NEWS, COMMENTARY, AND ARTS BY PSYCHIATRIC SURVIVORS, MENTAL HEALTH PEERS, AND OUR FAMILIES
VOL. XXXVIII NO. 3
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FROM THE HILLS OF VERMONT
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SINCE 1985
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WINTER ’23-’24
Judge Advises Limiting Potential Competency Restoration Program by BRETT YATES In Montpelier, Judge Steven Leifman of Florida keynoted what the Vermont Judiciary Commission on Mental Health and the Courts called its first annual summit. Leifman’s speech described how Miami-Dade County’s decision to prioritize mental health treatment for low-level criminal defendants, rather than prosecution, had saved money and reduced repeat offenses. The Vermont Supreme Court established the Commission last year “to propose measures to respond to the needs of court-involved individuals with mental health issues.” Its September summit at the State House convened all three branches of government, as well as mental health providers, for a full day of discussion. According to Leifman, Vermont can learn
Judge Steven Leifman (Counterpoint photo) something from South Florida, which, until recently, focused on bringing arrestees deemed mentally ill to trial through a narrowly targeted procedure called competency restoration. This process, in his view, did little to help them heal. “We have a statute that says that once you are adjudicated incompetent, the state of Florida
has 15 days to physically take you from jail and send you to a competency restoration facility,” Leifman said. “Because of the growth of people with mental illnesses going into the criminal justice system, we ran out of competency restoration beds, and it created this terrible backlog of individuals in jails waiting to be transported to the facility for restoration, and really horrible things happened.” “At the time, the State of Florida was spending about $220 million, about one-third of its entire adult mental health budget, to restore competency for about 3,000 people,” he added. In the vast majority of cases where these defendants became competent to stand trial, the trials didn’t amount to much by Leifman’s (Continued on page 3)
Peers Meet Montpelierites in Crisis by BRETT YATES
For several years, Vermont’s hospitals have reported increases in emergency department visits for mental health. Downtown Montpelier has a new option for people in distress who need help immediately. At Washington County Mental Health Services’ Access Hub, that help arrives first in the form of peer support. It opened on Oct. 2. “If I was in a mental health crisis and I went to the hospital and I was sitting under the very bright lights in the waiting room, probably at the ER for a while, that definitely would not help with all of the symptoms going on,” said Kallie Hunton, a peer support worker. “We can keep the lights dimmer, and it’s a more one-onone situation.” Before Access Hub’s opening, the WCMHS building at 34 Barre St. already housed two programs staffed partly or entirely by peers: the Sunrise Wellness Center for daytime activities and Maple House, a crisis bed. In a small, partitioned room with an entrance on Downing St., administrators found space for one more.
It may not look like much, but according to intensive adolescent outpatient clinic, Polaris. staffers, it has already made an impact. They’re Access Hub, which serves adults, operates still working to get the word out, but in the first from 8 a.m. to 4 p.m. on weekdays, with hopes three and a half weeks, they had counted 16 visits. of expanding to evenings and weekends. During “We’ve had some people come in for its development, WCMHS solicited input from suicidality,” Hunton said. “Mostly, it’s been for consumers through its Local Program Standing depression, anxiety. We’ve had one person who’s Committee and studied comparable projects come in multiple times, pretty dysregulated from other states, according to Director and having a lot of issues going on, and they’ve Tammy Miller. been able to meet with our peer support staff The most successful examples, in Miller’s and kind of work through their stuff and be view, didn’t operate as stand-alone emergency able to talk about what’s bothering them in an (Continued on page 4) appropriate setting.” Hunton or one of Access Hub’s two other peer staffers typically greets arrivals. After discussion, if the peer sees a need for additional support, they can call in a clinician from an office located just steps 34 Barre St. houses Montpelier’s Access Hub (Counterpoint photo). away in WCMHS’s
Act 81 6 The Arts14 Reader Poll23
2 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.
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 DISABILITY RIGHTS VERMONT
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
VERMONT CENTER FOR INDEPENDENT LIVING
Peer services and advocacy for persons with disabilities. 800-639-1522. vcil.org
PEER WORKFORCE DEVELOPMENT INITIATIVE
Webpage provides an up-to-date account of statewide peer training and registration information as well as updates about its progress and efforts. www.pathwaysvermont.org/what-we-do/statewide-peer-workforce-resources/
MADFREEDOM
MadFreedom is a human and civil rights membership
whose mission is to secure political power HEALTH CARE ADVOCATE To report problems with any organization to end discrimination and oppression of people based on health insurance or Medicaid/Medicare issues in Vermont. 800-917-7787 or 802-241-1102. vtlawhelp.org/health
VERMONT CLIENT ASSISTANCE PROGRAM
Rights when dealing with service organizations such as Vocational Rehabilitation. Box 1367, Burlington VT 05402; 800-747-5022.
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
perceived mental state. See more at madfreedom.org
MENTAL HEALTH LAW PROJECT
Representation for rights when facing commitment to a psychiatric hospital. 802-241-3222.
ADULT PROTECTIVE SERVICES
Reporting of abuse, neglect or exploitation of vulnerable adults, 800-564-1612; also to report violations at hospitals/nursing homes through Licensing and Protection at (802) 871-3317
Hospital Advisory VERMONT PSYCHIATRIC CARE HOSPITAL
Advisory Steering Committee, Berlin, check DMH website for dates at www.mentalhealth.vermont.gov
RUTLAND REGIONAL MEDICAL CENTER
Community Advisory Committee, fourth Mondays, noon, call 802-747-6295 or email lcathcart@rrmc.org.
UNIVERSITY OF VERMONT MEDICAL CENTER
Program Quality Committee, third Tuesdays, 9-10 a.m., for information call 802-847-4560.
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.
CENTRAL VERMONT MEDICAL CENTER
Contact counterpoint@vermontpsychiatricsurvivors.org for more information. Every other month, 4th Tues, 1112.
Conferences PEER WORKFORCE
The Los Angeles-based Self-Help and Recovery Exchange (SHARE!) will hold a Peer Workforce Conference online on Jan. 31, 2024. Under the theme “Bridging Research and Practice,” presenters will educate peer workers about the latest research and best practices in mental health and substance use. Go to share https://shareselfhelp. org/conferences/peer-workforce-conference/ to register.
PEERPOCALYPSE
VT Psychiatric Survivors, 128 Merchants Row Suite 606, Rutland, VT 05701 Phone: (802) 775-6834 email: counterpoint@ vermontpsychiatricsurvivors.org
MISSION STATEMENT: Counterpoint is a voice for news and the arts by psychiatric survivors, ex-patients, and consumers of mental healthservices, and our families and friends. Copyright 2023, All Rights Reserved FOUNDING EDITOR Robert Crosby Loomis (1943-1994) EDITORIAL BOARD Kara Greenblott, Zachary Hughes, Sara Neller, Laura Shanks, Joanne Desany 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 News articles without a byline written by the editor Opinions expressed by columnists and writers reflect the opinion of their authors and should not be taken as the position of Counterpoint. Counterpoint is funded by the freedom-loving people of Vermont through their Department of Mental Health. Financial support does not imply support, agreement or endorsement of any of the positions or opinions in this newspaper; DMH does not interfere with editorial content. Counterpoint is published by Vermont Psychiatric Survivors three times a year, distributed free of charge throughout Vermont, and also available by mail subscription. Vermont Psychiatric Survivors is an independent, statewide mutual support and civil rights advocacy organization run by and for psychiatric survivors. The mission of Vermont Psychiatric Survivors is to provide advocacy and mutual support that seeks to end psychiatric coercion, oppression and discrimination. Counterpoint does not use pseudonyms in its reporting without stating that a pseudonym is being used and without an explanation for why the person’s identity is not being disclosed. Counterpoint does not use anonymous sources under any circumstances.
Department of Mental Health
Peers will discuss “Justice, Equity, Diversity, & Inclusion” at the upcoming Peerpocalypse conference on May 6-9, 2024, in Seaside, OR, and virtually via Whova. The Mental Health & Addiction Association of Oregon plans to organize more than 5o workshops. Early bird registration ends Dec. 31. Visit https://www.mhaoforegon.org/ peerpocalypse-main-page to learn more.
802-241-0090 mentalhealth.vermont.gov ADDRESS: 280 State Drive NOB 2 North Waterbury, VT 05671-2010
Don’t Miss Out on a Counterpoint! Mail delivery straight to your home — be the first to get it, never miss an issue. c Enclosed is $10 for 3 issues (1 year). c I can’t afford it right now, but please sign me up (VT only). c Please use this extra donation to help in your work. (Our thanks!) Checks or money orders should be made payable to “Vermont Psychiatric Survivors.” Send to: C ounterpoint, Vermont Psychiatric Survivors, 128 Merchants Row, Suite 606, Rutland, VT 05701
Access Counterpoint online at www.vermontpsychiatricsurvivors.org
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NEWS .
Winter ’23-’24
IN THE NEWS • The Vermont Truth and Reconciliation Commission held its first public meeting on Sept. 5, shortly after hiring an executive director, Faith Yacubian. The legislature has instructed the Commission to “begin the process of dismantling institutional, structural, and systemic discrimination in Vermont, both past and present,” against groups including people with psychiatric “conditions.” • A senior behavioral interventionist at Howard Center, Katie Harris, won an election to become president of the Vermont AFL-CIO, a labor federation representing 20,000 members of affiliated unions. Harris, who ran as part of the left-wing United! slate, serves as a secretary and steward for AFSCME 1674. • Residents of the Lakeview Community Care Home in Burlington will reportedly relocate to a new, 8,000-square-foot facility on Route 7 in Shelburne “early in the new year.” Former senator Patrick Leahy, who secured a congressional earmark to fund the project before his retirement, joined Howard Center to celebrate its construction in an event in September. • Blue Cross Blue Shield of Vermont, the state’s largest private health insurer, publicized a new partnership with Brooklyn-based Valera Health, which provides online psychotherapy and psychiatric care for adults and children. Policyholders began booking virtual appointments in October. • Following accusations of financial and managerial problems last winter, Green Mountain Support Services, a Morrisville-based nonprofit overseen by the Vermont Department of Disabilities, Aging and Independent Living, won provisional “redesignation” as one of the five state-contracted “specialized service agencies” in October. A temporary partnership with Champlain Community Services reportedly helped GMSS improve practices and avoid a near closure. • This fall, the Vermont Department of Mental Health announced a new flood recovery outreach program called Starting Over Strong Vermont. According to DMH, Vermonters in the nine counties affected by July’s natural disaster can receive free, nonclinical support in their homes and communities by dialing 2-1-1. • Vermont Attorney General Charity Clark sued Meta, which operates Facebook and Instagram, on behalf of its young users for allegedly harming their mental health. A total of 43 states collaborated to file joint or independent lawsuits against the company on the same basis in October. • The Vermont Agency of Human Services announced in November that it would rush to establish four to five new homeless shelters in anticipation of a second round of evictions at state-funded motels on April 1. • iCare Health Network, based in Connecticut, won a contract from the Vermont Department of Disabilities, Aging and Independent Living to provide “specialized” care for seniors with complex needs, including psychiatric disabilities. The for-profit company plans to buy an existing licensed facility in Bennington, owned by Genesis HealthCare.
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JUDGE • Continued from page 1 account: “Three things happened to them. They had their charges dropped, they received credit for time served, or they received probation and they walked out of the front door of the courthouse without any access to treatment.” Leifman dedicated himself to reforming the system. A new approach, he believed, would start with fewer arrests of people in mental health crisis. Miami introduced a model called Crisis Intervention Team policing, which Leifman characterized as “a 40hour training program that teaches law enforcement how to identify people in crisis, how to de-escalate situations, and where to take people instead of arresting them.” He called it “stunningly successful.” “The number of arrests in Dade County went from 118,000 a year to 53,000,” Leifman boasted. “Our jail audit went from 7,400 to 4,400. Our police shootings almost stopped.” When mental health-related arrests still occur in Miami-Dade County, the arrestees now face a different process than they did in the past. The difference owes to a practice sometimes called “precharge diversion.” “Instead of ordering a competency evaluation – which we stopped doing, saving the county almost $2 million a year – we have an assessment done at the jail,” Leifman said. “If they meet criteria for some type of civil commitment or treatment, instead of going through a competency system, what we do is we transfer them within usually three days of their arrest to one of our crisis stabilizations.” Once they’ve stabilized, they receive an offer to participate in an outpatient treatment program. Upon its completion, prosecutors drop the charges against them for good. Leifman urged Vermont to follow this example. “Vermont is sitting in a very unique time right now. You do not have an inpatient competency restoration system, and I strongly personally encourage you to keep it very, very limited if you go that route,” he advised. “The Justice Department is involved in lawsuits against most of the states right now because people are sitting too long to get an evaluation and sitting in custody too long to get restored.” Earlier this year, the Vermont General Assembly authorized the establishment of the state’s first forensic mental health facility. In December, the Department of Mental Health will release a report that may recommend an accompanying competency restoration program. Vermont Supreme Court Justice Karen Carroll, who had led the Commission’s
Competency and Sanity Evaluation Committee, described competency restoration as a process of “preparing people to be in court – in other words, less treatment but more teaching them how they can better understand the charges against them, how they can better work with their attorney.” “People can differ about whether that is a better program than what we’re doing here in Vermont, which is essentially treating people until they’re better and able to come to court,” Carroll said. Another new Vermont law this year aimed to resolve a backlog of courtordered competency evaluations by expanding the number of mental health professionals who can perform them: not just psychiatrists, but also, at least until summer 2024, doctoral-level psychologists. At the summit, Sen. Ginny Lyons forecast an extension of this pilot program. “One of the preliminary decisions made at our meeting on Tuesday at the Justice Oversight Committee was to allow for doctoral-level psychologists with forensic training to continue beyond the next year to provide competency evaluations,” Lyons revealed. Another topic of discussion at the summit was pretrial services, which, in Vermont, provide risk assessment screenings of defendants and referrals to services for mental health and substance use. A committee led by Vermont Superior Court Judge Kate Hayes had examined the subject. Hayes reported that the committee had agreed to “strongly recommend to the Commission that we all work on getting peer supports added as a specific part of pretrial services statewide – that each pretrial services office should have available to it peer support for anybody who is given a pretrial services order.” Two peers, Pathways Vermont Training Coordinator Alexander Ferguson and Recovery Vermont Executive Director Will Eberle, later participated in a panel overview of “peer support strategies.” The Commission’s work will continue. On Sept. 8, it posted a recruitment notice for a “behavioral health project consultant,” a three-year position that will “assist with expanding and improving the judicial response to mental and behavioral health issues.” Many psychiatric survivors have long objected to the term “behavioral health.” The Commission did not respond to an email highlighting what Counterpoint views as the offensive nature of the phrase.
