Vermont mental health agencies fear staff shortages are reaching ‘point of no return’


A “mass exodus” of frontline workers from community mental health agencies in Vermont has restricted access to services and heightened concerns about the health system’s ability to provide timely treatment for psychiatric disorders.

Of 5,000 positions in Vermont’s 16 nonprofit community mental health organizations, 970 are now vacant, according to officials monitoring the issue.

Beth Sightler, executive director of Champlain Community Services in Colchester, told VPR in July that vacancies in her organization threatened its mission of supporting people with developmental disabilities.

“I’m not exaggerating to make a point: it’s close to disaster, I think, statewide for frontline service delivery,” Sightler said in July.

In a follow-up interview in November, Sightler said the situation is more serious now than it was in the summer.

“What’s happened in the last two months… is almost scary, you know?” Sightler said. “It’s kind of a mass exodus.”

“What I don’t know is whether we’ve passed the point of no return.”

Beth Sightler, Champlain Community Services

At Champlain Community Services, the vacancy rate among frontline workers has now exceeded 50%, and Sightler said she had 17 workers trying to support about 85 clients.

“You don’t want to admit that maybe things aren’t going to be right,” Sightler said. “But the reality is, this is a really critical point, and I have concerns about the safety of people that I have never had before.”

The staffing problem is not unique to the CCS. And Sightler, along with directors of other mental health agencies in Vermont, say the state is on the verge of irreversible damage to its mental health infrastructure.

“I said [in July] that it could be a disaster, and I think we probably are there, ”Sightler said. “What I don’t know is whether we’ve passed the point of no return.”

The problem became so serious that mental health organizations formally asked the Scott administration to mobilize the Vermont National Guard to fill direct support positions in the hardest hit mental health agencies.

Mental Health Commissioner Alison Krompf told VPR the agency rejected the request, in part to avoid exacerbating workforce issues in organizations that employ members of the guard.

“When you deploy the National Guard… people from an inpatient psychiatric facility, and then go to work elsewhere, and that can end up destabilizing other mental health programs. “

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Last month, Social Services Secretary Mike Smith allocated $ 2 million in emergency funds to “stop the bleeding” at mental health agencies, Kromp said, offering retention bonuses and d ‘other financial incentives for community mental health workers.
Julie Tessler, executive director of Vermont Care Partners, said mental health agencies are grateful for the help.

Tessler, however, said that significantly tackling the staffing “crisis” will require more substantial investments in the system of designated agencies and social service agencies that form the backbone of the health care system. mental community of Vermont.

“And we honestly think we need about $ 80 million – that’s a $ 500 million health care system – to bring our tariffs to the level that we could provide the compensation that would really recruit and keep. the staff, ”Tessler said.

“I have staff members who receive food subsidies and fuel subsidies, so it’s getting harder and harder to recruit people into a really big and meaningful line of work. “

Rachel Cummings, Addison County Council Service

At the Counseling Service of Addison County, executive director Rachel Cummings said low wages for frontline workers are the biggest barrier to hiring and retention.

She said many of her employees live in a local subsidized housing complex.

“I have staff who are getting food subsidies and fuel subsidies, so it’s getting harder and harder to recruit people into really important and meaningful work just because we can’t keep up with what. it takes to be part of the middle class and earn a living. in this state, ”Cummings said.

Cummings said she manages a 15% vacancy rate across the agency.

She said some departments, however, are more pinched than others. The agency’s 24/7 emergency service program, for example, has a total of six people, four of whom are mothers of young children.

“I am really worried that this work will not be valued. I’m concerned that… mental health and mental well-being is not a priority and a value, and that we are still… chasing disease rather than really helping people lead active, engaged and connected lives in the community Cumming said.

More RVP: She’s a single mother of twins and she works in mental health. Its pandemic workload has not been “balanced, achievable or healthy”.

Tessler said waiting lists for mental health counseling can have destabilizing effects on the health system as a whole.

“We don’t have full emergency services and mobile crisis response teams, so we’re not here to meet the needs of people in crisis to the extent that we should be. “said Tessler. “And… what that means is that people end up in the ER afterwards.”

Officials at the University of Vermont Medical Center recently cited the “mental health crisis” as one of the main reasons for inpatient capacity shortages at the state’s largest hospital.

Krompf said the concerns raised by Sightler, Cummings, Tessler and others are valid.

“The waiting lists for ongoing services for adults and for children have increased,” she said.

Krompf said his agency is exploring ways to increase financial support for community mental health agencies, but said the administration has yet to land on a final budget. And while wage increases for frontline workers are likely to be a critical part of any workforce solution, she said the state should also be wary of unintended consequences.

“Unfortunately, if you stabilize in one area or encourage recruiting in one area, you end up moving the same workforce from one thing to another,” she said. “And so we have to be very careful how we operate these incentive programs, so that we don’t end up discouraging other staff, because staff is a problem statewide. “

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