Counterpoint Summer 2024

Plan for Forensic Facility Dropped

by BRETT YATES

A bill originally intended to codify admissions criteria at Vermont’s first psychiatric facility exclusively for patients committed by a criminal court underwent major revisions over the course of the legislative session. By the time S.192 passed in May, lawmakers and the Vermont Department of Mental Health had decided – for the time being – against establishing a so-called forensic facility at all, preferring to make changes instead at the existing River Valley Therapeutic Residence in Essex.

Last year, Act 27 declared that a nine-bed wing of the state-run Vermont Psychiatric Care Hospital in Berlin would become a locked “residence” for criminal defendants deemed incompetent to stand trial or adjudicated

not guilty by reason of insanity. Unlike other states, Vermont has always mixed such “forensic patients” with civilly committed involuntary patients in its psychiatric facilities. By segregating the former in a separate environment, legislators expected to satisfy a demand put forward by crime victim advocates, whose push to address public safety concerns

in the mental health system had already scored several small legislative victories since 2021. As introduced by Senators Ginny Lyons and Dick Sears, S.192 would have represented the culmination of their recent political advocacy. By carrying out the plan envisioned by Act 27, it would also have quietly sought to avert an impending loss of crucial federal funding for the Vermont Psychiatric Care Hospital, whose size will soon render it ineligible for support from the Centers for Medicare & Medicaid Services. CMS reimbursement policies aim to discourage states from operating large, standalone psychiatric hospitals.

DMH hoped that shrinking VPCH from 25 to

(Continued on page 6)

Peer Certification Bill Passes

by BRETT YATES

The Vermont General Assembly approved a bill requiring the Office of Professional Regulation to certify peer support providers. It will take effect on July 1, 2025.

In 2022, Vermont’s five peer mental health organizations sought to persuade the legislature to enact a certification program that independent peer-run entities would have administered under the auspices of the Vermont Department of Mental Health, without OPR’s involvement. When that effort failed, they pressed DMH to take action through internal rulemaking, and Pathways Vermont’s Peer Workforce Development Initiative received a grant to develop a Medicaid-compliant plan for screening, training, and rostering peers based on the peer community’s input.

DMH received recommendations from Pathways’ peer-run subcontractor, Wilda L. White Consulting, last year, following a series of public meetings, and won funding from the

legislature to begin to stand up a program. H.847, which passed in May, does not override that preexisting work.

OPR – not a peer-run entity – will serve as Vermont’s certifying body, but peers seeking certification will need first to earn a credential

from a DMH-authorized “peer support provider credentialing body.” The new legislation doesn’t specify that the credentialing body must itself be a peer-run entity, but the Peer Workforce Development Initiative’s support for the bill seemed to indicate an expectation that DMH would choose to contract such an organization for the role, in accordance with its own guidance.

“We worked together with OPR, with Wilda, with the Department of Health, with folks from [the Vermont Association for Mental Health and Addiction Recovery], to really try to come together and bring you a bill that was ready to go,” Nicole DiStasio, DMH’s director of policy, told lawmakers.

The Secretary of State will have to appoint two peer support providers to advise OPR as it receives and reviews applications. The legislation defines peer support as a means of “increasing an individual’s capacity to live a

(Continued on page 7)

Vermont Psychiatric Care Hospital in Berlin (Counterpoint file photo)

Vermont State House (Counterpoint file photo)

Peer Leadership and Advocacy

Meeting Dates and Membership Information for Boards, Committees and Conferences Peer Organizations State Committees

VERMONT PSYCHIATRIC SURVIVORS BOARD

A membership organization providing peer support, outreach, advocacy and education. Board meets monthly. For information call 802-775-6834 or email info@vermontpsychiatricsurvivors.org.

COUNTERPOINT EDITORIAL ADVISORY BOARD

The Vermont Psychiatric Survivors newspaper can always use help! Assists with policy, editing and brainstorming. Contact counterpoint@vermontpsychiatricsurvivors.org

ALYSSUM Peer crisis respite. To serve on board, call 802-767-6000 or write to information@alyssum.org

DISABILITY RIGHTS VERMONT PAIMI COUNCIL

Protection and advocacy for individuals with mental illness. Call 1-800-834-7890.

DISABILITY RIGHTS VERMONT

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, noon-3 p.m. Check DMH website for call-in number. For further information, contact member Daniel Towle (dantowle@comcast.net) or the DMH quality team at Eva.Dayon@vermont.gov

LOCAL PROGRAM STANDING COMMITTEES

Advisory groups, required for every community mental health center. For membership or participation, contact your local agency for information (listings on back page).

Advocacy Organizations

Advocacy regarding abuse, neglect, other rights violations in a hospital, care home, or mental health agency. 141 Main St, Suite 7, Montpelier VT 05602; 800-8347890. disabilityrightsvt.org

MENTAL HEALTH LAW PROJECT

Representation for rights when facing commitment to a psychiatric hospital. 802-241-3222.

PEER WORKFORCE DEVELOPMENT INITIATIVE

Statewide peer training and registration information. pathwaysvermont.org/what-we-do/statewide-peer-workforce-resources/

HEALTH CARE ADVOCATE To report problems with any health insurance or Medicaid/Medicare issues in Vermont. 800-917-7787 or 802-241-1102. vtlawhelp.org/health

VERMONT CENTER FOR INDEPENDENT LIVING

Peer services and advocacy for persons with disabilities.

NAMI-VT

Family and peer support services, 802-876-7949 x101 or 800-639-6480; 600 Blair Park Road, Suite 301, Williston VT 05495; www.namitvt.org; info@namivt.org

ADULT PROTECTIVE SERVICES

Reporting of abuse, neglect or exploitation of vulnerable adults, 800-564-1612; also to report violations at hospitals/nursing homes through Licensing and Protection at (802) 871-3317 or 800-639-1522. vcil.org

MADFREEDOM

MadFreedom is a human and civil rights membership organization whose mission is to secure political power to end discrimination and oppression of people based on perceived mental state. See more at madfreedom.org

VERMONT CLIENT ASSISTANCE PROGRAM

Rights when dealing with service organizations such as Vocational Rehabilitation. Box 1367, Burlington VT 05402; 800-747-5022.

Hospital Advisory

VERMONT PSYCHIATRIC CARE HOSPITAL

Advisory Steering Committee, Berlin or online. Typically a Monday. Check DMH website for dates at mentalhealth. vermont.gov

UNIVERSITY OF VERMONT MEDICAL CENTER

Program Quality Committee, third Tuesdays, 9-10 a.m., for information call 802-847-4560.

COPELAND CENTER

BRATTLEBORO RETREAT

Consumer Advisory Council, fourth Tuesdays, 12-1:30 p.m., contact Director of Patient Advocacy and Consumer Affairs at 802-258-6118 for meeting information.

RUTLAND REGIONAL MEDICAL CENTER

Community Advisory Committee, fourth Mondays, noon, call 802-747-6295 or email lcathcart@rrmc.org

Conferences

On Aug. 11-13, Philadelphia, PA, will host “Taking Action for Wellbeing,” the Vermont-based Copeland Center for Wellness and Recovery’s 20th-anniversary conference for “peer leaders, activists, workers, and allies.” copelandcenter.com

NARPA

The National Association for Rights Protection and Advocacy will continue its mission “to support people with psychiatric diagnoses to exercise their legal and human rights” during its Annual Rights Conference on Sept. 4-7 in Portland, OR. Keynoters to include Chyrell Bellamy and Robert Dinerstein. narpa.org

NAPS

The National Association of Peer Supporters and the Alliance for Rights and Recovery will co-sponsor “Reclaiming Our Power!” on Oct. 16-17 in Chicago, IL. The conference will “delve into the power of reclaiming our narratives, our agency, and our futures.” peersupportworks.org

ISPS-US

“New Beginnings: Reimagining Psychosis Services & Systems in the US” is the theme of the 23rd annual conference of the US chapter of the International Society for Psychological and Social Approaches to Psychosis (Pittsburgh, PA, and online, Nov. 1-3). isps-us.org

VT Psychiatric Survivors, 128 Merchants Row Suite 606, Rutland, VT 05701

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email: counterpoint@ vermontpsychiatricsurvivors.org

MISSION STATEMENT:

Counterpoint is a voice for news and the arts by psychiatric survivors, ex-patients, and consumers of mental healthservices, and our families and friends.

Copyright 2024, All Rights Reserved

FOUNDING EDITOR

Robert Crosby Loomis (1943-1994)

EDITORIAL BOARD

Zachary Hughes, Sara Neller, Laura Shanks, Joanne Desany, Betsy Hoekstra

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

Brett Yates

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IN THE NEWS

• Alyssum, Vermont’s only peer respite, began its search for a new leader to replace founding director Gloria van den Berg. An ad for the Rochester-based position appeared in January, calling for someone with “lived mental health experience” and the ability to work “in a collaborative peer support environment.”

• Sandra McGuire became chief executive officer of Howard Center, Chittenden County’s community mental health center, on June 1, following the retirement of Bob Bick, who spent a decade in the role. McGuire served for ten years as Howard Center’s chief financial officer.

• In March, Governor Phil Scott appointed a new commissioner for the Vermont Department of Disabilities, Aging and Independent Living. Monica White had stepped down from the position in January after three years of service. Her successor, clinical psychologist Jill Bowen, previously led the Philadelphia Department of Behavioral Health and Intellectual Disability Services.

• No bidders responded to the Vermont Department of Mental Health’s March request for proposals for a two-bed “staffsecure residential treatment program” for

“individuals who may have histories of engaging in violent behavior, behaviors that have made living in less restrictive settings unsuccessful, and historical medication nonadherence outside of hospital settings.” The state reissued the RFP in May, and it will close again in June.

• Groundworks Collaborative announced plans to raze Brattleboro’s Morningside House, which had operated as a shelter from 1979 until the 2023 murder of one of its staffers, and to build a new, “safer” 40-bed facility on the site.

• In Vergennes, the Vermont Department for Children and Families will build a 14bed locked youth treatment facility on the site of the old Weeks School for Juvenile Delinquents, which shuttered in 1979. The new project will replace Essex’s scandalplagued Woodside Juvenile Rehabilitation Center, which closed in 2022. DCF shelved an earlier plan for a six-bed “secure group home” for justice-involved children in Newbury.

• New legislation allows out-of-state social workers to begin practicing upon moving to Vermont without earning a new license. The law made Vermont the ninth member of the interstate Social Work Licensure Compact; Maine also joined in April.

• In consultation with Vermont Psychiatric Survivors, NAMI-VT, Disability Rights Vermont, and other organizations, DMH will develop guidelines for municipalities on best practices for mental health responses for use by emergency medical technicians, firefighters, and police officers.

• U.S. Rep Becca Balint of Vermont introduced the MEND Act, which would send mobile mental health crisis units to areas where major emergencies or natural disasters have taken place.

• Vermont’s new statewide mobile crisis service started in January. Crisis Program Director Jeremy Therrien counted 125 encounters in its first month, 143 in its second, and “a minimum of 158” in March.

• Legislators revised the state’s motel voucher program, imposing a 1,100-room cap and an 80-day limit during the warmer months, as well as new restrictions that will limit eligibility to households that satisfy certain conditions (such as having a disability or a child) even during the winter. The state’s annual budget allocated $44 million for the program and another $10 million to fund “emergency shelters” between December and March for homeless Vermonters who will not qualify for motel rooms.

Budget Gives Small Increase to Mental Health

The state’s new fiscal year will start on July 1. In its annual appropriations bill, the legislature increased the Medicaid reimbursement rate Vermont’s community mental health centers by 3%.

In January, Gov. Scott had put forward a recommended budget that would have level-funded the 10 “designated agencies” that provide communitybased services on the Vermont Department of Mental Health’s behalf. But Vermont Care Partners, the industry trade group that represents those providers, asked lawmakers in February for a 6.5% raise, which would have supported a 5% salary increase for workers.

In the fall of 2023, DMH recorded 968 unfilled staff positions in the community

mental health system, amounting to a vacancy rate around 16%. Vacancies rose dramatically with the start of pandemic in 2020 and peaked at 1,077 in 2022. To help providers attract new employees, the legislature budgeted an 8% rate increase for the community mental health centers that year and a 5% increase in 2023.

Vermont Care Partners warned that an underfunded system could lead to a rise in homelessness, overcrowded emergency departments, and increased need for inpatient psychiatric care. “We can prevent a lot of that if we have a solid workforce on the ground,” said Mary Moulton, the executive director of

Washington County Mental Health Services. Overall, appropriations for DMH increased from $317,528,698 in fiscal year 2024 to $326,334,223 in fiscal year 2025, a 2.77% rise. In March, the department also received an extra $2,576,479 in the annual Budget Adjustment Act in response to its request for help in paying travel nurses at the state-run Vermont Psychiatric Care Hospital. Most of DMH’s budget comes from Medicaid and serves to reimburse its nonprofit contractors, of which Chittenden County’s Howard Center is the largest.

Youth Inpatient Plan Challenged

With financing already in place, Southwestern Vermont Medical Center still needs permission from state regulators before it can start construction on a psychiatric inpatient unit for adolescents in Bennington. Director of Planning James Trimarchi filed an application in February, but not everyone supports SVMC’s plan.