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NEWS
Winter ’23-’24
PEER SUPPORT AT ACCESS HUB • Continued from page 1 department alternatives. With its central location and adjacency to additional resources, including spaces for rest and relaxation, Access Hub aims not only to stabilize crises but to serve as a welcoming and informative point of entry for newcomers to the community mental health center. “What we’re finding at Access Hub is there’s a whole demographic of folks who need services, but they don’t know how to navigate services,” Miller observed. “They can access short-term case management, access short-term therapy, and it’s immediate. So you’re not on a 12-week waiting list – if someone is in some kind of duress, come on in.” Access Hub emerged out of a request for proposals for urgent care services, issued by the Vermont Department of Mental Health in October 2022. DMH subsequently distributed seven Medicaid-funded grants across the state for new programs, the majority of which proposed to use a primarily clinical model. But more than a year after the RFP, some have yet to get off the ground. Meanwhile, a statewide mobile crisis service, originally scheduled to start operations in September 2023, no longer has a clear launch date, though some limited operations may begin in January. The urgent care grants end after two years, upon the expiration of a period of enhanced federal funding for community-based crisis care. Miller doesn’t know what will happen then. “It is something I think about a lot,” Miller said. “My hope is that if it is successful and that we continue to provide these resources that the state can recognize based on the data, then they’ll continue to fund it in the future.” In August, the Counseling Service of Addison County opened a community crisis center in
Middlebury called Interlude, based on the same state-approved “living room” concept that informs WCMHS’s approach. Per DMH, the model should offer a “warm” and “safe” environment that promotes “respect, hope, empowerment, and social inclusion.” But while Interlude’s clients require a referral, anyone can use Montpelier’s Access
Kallie Hunton (Counterpoint photo) Hub. WCMHS has asked visitors to call ahead (802-301-3200) if they can, but the program doesn’t turn away walk-ins, of which it has already received a few. Amid a labor shortage in the mental health field, WCMHS managed to stand up Access Hub by shifting existing employees or adding to their responsibilities. Hunton, who still works
with lower-acuity clients at Sunrise, received extra training for her new role. “It’s really, really great to be supporting people who are doing pretty well and being pretty stable and their work on recovery, but I see how important it is to be able to support folks who are going through crises,” Hunton said. “I kind of have been working myself up to doing this type of work.” Hunton started at WCMHS as a part-timer before taking on more hours. In the past, her own mental health challenges had left her unable to hold a job or “to do much for multiple years,” during which she “relied a lot” on the support of family and friends. After that, Hunton wanted to spend her time “helping other people be able to improve their lives and work on managing mental illness in a way that they could have a life that feels worth living.” On one occasion, an Access Hub client’s needs appeared to exceed the program’s capacity for treatment, and they ended up at the hospital after all. But much of the time, as Hunton sees it, peer support and communitybased care represent the best option. “Probably, at least in some cases, folks going to the hospital are going there because they don’t know what else to do,” she theorized. “So if they come here, then we can help them come up with some ideas of what else they could do and ways that they can kind of work on things.” “Especially if they’re not already receiving very much mental healthcare, if at all, then we can kind of be an easier stepping stone into doing that,” Hunton continued. “With all the stigma around mental illness, this is, I think, a little bit easier to come into, as a walk-in clinic, and you don’t have to end up enrolled if you don’t want to or if that’s uncomfortable for you.”
Annual Mental Health Conference Includes Psych Survivor Perspectives
Under the title “Reshaping Mental Health Systems Through Integration,” the Vermont Department of Mental Health held its first annual conference since the COVID-19 pandemic at the Killington Grand Hotel on Oct. 19. Self-identified psychiatric survivors jointly or independently led at least five of the day’s “breakout sessions,” among a menu of 24 lectures that discussed various aspects of mental healthcare. Dan Towle, who founded the “peer-staffed” consulting firm Parker Advisors, offered two presentations: one on the role of peer specialists in mobile crisis response services and another on the state of peer support in Vermont overall. “I live, breathe, and eat peer support,” said Towle, who works part-time answering calls for the Pathways Vermont Support Line. As a consultant, he aims to help reshape how police deal with incidents involving mental health crisis. “Historically as, as we all are aware, law enforcement was the sole function for dealing
with crisis in the street. In recent decades, we started to layer in the mental health specialists, social workers, clinicians,” Towle explained. “The third leg of the stool is peer support.” According to Towle, peer support workers can “step in relatively quickly in many circumstances and deal with situations based on mutuality of experience and transparency.” He called them “a calming influence in what can be, in many cases, a very stressful and traumatizing experience.” Towle mentioned that, when the police department in Alamogordo, New Mexico, hired a peer support worker, officers benefited almost as much as the public. Officers “got to know this individual more and more, and they actually started peer support within the law enforcement,” he said. “This person helped facilitate the police officers and the staff to help each other.” In Towle’s preferred model, however, a community mental health center or peer-run
agency would employ the peer support worker, who would work with police in situations requiring a police presence. Peers and clinicians would also respond to incidents on their own. “You ideally only want to use two legs of that stool,” Towle said. “This is kind of bending the analogy.” Without the involvement of law enforcement, Vermont’s community mental health centers expect to deliver a statewide mobile crisis program sometime in 2024, using teams of two that will, at least in some cases, include peers. Meanwhile, the police department in the state’s largest city has begun staffing a program named Burlington CARES, modeled after an alternative public safety system called CAHOOTS that gained renown in Eugene, Oregon. In Eugene, paramedics and mental health professionals have replaced police officers for certain 911 calls since 1989. Towle urged conference attendees to examine mobile crisis (Continued on next page)
NEWS .
Winter ’23-’24
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CONFERENCE • Continued from previous page response practices in their communities and to talk to their city councilors and other local leaders. Towle’s second presentation focused on the role of peers in the rest of the mental health system. Currently, they staff respites, advocate for psychiatric inpatients, and lead support groups, among other services, but Towle believes that the peer workforce has plenty of room to grow. In Vermont, small, peer-run organizations like Vermont Psychiatric Survivors and Another Way employ peers, but so do traditional
No comprehensive survey of Vermont’s mental health providers has asked for an accounting of how many peers they employ. mental health agencies, hospitals, and other nonprofits like the Vermont Association for Mental Health and Addiction Recovery and the Vermont Federation of Families for Children’s Mental Health. Towle observed that, in other states and countries, schools, prisons, and homelessness services agencies also hire peers. According to a study that Towle had found, a quarter of all U.S. mental health facilities
Dan Towle (Counterpoint photo) include peers among their staff. But he pointed out that nobody knows exactly how many peers ply their trade in Vermont – no comprehensive survey of mental health providers has asked for an accounting. In Towle’s view, getting a clearer picture of where peer support already exists would help its advocates to expand the presence of peer support elsewhere in the mental health system. In addition to data collection, Towle emphasized a need for additional funding for peer support. DMH expects a forthcoming certification program to allow peers to begin drawing Medicaid reimbursement next year for their services. Towle urged Vermont’s peer community to make sure that private foundations also recognize the value of their work. He noted a recent $20 million gift to the Champlain
Housing Trust from philanthropist MacKenzie Scott. “That’s the model that we want to replicate over and over and over again,” Towle said. Towle’s presentations bookended a talk called “Only Sticks and Stones? How language reinforces implicit bias and creates obstacles to integrated care” by Anne Donahue, who formerly edited Counterpoint. Donahue highlighted offensive terminology that remains in currency in psychiatric facilities. These unexamined linguistic choices, she theorized, don’t just hurt mental health patients’ feelings – they also stigmatize mental healthcare itself, contributing to its separation from physical healthcare. “I think the ability of the broader healthcare system to embrace the importance of holistic and integrated care is impaired by the internalized biases that are communicated by the existing mental health system,” Donahue said. “You can’t integrate care if the patient is afraid to disclose the mental condition that’s linked to the medical one.” Donahue pointed out that, according to studies, about 50% of Americans who’ve received prescriptions for medication don’t take them as directed. The same, more or less, is true for mental health patients, but when the latter “go off their meds,” it’s a cause not only for greater alarm but also for different language: what medical literature would normally call “medication non-adherence” becomes “medication non-compliance” instead. Even job titles in the mental health field can seem to reflect infantilizing or dehumanizing attitudes. When a psychiatric patient needs someone on hand to monitor their safety, hospitals call that employee a “sitter.” “If you call yourself a sitter, that means you think of yourself as a sitter, and that turns the person that you are sitting with into a person who needs a sitter,” Donahue said. Donahue observed that, in healthcare settings as elsewhere, “technicians” – such as X-ray technicians and ultrasound technicians – “tend to be specialists in equipment,” except in the case of psychiatry. “What’s the message that people hear if you’re being treated by a psych tech? You must be a thing, a system, or maybe at best, a body part to be maintained,” she said. Donahue reserved her strongest opprobrium for the term “behavioral health,” which clinicians use to group together mental health and substance use conditions. “The message becomes that the cause of my condition is behavior, or that it’s being called behavioral because the symptoms are a behavior that I’m failing to control,” Donahue said. “Every time I hear that, to me, it’s a stab in the gut.” Donahue’s talk overlapped with “Discomfort as Opportunity: Pathways Vermont’s Relationship-First Program” by Katie Bourque and J Helms, a peer who later discussed “Disrupting the Institutional Circuit” with the Vermont Department of Corrections. All five
survivor-led presentations followed a keynote address by William Kellibrew, a social worker and author who described a journey of healing
William Kellibrew (Counterpoint photo) following the murder of his mother and older brother during his youth in Washington, D.C., where he still lives. Suicidal ideation led to an involuntary commitment for Kellibrew, who entered an adult psychiatric unit at age 13, one year too old for the local children’s hospital. Eventually, he met a therapist who would change his life – at first, simply by letting him eat as much ice cream as he wanted during their sessions. “She didn’t go in there and pick food for me,” Kellibrew said. “She created an environment where I could go in there and she could learn what was important to me, what I valued in that space.” In college, Kellibrew began to talk publicly about his childhood tragedy. That got him involved in what he called the “victim services movement,” where he learned how to assist and advocate for others who’d suffered as a result of violent crime. As an adult, Kellibrew tracked down the therapist who’d helped him in his early adolescence. He asked her what her job title had been at the time, and she told him that, back then, she’d been just an intern social worker. “I’m like, ‘An intern saved my life?’” Kellibrew said. “Well, that told me that it is anybody’s job. Everyone has a responsibility
Anne Donahue (Counterpoint photo) – from the lifeguard to the cafeteria worker to the teacher to the mom to the dad. Everybody has a role and can play a role.”
