Kids in Crisis: Challenges to involuntary commitment

Published: Jun. 27, 2019 at 2:34 PM EDT
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What happens to kids in crisis struggling in Vermont's mental health system?

More and more children are ending up in our emergency rooms experiencing mental health crises. And instances of serious mental health issues are also on the rise.

A mom contacted WCAX News asking us to look into what happens to families with kids in crisis as they try to navigate the mental health system. Basically, she says there are not enough mental health beds in the state for kids who need a hospital-level of care for their mental health diagnoses.

Our Cat Viglienzoni found something surprising as she was investigating. It was that, in Vermont, children have to consent to mental health hospitalization for it to be considered a voluntary admission. So parents can't make that choice for their child. Their child has to agree.

The mom Cat spoke with said that can contribute to the challenge of getting her child the care he needs. She said if her child doesn't agree to voluntary treatment, to get him admitted, they would have to have a psychiatrist evaluate him and say that he is a danger to himself or others at the time of the assessment. And that's a high bar to meet. So often, she says, the case is dropped at that point and the child has to go back home or they have to try to convince the child to change their mind.

A psychiatrist Cat spoke with agrees with the mom that this is an issue. Dr. David Rettew, a child psychiatrist and medical director of the Vermont Department of Mental Health, said while it's rare for the issue to come up, Vermont is somewhat of an outlier in that we require consent for all ages.

"And that's unusual. Most states have an age. So if a 6-year-old decides they don't want to be hospitalized, but all of the parents and all of the doctors say, 'I think this child needs to be hospitalized,' in most states that's considered a voluntary admission. Here, it's considered an involuntary admission. And the reason why that is important is we only have one facility in the state that can accept an involuntary admission, and that's Brattleboro Retreat. If someone is voluntary, there are at least, theoretically, some other options," Rettew said.

He did say that it's come up often enough that the mental health department is taking a look at that to see if it's worth exploring other options in line with what other states do.