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'We Deserve Better': Northeast Kingdom Activists Call For Better Mental Health Care

A group of people standing shoulder to shoulder on an outdoor gazebo.
Northeast Kingdom Organizing, Courtesy
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Penny Thomas, center, with the community group Northeast Kingdom Organizing, shares the struggles of residents trying to access mental health services. The group announced several changes it wants local providers and state officials to enact.

Demand for high-quality mental health care has grown more urgent since the onset of the coronavirus pandemic. Calls for that support are growing louder in the Northeast Kingdom, where residents in a community organization say local and state mental health officials are not providing an adequate level of mental health care. A coalition of community and faith-based groups known as Northeast Kingdom Organizing (NEKO) says long waitlists, a lack of counseling for families, older people and children, and other gaps are burdening residents and not meeting their needs.

NEKO points to numerous complaints against Northeast Kingdom Human Services (NKHS), the state-designated community mental health provider in the region. Those complaints resulted in the organization being placed on provisional status in December as state mental health officials reviewed “numerous areas where NKHS had not met the [state's] minimum standards.”

Penny Thomas is a NEKO board member who shared some of what she’s heard from residents in her community.

“From a client we heard this," Thomas quoted:

“I don't even go through mental health anymore … Anytime you go, it's a run-around. They schedule the appointment, and then cancel the appointment. It becomes months. I haven't seen my actual therapist in over a year.”

Thomas shared another experience from an elementary school counselor:

“I wish I could say positive things about this agency, because we are in such desperate need for these services. So many families that are struggling and need in-home support. There isn't any. The highest level of support they have for families in crisis is a 15-minute call. We generally don't trust them, and we don't work with them anymore."

Another experience collected by NEKO was from a local mother who said she's been trying to get mental health services for her second grader since 2018.

“She calls weekly, and sometimes monthly, to try and get services," Thomas said. "This is before the pandemic. This is not pandemic-related. This goes back... three, four years ago, and she still can't get services.”

“We have 80 kids who are on the waitlist of services,” Thomas added. “Yes, there are problems that have surfaced during the pandemic. But these issues that we are talking about with Northeast Kingdom Human Services are long-standing.”

More from NPR: If Your Brain Feels Foggy And You're Tired All The Time, You're Not Alone [May 2021]

"You know, there have been just numerous complaints over the years about this agency... and we deserve better." — Penny Thomas, NEKO

Thomas and NEKO are calling on Northeast Kingdom Human Services, and Vermont's Department of Mental Health, to solve these problems in very specific ways. They're calling for:

  • hiring more staff like a full-time child therapist, plus others for senior counseling and pediatrics
  • health officials to open a part-time clinic in Barton
  • licensing and training for youth respite care homes in Orleans County
  • the state to get the case management waiting list for children who need counseling reduced by half, from its current number of 80 kids down to 40

“You know, there have been just numerous complaints over the years about this agency," Thomas said. "And we deserve better."
In January, the CEO of Northeast Kingdom Human Services resigned, replaced on an interim basis by Paul Bengtson, previously the longtime CEO of Northeast Vermont Regional Hospital in St. Johnsbury.

Bengtson says the employees at NKHS are doing “an incredible job” under difficult conditions, but he said he’s aware of what needs to change.

“We need to get our tactics and our operations in good, proficient shape, so that when high demand comes our way, we're able to respond,” he told VPR.

Bengtson says more cross-collaboration is needed. That includes help from primary care physicians, who may be able to assist with the needs of some children currently on NKHS waiting lists. He called on the Kingdom’s faith-based organizations to help identify certain needs. And on the funding front, he'd like to see Medicaid reimbursement raised by 5%, because that repayment affects everything from services to staffing.

"If you de-designate an agency like Northeast Kingdom Human services ... all hell is gonna break loose. Because there ain't nobody else who's gonna be serving this population." — Paul Bengtson, interim CEO of Northeast Kingdom Human Services

Bengtson said the agency has made some progress on hiring, pointing to a new director of the child care program as an example. But he has this word of caution on whether the state may decide to de-designate the agency:

“If you de-designate an agency like Northeast Kingdom Human Services … all hell is gonna break loose,” he said. “Because there ain’t nobody else who’s gonna be serving this population."

Ultimately, the decision on how to hold Northeast Kingdom Human Services accountable falls to the state Department of Mental Health. Commissioner Sarah Squirrell agreed with Bengtson that certain improvements have already been made.

"Their new leadership has developed a recruitment strategy that has already filled many of the key vacant positions at the agency, including an emergency services director and a CRT program manager,” Squirrell said. “Fully resolving their capacity issues will take time to address. The Department of Mental Health will be continuing to monitor the number of vacancies that they have, and the turnover rates, and continuing to work with NKHS as they provide support around recruitment strategies.”

"The voice of community activists in agencies is essential, but so is problem solving. And I would invite all community partners and organizations who have concerns to also be willing to come to the table with solutions, to be willing to roll up their sleeves and to work side by side." — Mental Health Commissioner Sarah Squirrell

When it comes to an increase for Medicaid reimbursements, Squirrell said the state has done what it can to ensure mental health providers can continue to operate during the pandemic.

“The Department of Mental Health and the Agency of Human Services moved very, very quickly to support all of our community mental health agencies when the pandemic hit," she said. "We have provided over $19.7 million in [coronavirus relief funds] to our community mental health agencies to ensure that they would be able to continue to provide services."

Squirrell added that all community mental health agencies are under an alternative payment method:

“Essentially, we pay all of our community mental health agencies prospectively to provide those services to their communities," she said. "And even when utilization had to change, even when many of our community mental health agencies experienced significant staffing shortages — the provision of services had to decrease and change significantly given the impact of COVID — we have continued to provide the agencies with their full allotment of resources, so that they could weather the storm of the pandemic.”

More from VPR: 'We're Stretched': Mental Health Providers On The Pandemic's Toll [October 2020]

Squirrel said one other requirement of NKHS’s corrective action plan was to seek feedback from community stakeholders, to better understand their needs and what could be improved.

“Northeast Kingdom Human Services has done this, through a series of town halls," she said. "They've invited stakeholders to their board meetings. This is the first stage in the process to identify and communicate those issues."

Squirrell added that accountability is "key" in this process.

"The voice of community activists in agencies is essential, but so is problem solving," she said. "And I would invite all community partners and organizations who have concerns to also be willing to come to the table with solutions, to be willing to roll up their sleeves and to work side by side with Northeast Kingdom Human Services, and their board, to support a strong, healthy and resilient agency.”

According to Squirrell, NKHS was given six months to implement changes. She said the Department of Mental Health has “full confidence that Northeast Kingdom Human Services will continue to successfully implement their corrective action plan, and to get back into good standing.”

The state will make its decision about NKHS by August 11.

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