Psychiatrists oppose closure of the Central Vermont Medical Center in-patient psychiatric unit
Vermont Business Magazine The 112 Vermont psychiatrists who are members of the Vermont Psychiatric Association and practice in all corners of the State strongly oppose the impending closure of the in-patient psychiatric unit at Central Vermont Medical Center (CVMC).
"The anticipated impacts of cutting these services should be of grave concern to all Vermonters, particularly given the devastating impacts it will have on the most vulnerable members of our community — individuals experiencing mental health crises and their families. We have been advocating for years that Vermont has too few psychiatric beds to serve the needs of our patients. Public health research[i] indicates that an optimal level of mental health services requires at least 35 inpatient psychiatric beds per 100,000 population. Vermont only has 18 beds per 100,000, and some of these are restricted to certain kinds of admissions, falling woefully short of the recommended minimum. To eliminate more beds is taking our State in exactly the wrong direction.
"The closure of the psychiatric unit at CVMC is not just a reduction in services; it is the elimination of an entire unit that has long been a cornerstone of care for those experiencing acute psychiatric emergencies and will force patients into a system already stretched thin. This decision comes after years of financial losses to operate the unit and workforce shortages, as the underlying issues—systemic underfunding of mental health services, inadequate reimbursement rates, and lack of a commitment to true mental health parity —remain unaddressed at a state and federal level.
"This closure will directly impact our community by reducing access to in-patient psychiatric care. There are no locations with capacity to serve the needs of patients currently receiving in-patient care at CVMC – meaning increasing pressure and wait times in already overwhelmed emergency departments, and delays in care for those who need services. Patients have waited days or even weeks in Vermont emergency departments for an inpatient psychiatry bed. While we appreciate the plans to direct funding to community services, which are also desperately needed, it does not meet the same needs for the same patients who require in-patient level of care.
"The closure of the unit also risks undermining the future of psychiatric training and workforce development, as medical students and residents will have fewer opportunities to gain hands-on experience in mental health care. CVMC has been a very active site for this training. Without it, training in and remaining in Vermont will become less appealing. Moreover, the closure of the psychiatric unit will have far-reaching consequences for staff. The shortage of psychiatrists and mental health professionals has already taken a toll on the workforce, and this closure may contribute to further burnout, job dissatisfaction and staff departures.
"The closure of the in-patient psychiatric unit at CVMC was clearly the result of incredibly difficult decisions by CVMC and may have been a rational economic decision in response to a system in crisis, but the human toll is too high. This closure is yet another example of our overall health care finance and delivery system’s failure to prioritize care for patients experiencing mental illness. Rather than shutting down essential services, we need a long-term investment in mental health care, including appropriate funding, better reimbursement rates, and increased training opportunities for future professionals. In fact, the recent Act 167 consultants’ report[ii] recommends making CVMC a “center of excellence” for adult psychiatric care. If we fail to act now, we risk further erosion of mental health services in Vermont, leaving our most vulnerable residents without the support and treatment they need.
"We urge the Governor, legislature, GMCB, state regulators, and all relevant stakeholders to come together to work with CVMC, to prioritize the long-term well-being of our community over short-term financial calculations, and to find a path forward that would halt the closure of this unit. Reducing in-patient psychiatric beds will not only have disastrous consequences for those in need of care, but it will also send a harmful message to those pursuing careers in psychiatry and other mental health fields. It is time to invest in the future of mental health care in Vermont, not continue to gut an already inadequate system."
[i] https://www.tac.org/wp-content/uploads/2024/03/TAC_ORPA_ResearchSummary1.24.pdf
[ii]https://gmcboard.vermont.gov/sites/gmcb/files/documents/Act%20167%20Community%20Engagement_OW%20Exec%20Summary%20Report%20-%20revised%2010.21.2024.pdf – pg. 40
Source: Vermont Psychiatric Association. Montpelier, VT (Nov.26, 2024)
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