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NEWS
Winter ’23-’24
SF Suicide Attempt Survivor Shares Story in VT
According to California’s Bridge Rail “I sat there crying like a child, hoping, Hines sees it, “are deadened to their job.” Foundation, more than 1,700 people have leapt wishing, and praying that one person would “The way they treat us as second-class to their death off the Golden Gate Bridge since see me, see my pain, and say something kind citizens,” Hines said, “the way they get angry its opening in 1937, making it “the world’s and compassionate,” Hines recollected. “‘Kid, when we recidivize back in the psych ward, and deadliest structure.” Fewer than 35 jumpers is something wrong?’ ‘Can I help you?’ I would the way they look at us and call us out when have survived the fall. have told that person everything.” we’re in pain is inappropriate.” One of them is Kevin Hines, a San Francisco Forty minutes later, Hines jumped. As a mental health and suicide prevention native who visited Manchester’s Burr and “The millisecond my hands left that rail and advocate, Hines believes in an intervention Burton Academy on Oct. 19 to talk about my legs cleared it, I had an instantaneous regret called “caring letters,” which he attributed to a suicidality and recovery. United Counseling for my actions and the absolute recognition that San Francisco psychiatrist from the Department Service, Bennington County’s community I had just made the greatest mistake of my life,” of Veterans Affairs. He emphasized the special mental health center, sponsored the free public Hines recalled. “And it was likely too late.” power of written expressions of love and event. A passing driver used a carphone to call the compassion from friends, family members, In a little over an hour, Hines narrated an Coast Guard, which rescued Hines. He credits and peers. autobiography beginning in what he “You give them a letter from three called a “crack motel” in San Francisco’s to five different people,” Hines said. notorious Tenderloin neighborhood. A “You mail it to them like it’s a present. clerk’s phone call to child services placed They get it. They read it. They have him, dirty and ill-nourished, into foster it forever. When they feel hurt or in care. His brother, who accompanied pain, they read it again and again and him, suffered continued neglect and again.” would soon die from a bronchitis As an activist, Hines campaigned infection, according to Hines. for the installation of a safety net “Unlike my poor brother, I would get on the Golden Gate Bridge, a $400 very, very lucky,” Hines said. Through million project that contractors expect adoption, he would find a stable, happy to finish this winter. In his view, the home at the age of nine months. net isn’t just about catching jumpers. But that didn’t prevent him from “You show a community that you facing mental health challenges in his care by stopping an icon for suicide teenage years. Hines described an from being available,” he said. “Their Kevin Hines at Burr and Burton Academy’s Riley Center (Counterpoint photo) experience of “paranoid delusions; minds change.” hallucinations, auditory and visual; panic; a sea lion for keeping his badly injured body Today, Hines is an author and filmmaker highs, followed by depressive lows.” afloat until the boat’s arrival. who travels the country professionally as a “I thought that if I told anyone about what I “I experience excruciating physical pain motivational speaker. United Counseling was really going through, they would lock me most of the day, every day,” Hines said. “But Service held a screening of his documentary, up in a white-walled, padded room and throw it doesn’t come close to the enemy I battle Suicide: The Ripple Effect, on Oct. 4. away the key,” Hines said. within.” “I’ve seen Kevin a couple of times speaking in After Hines’s beloved high school drama Hines’s extreme mental states didn’t various places,” UCS Executive Director Lorna teacher died by suicide, he began to consider stop after his suicide attempt. But he never Mattern said. “Each time I was incredibly it as an option for himself. Seven months later, attempted suicide again, and he no longer inspired by his story, his journey, his ability to the voices in his head had intensified, telling suffers in silence. share his hope.” him that he “had to die, that it was inevitable.” “The difference between me and people who Hines tells audiences that their lives have “Your brain is so very powerful,” Hines said. die by suicide is that I do not stop saying ‘I need value and that other people care about them “And when it breaks, the rest of you will follow.” help now’ until someone is willing to answer and are ready to hear about their pain. On Sept. 25, 2000, a 19-year-old Hines rode the call,” Hines said. “Make a choice to never again silence your a bus to the tip of the Presidio of San Francisco. On ten occasions, Hines entered inpatient pain,” Hines said. “Why? Because your pain He disembarked among a horde of tourists care, sometimes involuntarily. At psychiatric is valid. Your pain is worthy of my time and who had gathered to view “the most beautiful hospitals, some doctors and nurses “genuinely others’. And your pain matters simply because manmade structure ever created.” care about what they’re doing,” but others, as all of you do.”
Witnesses Bring Lived Experience of Homelessness to Legislative Hearing
Passed during June’s veto session, Act 81 is the law that codified Vermont’s transition plan for the last beneficiaries of its pandemicera General Assistance Emergency Housing program. When the House Human Services and Senate Health and Welfare committees met for an update on its implementation this fall, their list of witnesses included, among the usual state officials and nonprofit executives, a pair of unconventional experts: people with lived experience of homelessness. Rebecca Duprey – an abuse survivor who,
like many homeless Vermonters, received a voucher to stay in a motel during COVID-19 – made a name for herself as an advocate in Montpelier last spring as the state prepared to evict her from the Hilltop Inn in Berlin. But Oct. 5 marked her first invited appearance before the legislature. Bryan Plant, a formerly homeless resident of Bristol, joined her. While the service providers tasked with helping the state find permanent housing for Vermont’s remaining motel dwellers before April outlined a litany
of roadblocks in their testimonies, Plant’s and Duprey’s stories revealed the human consequences. Both Duprey and Plant have found stable housing, but it didn’t come easily. Duprey credited two individual legislators, Sen. Ann Cummings and Rep. Anne Donahue, for introducing her to the activist Brenda Siegel, who helped Duprey access the motel program last winter and later vouched for her when she submitted a rental application to a (Continued on next page)
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WITNESSES • Continued from previous page landlord who happened to know Siegel’s father. Housing Authority denied “I didn’t find housing because [the Agency of repeated requests for an Human Services] did something. In fact, AHS extension. Fortunately, has been nowhere – not a single contact my administrators reversed the entire time I was in the hotels,” Duprey said. “I denial upon Plant’s appeal, applied for housing, sometimes 15 apartments and he ultimately found a in just one week. I was always put to the bottom unit in a newly constructed of the list, not accepted or even looked at the apartment building. second they found out I was homeless.” Plant’s and Duprey’s Duprey has stayed in touch with some of testimony constituted a small the homeless Vermonters who remain in the portion of a joint committee motels. For them, Act 81 created new eligibility meeting that lasted nearly rules, which have led to evictions. Duprey five hours, excluding a lunch put some of the blame on the Department break in the middle. In total, for Children and Families and its Economic 14 witnesses appeared. Services Division. Angus Chaney, the Countryside Motel in Shelburne (Counterpoint photo) “People that should be in the cohort up executive director of Rutland’s Representing the Department for Children until April of 2024 are being kicked out at fast Homeless Prevention Center, criticized “new and Families’ Economic Services Division, speeds and for reasons that are of no fault of construction initiatives” that, though intended their own, but rather the state’s,” Duprey said. to help the homeless, “use tenant selection Deputy Commissioner Miranda Gray shared “ESD offices are not clear on the rules, and they criteria so stringent they will effectively screen statistics. By AHS’s count, the fiscal year began on July 1 with 1,283 households living in motels discourage folks from reaching out for help out the people they would seek to house.” under Act 81. from other providers or are simply turning According to Allison Caldera from Capstone As of October, 874 remained. The state them away from the offices during office hours.” Community Action, the state sometimes had found “minimal success” in Plant spent nearly a year in a renegotiating rates with motel shelter, followed by two years in owners, as Act 81 had ordered, transitional housing, during which “I applied for housing, sometimes 15 paying $133 per night on average for he struggled to secure social services, each room. apartments in just one week. I was disability benefits, a cell phone, and Of the 409 beneficiaries that had a Section 8 voucher. His testimony always put to the bottom of the list, exited the program, 126, to AHS’s detailed an odyssey through mazes had found permanent of bureaucracy. not accepted or even looked at the the knowledge, housing. A plurality (191) had left “Every few months, it seemed like some agency or another needed second they found out I was homeless.” without notice. The state had kicked out 49 households for misconduct. paperwork filled out. Someone Ginny Lyons, who chairs the actually needs to read through the Senate Committee on Health and Welfare, questions, because many are often unclear, doesn’t share enough information about the especially when a person is worried that one motel residents for case managers to help them hinted at legislative action in the 2024 session. “This is just the beginning, of course. Our wrong answer can get them dropped from a effectively. She highlighted the importance of goal was to understand what’s happening in program,” Plant said. medical details in particular. Act 81, and we hear that we still have lightyears Packets would arrive at Plant’s doorstep “Our staff have sometimes discovered with what he called “unrealistic turnaround residents in unsafe situations because they are to go,” Sen. Lyons said. “I hope that we’ll meet request times.” In a panic, over the course of so ill, and I really am sad to say that our staff relatively early in the session to work and hear “roughly 24 to 48 hours,” he would collect the have found people who passed away in motels,” from our national experts and perhaps move forward collaboratively on a bill.” necessary information and send the documents Caldera said. Theresa Wood, who chairs the House back to an agency that would itself take weeks In her view, clients with serious medical Committee on Human Services, agreed. or months to process his response. needs should be shifted to “medical respite “We do have intentions of modernizing Service coordinators can help clients with beds,” but Vermont has few available. Caldera what’s currently known as the General tasks of this kind, but by Plant’s account, they cited “a robust medical respite program, tend to have spotty availability and sometimes designed in concert with local medical Assistance program. It’s going to be a heavy lift,” Rep. Wood said. “And one of the things disappear altogether. “I’m now on number 11 facilities,” as a major need. that we are very intent upon is hearing and in three years,” he said. Brenda Siegel, the executive director of End Plant pointed out that homeless people may Homelessness Vermont, contended that Act 81 building upon people’s lived experiences and how we respond to those as state government, face challenges related to mental health or violates the Americans with Disabilities Act. because that’s what we’re supposed to do.” substance use that can make long, duplicative “People with disabilities, dementia, and applications for assistance especially difficult medical vulnerability are essentially left to to fill out – not to mention follow-up phone fend for themselves,” Siegel said. “They are not calls and recertifications. offered reasonable accommodations, or when “Why are people who are experiencing this their disability gets in the way of their renewal, always held to a higher standard than providers, search for housing, or more, they are penalized The Service Building, 128 Merchants Row state agencies, and others?” he asked. “They or kicked out.” Suite 606, Rutland, VT 05701 can miss deadlines; we cannot. They can lose Kara Casey, the board president of the Email: paperwork; we cannot.” Housing and Homelessness Alliance of counterpoint@vermontpsychiatricsurvivors.org For Plant, winning a Section 8 voucher Vermont, warned that many motel residents wasn’t the end of his perilous journey. Within “will not have alternative housing solutions by COUNTERPOINT DEADLINES six months, he still had to find somewhere to the April 1, 2024, target identified in Act 81. We FALL (September delivery; submission deadline August 5) WINTER (December delivery; submission deadline November 6) use it in an extremely tight rental market. would like to see a more long-term, proactive SUMMER (June delivery; submission deadline May 1) When he couldn’t, the Vermont State plan in place moving forward.”
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Clients Celebrate Their Direct Support Professionals on State House Lawn
Vermont Care Partners, Green Mountain Self-Advocates, and the Vermont Developmental Disabilities Council gathered on the State House lawn to honor Vermont’s direct support professionals on Sept. 12. DSPs assist people with developmental and
Vermont State House, Montpelier, Sept. 12 intellectual disabilities. A trade association, Vermont Care Partners represents the nonprofits contracted by the Department of Mental Health and the Department of Disabilities, Aging and Independent Living to provide services across the state. Recently, these agencies have struggled to fill job openings, and the event in Montpelier gave administrators and state officials (including Lieutenant Governor David Zuckerman) a chance to publicize what they characterized as opportunities for meaningful,
satisfying careers, while also pushing the state to budget for pay increases for DSPs. Before long, however, these speakers passed the microphone to the agencies’ clients, who testified to the value that DSPs bring to their lives. Vermonters with developmental disabilities make up the leadership and membership of Green Mountain Self-Advocates, which, according to its mission statement, serves to “educate peers to take control over their own lives, make decisions, solve problems, and speak for themselves.” One of the group’s officers, Hassan Koh, described his DSP, Judy, as an ally in that struggle. “She is always with me about what I want to do. And I still remember what she helped me with, and also helping to understand what kind of dream I want to have, and also she’s always making sure I know what’s best for me,” Koh said. Koh then opened the podium to audience members, who came forward to share their own stories. More than a dozen verbal testimonies bolstered a nearby display of flags illustrated by clients to pay tribute to their DSPs. “Direct support staff are so amazing. They help us with whatever we need. In fact, my direct support staff helps me at work or taking me on trips. She also works with me on my goals. If I seem to be struggling with something, she will help,” one speaker said. “Sometimes it can be like family, helping us Counterpoint photos
out as best they can while still letting us take our bigger steps up in the community,” another added. “This is to my DSP, Lisa. She’s always willing to listen and she’s always willing to help me when I’m in trouble. Thank you, Lisa,” a client said.
Clients of disability services agencies designed banners to support DSPs. DSPs themselves also talked about their experiences on the job. Gloria Quinn, the executive director of Upper Valley Services, previously spent years in the role. “I fell in love with the people that we worked with,” she recalled. “I fell in love with the challenges and the triumphs and transformation that I saw happen on a day-to-day basis. I fell in love with the social justice. I fell in love with the social inclusion. I fell in love with everything, and it changed my life forever.”
