BRATTLEBORO—As much as any provider within the state’s strained mental health system, the staff at the Brattleboro Retreat are attuned to the fact that every day Vermonters in crisis wait for care in emergency departments across the state.
That’s why they are pushing to get back to pre-COVID-19 levels of inpatient beds as quickly as possible, and why they just launched a new ambulance transport service pilot program through a contract with Rescue Inc.
“The Retreat will be over that 100-bed mark here in 60 days,” said Brattleboro Retreat Vice President Erik Rosenbauer. “That is what the planning is, and that is why all these other initiatives are underway.”
Getting back to 100 beds would be an increase of 16 beds over what the state’s largest provider of inpatient mental health services has had available in recent days, Rosenbauer said.
But having the space open is just part of the solution.
Brattleboro Retreat CEO Linda Rossi said in a Jan. 17 statement announcing the new contract with Rescue Inc. that patients sometimes wait in hospitals for hours or days solely because of the lack of available transport.
In December, on any given day, between 25 and 30 patients were in emergency departments around Vermont, waiting to be transferred elsewhere for mental health care, according to the Vermont Association of Hospitals and Health Systems, which surveys its members on this topic twice a week. The majority wait longer than 24 hours.
The new Brattleboro Retreat contract will allocate one Rescue Inc. vehicle and crew entirely to the transport needs of incoming patients five days a week, between noon and 8 p.m., which is when historical trends suggest the service is most needed, said Drew Hazelton, Rescue Inc.’s chief of operations.
The crew is set to receive training from Retreat staff on best practices for interacting with patients in a mental health crisis. The ambulance itself will also be physically adapted to create a more calming environment.
“Ambulances can be very busy,” Hazelton said. “They are like emergency departments. There is a lot of stimulus in ambulances, and that can be challenging to some patients.”
Rescue Inc. has long provided transportation between local hospitals and the Retreat, but this program expands that service to other hospitals statewide, Hazelton said.
Hazelton also hopes to make the training available to EMS providers statewide through the Vermont EMS Academy, which Rescue Inc. launched in August in Newfane. Existing EMS training programs do not focus enough on interacting with mental health patients, he said.
Like the rest of the health care system, the Retreat experienced significant staff turnover during the Covid-19 pandemic, as well as several outbreaks of the virus, both of which led to the decrease in bed capacity.
According to a recently released Legislative report by the Vermont Department of Mental Health, the Retreat’s capacity fluctuated by more than 20 beds between October 2021 and late February 2022. Staffing shortages continue to force facilities to close beds at times, the report says.
With the new transportation program and the return to pre-pandemic bed levels, the Retreat is trying to make a difference in the long emergency room waits.
“From the bottom of my heart, I really think that this is something that can have an immediate impact,” Rosenbauer said.