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Mental Health officials outline crisis system vision, staffing challenges and 988 call activity
Summary
Department of Mental Health Commissioner Emily Hawes and colleagues described the state’s mental‑health system of care, staffing shortages at state facilities, plans for crisis response expansion including 988 and enhanced mobile crisis teams, and recent 988 call‑volume and answer‑rate data.
Emily Hawes, commissioner of the Vermont Department of Mental Health, briefed the committee on Jan. 29 on the department’s system of care, staffing status at state facilities, and the state’s crisis‑response model that centers 988 and enhanced mobile crisis teams.
Hawes summarized the department’s role and system components—including community mental health services, crisis supports and response, intensive residential settings and inpatient care—and said the department oversees facilities such as the Vermont Psychiatric Care Hospital (VPCH) and River Valley Therapeutic Community Residence. "VPCH is a 25 bed hospital located in Berlin," Hawes said; at the time of the briefing she reported the hospital’s census at 21 beds and plans to increase staffing to support 25 beds in coming months.
Hawes described workforce pressures across the system. The department reported a reduction in vacancy rates from an earlier high (cited verbally) but said vacancies remain substantial at clinical facilities. Travel nurses and contracted staff supplement vacancies, but officials said relying too heavily on temporary staff raises safety and cost concerns.
On the crisis system, Hawes and staff laid out a layered vision: people in crisis call 988; most calls (officials said roughly 95%) are resolved by phone. If an on‑scene response is needed, the state’s two‑person enhanced mobile crisis teams can respond; officials said about 81% of those on‑scene responses are resolved without hospitalization. If needed, alternatives to emergency departments—such as urgent care sites that can observe a person for up to 23 hours—are intended to reduce unnecessary hospitalizations. Hawes emphasized the system is designed to be co‑occurring (mental health and substance use) and to reduce reliance on law enforcement responses when appropriate.
Officials also discussed 988 call metrics and operations. They reported a recent increase in call volume and said that in September roughly 93% of calls were answered by Vermont‑based centers; when local capacity is exceeded calls route first to a contracted New Hampshire center and then to the national backstop. AHS said 988 calls are always answered and that about 90–95% of calls are resolved on the phone without further referral.
Hawes noted program expansions including mental‑health urgent care sites and a pending contract for a youth psychiatric residential treatment facility (PRTF). She also flagged a Central Vermont Medical Center adult inpatient unit planned to close at month end; that closure reduces inpatient capacity in the system and is being tracked by the department.
No formal actions were taken in the briefing; staff offered to return with data on 988 response times and outcomes. Officials pointed to workforce investments made since 2021—retention and recruitment funding, plus targeted rate increases—and said they will continue to monitor hiring and vacancy trends.