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New Chief Executive Officer Leads Vermont Psychiatric Care Hospital When Wendy Shapiro thinks about inpatient psychiatric care, she thinks about her aunt, Shirley. Shirley “always had a special place in my heart,” Shapiro recalled. “My mom and dad would always have her and her boyfriend come over to play cards and eat dinner at our house.” According to Shapiro, who became the CEO of the Vermont Psychiatric Care Hospital in May, Shirley had a diagnosis of schizophrenia, for which she sometimes received treatment at residential facilities and hospitals. “But no one in my family would discuss that with me,” Shapiro said. “I got in this field for her.” At the start of her career, Shapiro found a job as a mental health specialist on a psychiatric ward where she could visit Shirley during her breaks. “I worked on the children’s unit, and she was on the geriatric unit, and I would spend time with her,” Shapiro recollected. “My grandmother and my grandfather were already passed – her children didn’t come and visit.” “At that moment was when I decided I wanted to become a CEO,” Shapiro continued. “To make sure that the people that were receiving services where I worked were getting the support that they needed.” With a master’s degree in counseling psychology, Shapiro took on a variety of other roles first, from inpatient social worker to director of a crisis program at an emergency department. Eventually, she became the chief executive officer of the Clarion Psychiatric Center in Pennsylvania. Shapiro had grown up in Philadelphia. But she hoped, someday, to retire to Vermont, a state with which she “fell in love” during a trip at age 23. “And then I saw this job and it just aligned,” Shapiro said. “So I am extremely, extremely grateful.” After five months at VPCH in Berlin, where she leads a staff of 173, her feelings about Vermont haven’t changed. “Vermont is just definitely a little bit more progressive,” Shapiro reflected. “Just the level of involvement and support, even from community members coming up and realizing what I do for a living and saying thank you, and caring, and that level of support for people who are receiving services here as well as the entire system.” Shapiro singled out Kat Parker, a patient
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representative for Vermont Psychiatric Survivors, who “comes here every week” to provide peer support and advocacy. She also mentioned that VPCH’s previously sporadic advisory committee had resumed meetings. The Vermont Department of Mental Health opened VPCH in 2014, three years after the closure of the Vermont State Hospital, to provide intensive care for involuntary patients, which can involve restraint, seclusion, and forced drugging. For nine years, the University of Vermont Medical Center provided its physicians. On July 1, 2023, DMH entered a new
Wendy Shapiro (courtesy photo) contract with a Pennsylvania-based company, Columbus Medical Services. The decision occurred before Shapiro’s arrival. As the contractor onboarded new staff, admissions paused, and the 25-bed hospital’s average patient count dropped to its lowest level in years. It hasn’t yet recovered. But Shapiro argued that the changeover “never changed how we operated.” VPCH managed to hold onto its medical director, who became a Columbus employee. On Nov. 3, when Counterpoint interviewed Shapiro, VPCH had nine patients on site. It had sufficient staffing, however, to accommodate 21, thanks to what Shapiro described as a recent focus on recruitment and retention. “We’re putting in various things to really be able to recognize staff and have various fun
activities that combine the people who are receiving the services here as well as the staff,” Shapiro said. “We do a lot of socials, barbecues, which is wonderful.” Columbus still had yet to fill one of the hospital’s three staff psychiatrist positions, but Shapiro pointed to the number of nurses as the relevant factor in determining the hospital’s capacity. VPCH plans to hire more. Yet advocates and officials have debated how many level-one psychiatric beds Vermont actually needs. In May, DMH opened the River Valley Therapeutic Residence, a locked “step-down” facility, for the purpose of receiving patients no longer deemed to require hospital care, and several VPCH patients transferred over. Shapiro expects the patient count to rise again at VPCH. She just doesn’t know how fast. “Our goal is to be a 25-bed facility,” she said. The long-term plans of DMH’s administrators in Waterbury may differ. Last spring, they won permission from the legislature to turn a nine-bed wing of VPCH into another residential facility, which this time would serve exclusively patients committed by criminal courts. “That is something that the central office is focusing on,” Shapiro said. “So I’ve been really focused on my role here, and working with the team, working with the individuals in care here.” Shapiro emphasized the complex, multifaceted nature of that care. It begins, by her account, with an individualized treatment plan. “Each person that is here is a part of their own treatment,” Shapiro said. “It’s their goals. Where do they see themselves moving forward?” Psychologists provide one-on-one therapy, while social workers discuss topics like housing and Social Security. The aim, per Shapiro, is to maximize patients’ chances of success when they return to the community. “There are numerous groups that are throughout the day,” Shapiro added, “and the recovery services department reassesses that to make sure that the groups that they’re having are meeting the needs of the individuals.” Shapiro herself hosts a monthly social hour, during which patients can ask her questions and register complaints. “It’s really having them be a part of how we do things here and having them weigh in and, if they have a question, having them understand why something is a certain way,” she said. “Everyone here has a voice.”
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Middlesex Residence To Reopen
The Vermont Department for Children and Families has plans to develop five new youth facilities to replace Essex’s Woodside Juvenile Rehabilitation Center, which shuttered in 2020 amid a dwindling inmate population and reports of abuse by staff. One of them will reuse a pair of linked FEMA trailers that, following the Hurricane Ireneinduced closure of the Vermont State Hospital, served as a “temporary” locked residence for patients in the custody of the Department of Mental Health. When its residents finally moved to a new facility built on Woodside’s former grounds in 2023, it already had outlived its intended lifespan by seven years. The state plans to reopen the former Middlesex Therapeutic Community Residence – again, temporarily – as soon as January or as late as March. It will host four beds. DCF aims to have a permanent home for its “short-term secure stabilization and treatment” program by 2026. The Joint Legislative Justice Oversight Committee heard the news on Oct. 16, when DCF presented an overview of its latest efforts to beef up what it calls its “high-end system of care.” From “mental health emergency beds” to “intensive residential” programming, it currently has licensed capacity for 155 juvenile placements, but since Woodside’s closure, it has reportedly struggled to accommodate youths deemed especially violent. Lately, DCF’s workers have declared a state of emergency, and department officials have begun scrambling for solutions. They assembled their current plan without receiving feedback from a legislatively mandated working group meant to include families, adolescents, and advocacy organizations. In the spring, lawmakers instructed DCF to convene such stakeholders to “provide regular input on the planning, design, development, and implementation” of upcoming facilities and programming for justice-involved youth. But the law didn’t set a strict deadline for the group’s formation or spell out exactly how much of DCF’s decision-making could take place before that point. Commissioner Chris Winters said the group would hold its first meeting on Oct. 26.
DCF has already picked locations for four of the five facilities. In response to the department’s request for proposals for adolescent residential programming, the Brattleboro Retreat submitted a successful bid to house up to 15 adolescents in a repurposed inpatient unit. DCF also expects to turn a property in Newbury into a “short-term secure treatment” facility, but the proposal hinges on a forthcoming decision by the Vermont Supreme Court, which will determine whether local zoning administrators – who’ve characterized the project as a prison, not a group home as claimed – have the power to block it. Next summer, a new “staff-secure crisis stabilization” program with two to three beds will take over a portion of the building in Brattleboro that houses the Windham County Sheriff’s Office. The conversion will cost an estimated $1.3 million and allow for stays of up to six months. According to Deputy
Middlesex, VT (Counterpoint file photo) Commissioner Aryka Radke, the sheriff’s officers won’t staff the program, but DCF has contracted them to help out, depending on their availability, when the need arises. The permanent facility that will replace Middlesex doesn’t yet have a location. Earlier this year, DCF hired a consultant to draft a request for qualifications for a design-build contract, and three developers responded. One of them, ultimately, will construct and own the building, which may sit on private or public land, and will lease it to DCF, according to testimony. Not all of the children served by DCF’s new additions to its high-end system of care will be justice-involved. Officials described mental health treatment as an equally pressing need. “We have to have a system of therapeutic treatment with providers at a variety of levels
of care,” Winters said. “And it’s not just one facility. That can’t serve all of the needs that we have among Vermont’s children.” DCF’s presentation took place shortly after Vermont’s largest weekly newspaper published a major investigative story about violence and neglect at Woodside. It hung over the discussion. “I’m sure many of you may have read the Seven Days article by Joe Sexton yesterday regarding Woodside and some of the failures there,” Sen. Dick Sears said. “But it doesn’t lessen the fact that we don’t have a high-end system of care at this point.” DCF would adopt a different approach this time, Winters pledged. The new programs would offer “appropriate, trauma-informed treatment and educational supports to go with it.” Winters also argued that, in the future, DCF shouldn’t operate its own locked facilities. In August, it released two requests for proposals in the hope of contracting private providers, but as of Oct. 16, it had yet to receive any responses. According to the Vermont State Employees Association, the union that represents DCF workers, state officials need to move more quickly to address a “tsunami” of violence by Vermont’s juvenile offenders. Executive Director Steve Howard urged Gov. Scott to deploy the National Guard to handle the problem. “This is a public safety crisis,” Howard said. “Let me be clear: we cannot wait six years, six months, six weeks, six hours, or six minutes for a solution or even some relief.” Sen. Sears proposed reserving a wing of an existing adult correctional facility for adolescents, suggesting that the conversion could take place in a matter of hours or days. Howard received the idea favorably. “It’s a thought,” said Rep. Alice Emmons, the committee chair. Matthew Bernstein, Vermont’s Child, Youth, and Family Advocate, warned against haste. “We have to fit the treatment system to youth needs,” he pressed. “Not the other way around, which is kind of what we have right now.”
Mental Health Integration Council Wraps Up
Vermont’s Mental Health Integration Council held its last meeting in September. It will submit its final recommendations to lawmakers in January. The state legislature created the Council in 2020 to help incorporate “mental health into a holistic health care system.” Flooding in July postponed its scheduled termination by two months. In an interim report issued last winter, the Council described Vermont’s primary roadblock to healthcare integration as a “lack of focus on the promotion of mental health” in settings such as primary care and pediatric
care. Over the course of more than two years, it aimed to figure out what the state ought to do about it. The meeting in September gave the membership – which, in addition to state officials, includes representatives from organizations like Vermont Psychiatric Survivors and NAMI-VT – a chance to refine the interim report’s advice to legislators. A draft of the final report, prepared by Mental Health & Health Care Integration Director Kathleen Hentcy, circulated in November. It contains 11 recommendations. The first asks the legislature to remedy gaps in
Vermont’s mental health parity law, specifically as it pertains to reimbursement for “specialty care services.” The second proposes the introduction of new “training paradigms” to foster “interprofessional teamwork” among healthcare providers, who should “understand all aspects of health care systems.” The report later suggests that primary care practices might share their staff with mental health clinics when the latter experience labor shortages. Next, the Council promotes the Veterans Health Administration’s “Whole Health” (Continued on next page)
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Students Recommend Tea and Dreaming
A pair of sophomores at Bennington College had an idea for a new student organization this fall. They called it the Lucid Dream and Tea Club. Researchers have investigated lucid dreams’ effects on mental well-being for years. Some have concluded that they can ease depression and anxiety. Alice Kandel-Zasloff’s father told her about the practice during her childhood, where it helped her overcome challenges posed by persistent nightmares and severe sleep paralysis. “I would describe lucid dreaming as not only knowing you’re in a dream, but having a certain amount of control over where you go, what you do, having a certain amount of consciousness and awareness you wouldn’t have in a normal dream,” Kandel-Zasloff said. “These things can be accompanied by really vivid feelings,” she continued. “So if you’re flying in a lucid dream, a lot of people say, it really feels like you’re flying.” According to Kandel-Zasloff, lucid dreaming sometimes comes easily to children. Adults may struggle to achieve lucidity during sleep. “It takes a lot of time to learn how to lucid dream if you’re going to set yourself to do it,” Sisi Turner, who co-founded the club, acknowledged. Beginners may use a technique called a “reality check,” whereby one repeats a specific action – such as looking at one’s hand and asking oneself whether it’s real – at intervals
during the day, with a hope that the habit will carry over into one’s dreams, spurring lucidity. Tea can also help. While certain herbal blends are said to promote lucid dreaming, the ritual of making, serving, and drinking tea matters more to Turner, a tea enthusiast, than its particular variety. She believes that a traditional Chinese tea ceremony can promote a “mindfulness” that helps make lucid dreaming possible. “It’s very relaxing,” Turner said. This semester, Turner and Kandel-Zasloff invited their classmates to drink tea and discuss their dreams with them. When they spoke to Counterpoint, their small club had just had its first meeting. Alongside the “therapeutic qualities” of lucid dreaming, Kandel-Zasloff highlighted the healing capacity of community building. Like other schools, Bennington College offers a range of student-run extracurriculars, such as a chess club, a soccer club, and a gardening club. Lucid dreaming may register to its 785 undergraduates as a less familiar hobby, but as far as Turner can tell, they seem open-minded. “People are really into symbolism here, so I
think there’s already a natural inclination to learn about dreams,” she observed. “We have hippies.” “A lot of Iroquois groups would dreamshare every morning, and that was a part of their daily routine,” Kandel-Zasloff added. “Most people have completely lost that. That’s, I think, a reason it’s so hard for a lot of people to remember dreams.” Turner and Kandel-Zasloff don’t view lucid dreaming as a replacement for mental health treatment, but Kandel-Zasloff noted that some people who’ve experienced trauma may have related nightmares and can utilize lucid dreaming to transform those visions. “I would say the benefit of lucid dreaming would be to know how to either wake up from that nightmare because you know you’re dreaming or, in that case, completely change the setting of the dream so that you’re no longer in that terrifying flashback,” she said. Lucid dreaming is also, by Kandel-Zasloff’s account, a lot of fun. “It stimulates your creativity because you basically unlock this world that you can travel around,” she said. “You can adventure around.”
