Vermont used MINDS ON THE EDGE as the centerpiece of an extensive state-wide initiative to improve the mental healthcare system in Vermont. The effort has been a unique and expansive collaboration of state institutions and individuals in leadership positions who have been working together to move this project forward.

The collaboration has included the University of Vermont College of Medicine, Vermont Law School, Vermont Public Television, the Vermont Chapter of the National Alliance on Mental Illness and the Vermont Nurses Association.

The initiative kicked off with a Legislator "Boot Camp" on mental illness in early October 2009 followed by a series of 8 town hall meetings in communities throughout the state that attracted state legislators, mental health professionals, consumers, family members and the general public. Vermont Public Television advanced the initiative with PSAs, web-based promotion and coverage of the issues on its weekly public affairs program. In recognition of this outstanding effort, Vermont Public Television won the prestigious national EDGE Award for best public television outreach campaign.

• Legislator Boot Camp on Mental Illness The "boot camp" was held on October 2, 2009 at Vermont Law School. Dr. Thomas Simpatico, Director of the Division of Public Psychiatry at UVM and MINDS ON THE EDGE panelist, worked with Professor Oliver Goodenough at the Vermont Law School to design the intensive briefing for state legislators, introducing them to current medical research about serious mental illness and efficacious treatment and discussing whether Vermont statutes and practices were in line with this information. The day's discussions were built on the foundation of MINDS ON THE EDGE: Facing Mental Illness, which was presented in the morning session. Mark Heyrman, a law professor at University of Chicago, served as moderator of this portion of the program and helped to shape the discussion by stopping the program at key points and asking the legislators to place themselves in decision-making roles that have no easy answers. The presentation sparked discussions and fostered awareness of some of the ways many people with serious mental illness do not receive the services they require and how often they fall into the criminal justice system instead. Afternoon sessions included presentations illustrating treatment and system issues relevant to the care of persons with serious mental illness. Dr. Simpatico reports on the event in a letter to Richard Kilberg, President, Fred Friendly Seminars.
  
  See Dr. Simpatico's report on the event
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• Legislator/Citizen Meetings in 8 Vermont Cities With the increased public awareness informed by the public television broadcast of MINDS ON THE EDGENAMI-Vermont in partnership with other state-wide associations including the Vermont Nurses Association.
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• In Burlington, the first town hall meeting in the state took place on October 14, 2009 at the Frederick H. Tuttle Middle School library. Over 80 people attended to watch excerpts of MINDS ON THE EDGE and to participate in a facilitated discussion afterwards. The discussion was led by a prominent ex-Vermont legislator, Jim Leddy. Six legislators were in the audience including Doug Racine, current chairman of the Senate Health and Welfare committee and a strong contender in the next gubernatorial election. Among other notable audience members were Ann Pugh, chair of the House Human Services Committee; the commissioner of mental health; the Burlington and South Burlington Chiefs of Police; the principals of South Burlington high school and middle school; medical director from Burlington's community mental health center and six faculty members from the University of Vermont Department of Psychiatry. At the meeting, attendees generated a "to-do" list of issues to address.
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    Long-term Needs Identified
    
  • Long-term supported housing
  • Supported employment
  • More substance abuse treatment
  • More information about alternatives to drug treatment
  • More peer support
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    What Works
    
  • School counselors (home school coordinators from CMHC?)
  • Expansion of Mental Health Court
  • Drop-in centers
  • Peer crisis center
  • Long-term Counseling
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    Topics of Interest
    
  • Involuntary 72 hour hold
  • Involuntary treatment
  • Involuntary medication
  • Medication vs. other treatments
  • Prevention, outreach and intervention to avoid involuntary processes
  • Co-occurring disorders (mental health and substance abuse) relationship to crime
  • Mental Health Court in Burlington
  • Problem of slow and arduous court processes
  • Early diagnoses and treatment
  • More crisis services needed
  • Incentives for voluntary treatment
  • Recognition that medications are not always effective
  • Communication gaps between service providers in the system of care
  • Stigma
  • Long and short-term supported housing
  • Supported employment
  • ADA not fully implemented
  • None or inadequate treatment available in prisons
  • Informed consent process for treating with medication
  
  
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• Addison County in Middlebury was the site of the second meeting on October 15, 2009. Approximately 45 people were in attendance, including the commissioner of mental health and four local legislators.
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• Additional meetings took place through the month in Montpelier (October 19), Shelburne (October 22) and Bennington (October 26); three more meetings have occurred during the winter months.
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• In Morrisville, Lamoille Community Connections hosted a two-phase Town Meeting on January 25, 2010 and on March 22, 2010. The first phase was attended by 38 participants. The event featured the viewing of the first 3 chapters of MINDS ON THE EDGE. After each segment a discussion was facilitated by Dr. Tom Simpatico.
  
  1. Statewide initiatives around stigma
  2. Trauma services for adults as well as for children
  3. Employment services for clients at the early stages of working
  4. Effectiveness of peer supports and services
  5. Effectiveness of DA's Emergency Services role in the hospital's emergency rooms
  6. Next MINDS ON THE EDGE meeting at LCC
  
  
  Phase-two of the Town Meeting is scheduled for Monday, March 22, 2010 at 72 Harrel Street, Morrisville.
  
  
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• In White River Junction, Allied Medical Studies held a screening of MINDS ON THE EDGE for twenty-five students on December 8, 2009 at Hartford High School. A lively discussion followed. The students were strongly moved by the problems facing those dealing with mental illness.
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