New healthcare projects in Vermont must earn a Certificate of Need from the Green Mountain Care Board, a body composed of five gubernatorial appointees. Their monthslong process for reviewing applications can include outside input from qualifying groups and individuals. In March, Disability Rights Vermont, an advocacy organization designated as Vermont’s “mental health care ombudsman,” and the Brattleboro Retreat, a psychiatric hospital in Windham County, asked for a chance to weigh in.

In recent years, Vermont’s emergency departments have reported a rise in the number of children arriving with mental health needs. According to various clinicians, a lack of pediatric inpatient beds in Vermont’s psychiatric hospitals has led to prolonged boarding times in EDs.

In response to the perceived shortage, the Vermont Department of Mental Health issued a request for proposals in 2002, yielding a single bid by SVMC. But the Brattleboro Retreat, which currently provides Vermont’s only inpatient psychiatric services for youths, told the Care Board that it has enough capacity to meet demand without SVMC’s help.

Based on what the Care Board called the latter’s “financial and business interests,” the Retreat won “Interested Party” status in SVMC’s proceedings. DRVT did not, but it received a lesser status, amicus curiae (“friend of the court”), that will still allow it to submit materials for review.

The Retreat’s lawyer, Elizabeth R. Wohl, described a process of rebuilding following “staffing challenges” during the pandemic. Today, by her account, the hospital operates 23 youth beds and can add four more when necessary. It also plans to open a new residential treatment facility that will serve 15 adolescents (see “Brattleboro Facility Will Face Licensing”). Wohl fingered “outdated” data in SVMC’s application, which counted only “10 to 14” adolescent beds at the Retreat in making its case for the need for more.

On her employer’s behalf, Wohl warned that an excess of supply would leave psychiatric

beds unfilled. With patients diverted to SVMC, the Retreat would potentially lose $6 to $9 million in annual revenue, exacerbating the “extraordinary financial challenges” that it purports already to face.

In a subsequent communication between SVMC and the Care Board, Trimarchi acknowledged that “it is nearly impossible to accurately and definitively determine the demand for inpatient adolescent mental health beds in Vermont,” but he pointed to youths stuck in EDs while awaiting inpatient placements as evidence for the necessity of an additional psychiatric unit, citing a 31-hour average delay.

“Vermont adolescents deserve choice,” Trimarchi added. As part of a larger hospital, SVMC’s unit might have an advantage over the Retreat, a standalone psychiatric institution, for young patients with “medical comorbidities.”

Vermont taxpayers will pay for SVMC’s startup costs if the project moves forward, thanks to a $9.225 million appropriation last year by the state legislature and another $1 million this year. Disability Rights Vermont argued that the dollars “would be better utilized by creating short and long-term residential treatment facilities, and community-based outpatient programs to provide care for adolescents in the least restrictive setting, as required by law.”

Soteria to Move to Maple Street

Pathways Vermont has targeted a new location in Burlington for an expansion of its unique Soteria program, which offers a voluntary, nonclinical alternative to psychiatric hospitalization for people experiencing extreme states. If all goes to plan, a 19th-century South End rooming house with eight bedrooms, including two with ADA accessibility, will become a therapeutic residence providing peer support in July 2025.

The Champlain Housing Trust has offered to sell 141 Maple Street for just $250,000, according to Pathways, in spite of its appraised value of $642,700. Spectrum Youth and Family Services previously used the now vacant property to operate a group home for homeless teenagers.

The new Soteria House at 141 Maple Street will replace a rented five-bedroom property on Manhattan Drive in Burlington’s Old North End. Pathways cited “an aging building and expensive market leases” as driving factors in the move.

Additional space will be a bonus. “Referrals to Soteria surged by 70% from FY 20 to FY 24, underscoring the pressing demand,” Executive Director Hilary Melton noted in a letter to the Vermont Department of Mental Health.

Last year, the state legislature awarded $1 million to Pathways for the prospective purchase. The nonprofit told DMH that it has privately raised an additional $569,000. An

“investment of $1,141,567” from the Vermont Housing and Conservation Board, along with grants totaling $146,657, will cover the rest of the renovation costs.

Serving three extra individuals at a time will also require more operating funds.

A budget drafted by Pathways proposed an increase of nearly $1,000,000 in Soteria House’s annual grant from DMH, starting in fiscal year 2026. DMH responded that no such funding is currently available.

Pathways replied that it would expect to open the new facility with just five residents at first. The organization “will collaborate with DMH to identify additional funding to support the increase in capacity to serve eight individuals,” Melton wrote.

Last year, Pathways also announced plans to

develop a five-bed “peer respite pilot” in Burlington. Dedicated to person-centered crisis support, peer respites – like Windsor County’s Alyssum, the only one in Vermont so far – tend to offer shorter stays than the Soteria model.

Pathways subsequently posted a recruitment ad for a “peer respite pilot manager.” A spokesperson told Counterpoint this spring that the organization didn’t have “any updates to share at this time” regarding the project.

141 Maple St. (Counterpoint photo)

DATE: July 13, 2024

TIME: 12 PM - March

1-3 PM - Program

LOCATION: Battery Park Burlington, VT

ROUTE:  Begin at 12 PM at S. Winooski Avenue and Church Street and march to Battery Park. Program begins at 1 PM.

PROGRAM:  Spoken word, music, speeches, and more; Food and commemorative T-shirts provided

VERMONT MAD PRIDE is a march and celebration organized by psychiatric survivors, consumers, mad people, and folks the world has labeled “mentally ill.”

MAD PRIDE is about shedding shame, challenging discrimination, advocating for rights, affirming mad identities, remembering and participating in mad history, and having fun. Our lives and contributions are valuable and need celebration!

SPECIAL PERFORMANCE BY SUNNY WAR

SUNNY WAR is an internationally acclaimed blues/folk/punk singersongwriter, guitarist, and a psych survivor. Sunny has appeared on all the late-night television shows and NPR’s Tiny Desk Concert. Rolling Stone magazine called her most recent album “The Best Albums of 2023 (So Far).”

REGISTRATION  — https://tinyurl.com/wrwuuca5

16 beds would fix the problem. But this spring, General Counsel Karen Barber acknowledged that “further discussions with CMS” had ruled out that plan, which would have classified the hospital’s nine repurposed beds as a separate, non-hospital facility while requiring its patients, however, to share common areas with those at VPCH, in violation of federal rules.

The Senate’s early version of S.192 had aimed to have a forensic facility operational at VPCH by July 1, 2024. The bill envisioned a patient population that would have consisted of criminally charged individuals in the custody either of DMH or of the Department of Disabilities, Aging and Independent Living. A four-member “Community Safety Panel,” including the Commissioner of Corrections, would have offered advice on placements, with recommendations based partly on clinical criteria and partly on estimations of “dangerousness.”

But the inclusion of people with intellectual disabilities in a locked psychiatric facility faced opposition. Testimony by Green Mountain Self-Advocates brought up the large, prisonlike Brandon Training School, which closed in 1993. “Why go back to those days?” asked Outreach Director Max Barrows.

For 31 years, DAIL has cared for its charges – including those alleged to have committed violent crimes – in community settings, not institutional ones. Last year, a working group studied whether people with intellectual disabilities should join those with diagnoses of mental illness in Act 27’s proposed forensic facility, but its mandatory December report to the legislature revealed significant disagreement among its members.

In January, DAIL told lawmakers that a forensic facility “is needed for a small subset of those committed to the DAIL Commissioner’s custody.” This subset, according to General Counsel Stuart Schurr, “places the public and the individual’s support staff at an unreasonable risk of harm.”

Vermont Legal Aid’s Disability Law Project, however, disputed the facility’s necessity. Staff Attorney Susan Garcia pointed to “substantial restrictions” on “privacy, liberty and autonomy” that already exist for potentially dangerous individuals receiving treatment from DAIL. “Importantly, this treatment and supervision takes place in a residential setting, such as a staffed apartment or group home, rather than in an institution,” allowing DAIL’s charges to “build therapeutic relationships” and “practice self-regulation skills,” she added. In the spring, the House scrapped and

rewrote the Senate’s bill. Lawmakers determined that, for now, institutional forensic care in Vermont should not involve people with intellectual disabilities. Instead, DAIL “may submit an alternative proposal” to the legislature for “enhanced community-based services for those individuals committed to the Commissioner who require custody, care, and habilitation in a secure setting for brief periods of time.”

Rather than targeting VPCH for the establishment of a separate facility for justiceinvolved psychiatric patients, the House looked to enable DMH to serve its forensic population by using empty beds at the River Valley Therapeutic Residence, a locked “step-down” facility for Vermonters exiting involuntary psychiatric hospitalization. Their bill revised the rules governing its operations, allowing it to admit patients who haven’t passed through a hospital first.

When DMH proposed building River Valley in 2021, activists protested a plan to permit its staff to use restraint and seclusion upon

River Valley’s forensic programming will likely include competency restoration.

relatively low-acuity patients. The activists won. But as lawmakers and state officials now see it, River Valley will need access to emergency involuntary procedures, including forced drugging, in order to accommodate a new group of potentially more dangerous

facility’s practices. They’ll have a right to “apply to the Family Division of the Superior Court for a review as to whether the secure residential recovery facility continues to be the most appropriate and least restrictive setting necessary” for their treatment.

The forensic programming at River Valley will likely include competency restoration. “Competency restoration” – the subject of another legislatively mandated study last year – refers to a narrowly focused form of treatment that prepares alleged criminal offenders in psychiatric facilities to stand trial, with arguably a reduced emphasis on their overall well-being. The House instructed the Agency of Human Services to estimate the financial cost of such a program, despite reservations expressed by Disability Rights Vermont.

residents. S.192 grants that access, starting on July 1.

River Valley will continue to house involuntary patients who entered the mental health system through Vermont’s civil court alongside those who arrived by way of its criminal court, but legislators provided a potential exit route for those who became patients before the upcoming change in the

“DRVT maintains that the question exists, as to whether competency restoration is even an appropriate process to address alleged criminal conduct in our communities by persons who are presumed to lack capacity,” Executive Director Lindsay Owen and Legal Director Laura Cushman wrote in a letter to DMH. “We maintain that community-based supports for people experiencing mental illness would be far more effective in preventing or limiting their engagement with the criminal justice system, altogether.”

Following the House’s changes, S.192 returned to the Senate just two days before the legislature’s adjournment. The Senate accepted the amended bill on the condition that it include language emphasizing that none of its provisions should preclude lawmakers from establishing a segregated forensic facility at a later date, as Act 27 had imagined.

Sen. Ginny Lyons, S.192 sponsor (courtesy photo)

River Valley Therapeutic Residence in Essex (Counterpoint photo)

Retreat Project Will Face Licensing

State inspectors will have to approve a planned “psychiatric residential treatment” program for adolescents at the Brattleboro Retreat before it can begin operations.

Rep. Anne Donahue drafted a successful amendment to the legislature’s annual appropriations bill this spring to impose a licensure requirement upon the 15-bed project, which had seemed poised to enjoy unusually little scrutiny prior to opening. Another bill subsequently added patient protections and more detailed rules for oversight.

Because Medicaid will pay for services at the facility, it will have to demonstrate compliance with federal standards. Vermont’s hospitals and therapeutic residences must also acquire certification on the state level, but thanks to a regulatory blind spot, the proposed facility in Brattleboro appeared likely to fly under the radar before Donahue’s intervention.

“The Agency of Human Services kept saying this does not need to be licensed by the state,” Donahue, a psychiatric survivor, told the House Committee on Appropriations. “It wasn’t clear why it wouldn’t need to be licensed, and questions were asked and answers had not come back.”

Ironically, last year, the Retreat asked for an exemption from an obligation to apply to the Green Mountain Care Board for a Certificate of Need on the basis that its planned PRTF was not a new program but merely a resurrection of an old, briefly dormant outpatient operation.

The Retreat’s plan had arisen from a request for proposals issued by the Vermont Department for Children and Families, which, however, described a PRTF as a provider of “inpatient psychiatric services” with the power to use restraint and seclusion, not as an outpatient residence.

Donahue recounted turning to Vermont’s Division of Licensing and Protection for answers. In her telling, DLP responded that because no one in Vermont had ever sought to establish what the Centers for Medicare & Medicaid Services call a “PRTF” (or “psychiatric residential treatment facility”), state legislators had never written a law to demand the licensure of such a thing or standards for licensing it.

PEER CERTIFICATION

The Care Board, which must approve prospective healthcare projects in Vermont before they can break ground, accepted the Retreat’s reasoning and declined to assert jurisdiction, but it will review the question again following an update on the project that arrived in late April. A letter from the Retreat argued that a Certificate of Need remained unnecessary, but it now acknowledged some differences between its earlier form of residential treatment and the program currently in the works.

“It is important to note that the Brattleboro Retreat does not intend replicate the treatment that it provided in 2020, but rather has designed a program that will better meet the needs of today’s adolescents,” the hospital’s lawyer wrote.

Irrespective of the Care Board’s final decision, the Retreat will now have to file an application with the Vermont Department of Health before its PRTF can open. The State Board of Education will license its educational component. When using emergency involuntary procedures, such as forced drugging, the PRTF will have to follow the same protocol as a hospital, which

• Continued from page 1

of “increasing an individual’s capacity to live a self-determined life,” as it “promotes multiple perspectives, advocates for human dignity, and on genuine, relationships.”