INTEGRATION COUNCIL • Continued from previous page approach as a model for all providers. By the VA’s own account, the model uses a “transdisciplinary team” to deliver “personalized, proactive, and patient-driven” care. The fourth recommendation encourages the Department of Mental Health to continue to transform its community mental health centers into what federal officials call Certified Community Behavioral Health Centers. With the help of extra Medicaid dollars, agencies like the Clara Martin Center – Vermont’s first CCBHC – will, in the report’s telling, “provide high-quality community-based care for individuals experiencing mental health, substance use or co-occurring needs.” The Vermont Blueprint for Health, a reform initiative undertaken by the Department of Vermont Health Access, also receives a strong endorsement in the draft. The Council especially hopes to see an expansion of its DULCE (Developmental Understanding and Legal Collaboration for Everyone) program, which aims to reduce “ACE-producing (Adverse Childhood Experiences) circumstances” – such as “parent/caregiver depression, intimate partner violence, [and] food and housing insecurity” – among young families. Joblessness, similarly, can lead to negative health outcomes. In the Council’s view, health providers should play a role, for this reason, in helping clients secure employment. The report urges another of the legislature’s consultative bodies, the Health Equity Advisory Commission, to consider biases among providers “against people with mental illness of
any kind, and particularly those who experience psychosis.” Training may help, but for now, the presence of “peer support specialists in primary care and emergency department settings” can help ensure the availability of “person-centered options for treatment.” The final recommendation supports streamlining and standardizing documentation processes at clinics and hospitals for improved collection and sharing of data. The Council expects self-reported data from patients to prove especially valuable in furthering healthcare integration. “Integrating the vastly complex health care systems means integrating vastly different cultures,” the report concludes. “This magnitude of change will not be accomplished by any one model of integration or by an edict from on-high.” The draft recommendations could change before they become official next year. Throughout its process, the Council explored the role that peers could play in a holistic healthcare system. The state’s Director of Trauma Prevention and Resilience Development, Kheya Ganguly, who joined the Council as a guest for its final meeting, shared one vision. “I’ve always been in support of peers, but we also need to include peers with physical health issues,” she said. “Someone will come in with a chronic health issue and they’ve just received diagnosis – they don’t know anyone with this, and having a peer who may at least have familiarity with dealing with a chronic issue is really important.” “The second thing is we need to not
medicalize peers,” Ganguly continued. “One of my fears is suddenly they’re going to be wearing scrubs and they’re going to be another medical person who’s there, and we’re going to lose the benefit.” Interim Director of Health Care Reform Pat Jones, representing the Agency of Human Services, also sat in. She pointed out that Vermont’s efforts to get its healthcare system to take mental health as seriously as physical health started long ago, recalling the passage of a key law in 1998. “Back in the day, when Vermont passed the mental health and substance use disorder parity legislation, we were pretty cuttingedge. We were leaders. It took the federal government a number of years to actually catch up,” Jones recollected. Whether the Integration Council’s work will help Vermont rejoin the vanguard remains uncertain. Although lawmakers charged it to propose new legislation “where current statute is… inadequate to achieve full integration,” its draft recommendations don’t necessarily feature an obvious basis for a major healthcare bill. Even so, Commissioner of Health Mark Levine expressed a belief that the group’s efforts would lead to action of one sort or another. “I think most of us would agree the process hasn’t always been as straightforward as one would think,” Levine acknowledged. “We’ve addressed a lot of topics, some of which weren’t as comfortable as the others. And some may feel we did a lot of talking, and what else have we done? But that will change.”
12 NEWS 12 NEWS
Winter ’23-’24
Healthcare Committee Expects Busy Session Vermont lawmakers will reconvene in Montpelier for the second half of the legislative biennium on Jan. 3, 2024. As usual, the House Committee on Health Care and the Senate Committee on Health and Welfare will examine bills that address mental health. Rep. Lori Houghton chairs the former. She plans to keep tabs on several major, ongoing projects at the Vermont Department of Mental Health, including mobile crisis services, emergency department alternatives, and peer certification. “I kind of classify it as accountability,” Houghton said. “We need to make sure that we’re not just passing legislation and saying, ‘Yeah, go do it,’ and not following up with what’s happening.” Deputy Commissioner of Mental Health Alison Krompf also spoke of the unusual quantity of new programs and activities that received funding last year. She hinted at a focus on refinement in 2024, not on new proposals. “If there’s shifts in language or things that can make things easier in a small way, we’re going to look at that and open it,” Krompf said. “But we’re likely not going to see major initiative and implementation from the state until we can get everybody’s footing and people breathing again out in the field.” Still, Houghton foresees a full plate for legislators, who’ll likely return to the topic of forensic mental health, a prominent theme in
2023. With Act 27, the legislature authorized DMH, by next summer, to convert a nine-bed wing of the Vermont Psychiatric Care Hospital into a locked residence exclusively for patients committed by criminal courts. “We did not formally have it in our committee, but our committee did vote to support it,” Houghton recalled. “Obviously, there’s still a lot of unanswered questions, and that’s what a group of individuals now are working on.” This winter, the Agency of Human Services will present several committees, including Houghton’s, with information about the forensic facility’s potential programming. Depending on DMH’s recommendations, it could include a competency restoration program, which would aim to make psychiatric patients who’ve allegedly committed crimes fit to stand trial. “I think that will fall mostly in Judiciary within the House, with us taking a look at whatever they think is appropriate,” Houghton said. In recent years, community mental health centers and psychiatric hospitals have both struggled to recruit and retain employees. Houghton expects them to look to the legislature for extra support in 2024. “I wish I had some unique solutions. It’s going to come down to money,” Houghton said. “ It’s going to take us looking at licensing, which [the Office of Professional Regulation] is looking at now. And we have a social work interstate compact bill on our wall that I hope
to pass this year. It’s nothing that’s going to be fixed right away, but it’s something we have to continue to work on every year.” In 2023, the legislature also passed a pair of bills intended, in part, to protect community mental health workers and hospital employees from violence perceived to result from mental health crises. Both codified new responsibilities for law enforcement. But according to Houghton, the problem may need more work. “I think, overwhelmingly, we need to ensure that our healthcare workers are safe. And I’ve talked to several people who work in emergency rooms and administrators within some of the hospitals, and I think it hasn’t stopped the violence,” Houghton said. “I do anticipate having testimony on that to see where things stand and what else we might be able to do.” In January, the legislature will receive a final set of recommendations from the Mental Health Integration Council, which it created in 2020. Houghton expressed an eagerness to see them. She also mentioned looking forward to checking in on the Vermont Blueprint for Health, which last year received funding for a two-year pilot program to help primary care doctors address mental health and substance use issues. “We’ll be doing a lot of follow-up on that to see if it’s helping,” Houghton said. “What I’m hoping that we’re all moving towards in Vermont and at the federal level is finally looking at physical health, mental health, and substance use disorder in one.”
Vermont Psychiatric Survivors Adds to Board At its annual meeting at the Rutland Free celebrated VPS’s return to legislative advocacy funding that would potentially expand its scope Library, the membership of Vermont Psychiatric in Montpelier in 2023 after a period of inactivity. of activities. Survivors elected Keith Molinari, Rodney “We testified on a couple of different bills “I’ve got staff here that are capable of doing Nicklaw, and William J. Collins to its board a whole lot more than what they’re doing of directors. VPS publishes Counterpoint. in a wider range of services,” Wade said. Molinari, Nicklaw, and Collins had “But I can’t do it because it’s not part of served as temporary appointees since our grant language.” earlier in the year, when Walt Wade, Wade previously worked as VPS’s VPS’s new executive director, recruited peer support outreach coordinator. He them. Nicklaw and Collins both bring became ED in March. professional backgrounds in community “It’s been a lot of hectic stuff. But,” mental health. Wade said, “things are heading in the While Nicklaw works as a direct right direction.” service provider at the Counseling Service Tom Tench and Stephanie Kacanich of Addison County, Collins’s résumé delivered a report from VPS’s staff. includes former positions at Health Care Kacanich, a peer advocate, praised her & Rehabilitation Services of Southeastern colleagues for their work as patient Vermont, Rutland Mental Health representatives in hospitals and Services, and Mountainside House, a teen residential facilities, but she also lamented Board members, clockwise from left: Bill Collins, Rodney Nicklaw, Keith shelter in Ludlow. Molinari, a director of 2023’s unusually harsh challenges for Molinari, Bert Dyer, Sara Merrow, Zack Hughes (Counterpoint photo) public safety at Vermont State University’s the organization’s clientele, including a Castleton campus, cited his own “struggles with and blocked one piece of legislation,” Hughes mass eviction in June of homeless Vermonters anxiety and depression” as the basis for his said. “We’re back in business, and we’ll continue from state-supported motels. interest in mental health advocacy. to maintain our uniqueness in Vermont by “When that day came, how many people Sara Merrow, Zack Hughes, and Bert Dyer educating others about what their rights are and were out on the street?” Kacanich asked. “How fill out the rest of the VPS board. Merrow, the making sure that everybody is receiving what many people did we see out on the street in board president, dedicated the meeting on they need to receive.” Burlington, City Hall Park, Rutland, all over Oct. 28 to the memory of Thomas Christophre Wade emphasized that VPS could do even the city, struggling? How many friends have we Woods, a former VPS executive director who more. The organization relies on a grant from all lost due to addiction? Too many.” had passed away in February. the Vermont Department of Mental Health, Anne Donahue, who edited Counterpoint for On a happier note, Hughes, the vice president, but it has begun looking for additional private (Continued on next page)
NEWS . 13
Winter ’23-’24
Committees Reject Consolidation The Vermont Agency of Human Services has drafted a rewrite of decades-old administrative rules that govern its advisory bodies. The potential update initially included the possibility of a merger between the State Program Standing Committees for Adult Mental Health and for Child, Adolescent and Family Mental Health, but committee members successfully opposed that part of the revision. “The current state is the standing committees are not being combined,” Deputy Commissioner of Mental Health Alison Krompf told Counterpoint on Nov. 15. “They will remain autonomous, child and adult.” According to Krompf, the state hadn’t fully developed or endorsed a consolidation plan in the first place. “From my perspective, it was never proposed, but we could see how people thought it might be on the table,” Krompf said. “So we did examine the issue and decided not to go in that direction, and certainly the feedback is part of that.” The State Program Standing Committees serve to give consumers and their families a voice in decisions made by the Department of Mental Health. In particular, they evaluate the performance of Vermont’s 10 nonprofit community mental health centers in order to help determine whether the state should continue to fund them to provide services on its behalf. A similar advisory body oversees the private service providers contracted by the Department of Disabilities, Aging and Independent Living. DMH officials have pointed out that a single Developmental Services State Standing Committee has represented DAIL clients of all ages. DMH’s two committees must maintain rosters of nine to 15 members each. In addition, each of the ten community mental health centers currently hosts a parallel structure: a Local Program Standing Committee for adults and one for children. Per DMH, the community mental health centers have reported challenges finding enough volunteers, particularly for the latter. “We would love to give the option, especially at the local level – if it makes sense, if the folks
that are attending that committee want to, you could have one across-the-lifespan committee,” Assistant Director of Quality Eva Dayon said in early November. Dayon acknowledged encountering resistance during preliminary outreach on the topic. “I know that was the feedback we did hear from the Adult Mental Health State Program Standing Committee,” Dayon said. “They said, ‘We don’t feel qualified to speak to children’s mental health services, and please don’t force us to combine when we just had a conversation
“There are different populations with different needs.” about potentially doing that and said very clearly we don’t think that’s appropriate at this time.’” The adult committee reviewed the draft, which suggested a single committee of 10 to 15 members for mental health, on Oct. 9. When it came before the children’s committee on Nov 2, DMH hadn’t retracted the language, but Dayon reassured attendees that “our goal is not to force everyone to smoosh together.” Zachary Hughes, the vice president of Vermont Psychiatric Survivors’ board of directors, serves on the adult committee. He spoke against the potential consolidation at the state level. “I don’t really support that because there are different populations with different needs,” Hughes said. “At the local level, I think the agencies can do what they need to do.” Hughes also argued against a possible change whereby the governor would no longer appoint the committee members, allowing the state’s commissioner of mental health to take charge. “It’s such a monumental post,” Hughes said. “That’s how I feel about that sort of thing.” Members of the children’s committee, however, voiced little pushback on that proposed revision at their meeting.
“It just takes so long for it to get through the governor process sometimes,” Cinn Smith commented. “It’s irritating.” Under the new administrative rules, the committees would continue to review the performance of each community mental health center as they do now, but the language enumerating their official responsibilities would change wholesale. Dayon characterized the rewrite as an effort to make the document more accessible. “We’re trying to write in such a way that anyone can pick it up and understand what’s expected,” she said. In this section, the revision would reduce ten bullet points in the original text to six. In doing so, it would replace several mandates that DMH present information about actions, services, policies, and grievances to the committee for review with instructions, instead, for the committee to provide input on the same or similar subjects. For instance, while the current rules require the commissioner of mental health to “seek advice from the Committee” in the “hiring of key management,” the new language would permit the committee to offer “recommendations for candidates for classified leadership positions involved in the Agency Designation process.” “The language is shorter, but that was done to make the rules listed more clearly and concisely and be really specific,” Krompf emphasized. “The intention of the state is to clarify language but not at all change the scope.” DMH plans to hold “virtual forums” in December to gather more feedback. AHS may make adjustments to the proposed language in January before sending it to the Interagency Committee on Administrative Rules. Next, the Secretary of State will host a sixweek public comment period. Finally, the Legislative Committee on Administrative Rules will verify that AHS “followed all the steps in the right order,” as Dayon put it. “Then we can decide if we’re going to actually go forward with trying to adopt this rule,” Dayon said.
