The state is moving with plans to replace its Waterbury psychiatric hospital with new beds at other facilities around Vermont.
But the transition has been rough for patients and the medical hospitals where they’ve been cared for since the Waterbury facility was flooded by Tropical Storm Irene.
The number of people waiting in emergency rooms for a psychiatric bed to open up climbed through the summer and fall from 10 in April to 22 in September.
Acting Mental Health Commissioner Mary Moulton says the number then jumped to 30 in October.
"And that wait was averaging about two and a half days. So that is an impact we would certainly like to mitigate," she said.
Moulton told the Legislature’s Mental Health Oversight Committee that her staff has met with emergency room directors around the state in an effort to manage the problem.
"We are very aware of the pressures that those emergency rooms on them," she said. "But it’s very good to hear from the emergency room directors telling us what some of those difficulties are."
Moulton said the pressure should be relieved somewhat when the state opens a temporary seven-bed secure residential facility in Middlesex next month. Another eight-bed facility in Morrisville is also expected to open.
But Moulton faced tough questions from Northfield Republican Anne Donahue.
"What kind of treatment are you putting in place for people while they are in the emergency room beyond dealing with the crisis response and monitoring?" Donahue asked.
Moulton acknowledged some of the smaller hospitals don’t have psychiatrists on staff. She said emergency room doctors can call a state psychiatrist for advice in providing care.
"It’s telephone consultation that we’re providing to them," she said.
The situation has also put a strain on law enforcement, which is called on to transport patients and provide security.
Lamoille County Sheriff Roger Marcoux says in some cases patients have waited four or five days for a proper placement.
"You know it puts a tremendous amount of pressure on emergency room staff, local law enforcement, or state police who in the past had to provide security for these folks," he said. "And the folks aren’t getting the treatment while they’re in the emergency room. It’s just kind of a purgatory here until they can get to a place that can help them."
Marcoux’s department has a contract with the state to transport patients. He’s hired officers who undergo training in dealing with people in mental health crisis.
Marcoux said he’s made it a goal to use minimal restraints on patients while they’re being transported. He said the pilot project is working well with most patients not needing handcuffs or soft restraints. Marcoux said that preserves the dignity for patients.