“I think it’s past time for us to have some structure for peer support workers to be able to do this work and get the respect that it deserves,” Chris Nial, a peer support provider at Pathways, said.

The bill specifies that Vermonters will not to hold certification to support. But per federal rules, only those who do will have the ability to bill Medicaid for their services. With a certification program

in place, DMH anticipates filing a state plan amendment with the Centers for Medicare & Medicaid Services next year.

Zachary Hughes represented Vermont Psychiatric Survivors in legislative hearings. He serves as the board vice president.

“We’re pleased with the idea that people can continue to do peer work without certification necessarily,” Hughes said. “We believe in flexibility.”

Applicants for certification will pay a $50 biennial fee. Their initial payment will increase to $75 in 2027 – still the lowest sum among all OPR-regulated professions.

Under H.847, peer recovery support specialists, who help people with substance use

The Retreat acknowledged differences between its earlier residential program and the one currently in the works.

must always provide a written justification to Vermont’s Mental Health Ombudsman.

Legislation posited that these safeguards would ensure that the PRTF “complies fully with standards for health, safety, and sanitation” while upholding “person-centered care and resident dignity.” By Donahue’s account, the executive branch came around to seeing licensure as a good idea, too, even before it became law.

“Both the Department of Vermont Health Access and the Department of Mental Health have sent emails back saying they are completely fine,” she said. “It is their intent to get licensing now.”

Even so, the legislature decided – apparently with state officials’ blessing – to get it in writing. They also clarified that a PRTF would, in state law, constitute a form of inpatient care. In February, Commissioner of Mental Health Emily Hawes had labeled it as “an outpatient service” in legislative testimony.

“But it’s also not one-time-a-week therapy,” Hawes acknowledged at the time. “It’s residential, where folks are staying anywhere from three to 18 months and getting that intense family work that folks need in order to step back down into their communities.”

The Retreat’s Linden Lodge, a historic building where physicians also provide hospital-level care, will house the program.

challenges, will also have the opportunity to earn professional certification. Parallel language tasks the Department of Health with authorizing a “peer recovery support specialist credentialing body.”

The version of the bill passed by the House of Representatives left out the word “peer” in this section, defining the workers simply as “recovery support specialists.” A few legislators noticed and proposed a floor amendment just before the vote, but their last-minute effort didn’t succeed.

“All recovery coaches are people in recovery themselves or family members of someone in recovery,” Gary De Carolis, executive director of Recovery Partners of Vermont, subsequently emphasized in Senate testimony. “That needs to be added to the language of this bill.”

The Senate’s version called them “peer recovery support specialists.” The House concurred. At press time, Gov. Scott had not yet signed the bill into law.

Veterans Support Veterans at VA

Across the country, the US Department of Veterans Affairs has made peer support an integral part of mental healthcare. Vermont is no exception.

Nationally, the Veterans Health Administration employs about 1,400 peers. Joshua Gerasimof, a supervisory peer specialist, oversees a team of nine in the VA White River Junction Health System, which includes not just the hospital itself but also clinics in Burlington, Rutland, and New Hampshire.

Peer support lets veterans “know that recovery is possible and that this is what it can look like,” Gerasimof said. “I think peer specialists are so effective because it’s relatable.”

Gerasimof served as a soldier in Afghanistan. After he came home, conversations with other veterans showed him the therapeutic power of peer-to-peer connection.

“I got out of the military and went through those readjustment issues of getting back to the civilian world,” he said. “I just remember waking up and being like, ‘Wow, what just happened? The past years in service – maybe that wasn’t normal.’”

“I took a long walk on the Appalachian Trail, and I met with other veterans,” Gerasimof recounted. “And unbeknownst to me, I was doing peer support and learning from other veterans who were having the same readjustment issues, the same struggles that I was having.”

about this peer support profession, and I dove right into it.”

In Gerasimof’s telling, the VA’s “big push” to expand peer support began with an executive order by the Obama administration in 2012. By the following year, the VA had hired 815 new peer specialists. Today, it’s the nation’s largest employer of peers.

And it hasn’t let up. Gerasimof noted that, recently, the VA has added more peers to the Veterans Crisis Line, which callers can access by dialing 988 and then pressing 1.

help group.’ ‘I don’t want to do that.’ ‘Well, let’s go to a guitar group.’ ‘OK, let’s do that.’”

Gerasimof also hosts what he calls coffee socials.

“The only criteria to be there is to be a veteran,” he said. “And they come and then they learn, oh, maybe my sleeping habits are not that great. Or maybe what my spouse is saying about being hypervigilant or feeling down –we may talk about those things, and then they realize, ‘Oh, I could reach out for help.’”

When a veteran chooses to engage with clinical mental healthcare, peers are there to help them navigate the system.

Gerasimof vowed then to make a career of helping other veterans. At Johnson State College, he studied clinical mental health, having never heard of “peer specialist” as a job title.

“If I would have known that that was an avenue,” he said, “I probably could have saved the VA a little bit of money, because they ended up paying for my education.”

After earning a masters degree in counseling, Gerasimof worked in community mental health for a crisis team.

“I felt like I was able to connect more with the people that were in crisis through my own personal experience,” he remembered. “That’s when – I think it was probably 2014 – I learned

“Unbeknownst to me, I was doing peer support and learning from other veterans who were having the same readjustment issues.”

The VA requires that its peer specialists complete a certification course, but the state of Vermont doesn’t yet offer one. Gerasimof earned certification in Florida before applying for a job at the VA in Vermont.

For now, peers continue to travel out-ofstate to fulfill the requirement. According to Gerasimof, the VA usually hires peers in Vermont as apprentices before sending them on a one-week trip to complete the in-person component of a certification course elsewhere.

At the VA, in addition to typical support groups, peers help coordinate a range of activities that don’t look much like traditional mental health services, from ski trips to jam sessions.

“I have a great peer specialist where music was a huge thing of his recovery. So he’s selftaught, and now he runs a guitar group,” Gerasimof said. “It’s called Vets Rock, and they get together and they teach people who want to learn how to play guitar. And then a lot of them already know how to play guitar, but it’s just connecting them with other veterans.”

“And it’s kind of providing just that carrot,” he continued, “because we all know there’s that unfortunate stigma. It’s like ‘Let’s go to a self-

“We work with the individual and kind of explain different options for treatment. And traditional therapy might not be one of them, but we like to explore all options and know what’s out there,” Gerasimof said.

As a supervisory peer specialist, Gerasimof gets to play a role in shaping the broader landscape of mental healthcare within the White River Junction system.

“I’m one of the managers for the mental health team. I have a seat at the table along with the psychiatrist, the psychologist, the social workers,” he said. “When they make decisions, I bring in the veteran perspective. Sometimes medication management isn’t going to work for somebody, and I feel validated when I speak up for that.”

Having a peer by their side can help a veteran “take control of their own recovery,” as Gerasimof put it.

“If they’re having issues with their treatment, we’ll go to appointments with them and we’ll sit there with them and encourage them to advocate for themselves and find what they need,” he described.

According to VA Public Affairs Officer Katherine Tang, Gerasimof’s ability to relate to other veterans has served to connect them not only to mental healthcare but to healthcare in general. Employees like Tang and Gerasimof often attend community events to let veterans know about the VA’s offerings.

“We were at the Champlain Valley Fair, and I could be talking to a veteran, and I’d gladly let Josh take over. I can see that I’m losing the veteran because they’re like, ‘Oh, she’s just another government employee,’” Tang said. “He is one of our best at outreach because he speaks their language.”

As a former community mental health provider, Gerasimof knows that not every Vermonter has the same access to diverse, wellfunded, peer-based mental health services that veterans do. He hopes that’ll change.

“We have a lot of these modes of treatment that the regular community does not, and I wish they did,” he said. “The VA is very, very rich in what they have for treatment options, and I feel guilty about that at times, but I also feel very, very lucky.”

VHA Peer Specialist Joshua Gerasimof (courtesy photo)

State Renames ‘Behavioral Health Clinics’

The Vermont Department of Mental Health made good on a promise to replace the term “Certified Community Behavioral Health Clinic” this spring.

DMH had inherited the nomenclature from a federal program at the Substance Abuse and Mental Health Services Administration. SAMHSA’s model – which aims to offer “comprehensive, coordinated, traumainformed, and recovery-oriented care for mental health and substance use conditions” – will guide expansion plans at Vermont’s community mental health centers, but while preserving the abbreviation “CCBHC,” they will call themselves “Certified CommunityBased Integrated Health Centers” instead.

Counterpoint has long opposed the term “behavioral health” on the basis that it characterizes mental health and substance use struggles in terms of bad behavior, in which suffering becomes a potentially blameworthy disruption or impoliteness. Last year, Vermont became one of 15 states to win a $1 million federal grant to develop a network of CCBHCs, but DMH pledged to develop a different name for them.

In the meantime, however, planning began under the original nomenclature. Five of the ten nonprofit agencies that deliver mental health services on behalf of the state won grants of their own to start the process of becoming CCBHCs.

Soon, the term started to migrate beyond the closed doors of policymakers. The Clara Martin Center achieved compliance with SAMHSA’s standards first and began to advertise itself on its website as a Certified Community Behavioral Health Clinic in prominent text.

DMH revealed its reworking of the initialism in a May 6 press release publicizing an extension of its aforementioned planning grant, which will give officials an additional year to develop a certification program for CCBHCs. The press

Counterpoint has long opposed the term “behavioral health.”

release declared that “the term ‘behavioral health’ does not align with DMH values.” “Certified Community-Based Integrated Health Center,” on the other hand, “reflects ongoing integration efforts across the state.”

Last year, DMH convened a CCBHC Steering Committee composed of mental health providers, advocates, and peers. During two polls, members voted to turn “CCBHC” into “Certified Community-Based Health Center.”

DMH chose “Certified Community-Based Integrated Health Center” instead, telling the committee that the addition of “Integrated”

would help avoid confusion with Federally Qualified Health Centers. Some members argued that the CCBHCs would not, in fact, offer integrated healthcare.

CCBHCs do not provide primary care services, but either directly or through a “designated collaborating organization,” they must administer “outpatient primary care screening and monitoring of key health indicators,” such as weight and tobacco use. Vermont’s community mental health centers expect to hire additional nurses as they become CCBHCs.

In January, Vermont’s Mental Health Integration Council endorsed the development of CCBHCs. Its final report to the legislature highlighted their promise to establish “a standard definition for care coordination across primary care and mental health,” but the recommendation was not unanimous, as some members worried that CCBHCs “may further separate people with mental health needs from physical health care,” according to the document.

SAMHSA first developed the criteria for CCBHCs in 2015. Howard Center, Northeast Kingdom Human Services, Health Care and Rehabilitation Services of Southeastern Vermont, and Rutland Mental Health Services have begun work toward compliance. Certified entities can access enhanced Medicaid reimbursement rates.

Crisis Commission To Review Two Incidents

The Office of the Vermont Attorney General referred five cases last year to the Vermont Mental Health Crisis Response Commission, an 11-member body tasked with investigating fatal and near-fatal police interactions with individuals experiencing mental health emergencies. According to their most recent annual report, commissioners determined, after preliminary reviews, that they would not pursue indepth inquiries into three of the incidents, but they would continue to examine the other two.

They have not yet submitted their findings.

Created by the state legislature in 2017, the

Mental Health Crisis Response Commission includes appointees from Vermont Psychiatric Survivors, Disability Rights Vermont, and NAMI-VT, in addition to members representing state and local police, the Attorney General, and the Vermont Department of Mental Health. In 2019, it investigated the death of Howard Center client Phil Grenon, concluding that “a breakdown in services” precipitated an emergency in which the Burlington Police Department “was compelled to use lethal force.”

The commission’s second full investigation, completed in February of last year, concerned the fatal shooting of a Washington County Mental Health Services client, Mark Johnson, who reportedly had ceased to take his regular

medication. Commissioners didn’t fault WCMHS or the Montpelier Police Department, whose “attempts at de-escalation not only followed policy, but were laudable for their extensive attempts at verbal engagement in which officers treated Mr. Johnson in a respectful fashion.” Like Grenon, Johnson had wielded a knife at the time of the shooting.

In 2023, commissioners closed three cases on the basis of insufficient evidence that the incidents had taken place amid mental health crises. For the other two, it had begun by fall to review records from relevant community mental health centers.

Last summer, DMH Care Management Director Allie Nerenberg became the commission’s chair, after Kate Lamphere, the chief clinical services officer at Healthcare and Rehabilitation Services of Southeastern Vermont, stepped down.

Commission Hosts Disability Rights Advocates

On May 22, four advocates for people with disabilities, including one with psychiatric disabilities, shared their perspectives with state commissioners tasked with “dismantling institutional, structural, and systemic discrimination” in Vermont. Members of the public also attended the virtual event.

Established in 2022, the Vermont Truth and Reconciliation Commission carries it out its business – which involves creating a “public record” of past and current harms experienced by various marginalized populations as a result of state policies – in regular monthly meetings. This spring, it initiated a supplemental “educational series” called “VTRC Narratives from History to the Present Day: Extending the Olive Branch through Education.”

“The education series is about expanding our understanding and hearts,” VTRC Executive Director Faith Yacubian said. “The commissioners will not be voting on proposals today.”