VPS BOARD • Continued from previous page VPS for more than two decades, attended the annual meeting for the first time as a VPS member. She described having recently spent “hundreds of hours” researching the cemetery at the Vermont State Hospital, a longtime project. Donahue used old newspaper articles to find the names of long-forgotten psychiatric patients who had died at the institution between 1891 and 1915. In 1991, a hillside in Waterbury received a plaque to mark their remains, but Donahue has come to believe in rumors of a second burial ground on the asylum’s former grounds and hopes to see it identified and protected. “To me, it really matters who’s there, because
it’s about restoring their dignity and their names,” she said. Donahue plans to introduce a bill on the subject. She represents Northfield in the Vermont House of Representatives. “I certainly hope that, when the bill comes up in the legislature this year,” she added, “VPS will be there to say, ‘This is really critically important.’” Molinari expressed a hope for a bigger annual meeting in 2024. “I know you guys would like to see a lot more members here. I think COVID took away so much from the organization,” he said. “But I know that this is the start of a new beginning. I really do feel that.”
Tom Tench and Stephanie Kacanich (Counterpoint photo)
Winter ’23-’24
The Arts On Camera and Off, We May Be
14 an ‘Anxious Nation,’ But Why? FILM REVIEW by BRETT YATES
ongoing, COVID-19 hits, giving everyone another big reason to worry. Solutions, according to Anxious Nation, will vary from person to person. The filmmakers showcase talk therapy, exercise, music, and self-help strategies like journaling, as well as pharmaceutical interventions. While debilitating hang-ups must, it seems, be defeated, the film urges against an anxiety of anxieties, emphasizing that some quantity of discomfort in the face of the world’s uncertainties is natural and healthy. Above all, it promotes open dialogue among families and a willingness to use professional help when needed. Anxious Nation’s best quality, its openmindedness, is also its worst: correspondingly, it has no critical perspective. It displays no
trouble correctly assigning the blame in such a case. This anxiety, obviously, originates not from a disorder of the brain but from our institutions’ What causes anxiety? careless treatment of marginalized people. What can those who experience it intensely The filmmakers have and persistently do to ease their burden? nothing comparably Anxious Nation, a documentary that played in damning to say about the five theaters across the state this fall in a series of documentary’s primary special events organized by NAMI-VT, proposes setting: the comfortable, the same answer to both questions. The answer professional-class milieu is: well, a lot of stuff – it depends on the person. that, despite its promise Laura Morton, the mother of a teenager who of safety, has apparently suffers regularly from panic attacks, initiated left its kids equally paralyzed by angst. The the project in California. It takes an up-close filmmakers might have given their own home look at adolescent anxiety through the eyes turf a second look. of young people themselves, with additional One mother mentions off-handedly that commentary by parents, clinicians, and, she first noticed her child’s anxiety during occasionally, celebrities. their interviews for private kindergarten With no prior film credits of her own, placements. At another point, a parent Morton brought on an experienced seems to forget the camera for a moment documentarian, Vanessa Roth, as her and begins to berate her daughter, a child co-director. But much of their footage actress and singer, for flubbing lines at ultimately came directly from their professional auditions as she boasts about teenage subjects, who self-recorded video her own superior performing talent. diaries about their struggles. Here, at the edges of Anxious Nation’s “The pressures our kids feel, the relatively vanilla commentary by complexities of the world, and their credentialed experts and responsibly ability to cope with it has made anxiety concerned parents, one starts to perceive impact our kids on a level we’ve never the more interesting stories it has chosen to seen before,” Morton says. “So I set out leave out. They are the stories that clinical to make this film to understand what our mental health has never known what to kids are going through.” do with – the ones that reveal something One interviewee describes anxiety as “a storm of negativity.” Others cite difficulty On right, from left: Margie Lemay, Daisy Berbeco, and Paul Foxman about a way of life, whose deficiencies can’t breathing, difficulty thinking, dread at the at Main Street Landing, Burlington (Counterpoint photo) be resolved through small modifications of individual behavior or attitude. prospect of going to school, and suicidal interest in examining the political character of The documentary identifies what it calls a ideation. For visual interest, Morton and Roth overlay any particular conception of the “disorder” in “national crisis” of rising anxiety among young people. But it’s a crisis for which no one, it seems, vintage cartoons that sometimes feel out of question. Despite a patina of race- and sexuality- bears significant responsibility, and for which place. Other segments feature unidentified drawings and paintings of a sometimes based diversity, all of Anxious Nation’s teenage no truly disruptive course of action is required. abstract nature, and a title card in the closing subjects appear, at first, to come from more or We must instead use “strategies” to cope. Anxious Nation’s most arresting segments credits finally discloses their poignant source: less the same bourgeois background. And their young people, like the ones in the movie, who problems, therefore, are, in the filmmakers’ are its recordings of crisis itself: home had used art to try to capture their feelings of eyes, mostly the problems of individuals video footage of children undergoing severe and families, not indictments of the largely panic attacks. It’s recognizably authentic anxiety. and unfiltered, and the filmmakers offer no Anxious Nation begins without a clear wholesome world in which they live. But then another major event transpires explanation for why it exists – why, that diagnostic or prescriptive agenda, and in a seemingly genuine spirit of curiosity, it surveys during production: the murder of George Floyd is, the parents continued to hold up their in Minneapolis. The subsequent nationwide iPhones instead of giving their full attention to a range of testimony and theory. Anxiety, it seems, has both genetic and protests appear to inspire the filmmakers to comforting their children. In September and October, NAMI-VT environmental causes, the latter of which visit the opposite end of the socioeconomic may arise from individual circumstances (for spectrum, where they find a young man sponsored free screenings of Anxious Nation in example, a child’s experience of their parents’ whose history of terror at the hands of both South Burlington, St. Johnsbury, Burlington, acrimonious divorce) or broad social phenomena police officers and psychiatrists has left him Brattleboro, and Montpelier. On Oct. 5, the predictably traumatized. Main Street Landing Performing Arts Center (such as the threat of climate change). Anxious Nation’s liberal sensibility has no hosted a post-film panel discussion with Rep. Instagram and TikTok, which appear to Daisy Berbeco, Dr. Paul encourage insecurity Foxman, and NAMI-VT’s among teens who Margie Lemay. use them to compare At home, viewers can rent themselves to their peers a streaming copy of Anxious in terms of looks and counterpoint @ vermontpsychiatricsurvivors.org or mail to Counterpoint, Nation at Amazon and other popularity, also earn The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701 services, such as YouTube heavy scrutiny here. Please include name and town and Apple TV. Finally, with filming
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The Arts .. 15
Winter Winter’23-’24 ‘23-’24
In New History, a ‘Vermont for the Vermonters’ Wasn’t for Everybody
Eugenics – the pseudoscience that promotes selective human breeding through policies like sterilization, marriage restriction, and family separation – became a nationwide movement in the first half of the 20th century. In Vermont, the particular concerns and preoccupations of local social reformers shaped its application. The Vermont Historical Society published a new book in September, “Vermont for the Vermonters”: The History of Eugenics in the Green Mountain State by Mercedes de Guardiola. A corporate communications consultant based in New York City, de Guardiola is not an academic historian by trade, but one wouldn’t necessarily know it from a volume whose citations and bibliography take up nearly 50 pages. With new research, the book tells an old story that hasn’t gone away. Just two years ago, the Vermont General Assembly issued an official apology for its past efforts to eliminate a population that it had once referred to as “imbeciles, feebleminded and insane persons, rapists, confirmed criminals and other defectives.” And while Vermont’s legislators have not repealed a law that still permits the forced sterilization of people with intellectual disabilities with a judge’s permission, they recently established a Truth and Reconciliation Commission that will study historic and ongoing instances of state-sanctioned discrimination until 2026. De Guardiola’s account may help. Expanding on scholarship that has focused largely on the infamous 1925 Eugenics Survey of Vermont, “Vermont for the Vermonters” begins in the late 1800s, a period of depopulation in the countryside. Many of the state’s farmers had fled to cities elsewhere for work or to try their luck on abundant free land in the West. Vermont’s rural communities suffered visibly, and nostalgists blamed their decline on a deterioration of their gene pool. In the popular imagination, virile 18th-century frontiersmen like Ethan and Ira Allen still embodied the spirit of the Green Mountains, but their legends couldn’t conceal an increasingly bleak landscape in which invalids and madmen, as their social betters of “old stock” saw them, seemed now to predominate. In the early 20th century, according to de Guardiola, a new economic emphasis on tourism added financial stakes to the conflict between Vermont’s self-image and its reality. In an “oversaturated market of New England rural purity,” Vermont’s presentation of Yankee wholesomeness couldn’t afford any black marks. Between 1866 and 1915, the state took action, founding three major institutions: an insane asylum (the Vermont State Hospital in Waterbury, built to supplement the private Brattleboro Retreat) and two quasi-educational facilities (the Weeks School in Vergennes for juvenile delinquents and the Brandon Training School for children with developmental disabilities). De Guardiola offers a history of each.
Institutionalization ultimately served a eugenical end insofar as it worked merely to isolate perceived contagions, such as “insanity,” from the rest of humanity. But many early advocates sincerely believed that modern facilities with staff trained in the latest medical techniques could improve the lives of society’s vulnerable outcasts. Before long, however, overcrowding precluded even a crude form of treatment as a legible aim. The absence of a modern welfare state contributed to the problem. Courts took pity on orphans and invented minor crimes that would have them placed at Vergennes, where they would at least have food and shelter. Normal public schools failed to accommodate not only children with developmental disabilities but also those with physical ailments, who ended up at Brandon instead. And when Brandon’s students aged out, Waterbury sometimes followed – not because they needed psychiatric care but because they had nowhere else to go. As new allocations of funding from the legislature failed to keep pace, the institutions used forced labor by their residents to stay afloat. At Waterbury, patients tended a 700-acre farm whose crops “not only supplied hospital needs, but were also sold at a profit,” alongside handcrafted goods whose making supposedly functioned as occupational therapy. In an environment where patients had to “crawl over other beds to reach their own beds,” therapy didn’t work, which seemed to prove the hereditary nature of their problems. Of the three institutions, Waterbury was the last to close, nearly half a century after President John F. Kennedy signed the Community Mental Health Act of 1963. By 2011, a popular association with the evils of Nazi Germany had long ago discredited eugenics. “Vermont for the Vermonters” takes care to depict American eugenics as a fad of the Progressive Era, not as a product of a conscious fascism. Forward-thinking academics, social workers, and philanthropists saw in it “a civilized answer to social ills,” whereby the miserable creatures of the world would someday simply cease to exist. Progressives didn’t stand alone. Eugenics often contained a racist focus, and as de Guardiola points out, the Ku Klux Klan embraced the idea. And in Vermont, some eugenicists singled out French Canadians, whose population, according to rumors, had mixed liberally with the Western Abenaki. But racism was not a necessary component. The author Elin Anderson, working as an ethnographer in Burlington, lamented in 1937
BOOK REVIEW by BRETT YATES
that “racial and religious prejudices frequently stand in the way of the realization of any ideal biological blending.” For compassionate reformers, the legalization of forced sterilization represented a particularly important goal because it offered a chance to release patients from increasingly run-down institutions without risk that they’d use their freedom to procreate. To their chagrin, Governor Allen M. Fletcher had vetoed a sterilization bill in 1912, and courts had struck down the practice in other states. The US Supreme Court, however, finally presented a green light in 1927. And advocates in Vermont got their wish in 1931, when the efforts of the state’s most famous eugenicist, Henry Perkins, culminated in the passage of law that, according to the records of the Department of Public Welfare, led to about 250 surgeries over the following two decades. A University of Vermont professor, Perkins had founded the Eugenics Survey of Vermont. In de Guardiola’s telling, the college unofficially sponsored his ostensibly private organization, and “numerous public officials served in it in their public roles.” The author details the shoddy methods of the project’s fieldworkers, who hunted signs of “degeneracy” among Vermont families in confidential medical records willingly surrendered by public institutions and in interviews with Vermonters themselves. Per de Guardiola, these methods included fabrication. What does all this have to do with Vermont in 2023? If a throughline connects yesterday’s teeming institutions to today’s prisons, psychiatric hospitals, and group homes, the Truth and Reconciliation Commission will have to locate it. “Vermont for the Vermonters” is a compilation of facts, not a projection of theory. De Guardiola follows her story to the present, however, where she takes the common view that deinstitutionalization went too far. She praises two remaining relics of the 1800s – the Brattleboro Retreat and the Lund Home for new mothers – for their “high-quality inpatient care” and asserts a contemporary shortage of psychiatric beds. In the author’s view, community-based mental health services have “largely failed to address care and treatment needs for the severely mentally ill and disabled.” She laments that, while the Vermont Department of Mental Health’s charge to provide care in the “least restrictive” environment “protects individual rights, it can also lead to a lack of sorely needed ongoing treatment.” Psychiatric survivors may feel differently.
16E The Arts
Winter ’23-’24
A Psychiatric Survivor Goes West
Steven Morgan moved to Vermont from Georgia because he wanted to live in the quiet of nature. Eventually, he had to travel even farther to find serenity. Fortunately, he took plenty of pictures when he got there. “I have real sensitivities to machine sounds and stuff like that, like lawnmowers, airplanes flying, highways,” Morgan told Counterpoint. “It’s not just like a nuisance. I can’t do anything else if I hear all this noise.” Morgan tried noise-canceling headphones, meditation, and medication. None of it worked, but Vermont, where he became the executive director of Montpelier’s peer-run community center Another Way, offered untouched forests where he could live in a tent for five months of the year. Morgan’s career, however, eventually led him to the state’s biggest city, where he served as the project developer of Soteria House for Pathways Vermont in Burlington. For Morgan, getting Soteria House off the ground was a dream come true, but his health began to deteriorate, owing to a condition called ankylosing spondylitis. “I just kind of hit a wall where I was like, ‘I can’t do this anymore. I’m sick.’ I didn’t know how disabled I was going to get, because the disease can be really, really bad,” Morgan said. “I kind of had a nervous breakdown-type thing.”
