No Exit for Patients Confined at the Vermont State Hospital

• Publication year: 2006
• Citation: Vol. 2006 No. 07

Vermont Bar Journal 2006.

July 2006 - #4. No Exit for Patients Confined at the Vermont State Hospital

The Vermont Bar Journal

#166, Volume 32, No. 2

Summer 2006

No Exit for Patients Confined at the Vermont State Hospital

by Meris Bergquist, Esq.

"Exit Sign: The exit sign in the main corridor has an arrow on it that points to the day room. However, there is no exit to the outside of the building in the day room."(fn1)

The fundamental right to establish a home is guaranteed by the United States Constitution.(fn2) For many individuals with mental illness, the right to establish a home, especially a group home, has been-and remains-difficult to achieve. Historically, state actions have segregated individuals with mental illness from society and involuntarily confined them to state institutions.(fn3) Even though Congress, in passing the Fair Housing Amendments Act in 1988 and The Americans with Disabilities Act in 1990, intended to abolish the segregation and unnecessary institutionalization of persons with disabilities, individuals with mental illness still face blatant discrimination when they attempt to create a home to meet their needs in a community of their choice.(fn4)

These forms of discrimination persist today against individuals with mental illness, including psychiatric patients at the Vermont State Hospital (VSH), who would benefit from community residential treatment. Unfortunately, these patients remain segregated and behind locked doors. Two recent and well-publicized attempts to establish residential treatment centers for VSH patients in Vergennes and Greensboro have failed. The responsibility for these failures can, in part, be traced to the State of Vermont's publicly announced policy of refusing to locate a residential treatment center for VSH patients in any Vermont community that opposes it.(fn5)

This policy is directly contrary to landmark federal anti-discrimination laws, which guarantee all individuals with mental disabilities the right to live in the most integrated setting possible and to reside in the community of their choice. Their right to live in a home, including a group home, in any community of their choice is guaranteed by the Fair Housing Amendments Act.(fn6) Their right to live in the most integrated setting possible is guaranteed by The Americans with Disabilities Act.(fn7) Unfortunately, when the State of Vermont fails to challenge significant violations of these federal civil rights laws, it enables Vermont communities to succeed in discriminating against people with mental illness. This policy has irreparably harmed patients at VSH-who would benefit from living in a less restrictive residential setting-by unjustly prolonging their institutionalization.

Life in any institution can be dehumanizing. There is overwhelming evidence that life at VSH is worse than life in other similar institutions.(fn8) The federal government has decertified the hospital twice since 2003 in response to concerns about patient safety.(fn9) In July, 2005, the Justice Department issued a detailed report about VSH. This report found that "conditions and services at VSH substantially depart from generally accepted standards of care, [and that] certain conditions at VSH violate the constitutional and federal statutory rights of patients."(fn10)

This report is difficult reading for anyone concerned about civil rights. It depicts an institution that looks and operates more like a jail than a therapeutic environment for people with severe mental illness.(fn11) To quote directly from the report: "The conditions of the physical plant ... are dehumanizing. No one should expect individuals to achieve recovery when they have to reside in a jail-like setting, sleeping right next to their uncovered toilets and having no functional closet space for their belongings."(fn12) Given these oppressive conditions of confinement, it is more than troubling that the State has unreasonably delayed the process of integrating former mental patients into the community by failing to uphold the civil rights of VSH patients to live in a less restrictive setting in the Vermont communities of Vergennes and Greensboro.

When the State attempted to establish a residential treatment center in Vergennes in November, 2005, it proposed to convert a former nursing home into a small facility for VSH patients. Although for planning and zoning purposes, the general use of thebuilding would have been the same, the proposal was quickly rebuffed by local officials. The mayor and city council voted unanimously against the proposal and issued a formal resolution stating that such a facility would negatively affect property values and the reputation of Vergennes.(fn13)

These are discriminatory code words. They reflect a common prejudice against people with mental illness based on false stereotypes and myths. There is no objective evidence that group homes for people with any form of mental illness have any adverse affect on their neighborhood.(fn14)

In response to the Vergennes resolution, the Vermont Secretary of Human Services, Michael K. Smith, issued a press release on December 1, 2005.(fn15) He criticized the mayor of Vergennes for stigmatizing those struggling with mental illness and for taking a position that is exclusionary and "downright discriminatory." He stated that "[w]e should not allow the subtle signs of discrimination to drive public policy, or prevent us from doing what is right, as we care for the most vulnerable among us."(fn16) This is hypocritical. The State's public...