In April, a panel discussed “Experiences of Native Americans and French Indians of Vermont.” “Experiences of People with Disabilities” was the title of the second conversation in the series.

One of the panelists, Vermont Center for Independent Living Executive Director Sarah Launderville, identified as a psychiatric survivor. She joined Green Mountain SelfAdvocates Outreach Director Max Barrows, who called himself “a person on the autism spectrum”; Cammie M. Naylor, an attorney with Vermont Legal Aid’s Disability Law Project; and Cheryl Van Epps, a traumatic brain injury survivor.

Launderville described having been “locked up because I have mental health issues and psychiatric disabilities.” Later, when she had become a leader in the independent living

movement, her story began to elicit surprise and skepticism.

“I will always hear feedback like, ‘Oh, you don’t seem that bad,’ or, ‘You don’t seem like you have those issues,’ as if, because I seem and look a certain way, I don’t have a disability,” Launderville recounted. “And non-disabled people will sometimes think that’s a compliment, and for me, who’s pretty prideful that my identity includes multiple disabilities, it’s not.”

“I lived in this life that wasn’t the life I wanted to be living. And it was because I wanted to work.”

Launderville discussed her early struggles to secure accommodations in the workplace for disabilities that didn’t reflect “some of those older ideas around what a disability looks like.”

“When I moved to Vermont, I was moved to a group home, and that’s how I came to live here. And I really, really wanted to work,” she recalled. “I kept losing employment because people don’t always know how to accommodate people.”

“So my case manager helped me fill out benefits for Social Security,” Launderville continued, “and I got in subsidized housing, and I lived in this life that wasn’t the life I wanted to be living. And it was because I wanted to work. And it wasn’t until I found people who understood what it was like to have a disability and accommodate people that I was able to sort of thrive and move into a life that I think that not only I but other people deserve.”

Yacubian asked the panelists to choose any existing “service aimed to support persons

with disabilities in education, healthcare, employment, or another institution in Vermont” and explain how they would remake or improve it if they had the power to do so. In response, Launderville sought to “push back,” as she put it, on the question’s focus on services within institutions, instead of institutions themselves. She advocated for “thinking things through a little bit more holistically.”

“All the different things you just said, like education, healthcare, employment, all of them have flaws around how we make sure that this world is really accessible to folks with disabilities,” Launderville said. “Let’s start talking for real about how we need to build this back up from those root causes to something that’s really going to work for everybody.”

In her view, that conversation can take place only by “centering the voices of people with disabilities, no matter what. Not the parents, not friends, not family members. People with disabilities.”

The Commission will hold the next event in its educational series, “Experiences of Black People of Vermont,” on June 26. Its work will continue until May 2027, thanks to recent legislation that extended the deadline for its final report by 10 months. One of the commissioners had resigned in November, and since then, the VTRC has made do with just two.

The bill was controversial on account of another provision that exempted the Commission from the Vermont Open Meeting Law. In determining to allow the VTRC and its subcommittees to deliberate behind closed doors, lawmakers cited the “the highly sensitive nature” of their duties.

The Vermont Press Association opposed the legislation. Much of the VTRC’s work will remain publicly accessible, including its educational series.

Mental Health Dominates VT Telemedicine

Patients with mental health diagnoses use about 80% of all telehealth services in Vermont, according to a report issued by the Vermont Program for Quality in Health Care.

In accordance with Act 6 of 2021, VPQHC, a nonprofit established by the state legislature, studied the rise of telehealth services during the COVID-19 pandemic, using claims data from Medicaid, Medicare, and the state’s three largest private insurers that spanned 2018 to 2022. VPQHC presented the report to the legislature this February.

In 2019, Vermont insurers processed just 425,958 total telehealth claims, compared to 8,563,939 claims for in-person services. The next year, with the start of the pandemic, the number of telehealth claims rose dramatically to 1,017,134, while in-person services fell, yielding 6,836,483 claims. By 2022, Vermonters had reduced their usage of telehealth somewhat (758,760 claims), but inperson healthcare visits had not returned to

previous levels (7,196,266 claims).

Mental health providers of various kinds billed Vermonters for telehealth services 492,656 times in 2022. Mental health counselors topped the list at 142,384, followed by clinical social workers. Outside of the mental health field, Vermonters using telehealth

services consulted most often with family medicine physicians, who provided billable services 23,322 times.

Per VPQHC, the vast majority of telehealth providers make use of both audio and video, and the rate of audio-only consultations is lower for mental health than for other services. Women in Vermont use telehealth about twice as often as men. VPQHC did not present data about patient satisfaction for telehealth users, despite language in Act 6 that called for its inclusion in the report.

“More research is needed on the quality of care delivered through telehealth,” said Quality Improvement Specialist Ali Johnson on behalf of VPQH.

In May, the legislature passed S.861, extending a provision from 2020 that had temporarily required insurers to reimburse telehealth consultations at the same rate as in-person services. Now permanent, the rule otherwise would have expired in 2026.

Psychedelics Legislation Becomes a Study

Some researchers say that psychedelic drugs can help people facing mental health challenges. But the Vermont General Assembly wants to find out more before taking any potential action.

In January, Sen. Martine Gulick introduced a bill that would have decriminalized psilocybin, commonly known as magic mushrooms, and created a path toward its eventual legalization in therapeutic settings. A shortened version passed in May, creating a working group that will study “the cost-benefit profile of the use of psychedelics to improve mental health.”

The legislature will receive a report next year. The House removed a provision from the Senate’s bill that would have required the working group to “provide an opportunity for individuals with lived experience to provide testimony in both a public setting and through confidential means, due to stigma and current criminalization of the use of psychedelics.”

experiences. One highlighted the advantages of “microdosing” in particular.

The advocate defined microdosing as “a way of consuming psilocybin in a natural form without any psychoactive experience. You can take it and go to work, care for your kids, drive a car, etc. It’s absolutely no different than taking a pharmaceutical

She described using psilocybin to overcome post-traumatic stress disorder, calling it “life-changing.” It has also helped her to “maintain psychological balance” more broadly and to manage her attention-deficit disorder.

Another advocate weighed in as both a scientist with subject matter expertise and as a psilocybin user. She cited it as an effective treatment for depression.

not sure what kind of mom I would be, what kind of functional teacher I would be.”

“I’ve always had a fear of what would happen if something criminal came out of my own desire to ease my suffering,” she added. “It’s a concern I live with every day and I know that other parents and caregivers think about this.” Even so, Rep. Anne Donahue urged fellow lawmakers to exercise caution. As a psychiatric survivor, she spoke of the dangers of unproven mental health treatments. Electroconvulsive therapy had “practically destroyed” her life years earlier.

“I have lived the life of somebody who has been told, ‘Oh, this is safe, this is safe, this

Psilocybin users submitted testimony about their positive experiences.

In spite of these concerns, a few psilocybin users submitted testimony during the winter to tell legislators about their positive

“When my sister died in 2013, it was like falling into an abyss. I sought therapy. I sought treatment from medical doctors,” she said. “But ultimately, I sought treatment from the medicine that I had seen help so many of the folks that I worked with at [Johns] Hopkins. And without those experiences with psilocybin, I’m not sure that I would be alive today and I’m

is safe. We in psychiatry and mental health know what we’re doing,’” Donahue said. Her amendment to S.114 removed the co-founder of Psychedelic Society of Vermont from the legislatively appointed working group.

Federal officials classify psilocybin as a Schedule I controlled substance with “no accepted medical use and high potential for abuse.” Several large US cities, however, have decriminalized it, and Colorado and Oregon have legalized its supervised use.

Deputy Commissioner of Mental Health Departs

Deputy Commissioner of Mental Health Alison Krompf resigned this spring, taking a new position with a private foundation. Her new employer, the Four Pines Fund, disburses grants for suicide prevention programs.

“I didn’t take this move lightly. I love, love this job,” Krompf said. “It just so happened that an opportunity came my way that’s just directly in the line of my absolute passion, which is helping create the best support possible for people who are experiencing thoughts of suicide.”

Four Pines has “started out by doing a little work in Vermont already, funding different aspects of treatment options,” Krompf continued. “And I say treatment lightly because they’re open to alternative supports outside of the medical model.”

By her account, that includes peer respites. Krompf said she would serve as the foundation’s director of strategy for its Vermont operations.

“The thing I’m probably most excited about is breaking free of the bounds of the Medicaid rules,” she said, “because it just feels like a little bit more of an option to try out some creative ideas.”

Krompf rose to second-in-command at the Vermont Department of Mental Health in 2021, following a two-year stint as its director of quality and accountability. Psychiatric survivor

Dan Towle lamented Krompf’s exit, describing her as “a consummate professional and someone who really cares.”

“I’m not delighted that you’re leaving DMH,” Towle told Krompf at a meeting of the Adult Mental Health Standing Committee.

“I personally feel you’ve had an impact on DMH, of course, but also on the mental healthcare system and even broader, in terms of the things we’ve been doing with the Mental Health Integration Council and all.”

Krompf reflected on the importance of the committee’s input during her tenure. She noted that its members had, for example, urged DMH to begin publicizing the Pathways Vermont Support Line in its lists of resources for people seeking help, and that it now regularly does so.

want,” Krompf said. “But I just deeply want to let you know that your time in this group really makes a difference.”

“I know that sometimes you don’t always get everybody’s attention as much as you might

On May 28, the Agency of Human Services announced that Gov. Scott had appointed Samantha Sweet, DMH’s director of mental health services since 2021, to replace Krompf.

Alison Krompf (courtesy photo)

The Arts 12

Upper Valley Anthropologist Reveals ‘Families on the Edge’

BOOK REVIEW by BRETT YATES

In 2009, when Dartmouth professor Elizabeth Carpenter-Song launched what would become a decade-long ethnographic study of homelessness in the Upper Connecticut River Valley, plenty of its residents, by her account, didn’t know that a homeless population existed in the area at all.

Today, the adjacent towns of Norwich, Vermont, and Hanover, New Hampshire, continue to place at or near the top of median household income rankings in their respective states, but the consequences of their region’s increasingly insurmountable cost of housing have become impossible to ignore. Unfortunately, stories like the ones in Carpenter-Song’s Families on the Edge: Experiences of Homelessness and Care in Rural New England (MIT Press, 2023) have doubtless grown more common over the years.

The author dubs herself an “anthropologist of mental health,” and much of her “personcentered” scholarship has focused on individuals caught in what she calls “the psychiatric net.” Families on the Edge, her first book, showcases her continued interest in people’s experiences of the mental health system. That system figures prominently in the lives of the five families who became her subjects after meeting her at a shelter in Vermont where she’d come to do research.

According to Carpenter-Song, “there is no single path that leads a family into homelessness. Indeed, to speak of pathways overlays a sense of linearity onto experiences that are instead a thorny tangle – a gradual accretion of misfortune, the subtle erosion of relationships, or the incremental fraying of a life shadowed by trauma and mental illness.”

This is not to mystify the central, big-picture cause of homelessness, which Carpenter-Song identifies, again and again, as a shortage of housing. Still, every victim of New England’s housing crisis has a unique tale to tell. Some contain surprises. Amid increased attention in the press, rural homelessness remains, at times, misunderstood or even invisible.

Carpenter-Song challenges “definitions of homelessness [that] tend to focus on rooflessness, which does not take into account varied and complex housing ‘mobilities’ in rural areas.” Attuned to what she terms “housing instability” or “housing distress,” she argues that “categorical distinctions between the rural homeless and rural poor people may be spurious.”

When these five “families on the edge” arrived at the shelter, most had come not from a street corner or a tent in the woods but from a motel room that they could no longer afford or a couch belonging to a friend or relative with whom they could no longer get along. Months later, as

they left for subsidized or shared apartments, Carpenter-Song wondered whether her study had ended. She decided it hadn’t.

Over the years, evictions followed, or else doubled-up households collapsed under the weight of interpersonal conflict. Families hopscotched from one ill-suited or temporary arrangement to another. Cheap housing in remote areas came with difficulties in accessing

transportation, childcare, and employment –not to mention loneliness, which exacerbated challenges with mental health and substance use. In spite of the “resource-rich” Upper

The author cites national data suggesting a bias against parents with psychiatric labels, especially those who’ve experienced hospitalization.

Valley’s “kaleidoscope of professional services,” their interventions rarely reversed these downward spirals.

Carpenter-Song chronicles her subjects’ engagement with counselors and psychiatrists as a string of “missed opportunities and unintended consequences.” Some resisted psychotherapy, contending, for instance, that doctors “haven’t been through the same things, so it doesn’t help. They can say, ‘I understand,’

but they really don’t.” Incidentally, shelter staff reportedly discouraged guests from turning to one another for counsel, cutting off a potentially effective source of peer support.

The author’s ambivalent view of professional mental health services acknowledges a risk, in the treatment of homeless individuals especially, “of medicalizing social and structural inequalities.” Her subjects echo the concern, particularly as it pertains to psychotropic medication. “You’re not dealing with the problem. You’re just masking it. And you’re just walking around in a cloud,” one says.

Carpenter-Song laments a “misalignment between biomedical and individual, familial, and community perspectives” in their understandings of human suffering, which for her explains, in part, “why the majority of people with mental health problems in the United States do not seek professional treatment.” This lamentation contains, however, a tacit belief in the basic legitimacy and necessity of such treatment, and when the author’s subjects disagree, she tends to pathologize their refusals to accept professional help as manifestations of “the bootstrap mentality of rural New England.”