In the past, Morgan’s struggles had landed him in psychiatric hospitals. This time, he took off for the remote Big Bend region of Texas, with the encouragement of the executive director at Pathways. “Hilary Melton was like, ‘We can find a replacement. Go, if you need to go.’ And so I vacated my entire life, and I got in my car,”
Morgan recollected. “It had like 186,000 miles on it, and I just drove west with a little bit of savings.” That was 10 years ago. Morgan has lived on the road ever since, typically parking his camper in Arizona, Colorado, Wyoming, or Montana, depending on the season, and working mostly remotely for Intentional Peer Support.
Morgan had studied filmmaking in college, but during that time, he’d discovered still photography as a lower-cost way to create images. For years now, he has shot the deserts and mountains of the West on an iPhone, which he likes for its simplicity. “You really can’t zoom in with it,” Morgan explained. “In other words, if I want to get the right framing of a mountain. I actually have to walk to the place I want.” He edits the photos very little. His website, stevenmorganjr.com, now hosts a large collection, which anyone can use for free, without attribution. “I may be coming to the end of my time living on the road,” Morgan said. “I’ve been doing it for a while. I think I kind of have done what I needed to do out here.” Sometimes, Morgan thinks about coming back to Vermont. “I miss the land, but I really miss the people. It’s a wonderful place,” he said. “It looks like the rents have doubled since I was there.” Photos by Steven Morgan. Top row from left: Big Bend, TX; Bryce, UT. Center: Death Valley, CA. Bottom row from left: Northern Montana, Western Colorado.
The Arts . 17
Winter ’23-’24
Joan’s Dream by Jacob Weber
Tribute to the Founder by Kecia Gaboriault
Arts Collective Keeps Busy
The Howard Center Arts Collective mounted back-to-back shows in the second half of 2023, starting at Burlington’s Flynndog Gallery from August through September. Sponsored by Chittenden County’s community mental health center, the Arts Collective, by its own description, brings together “artists of all levels” who “have lived experience with mental health and/or substance use challenges, via their own personal lived experience, experience with family members or friends, or through their work.” In February, the Flynn Center invited the group to see the touring Philadelphia Dance Company, an internationally acclaimed, predominantly Black contemporary dance troupe. The Arts Collective’s show at the Flynndog, “Philadanco,” drew inspiration from the performance, the company’s first ever in Vermont. At a reception held during the annual South End Art Hop, the Flynn’s executive director, Jay Wahl, spoke of “the way that art becomes this domino effect and encourages more and more acts of creation. That’s an extraordinary thing.” Arts Collective member Kecia Gaboriault dedicated her painting, Tribute to the Flood by Amjed Jumaa
Founder, to Joan Myers Brown, the 91-yearold trailblazer who created Philadanco in 1970 and remains active in the organization. “I know she was having a really hard time finding companies to allow her to dance the way she wanted to dance, and so she took it upon herself to do it herself,” Gaboriault said. Gaboriault’s piece shows stenciled dancers on a brick wall made of alcohol ink. “I was an urban artist at one time,” Gaboriault added. “So I thought, well, it’d be kind of cool to combine urban arts with a tribute to her.” The Arts Collective’s next show, “Flow,” will run through December at Burlington City Arts’ Metropolitan Gallery, located at City Hall. “Inspired by water and the spirit of rebuilding after disaster,” it opened in October, three months after the flooding that devastated much of Vermont. 50% of sales proceeds will benefit Studio Place Arts, a storm-damaged nonprofit in Barre. One of the show’s contributors, Amjed Jumaa, came to Vermont after living in Iraq, his home country, where a manmade disaster – a US invasion – displaced millions between 2003 and 2011. “I was thinking about people I had left behind there in my country, and how I could see them Rotary Park, Winooski (Counterpoint photo)
and meet them again. Suddenly, the winds of the storm blew, and then the flood came,” Jumaa said. He painted Flood with a hope that, in Vermont, “everyone would survive, live, and search for a safe place.” Finally, in Winooski, Rotary Park has a new touch of color, thanks to five Arts Collective members – Gaboriault, Jumaa, Sherridan Beyer, Adam Forguites, and Annie Caswell – who got permission to paint the exterior of an electrical box. Each took responsibility for one side, including the top. “We were looking at a whole bunch of different options around town to do a mural of sorts,” Caswell explained. “And we decided on the electrical box because there was a wall that was tagged heavily, and we thought, well, it’s probably going to get tagged again.” The panels reflect aspects of life in Winooski and the city’s identity, from the iconic yoga sculpture on the river that disappeared during the summer’s flooding to the noise pollution from the F-35s overhead. Caswell’s piece includes a picture of one of the wild leeks that gave the Winooski River its name, as well as a brick and water motif that refers to its riverside mills. With silhouettes of various shapes and sizes, it also celebrates the people of Winooski, the state’s most diverse city by several metrics. Curtain Call by Colleen Murphy
18E The Arts
Winter ’23-’24
Sunset in St. Albans (Counterpoint photo)
Rubix Kube, a 1980s tribute band (Counterpoint photo)
Music Festival Raises Funds
“Music is good for your mental health.” That’s what the lead singer of the sextet Cozy told the crowd that had gathered at Hard’ack Recreation Area in St. Albans for the festival known as Afterglow. It was early afternoon on a sunny fall Saturday, and as attendees continued to eat, drink, and dance into the night, it looked like the singer was right. Andrea Wells and John Holzscheiter cofounded the Afterglow Foundation in honor of their son, AJ, a star athlete who, after a series of devastating Bill Atkinson knee injuries, died by suicide at age 18. Since 2019, they’ve organized an annual music festival whose proceeds support several local organizations that focus on mental health. “After he passed, we were trying to think of what we could do to raise awareness on suicide,” Wells said. “We didn’t want the typical golf tournament, that kind of stuff. So we were like, we’ve got to do something with music because AJ just loved music.” A handful of corporate sponsors – Deringer, Heritage Ford, Heritage Toyota, The Vermont Agency, and TI Advisors – cover the cost of putting on the show, which allows all the money from ticket sales, raffles, and donations to go to
the cause of suicide prevention. This year, Wells and Holzscheiter hoped lots of Vermonters would turn out to see a headliner from New York City, the 1980s tribute band Rubix Kube. “The past three years, we’ve always done three local bands,” Wells said. “But we knew we had to step up the game to start bringing in bigger crowds.” On Sept. 23, food trucks, local breweries, and kid-friendly activities such as a climbing wall, cornhole, and face-painting contributed to a festive atmosphere. Between bands, however, speakers took the stage to talk about the impacts of suicide and suicidality. One of them came from Northwest Counseling and Support Services, the community mental health center for Franklin and Grand Isle counties. Emergency Services Program Director Tony Stevens recalled losing his older brother to suicide in 1997. “My brother had made one prior suicide attempt when he was 17 and a junior in high school,” he remembered. “I can honestly say that in those seven years since he made that first attempt to when he ended his life by suicide, we didn’t talk about suicide as a family.” After his speech, Stevens praised Afterglow’s contribution to normalizing such discussions. “I think this is an incredible example today of just making it okay to talk about: just sort of having conversations, providing resources, making it comfortable to have fun, be in a sort of normal social atmosphere, but understand a little more about it, or talk to organizations
that can provide resources or help, which can feel very different than walking through the doors of a clinic,” he told Counterpoint. Another speaker, former Navy SEAL Bill Atkinson, testified to the power of peer-topeer connection at a moment of hopelessness in his own life. Following his military service, Atkinson had struggled to find stability or get along with other civilians. “I didn’t understand, with all my education and training and skills, why people didn’t hire me, why I wasn’t a good fit, why I didn’t seem to belong,” he recollected. “I thought about ending my life. I thought, ‘Jeez, I’m a failure. I’m a screw-up. My time in the SEAL teams, I was somebody, but I’m not somebody anymore.’” “The VA suggested I go to this place called Josh’s House,” Atkinson continued, “because it was a place for veterans to meet, to speak the same language, to understand each other, to tell stories, to have fun, to rebuild that camaraderie that all of us knew as service members.” Atkinson now volunteers as a cook at Josh’s House, a wellness center that offers meals, games, a gym, and massages for veterans in Colchester. Its parent organization, the Josh Pallotta Fund (named after a former Vermont National Guardsman who died by suicide in 2014), received a share of Afterglow’s revenue, which totaled $55,000. The rest went to NCSS, the Vermont chapter of the American Federation of Suicide Prevention, and the St. Albans Department of Recreation.
Troy Millette & the Fire Below (Counterpoint photo)
Hard’ack Recreation Area (Counterpoint photo)
A “memory wall” of loved ones (Counterpoint photo)
The Arts . 19
Winter ’23-’24
Art & Poetry by Our Readers Time’s practical joke, miss me please? Serene happiness garnered not without the gentle caring that goes along with considering one’s self
at these very daunting facts. Feeling restless sadness at the real possibility of my symptoms getting worse.
Feeling folly at the possibility of dying 20 years before i potentially could. That’s 20, twenty years too soon. That’s a full 20 years where i could speak to my sister... tell her the usual and, maybe more pointedly, the unusual. Not to mention gems of friends i’ve cultivated relationships with... i miss them already. My inner fortress rusting and getting primarily dusted from lack of attentive seriousness
I think of that elder warrior, almost slain in the movie Gladiator, by Maximus... blood running from his mouth as he knelt in pain. Live every moment like it is your last... well yes... alas; those moments should not be rushed, but for me, they are. I ponder the white winter day outside my window searching for solace, hoping for time’s practical joke to miss me, most entirely.
GEOFFREY L. MCLAM, St. Albans Drawing (top-left) by RICHIE AMERSON, Burlington Photograph (left) by SCOTT NORMAN ROSENTHAL, Irasburg
To secret places go When the world is at its darkest not because of nightfall When the fires of rage are burning and we are feeling ever so small When the pain of merely living becomes too great to bear To secret places go and I will meet you there When tears of sorrow have turned your heat to desert dust Leaving behind but a withered, shallow crust When the world takes on a monochromatic hue And checking out is all there is left to do Please,if you will, to secret places go It is the safest of places that I know Gardens rich, a wild growing Elves, dwarves, and gnomes knowing An innocence of a time long past A safe haven for a moment to last Human fatalities have we Temporary admittance to the land fairie Existing there are realms other than here Believe; hold close your belief in them most dear There are beautiful worlds of light, I know When it’s darkest here, to secret places go
by LAURA LEE SAORSA SMITH, Marshfield
Louise Wahl Memorial
Writing Contest Enter the 2024 Contest: Deadline July 17 $250 in Total Prizes!
Named for a former Vermont activist to encourage creative writing by psychiatric survivors, mental health consumers and peers. One entry per category (prose or poetry); 3,000 word preferred maximum. Repeat entrants limited to two First Place awards. Entries are judged by an independent panel. Winners will be published in the fall 2024 Counterpoint. Send submissions by email to counterpoint@vermontpsychiatricsurvivors.org or by mail to: Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701
Include name and address.
20 .COMMENTARY COMMENTARY
Winter ’23-’24
Forced Hospitalization Leaves a Lasting Mark by LAURA SHANKS
“Say what you want, it is a jail. Am I locked up? Yes. Are there guards? Yes. Can I leave? No.” “I think the whole system is a mess. No one has explained anything to me.” “I just feel very controlled. If I had been given the option to leave on my own accord, I can’t say things would have ended up any differently, but at least the choice was mine.” These are the words of our peers currently under involuntary orders, or civil commitment, in state-designated psychiatric hospitals. Confusion, fear, helplessness, sadness, and anxiety are just a few of the side effects. This is the impact of court-ordered hospitalization. This is a glimpse into an archaic practice that often turns a cry for help into a prison sentence. A majority of the peers I work with at Vermont Psychiatric Survivors are either currently under involuntary psychiatric hospitalization orders or have been in the past. During my three years with VPS, I’ve observed its impacts and have assisted peers in working through the trauma it produces.
Civil commitment takes psychiatric practices to the extreme, revoking basic rights and placing individuals into psychiatric care against their will. While the laws around this vary from state to state, the general premise is that when someone is deemed a danger to themselves or others, a concerned party can file for an emergency examination. If a doctor, in a short assessment, agrees that the individual in question is a danger, they are taken into “temporary custody” and transported to a hospital. “Unsafe,” however, is a vague term and I’ve certainly seen this power abused. What is meant to be a statute to save lives can, like everything else, be misused, and a short lapse in judgment or a misspoken word can leave someone locked up in a psychiatric hospital for months. This experience is rarely therapeutic. “It’s just traumatic,” a peer, back in the community after several involuntary admissions, said. “Everything is uncertain, and you’re already in a crisis. It gives me a mental breakdown, not a break, when other people make the decision for me to be hospitalized.” This has become one of the most challenging and heartbreaking aspects of my job and one of the most complicated to navigate. As it’s a legal matter, aside from being able to advise peers of the few rights they have left and offer support, I am generally helpless. The most I’ve been able to do is offer continued care and peer support to help them work past their experiences when they are back in the community.
