Local News

Psych mobile response unit could help Vt. youth

By PATRICK McARDLE
Staff Writer
Republican Gov. Phil Scott proposed in his State of the State speech this week a Mobile Response Unit that would treat mental health emergencies for youth and children that would be funded by a $600,000 line item in the proposed state budget.

“In other states, this model has reduced emergency room visits and hospital admissions, saved many hours of law enforcement time and helped foster kids find stability. I propose to begin this initiative in Rutland and if it’s successful, with your support we can work to expand it statewide.” Scott said in the address.

Department of Mental Health Commissioner Sarah Squirrell pointed out that the short-term next step would be the passage of the budget by the legislature and Scott with the line item intact. If the program moves forward, it will probably be supported by a mix of state and federal funding with the allocation from the state budget providing Vermont dollars and the expected Medicaid-eligibility of patients providing federal dollars.

Planning the Mobile Response Unit, or MRU, will probably start in the next few months, Squirrell.

Squirrell said the MRU would be something that supports and expands the existing emergency services in Rutland.

“Essentially, it’s designed to support children, youth and families in distress with a face-to-face response to provide for an intervention, before emotional and behavioral difficulties escalate,” she said. The response would be provided by a team that be part of emergency services at Community Care Services, commonly called locally Rutland Mental Health. The unit would provide the face-to-face response where the child or young person needs it at a location like a home or school.

Services provided would include de-escalation, assessment, planning, referrals, and follow-up stabilization and case management.

In 2019, the state placed 35 children in residential care who were 5- to 10-years-old.

“From my perspective, that’s 35 too many, Squirrell said.

Dick Courcelle, CEO of RMH, said the MRU would be an important complement to the services already provided by RMH staff.

“This type of a model is structured to really help children and youth who are experiencing emotional or behavioral crises so the goal of it is really to diminish the immediate crisis, keep everyone safe, maintain the children in their own homes or current living situations,” she said.

The MRU could de-escalate a crisis in the child’s home, if that’s where the crisis starts, before it needs a higher care level like emergency departments, in-patient psychiatric care or residential treatment, Squirrell added.

The Rutland MRU would likely be a pilot for determining whether the program could be replicated in other Vermont counties, Squirrell said. Part of the responsibility of the Rutland MRU would be to collect information about outcomes to determine its effectiveness.

Rutland was chosen for the pilot because it has the highest use by children and youth of emergency department services, Squirrell said.

Courcelle said during the most recent fiscal year, which ended at the start of July, almost 30 percent of the crises to which RMH responded were children.

Vermont mental health officials have already looked at promising statistics in other states that use an MRU. In Connecticut, an emergency department saw a 25 reduction in use by children and youth; Seattle, Washington, has diverted almost 90 percent of hospital admissions among the population served by the MRU; and New Jersey uses the MRU to stabilize children in foster care.

Squirrell said Vermont officials have been in touch with those other states to get information they will use to develop their own program.

DMH staff is “really excited about this opportunity,” according to Squirrell.

“It really demonstrates the administration’s support of our mental health system of care and infusing more supports and services into our mental health system particularly for the youngest Vermonters, children and youth and their families,” she said.

The MRU discussions have included input from the Agency of Human Services, Department of Mental Health, Department of Vermont Health Access, Department of Disability, Aging and Independent Living, and the Department for Children and Families.

Both Squirrell and Courcelle said they expected the MRU would add jobs to Rutland County to staff the program. Squirrell said some of the governor’s proposed line item is allocated specifically to staffing.

But she added that the investment of $600,000 could provide an overall savings for taxpayers as the intervention would take place at earlier, less expensive stages than emergency department visits or residential settings.

Courcelle said he is hopeful the pilot will create a model that will serve the whole state.

“The goal is to demonstrate the evidence of success so that when this works it can be implemented elsewhere in the state so that more communities can benefit. It’s an exciting proposition. We’re very proud to be asked by the Department of Mental Health and the governor to do this. We’re hopeful that the Legislature will, in fact, appropriate the resources to allow this to happen and we will be working to get this program in place over the next several months,” he said.

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