Yet her own work reveals the invasive and sometimes even punitive character of this same help. While explicitly rejecting a Foucaldian view of both medical and social services and emphasizing instead the “well-intentioned” nature of the workforce in these sectors, Carpenter-Song (deliberately or not) paints a particularly disturbing portrait of the Vermont Department for Children and Families, which, according to her research, removes kids from their homes at a higher-than-normal rate compared to other states.

The author largely blames “limited funding and caseloads far exceeding recommended standards” for what might look like illconsidered decisions by DCF, but she also cites national data suggesting a bias against parents with psychiatric labels, especially those who’ve experienced hospitalization. Such mothers and fathers must prove to state officials that they’re healthy enough to care for their kids, but in Carpenter-Song’s telling, it is, above all, the “traumatic rupture” of the loss of their children (and of their own identities as parents) that has seriously damaged their mental health in the first place. In one case, the pain of DCF’s seemingly arbitrary unwillingness to return them, even when the parents believe they have fulfilled the state’s conditions, becomes the final blow.

While Carpenter-Song’s sometimes clunky scaffolding of academic analysis can occasionally blunt the impact of the real-life stories she reports, their immense pathos mostly shines through, ultimately calling the reader to action. The author’s concluding

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In ‘Airswimming,’ Psychiatric Incarceration Feels Like It’ll Last Forever, and Then It Does

THEATER REVIEW

by BRETT YATES

“It’s not the Dorchester, is it?” says one inmate at an English “hospital for the criminally insane” to a newer patient, referring sarcastically to the famous five-star hotel in London.

“Although most of our guests stay for much longer,” she adds. “It’s the camaraderie, I think.”

Airswimming, a one-act comedy of sorts, depicts a friendship that spans five decades of psychiatric incarceration – and then some. A newspaper clipping about a pair of women released from an asylum in the their involuntary commitment in the 1920s, reportedly inspired the playwright British playwright Charlotte Jones, whose theatrical telling debuted in 1997.

This spring, Middlebury College junior Elsa Marrian directed a production on campus, with four shows between April 18 and 20. Her stars, seniors Maggie Blake and Kristen Morgenstern, helped bring the spare but vividly realized two-hander to life with confident, spirited, humorous performances.

staircase – their mandated chores at the hospital, which doesn’t give them much else to do – and find ways to pass the time and support each other. No doctor or nurse ever appears in Airswimming, which locates its characters’ misery in scenes not of psychiatric torture but of almost Beckettian nothingness, filled only by conversation that much of the time manages to remain fairly lighthearted.

Jones arranges scenes from their lives in a nonlinear but somewhat schematic fashion. Still, the empty, repetitive nature of Dora and Persephone’s existence begins to melt time and space. Are they still inside the hospital, or does their freedom, granted at such a late date, look almost identical to their incarceration? The play’s title – which refers to an oddball hobby whereby, without access to a pool, the characters mimic synchronized swimmers – becomes a metaphor for their surreal journey through the decades.

Persephone and Dora change over time. It’s one of the ways we know that time hasn’t

“representations of mental illness” among other potential triggers. It wasn’t clear to me that this was what the play was about at all. A “producers’ note,” however, identified Airswimming as a story of injustice.

Jones presents her characters, Persephone and Dora, as victims of society’s rigid gender norms. An embarrassment to her upper-crust family, Persephone has given birth out of wedlock. Dora, labeled a “transsexual,” dreams of being a soldier, like her three brothers who died in World War I; her romantic fantasies revolve around a Bolshevik commander, Maria Bochkareva, who led an all-female battalion in the Russian Revolution.

Together, they scrub a bathtub and a

‘FAMILIES ON

THE EDGE’

Hardy bravado gives way to open despair.

stopped. Prickly and snobbish at first, the former grows more childlike, developing a girlish fixation on the movie star Doris Day. The former’s hardy bravado gives way to open despair.

My $5 ticket came with a program, which included a “content warning” noting

• Continued from previous page

policy prescriptions inevitably center the need for greater investments in affordable housing.

She also offers guidance on “reimagining supportive services for families,” having witnessed the failures of existing services at various crucial junctures in the lives spotlighted by her book. The author doesn’t seem to perceive a tension between investing in targeted services and investing in universal goods, like housing, public transit, and childcare, even as her work comes close to calling into question the fundamental logic of the former approach, with its tendency not only to surveil and police homeless families but also to burden them with appointments

and paperwork of dubious value, as if for the purpose of generating a deliberately unpleasant simulacrum of a “normal life” with job responsibilities and bills to pay.

“Health and social services need to meaningfully attend to the lived realities of surviving in poverty,” CarpenterSong writes. She wants providers to receive increased “training in the social determinants of health and traumainformed care.” But their interactions with clients should also include “honest discussions of the usefulness

“These injustices,” it said, “are not just historically situated, as the pathologization of womanhood and entrenched biases within the medical system continues to harm people today, particularly women of color and trans/ queer individuals.”

The Middlebury College Department of Theatre’s 2023-’24 season concluded with a staging of Orlando by Sarah Ruhl in May. Productions will resume in the fall. Airswimming is available in paperback from Samuel French.

and limitations of specific therapeutic modalities.”

Mental health professionals must be honest with themselves about these limitations first. Carpenter-Song quotes an unnamed “community psychiatrist,” a paragon of modesty in describing his own approach.

“Don’t try to help. Try to understand what this individual is experiencing. Try to understand how the individual has developed his or her personality and relationships based on a life of experiences,” he says. “Diagnosis is trivial, especially in comparison to context. Medical solutions for social problems are expensive and ineffective. Who does this individual trust to help? It’s rarely a doctor or social worker. How does he or she learn? It’s unlikely to be from professional advice.”

Murals Brighten Group Homes

Over the past year, the Howard Center Arts Collective has collaborated with residents and staff at four Chittenden County group homes to bring color and imagination to the walls of their common spaces.

The Arts Collective hired memberartist Annie Caswell to spearhead these projects. When she spoke to Counterpoint this spring, Caswell had completed murals at Allen Home in Winooski, Next Door in Burlington, and MyPad in Essex, and she had begun another at the new Lakeview House in Shelburne.

The murals depict a variety of scenes: a coral reef, downtown Winooski, The Wizard of Oz’s yellow brick road, and a “magical village” with gnomes and a unicorn. Each can take months to finish.

starts from the mural’s conceptualization and continues throughout its execution. Some haven’t made art since childhood, while others may have professional-level skills. Regardless,

Caswell, who operates a “micro-business” called Kissed by Fire Creations, has also worked for Howard Center in various capacities. And like many other members of the Arts Collective, she identifies as an individual with her own lived experience of mental health challenges.

The involvement of group home residents

Caswell tries to get as many as possible to pick up a brush.

“I had many people say, ‘I can’t do this,’” she recalled. “And then that’s my job to get their confidence up.”

Some participants expressed a fear of

messing up, so Caswell had them draw first on paper, where they could have as many tries as they needed, and then transferred their designs to the wall for subsequent coloring. Others contributed ideas or aesthetic preferences.

“I have a pretty detailed conversation with them, saying, ‘What do you want on the wall? What do you think about words that you would like to see on the wall that are positive? Or what are some triggers that you might not want to see on the wall?’” she described.

According to Caswell, residents have reported enjoying the experience. She quoted one testimonial that called the process “a sort of meditation” and noted “a sense of accomplishment” at the end of it.

“I think that’s the important thing: what does this mural do?” Caswell said. “Yes, it makes a picture on the wall, but more importantly, it’s how it affects the community.”

Photos by Annie Caswell. Clockwise from top-left: Allen Home, Winooski; Allen Home; MyPad, Essex; Next Door, Burlington. Center: Allen Home.

An Unusual Sort of Nervous Breakdown Short Fiction

by RON MERKIN, Montpelier

“Sorry, Samantha, I’m calling because I can’t be at our board meeting this Tuesday. I made an appointment to have a nervous breakdown that day.”

There was silence. Then, “You made… an appointment… to have a… nervous breakdown?”

“Yes, with a specialist! I’m really excited!”

“But… Gloria. I mean… no one… makes appointments to have nervous breakdowns!”

“They don’t?”

“Well, of course not!”

“No one? I didn’t know that. But now that you made me think about it, it seems like all the more reason why I should!”

Samantha slammed the phone down. I just can’t deal with any more of her nonsense, she reasoned.

In spite of that, Samantha phoned again the day before the board meeting. Maybe, regardless of the way she frustrates me, I can convince her to postpone her nervous breakdown, Samantha thought. Now that a few days have passed, some rethinking on her part, along with some gentle coaxing, might do something for her sanity. Attendance at the meetings was dwindling. Gloria was needed.

“How do you feel today?” Samantha asked.

“Why, with my fingers. How do you feel?”

Samantha hung up a second time. She took a deep breath. Gloria’s weirdness was not her fault, after all.

On Tuesday, Gloria’s nervous breakdown went smoothly. Having slapped her face 42 times, Dr. Dejetarias de Glomderwurgedictator jerked her hair. Shorter than Gloria, mustached, he had refined his skill over the years. The balance he’d perfected between force and restraint humiliated and pained his patients to exactly the right degree.

“You’re so stupid! And look at the way you dress! You should be ashamed of yourself!” he intoned, breaking into laughter.

He pointed a finger at Gloria. “For heaven’s sake, why can’t you be more like your brothers and sisters? Success is written all over them!”

“I don’t have any brothers or sisters,” Gloria mumbled. “You asked me about that, and I told you before we started this session.”

Dejetarias’s finger wagged as he improvised. “Don’t project your hallucinatory wishes on me, young lady! You’re the one who can’t do anything right. I’m the expert! You were born without a brain!”

He was screaming by then. Glancing at this watch, he slapped Gloria a few more times and finished the treatment by switching to a normal tone of voice.

“We recommend that you commit yourself to the Green Field Psychiatric Hospital twelve miles away,” he explained. “There, a series of ten electroshock treatments would begin. Should you do this immediately, you won’t

have to pay today for this session. It’ll be added to the overall bill at the end of your psychotherapy. Assuming you agree, I’ll call an ambulance to transport you to the hospital. Shock treatments should begin as soon as possible after the introductory indoctrination in order to maximize the lasting effect.”

Gloria wasn’t sure what to say. At least, while slapping me, he didn’t dishevel my clothes, she noticed as she glanced downward.

”Should you need additional convincing, we can schedule another appointment tomorrow,” the doctor went on. “Like the shock treatments,

a second preliminary session, similar to today’s, should be scheduled immediately.”

“Why did you have to pull my hair?” Gloria ventured.

“Sorry, sweetheart. We’re over our time limit. That means I can’t comment on procedure.” Dr. Degetarias smiled. “If you’re going home instead of going to the hospital, I’ll tell my receptionist to give you a prescription for some medication that’s effective for patients who have trouble sleeping. Based on how today went, I can’t imagine that you’ll have that problem…”

Then he grabbed her gently by the shoulders. “You worry me. I’m concerned about your future.”

Once home, Gloria thought maybe she shouldn’t have canceled her attendance at the board meeting. By way of apology, she phoned Samantha to ask how it went.

“OK,” Samantha said. “And how was your nervous breakdown?”

“Oh, it’s not finished. Today was a prep session. The psychiatrist who did it told me I need electroshock treatments next.”

“Electroshock treatments! They’re no longer done! Today, everything’s drugs.”

“Drugs?”

“Yes, you know. Psychotropic medications.

Xanax, Celexa, Zoloft, Prozac, Ativan, Desyrel…”

“How do you know about these drugs?”

“My mother. Have you forgotten? She’s a psychiatric nurse.”

“Oh. Is she available to do nervous breakdowns? I wasn’t crazy about the psychiatrist’s approach…”

But Samantha had abruptly ended the call again.

To Gloria’s surprise, she did have trouble sleeping that night. I don’t want to take any of those goddam pills Dr. whatever his name was gave me, she thought, still awake an hour later. Well, maybe just one…

Swallowing it felt discomforting. A second after she had, Gloria felt so tired that luck alone seemed to enable her to walk the two feet to her bed. Thinking the day over before collapsing into sleep, she wondered why in the hell she’d gone through with the stupid nervous breakdown.

“You’ll understand when you wake up,” a voice she thought she heard told her.

“But when will I wake up?” she asked.

“Oh… when you’re ready, idiot.”

She floated aimlessly above gravity. What’s gravity? I have no idea, she realized. A loud noise brought her down to earth.

My fire alarm!

Jolting awake, she could smell the smoke. She had to get out of there! Rushing to put on a bathrobe, she made it to her front lawn in two minutes. Then, watching the fire, she burst out laughing.

Who had started it? What was making it spread? Could this have anything to do with her nervous breakdown? She couldn’t stop laughing.

Groggy, wondering what had happened to the fire, she reached for her phone on the night table next to her bed. “Who’s this?” she grumbled.

“Oh. My name is Bob Zeltby. I’m a reporter for the Whartonville Times. We’re writing an article about nervous breakdown therapy and would appreciate hearing about your experience. Dr. Dejetarias said you’d be a willing interviewee.”

“Huh?”

“Doctor…”

“Has he never heard of privacy!? What about confidentiality?” Gloria erupted. Then, after not getting a response: “Are you there, sir?”