My own experiences with involuntary admission were over 18 years ago as an adolescent, and I still remember the unnecessary and traumatic experience of being strip-searched and handcuffed. What did I and many others learn from this experience? That being sad or sick is punishable and that others can’t be trusted with our feelings. Ultimately, however, I did need to be hospitalized at that time in my life, and many others experiencing involuntary hospitalization are similarly coming from an acute experience that requires some form of extreme intervention. So how can we make this experience less traumatic? What are the alternatives to involuntary hospitalization? These are the questions I’m left asking, and aside from a complete upheaval of the current system, I won’t claim to have any real answers. What we can do now, however, is create an open dialogue around these practices. We can create more transparency around the gray areas in the legal system and come together to hold doctors and designated agencies accountable when their powers are abused, while we work to create alternative approaches. Because, as the Zen principle of Wu Wei implies, anything forced will never last and holds no real value. Laura Shanks is Vermont Psychiatric Survivors’ patient representative for Southern Vermont.
Letter to the Editor: Give Counselors Breaks
Counterpoint, Greetings. I am glad to see that Vermont has a newspaper for psychiatric survivors, of which I am one. Before I tell you about some suggestions that I have made to government officials, including at least one member of the US Congress from Vermont, I’ll give you a little bio: I have worked as a musician and a linguist in America and Europe. I am a veteran of the US Armed Forces, active duty 1979-85. I have worked in human services in Vermont, including at a rehabilitation center and as a caregiver for the developmentally disabled. One suggestion I have is that people who work in mental health, specifically psychiatrists, psychologists, counselors, social workers, therapists, etc. – people who are “in the trenches,” doing the actual counseling, caregiving, etc. – should work three months on, three months off (at full salary). Continually alternating like this will significantly stave off burnout. Human beings
were not meant to listen to people’s problems (and then some) 40 hours per week, yearround. Perhaps 20 hours per week for the people doing the hands-on healing might be
the limit, then another five or so hours per week for the purpose of administration. That’s just a suggestion – I don’t really know. I’m just a guitar player from Syracuse.
Another suggestion I made, I believe, to US Senator Peter Welch, some time ago, was that we form at least 100,000 teams, comprised of two people each: possibly a psychiatrist and a caregiver with a masters of social work who is also a licensed psychotherapist – this would be at the federal level (approval, funding, management, etc.) – to go around the country and, for the most part, sit in on counseling sessions and group sessions at public and private practices, institutions, etc., to help ensure competence, to detect burnout, to make sure caregivers are not just putting patients on meds, then sending them on their merry way. I have seen this up close. It is a serious problem in America, and in the meantime, the pharmaceutical industry is getting filthy rich. I would refer you to the book Selling Sickness by Ray Moynihan and Alan Cassels. Spread the word about the abovementioned suggestions to people in Vermont, and across the US. Thank you. God bless. Namaste, Eddy Beckwith, Springfield
Send your commentary or letter to the editor to: Counterpoint, The Service Building, 128 Merchants Row, Suite 606, Rutland, VT 05701, or to counterpoint@vermontpsychiatricsurvivors.org Please include name, address and email
COMMENTARY . 21
Winter ’23-’24
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Let your voice spark change.
22 20 .COMMENTARY COMMENTARY
Winter ’23-’24
Editorial: Burnout Is Probably Real, But the Proposed Solutions Are Not The World Health Organization’s shift”? According to Moss, they are the internal A new parent in Vermont, meanwhile, can International Classification of Diseases policies of organizations, and managers have skip work for up to 12 weeks without getting recognized “burn-out” in 2019 as “a syndrome the power to implement changes for the benefit fired, but only if they’ve saved enough money conceptualized as resulting from chronic of employee well-being. to make do without a salary of any kind for 12 workplace stress that has not been successfully It’s true that good management can play a weeks. And what happens to us in Vermont managed.” A year later, as frontline workers role in creating a friendlier, more stimulating, when we fall ill? scrambled to keep up essential services amid and less exasperating workplace for both highBy law, a Vermonter must earn at least one a deadly pandemic, burnout went mainstream. and low-level employees. But it has strict limits, hour of paid sick time for every 52 hours worked It wasn’t just for nurses. With schools which management consultants take for granted. – accruing no more than 40 annual hours of closed, working parents struggled to adjust to Specifically, private-sector firms can’t willingly paid sick time in total, however, unless their the chaos of their cramped home offices while offer concessions to employees that would make employer chooses to allow more. And the boss caring for their children full-time. the firm less profitable. In the case of the public may legally prevent the employee from using Three years later, for many Americans, sector, too, tight budgets make substantive their accrued hours until they’ve completed burnout feels permanent. When the economy demands for better working conditions one full year of service with the company. reopened in full, it couldn’t find enough labor, impossible to fulfill without political change. In Norway, on the other hand, a worker who and overworked healthcare professionals, who’d Yet when working conditions become needs medical care can recuperate in bed for up hoped for a break after COVID-19, never got intolerable, as the apparent epidemic of to one year without missing out on a paycheck. one, thanks to what had become a chronically burnout indicates they have in nearly every And of course, thanks to universal public understaffed system. With kids back in school, part of the economy, workers must put forward health insurance, visits to hospitals and clinics white-collar workers continued to look upon substantive demands. Doing so requires cost virtually nothing at the point of service: their laptop-bound lives with dread. Norwegians pay a yearly maximum of Is it all one phenomenon – the fatigue $270 in out-of-pocket costs, including of largely remote administration on the the price of prescription drugs. one hand and the fatigue of direct care None of these facts will ever come up work on the other? For the purposes of within corporate consultants’ discussions a new crop of nonclinical mental health of burnout or wellness. It’s not because “thought leaders” who’ve emerged to they don’t matter. address the crisis of burnout, it makes Rather, it’s because any concession to sense to collapse the problems of different workers that management might offer classes of employees into a single issue. willingly to address employee burnout The rest of us may speculate whether, Author Jennifer Moss used videoconferencing software to deliver her would look paltry by comparison. for the administrators, the burden address remotely on Oct. 19 (Counterpoint photo). Moss acknowledged, in her speech of their work may owe in part to a in October, the modesty of her own spiritual revulsion. The virtual office has no rejecting a discourse of burnout that neglects recommendations. social component to ease the existential sting its material basis in favor of explanations “We’re only going to be able to make tiny of pointless work, or of the suspicion, at least, rooted in culture, individual psychology, and shifts,” she said. “And that’s really what we that only a very badly organized system would easily adjustable workplace practices. should be focusing on: just getting to that demand a ceaseless stream of emails and Here is an actual fact about what Moss calls phase where we feel OK coming into work.” Zooms to stay afloat, as it must. America’s “state of toxic productivity”: the Wellness, evidently, is not happiness. For This fall, the Vermont Department of Mental average American worker spends 1,815 hours the latter, there is no new strategy on hand. Health invited the author Jennifer Moss to on the job annually, according to the OECD. In the workplace, an old-fashioned solution keynote its annual conference. The Harvard That’s about 450 more hours than a worker remains the most promising: powerful, militant Business Review Press published Moss’s book, in Sweden or Germany. Working Americans labor unions of a kind that our own country has The Burnout Epidemic: The Rise of Chronic enjoy less free time than workers in all but two rarely, if ever, known. This is true for mental Stress and How We Can Fix It, in 2021. of the 27 countries in the European Union. health workers – only two of Vermont’s ten A former management consultant, Moss Much of the discrepancy owes to Americans’ community mental health centers have unions addressed a mixed audience of caregivers and inability to take vacations or stay home when – and for every worker who faces the challenges bureaucrats, with tips for both. But the bulk of her they get sick. The United States doesn’t require of mental health, as we all do. advice – on how to hold fewer Zoom meetings, employers to offer their workers any paid time Workers don’t need to rely on their managers how to make Zoom meetings more efficient, and off, rendering it wholly unique among the to come up with clever strategies to mitigate the even how to make Zoom meetings more fun – world’s developed economies. misery of the daily grind: as long as they have a skewed toward the managers in the crowd. In France, for instance, every worker gets at collective voice, they can introduce their own. Moss spoke with empathy about how least 25 days of paid vacation, plus 11 public And if they can unify across sectors, they can individuals aren’t to blame for their burnout. In holidays. The United States also has 11 federal enter the political arena to win a society that her view, they can’t be expected to solve it alone. holidays, but they mean little to Americans structurally – not just rhetorically – respects “Yes, I’m going to talk about self-care. It’s whose companies can still force them to come humans’ basic psychological and emotional important,” Moss said. “But when we look at to work without overtime pay. needs, which include lots of time for rest, burnout as institutional stressors that require Demanding jobs with long hours can be leisure, and bonding with family. policies to change and shift, this isn’t going to especially stressful for new parents. That’s why, In its incipient form, that kind of society is be a conversation where I say just taking a bath upon the birth of every child, Finland disburses called social democracy. Workers have already or listening to rain for 15 seconds on an app or 320 days of paid family leave, split between the built it in Finland, Sweden, and Norway. We meditating for two minutes or just breathing parents or, in single-parent households, taken don’t yet know what it would look like in full are going to solve these problems.” by one mother or father on their own. That’s on bloom. There are no guarantees, but it might What are the policies that need to “change and top of 40 days of paid pregnancy leave. have relatively few Zoom meetings.
COMMENTARY . 23
Winter ’23-’24
Readers Blame Housing Costs
According to 93.8% of Counterpoint readers who responded to the summer issue’s poll, high housing costs – not mental health challenges – play a primary role in creating homelessness. The question looked to survey psychiatric survivors on a crisis that dominated Vermont headlines in the spring, as the state legislature aimed to wind down assistance for recipients of pandemic-era motel vouchers. Gov. Scott
also signed legislation intended to encourage the construction of new housing, with the hope of easing a major supply crunch, but in the meantime, nonprofit service providers distributed tents and sleeping bags. Policymakers have long fought over whether to prioritize shelter or treatment for a needy population that the general public tends to associate with psychosis and substance use. When psychiatrically labeled people end up on the street, a perennial debate surrounds them: did rent increases put them there, as they might
anyone else, or does “mental illness” make the housing market simply too difficult to navigate, regardless of fluctuations in the affordability or availability of residential units? Counterpoint’s readers answered almost unanimously, with just one dissenting vote out of 16. Eight submitted anonymous written comments, including the following: • “I think high housing costs and homelessness can increase mental health struggles, but mental illness does not cause someone to be homeless on its own.” • “Although discrimination and prejudice do play a huge role indeed, high housing costs and lack of affordable housing play an even greater role, not ‘mental health challenges’ per se.” • “This is not either/or. It is both.” • “Mental health challenges can make it difficult for people to find or maintain housing, but the rising housing costs affect a wider number of people. My rent went up $100 last year and $200 this year. I was able to manage this year, but in the future?” • “I wanted to live in Brattleboro, but Brattleboro was so expensive, and they wanted credit scores higher than the banks, so I had to move to Dover. I have already been assaulted by a police officer because I’m the only black person in this vicinity and coming from a homeless shelter. Therefore, if there was apartments available for me in Brattleboro, I would not have gone through that.” • “High housing costs generate tremendous stress and anxiety for those without the means,
6.2%
93.8%
“Do high housing costs or mental health challenges play a greater role in creating homelessness?” BLACK: HIGH HOUSING COSTS GRAY: MENTAL HEALTH CHALLENGES preventing them from having a safe refuge from a shitty, sick and cruel social reality.” The winter poll asks, “Would increasing mental health workers’ wages improve mental healthcare for consumers?” The question uses the lens of the consumer to consider the widely reported labor shortage among Vermont’s community mental health centers and inpatient psychiatric units, which struggle to offer high enough wages to recruit and retain employees. How should psychiatric survivors feel about the well-being of a workforce that has caused them harm, including, sometimes, in community settings? Should legislators do more to alleviate high turnover and staffing shortages that exacerbate the problems of an already flawed system, or are oppressive structures better left to crumble? Can mental health workers and survivors find solidarity in each others’ struggles, or does the presence of coercion preclude such an alliance? As always, Counterpoint wants to know what you think.
Counterpoint Opinion Poll
QUESTION: VOTE by scanning this onto your mobile phone:
Would increasing mental health workers’ wages improve mental healthcare for consumers?
OR by going to www.vermontpsychiatricsurvivors.org/counterpoint/ Results of the poll will be published in the next issue of Counterpoint.
24 Resources Directory 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
Winter ’23-’24 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.
SUICIDE & CRISIS LIFELINE
988
24/7 support (call or text)
Public Community Mental Health COUNSELING SERVICE OF ADDISON COUNTY, 89 Main St., Middlebury, 05753; www.csac-vt.org; 802-388-6751
Crisis Text Line
Around the clock help via text: send “VT” to 741-741 for ground rules; message routed to a trained counselor.
CHITTENDEN COUNTY: HOWARD CENTER, 300 Flynn Ave., Burlington, 05401; 802-488-6000; www.howardcenter.org
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
ANOTHER WAY 125 Barre St, Montpelier, 802-229-0920; info@anotherwayvt.org; www.anotherwayvt.org; see website for events calendar.
The Trans Lifeline (dedicated to the trans population) can be reached at 877-565-8860.
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
The Trevor Lifeline, 866-488-7386. TrevorText : 678-678
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
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
LGBTQ Youth Crisis Hotline:
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/
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
MakeTheConnection.net
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
Website sponsored by the Department of Veterans Affairs. Testimonials by veterans, resources, health information.