORD AREA: 802-222-4824; cell: 802-734-2282 COLCHESTER AREA: 802-338-3078; cell: 802-310-5743 ENOSBURG AREA: 802-933-2166; cell: 802-399-6068 JERICHO AREA: 802-899-5291; cell: 802-310-0631 NEWPORT AREA: 802-338-4162; cell: 802-399-6250 RUTLAND AREA: 802-775-0195; cell: 802-310-5334 VERGENNES AREA: 802-877-2356; cell: 802-881-6680 WHITE RIVER AREA: 802-295-7921; cell: 802-881-6232 WILLISTON AREA: 802-879-1385; cell: 802-734-2123 OUTREACH TEAM LEADER: 802-338-3022; cell: 802-881-5057 TOLL-FREE HOTLINE (24/7) 1-888-607-8773
HOMELESS PROGRAM COORDINATOR: 802-742-3291 BRATTLEBORO: Morningside 802-257-0066 RUTLAND: Open Door Mission 802-775-5661; Transitional Residence: Dodge House, 802-775-6772
BURLINGTON: Waystation/Wilson 802-864-7402 FREE TRANSPORTATION: Disabled American Veterans:
Toll Free: 1-866-687-8387 X5394
Vermont Veterans Services (VVS) program for homeless veterans with very low income, call 802-656-3232.
www.MakeTheConnection.net Web site sponsored by The Department of Veterans Affairs with testimonials by veterans to help connect with the experiences of other veterans, and with information and resources to help transition from service, face health issues, or navigate daily life as a civilian.
VA Mental Health Services
VA HOSPITAL: Toll Free 1-866-687-8387 MENTAL HEALTH CLINIC: Toll Free 1-866-687-8387 Ext 6132 OUTPATIENT CLINICS: Bennington: 802-447-6913; Brattleboro: 802-251-2200; Burlington Lakeside Clinic: 802-6577000; Newport: 802-334-9777; Rutland: 802-772-2300 VET CENTERS: (Burlington) 802-862-1806; (White River Jnct) 802-295-2908