“Oh, yes. I was checking to make sure your comment has been recorded. I’m having a problem with...”

Gloria slammed the phone down. Its impact made her wonder if at this rate both her and Samantha’s phones would soon be ruined.

The thought made her laugh again. She was doubled over as the laughter began reinventing itself. Metamorphosing into a scream, it got (Continued on next page)

Inclusive Arts Exhibition Tours State

Inclusive Arts Vermont’s fifth biennial exhibition, CYCLES, opened on Feb. 15 in Burlington at the University of Vermont’s Davis Center. It will travel throughout the state until December.

A nonprofit established in 1986, Inclusive Arts Vermont uses “the magic of the arts to engage the capabilities and enhance the confidence of children and adults with disabilities.” The paintings, photographs, and mixed-media creations in CYCLES express “cycles of nature” and “of the body, mind, and spirit.”

According to Ashley Strobridge, her painting emerged from a period of “cycling through different bipolar meds and through my own bipolar manias and depressions” during her teenage years. Following “a particularly bad mental health crisis brought on by progressive physical decline and medical trauma,” Julien Majonen “turned to pottery as a way to try to get back into the world and find some semblance of feeling okay again.”

After a month at the Vermont State House, CYCLES moved to All Souls Unitarian Univeralist Church in Brattleboro in May. In late summer, it will go to St. Johnsbury before returning to Burlington.

SHORT FICTION • Continued from previous page

loud, louder… the neighbors can’t hear me, they’re too far away, she reminded herself. Shouting to express her feelings even as her throat started to hurt, she found herself dancing in a circle.

Wait a minute! She was going to be late for work!

Glancing at her watch, Gloria realized she’d have to leave immediately. Her boss had been understanding enough to find a fill-in while she was at the “friend’s funeral” she’d lied to him about the day before. But the dental clinic where she worked couldn’t function without someone at the front desk.

“Hello, how ya doin’ today?” she rehearsed as she raced to get dressed. Gloria wondered why she overdid her enthusiasm while greeting patients. A few minutes later, she floored the car’s gas pedal.

“You’re a little late.” It was Dr. Koreen.

“I’m sorry,” she told him.

She began to wonder how she’d managed to sustain this job. She was hired nearly a year ago. She felt a little pride, but her self-esteem was compromised when she remembered that there was an enormous shortage of dental office managers. Was she better than nothing? How she could function in a professional way when she seemed so crazy to herself at home also perplexed her.

Gloria had been at her desk only a few minutes

when she heard a dog barking outside, probably in front of the building. But she heard its sound getting closer. Could it be climbing the stairs to the office?

A second or two later a woman with an unleashed dog walked in and approached Gloria’s desk. “Hi. My name’s Doris Filbourne. I called yesterday to make an emergency appointment for 15 minutes from now.”

“Aha,” Gloria greeted her. “But, sorry, I’m afraid dogs are not allowed in our office.”

There was a pause, then: “My dog is the patient.”

“Your dog is the… patient? I mean, we don’t… we don’t treat dogs here. You need a veterinarian specializing in animal dentistry.”

“Nonsense!” the woman said. “All dentists today have animal skills. They all treat dogs!”

A moment, then: “I’m afraid that’s not so, Ms...”

“What? You’re telling me I wasted forty five minutes traveling here for nothing? You’re refusing to treat my dog? He’s in acute pain. You can hear that!”

“There’s nothing I can…”

“I’m going to report you to the Humane Society!”

With that, the woman turned and started walking to the door before glancing back.

“Casper, aren’t you coming with me? Or would you prefer to stay with this stupid woman? We’re leaving, for Christ’s sake! Casper, come here this minute!”

Having stopped his barking, the dog walked to her slowly. Looking through files on her computer, Gloria found the woman’s appointment for the time she said it was scheduled. But nothing was written about a dog.

Should she tell Dr. Koreen about this? Only if he asks, she decided.

That night Gloria dreamed that the dog was attacking her. What she couldn’t account for was why its face looked exactly like the nervous breakdown doctor’s.

And as if that wasn’t enough: it was Samantha’s voice doing the barking – not the dog’s! The dog was quiet! What was this about?

All this swam in her head. Eventually, Gloria eased into a deeper sleep.

The next day, she thought about the dream, but she couldn’t figure out its meaning. Then, as she nodded off during a slow moment at work, a version of the dream repeated itself.

This time, Dr. Dejetarias de Glomderwurgedictator was holding her again by the shoulders. His sincerity – “I’m really concerned about you” – made her realize that everything would be clarified: easier, for the rest of her life.

“Queer Metamorphosis” by Julien Majonen “The Depth of Seasons” by Ashley Strobridge Visit inclusiveartsvermont.org for more information.

Art & Poetry by Our Readers

The Lost Enchanter Recalls Honey

(for Rob Peters and Dave Gandolfo)

1.

In the bouquets was strength. running through the veins like wine as I drank tea in the mornings, and in the long afternoons, in my house with the windows open...

2. Now that the sun is like an old lost love, or a false friend, too late found out, ... now the noise of the morning, the traffic in the street, becomes bees, buzzing in my dreams...

3.

The people and the houses, the lamp-lit streets, are no less alien than I... ... the whole surface of the earth is foreign... and the nighted roads, will not lead me home...

by SCOTT NORMAN ROSENTHAL, Irasburg

Louise Wahl Memorial Writing Contest POSTPONED

A NOTE FROM VERMONT PSYCHIATRIC SURVIVORS’ BOARD OF DIRECTORS:

I am writing to tell you about arriving at a crossroads at Vermont Psychiatric Survivors. VPS is the publisher of Counterpoint. The grant that has funded us for over ten years has been put out to bid.

This means other organizations may apply for it. VPS through its Board of Directors has decided to reapply for this grant. In the interim, what does this mean for Counterpoint and VPS?

In short, we may be taking a temporary hiatus from some things and continuing others. Our intent is to continue to publish Counterpoint, contingent on resources and funding. VPS will continue regardless of the outcome of this!

We recognize this is a crossroads for VPS. This action has opened us to other possibilities. We will continue our mission and continue our work to the best of our ability.

I think VPS is unique and has been through waves and storms. We will weather this and come out stronger!

Respectfully, Zachary Hughes VPS member, VPS Board Member, VPS Vice President

Drawing by RICHIE AMERSON, Burlington

Photos by NEAL MUSE, Burlington

‘Housing First’ Must Mean Housing Editorial

Saying that housing is the solution to homelessness is a little like saying that oxygen is the solution to asphyxiation. Both statements are obviously true – though the former hasn’t always been as obvious to some as the latter.

But on their own, both also leave a few major questions hanging in the air. What can we do to unblock the choking person’s airway? Who will pull the drowning swimmer to shore? Where in Vermont can you find a vacant apartment? And if there aren’t any, how do we go about creating some?

A new advocacy coalition emerged this year to promote a program for ending homelessness in our state. Housing First Vermont consists of a handful of individuals and six admirable organizations: Disability Rights Vermont, Pathways Vermont, the ACLU of Vermont, the Vermont Center for Independent Living, Vermont Legal Aid, and End Homelessness Vermont.

“Housing First” is the name of a philosophy that progressive governments have increasingly begun to embrace. In our state, it’s also the name of a successful program operated by Pathways Vermont, a nonprofit that by its own count, has connected 873 homeless Vermonters to permanent housing since 2010.

As a philosophy, Housing First signifies a belief that the lack of a home constitutes the most urgent problem in a homeless person’s life and must be rectified as quickly as possible, regardless of their sobriety, mental state, or employment status. Adherents of Housing First aim to offer connections to supportive services, but if a client doesn’t want them, they will work just as hard to find that person an apartment.

survivor movement, which has long argued that the medicalization of psychological stress among poor people masks society’s refusal to resolve their inevitably distressing material deprivations.

No one should be deprived of housing. Some Vermonters have begun to see that, but it’s an ongoing process. Pathways, which operates its Housing First program in seven counties, continues to compete with other nonprofits in the same sector for governmental support, including some that may have more oldfashioned attitudes. This year, Pathways asked the legislature, unsuccessfully, for $5.3 million to bring Housing First statewide.

Granting this request was just one item in a list of eight policy recommendations put

No one knows this better than service providers themselves, whose job of linking individuals to homes is made infinitely harder by Vermont’s widely lamented shortage of the latter. Legislators spent a major chunk of the legislative session debating what the state should do – and how far it should go – to fix it.

The major disputes revolved around H.829, H.687, and S.311. The first bill proposed to create a new high-income tax bracket to fund the state’s investments in affordable housing; the second and third competed to reform Act 250, Vermont’s statewide land-use law, by removing regulatory hurdles for developers in different ways.

All three bills saw impassioned testimony, but statehouse advocacy on behalf of Vermont’s homeless community continues to take place in a largely separate universe, even as such advocacy has become increasingly premised on the conviction that the answer to homelessness, as stated above, is housing. Ultimately, that comes down to the brick-and-mortar thing itself.

forward by Housing First Vermont. We appear to have a long way to go.

The indirectness of the link between forthcoming market-rate construction and the prospects of individuals living in shelters or on the street right now may account for part of the political gap between fights about housing and fights about homelessness. But efforts to expand profit-driven development through land-use liberalization constitute just one dimension of a struggle that can take countless shapes, including demands for rent control, “just cause eviction” laws, and new public housing authorities.

This marks a departure from paternalistic approaches to homelessness services that instead target the perceived behavioral issues that may have caused the client to “fail” to retain housing or to secure it on their own. Before Housing First, the client had to prove that they had taken steps to address these issues before the prospect of permanent housing could enter the discussion.

Housing First recognizes that homeless people have not “failed.” Like all of us, they may have various personal issues to deal with, but every issue is easier to address when you have a warm, safe place to sleep. The philosophy aligns, in this way, with some of the central premises of the psychiatric

But could a fuller commitment to the principles of Housing First eventually solve Vermont’s homelessness problem? Unfortunately, insofar as these principles address the attitudes and practices of service providers, rather than the policies governing the building of homes, it can’t.

That’s because Housing First, as we’ve come to define it, is not housing itself. For service providers, it is an order of operations: before anything else, help the client apply for a Section 8 voucher, talk to landlords on their behalf, get them on the Champlain Housing Trust’s wait list, and so on.

This makes sense. But if no housing is available, a service provider’s best efforts can’t do anything – not until something opens up.

Housing First Vermont’s relatively narrow policy recommendations address the state’s programs for the homeless: how they should work and what kinds of organizations should administer them. They don’t say anything about the laws that will determine how many homes will exist in Vermont.

Both subjects are important. But the importance of homelessness services – and of their particular character – is conditional: a proper housing regime wouldn’t require them in the first place.

Getting there means getting political in a bigpicture way. Organizations on the front lines of the existing crisis should play a role in the battle, but it will require seeing and speaking beyond their own crucial programming and expertise.

Letter: New History Misses Mark

by ANNE DONAHUE, Northfield

To the Editor:

The Counterpoint book review of Vermont for the Vermonters: The History of Eugenics in the Green Mountain State (Vermont Historical Society, 2023) in its winter issue captured Mercedes de Guardiola’s effort at pulling back the curtains on the eugenics movement in Vermont.

The review observed how the author, Mercedes de Guardiola, exposed the major role that discrimination against psychiatric disabilities played in mass incarceration in state institutions long before sterilization became an added tool for eugenic policies. What the book review failed to observe, however, was the extent to which the author exposed her own implicit bias in the ways she compared those events to the status of the mental health system of today.

The tricky thing about implicit bias is that if you know it’s there, it is no longer implicit. It is explicit.

The tricky thing about systemic discrimination is that it is usually hidden within implicit bias. We don’t fight it because we don’t recognize it.

While de Guardiola condemns the abuses of the past and condemns the lack of funding for community services now, in the same breath she criticizes current law that requires that care be provided in the “least restrictive environment” and be limited to those at danger to self and others. That’s because, she says, it “protects individual rights [but] can also lead to a lack of solely needed ongoing treatment.”

She fails to even wrestle with the question over whether forced treatment being imposed today is any different from that imposed 100 years ago, as well as whether its roots are the same bias of deeming those with disabilities less worthy.

She’s not denying it; she is completely failing to see it, subject as she is to ongoing systemic discrimination against us. A great deal of de Guardiola’s book is editorialized, which plays a large role in enabling implicit bias to take hold.

She takes a string of facts and draws conclusions without providing evidence for the conclusions themselves. We might draw the same conclusions, but they are also based upon our own opinion, not on objective historical evidence.

One example (among many) is the accusation that the state hospital in Waterbury used patient labor for the purpose of saving money to pay for food, heat and so forth. That was most certainly a desirable outcome of having patients chop the wood for the furnace and grow crops and run a dairy herd.

But in that day, it was a point of huge progress to not simply lock up insane people in basements. She acknowledges that the concept argued by the institutions was that fresh air and hard work was therapeutic, but her editorial tone dismisses those rationales altogether.

Thinking of forced labor as being a well-

intentioned effort at promoting better health – in the context of the time – is not irrational. It is likely that both motives were at play: good for patients and good for the financial bottom line.

And de Guardiola’s research is neither of the depth nor of quality one might want. At the basic level, she repeatedly calls the Vermont State

Hospital,” the “Waterbury Hospital,” based on asserting it was better known by that name. In everyday parlance, Vermonters actually said “the state hospital” or simply “Waterbury.”

De Guardiola does not even adapt language to person-first standards, referring to current people with disabilities as “the severely mentally ill and disabled.” She also misses some of the more critical early quotations from VSH reports showing early support for eugenics as the means to address the growing number of the insane.

She cites only “private statements” that tied VSH leaders to eugenic policies prior to 1912, ignoring the 1898 Biennial Report to the governor and legislature, which stated that

The very systemic discrimination that the author is attempting to expose is actually alive in her own work.

laws referring to support of “the State insane and dotards” needed to radically change to avoid steady increases in “defective wards being committed to state care.” The decreases in infant mortality “tends to the survival of the unfit, and consequently the number of

defective individuals will probably increase,” the three hospital trustees wrote.

Although de Guardiola quotes those references earlier in the book, she ignores them in the chapter discussing actual connections between state hospital leadership and eugenics. (In a staggering statement, the trustees added that, “The people [inmates], themselves, also, are learning to appreciate the advantages of the modern mental hospital.”)

Based upon the involuntary servitude discussion, de Guardiola later concludes that many institutions ultimately began to close down after a 1966 federal act banned exploitative unpaid labor, seemingly evidence that the only purpose had been to make locking people up economically feasible.

In fact, de Guardiola also cites the federal refusal to fund large psychiatric institutions (the “IMD” rule) as discrimination that strapped state governments for funding, while in reality, it is based upon a refusal to fund large standalone treatment facilities in lieu of integrated inpatient hospitals.

More complete research would point to a huge number of factors that led to the downsizing of state institutions.

Vermont’s early history included leading the first major study of successful community living by those with so-called severe and chronic illness who had been deinstitutionalized. De Guardiola ignores that critical and groundbreaking early work, which found high rates of improvement or recovery in a long-term follow-up of those discharged to strong community supports in the 1950s (the Vermont longitudinal study of persons with severe mental illness, pubmed.ncbi.nlm.nih. gov/3591992/).

The public has likewise forgotten that research in Vermont when, instead of looking at inadequate funding, they assert that community-based care is a failure and has resulted in those who were once in state hospitals now being institutionalized in our prison systems. Some use it as an argument to rebuild and expand state hospitals, and it’s an active discussion among some Vermonters.

Vermont is now moving to open a new “forensic treatment facility” to incarcerate those individuals in a forced treatment setting. The mantra often appears to be, “Take these poor folks out of prison and lock them up in hospitals instead, where we can inject them with drugs to keep them [us] safe.”

De Guardiola recounts with dismay that efforts to add hospital beds in Vermont in recent years have been stymied and asserts there are an insufficient number of beds and overly-short stays.

This underscores that the very systemic discrimination that she is attempting to expose is actually very alive in her own work and implicit biases.

These arguments defy the effort to learn

(Continued on next page)

Anne Donahue (courtesy photo)

Navigating the Nuances: The Rise of PeerRun Mental Health Pages on Social Media

by LAURA SHANKS

Over the past few years, I have observed a growing number of social media pages by peers, for peers. Because I identify as neurodivergent, pages on Instagram and Tik Tok geared toward neurodivergent diagnosis have been my primary focus, but upon a quick search, pages for every mental health concern can be found. From borderline personality disorder, anxiety, and depression to narcissism and antisocial personality disorder, there is a peer-run page for just about every diagnosis in the DSM.

Each of these pages offers a unique perspective; some take a comedic approach,

using humor to address their diagnosis, while others lean toward factual information or support.

Upon stumbling upon these pages, I initially felt a sense of relief. Topics that were once

Upon stumbling upon these pages, I initially felt a sense of relief.

heavily stigmatized, ones I had spent years masking and concealing, were now being openly discussed in public forums and met with support and enthusiasm. However, as I’ve taken a deeper dive into these communities and conversed with peers, I’ve become aware of the nuances of mainstream mental health discourse, both its advantages and drawbacks.

“Too many people are selfdiagnosing from these pages,” a peer shared with me. They are concerned that too many of the “signs and symptoms” of mental health issues shared on social media are too generic and lead too many to identify unnecessarily with them.

So while a broader audience is now being educated about mental health through social media, whether or not that information

DONAHUE LETTER • Continued from previous page

from eugenics. Those with mental health trauma or disabilities aren’t defective. With support, those of us who face life struggles can be active participants in a holistically-based and inclusive society.

It calls to mind a recent meme: “Education is not about memorizing that Hitler killed 6 million Jews. Education is about understanding how

With support, those of us who face life struggles can be active participants in a holistically-based and inclusive society.

millions of ordinary Germans were convinced that it was required. Education is learning how to spot the signs of history repeating itself.”

We, too, were targets of Hitler, and we were among the forerunners victimized by

the thinking behind eugenics that led to Hitler’s final solution.

That sense of needing to spot the signs of embedded past history feels about where we are right now. As the marginalized group whose voice is most easily dismissed in today’s supposedly “woke” world, we are often at greatest risk of movements to repeat the myths that underlies eugenics.

John Kennedy said, “The great enemy of truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive, and unrealistic.”

Persuasive myths of genetic defectiveness made eugenics possible yesterday. Those myths stay alive today through the ongoing forces of implicit bias and discrimination.

Anne Donahue represents Northfield in the Vermont House of Representatives. She previously edited Counterpoint

is factual, let alone regulated, is questionable. Another concern brought about by peers is that with greater discussion around mental health in social media comes desensitization. They are concerned that with more people on social media making light of mental health issues, the risk of not being taken seriously grows. As my colleague Nate Lulek put it, “the premise has become flawed because people create content showcasing the good or acceptable for consumption by the masses.”

With one minute or less to share information, the chances of covering a topic completely are slim; however, from my personal experience, these pages have made me feel more accepted, seen, and understood. There will be pros and cons to everything, but as someone who wholeheartedly believes in seeing the positive in every situation, I believe increased discussion of mental health on social media is one of the biggest steps we’ve taken as a society toward decreasing stigma around the matter.

Laura Shanks is Vermont Psychiatric Survivors’ patient representative for Southern Vermont.

Laura Shanks (courtesy photo)

Things Are Starting to Look Up

by BRYAN PLANT II

While my mental health has been a lifelong struggle, the road back began in 2018. A simple routine visit with my doctor was an unintended first step.

He asked the simple question, “How are you doing?” Apparently, that was all I needed to break down uncontrollably sobbing, as I couldn’t take it any longer. I had troubles, and needed a way out. I needed help.

For many years I had been sliding into a deep depression, fed by anxiety and insecurities, narrated by an unrelenting inner critic, always ready to remind of all the worst things I believed about myself, to delight in the smallest mistake, and diminish any reason I might have to celebrate. Why wouldn’t I believe this messenger? Those blows were in my own voice.

I’ve always struggled with my weight. I’ve struggled with low self-... well, everything: selfesteem, self-worth, self-image, and the new one I’m learning about – self-love. I’ve often struggled with social anxiety. When all you want to do is hide, or at least blend in, it’s extremely hard to do when you’re my size.

Apparently the discomfort wasn’t great enough to encourage me to make changes – it was easier just to start hiding. I’m eternally grateful for the friends and family that wouldn’t let me. Unfortunately it wasn’t enough.

A vicious loop began dragging me down. I would exaggerate even the smallest piece of negative feedback. Every time I would be rejected in romantic attempts, it became a harsh judgment on my value as a human. It eventually became easier to reject myself.

to find my way back, but all I was doing was spinning my wheels, sinking further into the muck. I bled my 401K dry to have something to live off, and I lived off the generosity of others for a few years.

But these were just slowing the descent that ultimately landed me in a homeless shelter. I thought that was the lowest point in my life, a reality check. It still took another year to hit what I consider my true rock bottom.

I struggled immensely between my mental health, my physical health, and now difficulties

way. I’ll probably continue to apologize to the people at the Counseling Service of Addison County for pushing back against all the soft language that many, many three-letter systems employ. I’d literally have to take handouts and slides home to reread and put them into my own words for them to have any chance to resonate with me.

Additionally, making some good friends among my peers has made all the difference. They listened when I needed to vent, which was often. I learned I wasn’t alone.

I was unfulfilled with my work, but the pay was good. I felt stuck, so I endured the frustration. As my weight went up, I shrank my world until there wasn’t much left. And then I was laid off.

Losing my job hit me hard. I lost a sense of identity. I tried to deny this shock to the system, but an underlying depression began to hinder my efforts to find a new job.

It didn’t take long before the fear of losing my home became a reality. I luckily sold it before it was foreclosed on, but I had to make the decision to move back home to regroup.

In my head, this made me a failure, a loser, worthless. I was supposed to be stronger, better, tougher than this. I clearly was not. I halfheartedly tried to find work, I tried

navigating the complexities of the government social services programs. It was a slog. I felt under constant threat. I battled through too many barriers, including my own biases and beliefs.

I compounded it by making the decision to do this without medication. That’s not a judgment on those who need the tool of medication. I had avoided facing how I truly felt about things for so long that, to come back, I needed to break that habit. I needed to become open to trying new things, even if I thought they were too touchy-feely.

What I was doing hadn’t been working –maybe someone else knew a different or better

Today, a few long years later, I’m in a better, more stable place. I’ve successfully come out of homelessness. My health still presents its challenges, but everything is trending in the right direction for a change. The light at the end of the tunnel is looking bright.

I’m here today for many reasons. I think we need to share stories of our successes, and stories of our pain. In spite of my anxiety, I found the strength to sit in front of legislators. In spite of my struggles, I try to find opportunities to volunteer.

And while I’m not an advocate, I’m finding ways to get a seat at the table to maybe help others have an easier go of things. I’ve even found a way to make some time to start learning the ukulele. I believe we all have something to offer. Don’t forget it, even if it’s hard to believe.

Better days are ahead if one is brave enough to fight for them, even if the fight that day is getting out of bed. Seek out the support you need. If the people around you aren’t helping, seek out those who help you be your best self.

You have to want it. It won’t be easy, but it is worth it. For a long time, I believed I was trapped in a prison of my own making in my mind with depression and anxiety. And while there’s work to continue, I’m turning the tide.

Depression and anxiety aren’t going anywhere, I understand they will very likely be with me the rest of my days. But now, they are trapped in my mind with me! I’m winning. My future looks more optimistic, brighter. I wish this for those involved today, and those who could not be. Don’t give up.

Bryan Plant II delivered the testimony above at Mental Health Advocacy Day on Jan. 29 before submitting it to Counterpoint for publication.

Bryan Plant II, right, with Sen. Ruth Hardy (courtesy photo)

Mental Health Organizations: Congress Should Pass the Peers in Medicare Act

PRESS RELEASE by MENTAL HEALTH AMERICA

Mental Health America (MHA), the National Association of Peer Supporters (NAPS), the National Association of State Mental Health Program Directors (NASMHPD), the Depression and Bipolar Support Alliance (DBSA), the Association for Behavioral Health and Wellness (ABHW), and the National Council for Mental Wellbeing (NCMW) are pleased to see the introduction in Congress of the Peers in Medicare Act, bipartisan legislation to provide for Medicare coverage of peer support services when delivered by community health centers and other peer services providers.

federally qualified health centers, rural health clinics, and certified community behavioral health clinics.

peer support as an effective, evidence-based practice and most recently released national model standards for certification of peer support specialists. The Veterans Health Administration has offered peer support services and continues to expand the number of peer support specialists it hires because of their ability to help veterans stay healthy. Additionally, the Centers for Medicare & Medicaid Services issued 2007 guidance recognizing peer support services as a reimbursable service through Medicaid and 2019 guidance to Medicare Advantage plans encouraging the use of peer services as a non-opioid form of pain management.

Sen. Catherine Cortez Masto (D-NV), Sen. Bill Cassidy (R-LA), Congresswoman Judy Chu (D-CA), and Congressman Adrian Smith (RNE) are again paving a way for individuals with mental health conditions and substance use disorders to access a full continuum of services that are person-centered and recovery-oriented. This bill builds on top of their work in the 117th Congress recognizing peer support specialists in Medicare as part of interdisciplinary integrated care teams and mobile crisis teams. It does so by expanding the ability to provide peer support services in community mental health centers,

Peer support specialists use their lived experience with a mental health condition and/ or substance use disorder along with specialized training to complement and enhance another individual’s recovery through the delivery of peer support services. Peer support services help reduce hospitalizations and behavioral crises, improve management of co-occurring physical conditions, help restore relationships and social connection, and ultimately saves lives.

The Substance Abuse and Mental Health Services Administration (SAMHSA) recognizes

As our nation responds to the growing mental and substance use needs, MHA, NAPS, NASMHPD, DBSA, ABHW, and NCMW strongly support this measure providing Medicare coverage for peer support services, and we urge swift passage of this important legislation.

Mental Health America is the nation’s leading community-driven nonprofit dedicated to promoting mental health and well-being, resilience, recovery, and closing the mental health equity gap.

Letter: Legislators Should Work Together

by MORGAN W. BROWN, Montpelier

Dear Editor,

Recently, a Chittenden County Superior court judge handed down a decision siding with the state against the plaintiffs in a case brought by Vermont Legal Aid on behalf of those who are living unhoused and had been evicted from motels during the middle of March.

Although I disagree with the decision by the judge, I agree with the statement made toward the end of it: Parties on all sides of this case “could work together to design a big-picture approach to the problem rather than continuing to cobble together short-term solutions while in crisis mode.”

In fact, while thinking upon these and related matters myself, prior to the judge’s decision being handed down, this is, generally speaking, the conclusion I had reached as well. Finding a better way to meaningfully and seriously address homelessness within the state long-term has been handled by all sides as nothing more than a political football.

Everyone is looking to someone else to figure it out, come up with a plan and act first.

What both the administration and the legislature have been doing up to now has been rather haphazard, lacking any actual, coherent, real, significant and workable action plan to move forward with.

Given that this seemingly formidable task could take a while to accomplish, one might ask what is one to do in the meantime?

One solution that comes to mind might be to have high-level representatives from each party involved be locked within a room together until they have a workable plan to put in place.

They could use the Agency of Natural Resources annex building located in Berlin and have access to porta-potties, as provided to those who stayed at the temporary regional homeless shelter hosted there.

Morgan W. Brown (courtesy photo)

Readers Support Raising Mental Health Workers’ Wages

All but two Counterpoint readers who responded to the winter issue’s poll expressed a belief that improving mental health workers’ pay would lead to better experiences for mental health consumers. The question aimed to discover psychiatric survivors’ attitudes toward the pleas of a reportedly overburdened, underpaid workforce that, however, has also caused harm to them.

Five of the 15 respondents submitted comments. Among these, opinion was more evenly mixed. One averred that better pay would not fix the “sanist” perspectives of mainstream mental health professionals, who “don’t meet the needs

additional dollars to traditional psychiatry:

• “I think this really depends on how we’re defining ‘mental health workers.’ However, if talking about the traditional medical-model

workers, if we want to improve the quality of healthcare, wages is not the place to start. Instead, the harm that’s being caused by these institutions and workers needs to be addressed. Education on alternative practices is needed in these spaces, but ultimately the investment of funds should be going into programs that support people through harm reduction, consent, and mutuality – peer respites, peer support, and peer-run/led entities. Our resources should be investing in making space for folks to build their own narratives, make their own meaning, and connect in authentic relationships. Not higher wages for ‘problemfixing’ mental health care workers.”

Three others theorized that consumers would see at least some modest trickle-down benefits from higher salaries in the mental health field and, presumably, better employee retention within community mental health centers:

• “Raising wages alone will not change systemic problems in our mental health system, but it can alleviate some downstream effects, such as high turnover, low morale, and worker exhaustion due to having to work multiple jobs to survive, hence not being fully available mentally, physically and emotionally when working in mental health systems. It should be accompanied by more robust education for mental health workers about the harms that the mental health system

“Would increasing mental health workers’ wages improve mental healthcare for consumers?”

often inflicts, and what they can do about it.”

• “I briefly worked at mental health facilities and programs and met some people who were barely qualified to work with clients. The low wages of workers at designated agencies are appalling.”

• “Increasing wages alone will not improve mental healthcare for consumers but nonetheless is one necessary step in ensuring that a well trained, compassionate, sustainable workforce exists.”

The summer poll asks, “Does Vermont need a new adolescent inpatient psychiatric unit in Bennington?”

In February, Southwestern Vermont Medical Center sent an application for a Certificate of Need to the Green Mountain Care Board. The hospital plans to spend $9.5 million on 12 new beds, but the Brattleboro Retreat, which currently operates Vermont’s only inpatient psychiatric unit for adolescents, has called the project’s necessity into question, as has Disability Rights Vermont.

As usual, Counterpoint wants to know what you think.

SURVIVOR PEER SERVICES

Vermont Psychiatric Survivors

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

VPS OUTREACH AND PATIENT REPRESENTATIVES (802) 775-6834 info@vermontpsychiatricsurvivors.org

VERMONT SUPPORT LINE (STATEWIDE WARM LINE): 833-888-2557; 24 hours, 365 days [833-VT-TALKS] By call or text

CRISIS RESPITE

Alyssum, 802-767-6000; www.alyssum.org; info@alyssum.org

HOSPITALIZATION ALTERNATIVE

Soteria House, information and online application at www.pathwaysvermont.org/what-we-do/ our-programs/soteria-house/ or call Pathways Vermont Intake Line, 888-492-8212, ext. 140

Peer Centers & Employment Support

ANOTHER WAY

125 Barre St, Montpelier, 802-229-0920; info@anotherwayvt.org; www.anotherwayvt.org; see website for events calendar.

PATHWAYS VERMONT COMMUNITY CENTER 279 North Winooski Avenue, Burlington, 802-777-4633; pvcc@pathwaysvermont.org www.facebook.com/PathwaysVTCommunityCenter; www.pathwaysvermont.org/what-we-do/ our-programs/pvcc

Some Peer Centers and Recovery Centers may have changed hours as a result of COVID-19. Call to check on up-to-date schedules.

Vermont Recovery Centers

WWW.VTRECOVERYNETWORK.ORG

BARRE, Turning Point Center of Central Vermont, 489 N. Main St.; 479-7373; www.tpccv.org; tpccvbarre@ gmail.com

BENNINGTON, Turning Point Center, 160 Belmont Dr; 802-442-9700; info@tpcbennington.org

BRATTLEBORO, Turning Point Center of Windham County, 39 Elm St.; 802-257-5600; tpwc.1@hotmail.com

BURLINGTON, Turning Point Center of Chittenden County, 179 South Winooski Ave, Suite 301; 802-8613150; www.turningpointcentervt.org or support@ turningpointcentervt.org

MIDDLEBURY, Turning Point Center of Addison County, 5 A Creek Rd; 802-388-4249; info@turningpointaddisonvt.org

MORRISVILLE, North Central Vermont Recovery Center, 275 Brooklyn St., 802-851-8120; JOHNSON, 117 St. John’s St. 802-730-8122; recovery@ncvrc.com

NEWPORT, Journey to Recovery Center, 212 Prouty Dr. 802-624-4156

JOHNSON, Jenna’s Promise, 114 St. John’s Rd, 802343-8741; info@jennaspromise.org

RUTLAND, Turning Point Center, 141 State St; 802-7736010; turningpointcenterrutlandvt.org

SPRINGFIELD, Turning Point Recovery Center of Springfield, 7 Morgan St., 802-885-4668; webadmin@spfldtp.org; www.spfldtp.org

ST. ALBANS, Turning Point of Franklin County, 182 Lake St; 802-782-8454; contacta@turningpointfranklincounty.org

ST. JOHNSBURY, Kingdom Recovery Center, 297 Summer St; 802-751-8520; recoveryinfo@stjkrc.org; www.kingdomrecoverycenter.com

WHITE RIVER JUNCTION, Upper Valley Turning Point, 200 Olcott Dr; 802-295-5206; www.uppervalleyturningpoint.org; info@secondwindfound.org

SUICIDE & CRISIS LIFELINE 988

24/7 support (call or text)

Crisis Text Line

Around the clock help via text: send “VT” to 741-741 for ground rules; message routed to a trained counselor.

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; www.vffcmh.org

Pride Center of Vermont

LGBTQ Individuals with Disabilities Social and Support: Connections and support around coming out, socializing, employment challenges, safe sex, self-advocacy. For center hours call (802) 860-7812 or go to www. pridecentervt.org

Brain Injury Association

Support Group locations on web: www.biavt.org; support@biavt.org; 802-244-6850

Trans Crisis Hotline

The Trans Lifeline (dedicated to the trans population) can be reached at 877-565-8860.

LGBTQ Youth Crisis Hotline: The Trevor Lifeline, 866-488-7386. TrevorText : 678-678

Hearing Voices Network Online Groups

Opportunities to connect and find mutual support for those with personal lived experience with hearing voices, seeing visions, and/or negotiating alternative realities. To access the group[s]: info@hearingvoicesusa.org.

NATIONAL ALLIANCE ON MENTAL ILLNESS-VT (NAMI-VT): 802-876-7949 x101, or 800-639-6480; 600 Blair Park Road, Suite 301, Williston, 05495; www.namivt. org; info@namivt.org

Connections Peer Support Groups

Meetings are led by trained peer support leaders. The groups provide a safe place that offers respect, understanding, encouragement, and inspires hope to all who attend. Southern Vermont (virtual): 2nd & 4th Mondays, 7pm. Barre (hybrid): Thursdays, 6pm, 51 Church St. Burlington (in-person): Thursdays, 3pm, 2 Cherry St. Rutland (in-person): 1st & 3rd Sundays, 4:30pm, 78 South Main St. To learn more, visit: www.namivt.org/support-groups/peer-support/

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.

Public Community Mental Health

COUNSELING SERVICE OF ADDISON COUNTY, 89 Main St., Middlebury, 05753; www.csac-vt.org; 802-388-6751

UNITED COUNSELING SERVICE OF BENNINGTON COUNTY, PO Box 588, Ledge Hill Dr., Bennington, 05201; 802-442-5491; 5312 Main St., Manchester, 802-3623950; www. ucsvt.org

CHITTENDEN COUNTY: HOWARD CENTER, 300 Flynn Ave., Burlington, 05401; 802-488-6000; www.howardcenter.org

FRANKLIN & GRAND ISLE: NORTHWESTERN COUNSELING AND SUPPORT SERVICES, 107 Fisher Pond Road, St. Albans, 05478; 802-524-6554; www.ncssinc.org

LAMOILLE COUNTY MENTAL HEALTH SERVICES, 72 Harrel Street, Morrisville, 05661; 802-888-5026; www.lamoille.org

NORTHEAST KINGDOM HUMAN SERVICES, 181 Crawford Road, Derby; 802-334-6744; 2225 Portland St., St. Johnsbury; 802-748-3181; www.nkhs.org

ORANGE COUNTY: CLARA MARTIN CENTER, 11 Main St., Randolph, 05060-0167; 802-728-4466; www.claramartin. org

RUTLAND MENTAL HEALTH SERVICES, 78 So. Main St., Rutland, 05701; 802-775-2381; rmhsccn.org

WASHINGTON COUNTY MENTAL HEALTH SERVICES, 9 Heaton St., Montpelier, 05601; 802-223-6328; www.wcmhs.org

WINDHAM AND WINDSOR COUNTIES: HEALTH CARE AND REHABILITATION SERVICES OF SOUTHEASTERN VERMONT, 390 River Street, Springfield, 05156; 886-4500; 51 Fairview St., Brattleboro, 05301, 802-254-6028; 49 School St., Hartford, 05047, 802-295-3031; www.hcrs.org

24-Hour Crisis Lines and Involuntary Custody Screening

ADDISON COUNTY: Counseling Services of Addison County 802-388-7641

BENNINGTON COUNTY: United Counseling Service, 802-4425491; (Manchester) 802-362-3950

CHITTENDEN COUNTY: Howard Center, 802-488-7777

FRANKLIN AND GRAND ISLE COUNTIES: Northwestern Counseling and Support Services, 802-524-6554; 800-8347793

LAMOILLE COUNTY: Lamoille County Mental Health, Weekdays 8 a.m.-4 p.m. 802-888-5026; Nights and weekends 802-888-8888

ESSEX, CALEDONIA AND ORLEANS: Northeast Kingdom Human Services 802-334-6744

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 Rehabilitation Services, 800-622-4235

Please contact us if your organization’s information changes: counterpoint@vermontpsychiatricsurvivors.org

Veterans’ Services

24/7 HOTLINE: 988, then press 1; or text 838255. CRISIS LINE: Toll-Free: 866-687-8387, press 7 FREE TRANSPORTATION: Disabled American Veterans: Toll-Free: 866-687-8387 X5394

HOMELESS PROGRAM COORDINATOR: 802-295-9363, ext 6184

TRANSITIONAL RESIDENCES: Canal Street Veteran’s Housing, Winooski 802-864-7402; Dodge House, Rutland, 802-775-6772; Veteran’s Inc, Bradford, 802-627-7838; The Veteran’s Place, Northfield, 802-485-8874.

VERMONT VETERANS SERVICES: program for homeless veterans with very low incomes: 802-656-3232.

Vermont Veterans Outreach Team

Peer-to-Peer Support: Veteran’s Outreach program staff with very diverse backgrounds including service in different branches of the military.

OUTREACH TEAM LEADER: 802-338-3022

ADDISON COUNTY: 802-338-4313

CALEDONIA/ORANGE/WINDSOR COUNTY: 802-338-4324

CHITTENDEN NORTH: 802-338-3078

CHITTENDEN SOUTH: 802-338-4316

LAMOILLE COUNTY: 802-338-3411

ORLEANS/ESSEX COUNTY: 802-338-4325

RUTLAND COUNTY: 802-338-4315

WASHINGTON COUNTY: 802-338-4318

WINDHAM COUNTY: 802-338-4171

MENTAL HEALTH SERVICES: 802-338-3445

VA Mental Health Services

VA HOSPITAL Toll-Free 866-687-8387

MENTAL HEALTH CLINIC, White River Jt, Toll-Free 866-687-8387 Ext 6132

OUTPATIENT CLINICS Bennington: 802-440-3300; Brattleboro: 802-251-2200; Burlington Lakeside Clinic: 802-657-7000; Newport: 802-624-2400; Rutland: 802-772-2300

VET CENTERS So. Burlington: 802-862-1806; (White River Jctn) 802-295-2908