Contract negotiations between unionized nurses and caregivers at the Brattleboro Retreat have gotten increasingly testy. The psychiatric hospital and its 500 unionized workers were far apart when talks ended last week.
Then the Retreat announced it plans to lay off 31 employees, including two entire therapeutic departments.
The layoffs the Retreat’s therapeutic activities department, some education services and all of the chemical dependency counselors on the hospital’s inpatient units.
Union President Beth Kendell, a registered nurse, says the programs being cut are anything but "non-essential."
"The therapeutic services program at the Retreat has been in charge of all the programming on the unit, the group therapy," Kendell said. "And then, a huge percentage of our patients are chemically dependent, so our chemical dependency counselors have not been idle. We also consider them essential, as do our patients."
By the end of last week, unhappy Retreat workers were out in force outside the hospital, expressing their outrage. They carried signs accusing the hospital of mismanagement and not putting patient care first.
But a Retreat spokesman says the hospital needs to re-allocate resources because of changes in the mental health care system.
Peter Albert is the Retreat’s vice president for communications. He says patients are staying in the hospital for shorter and shorter periods of time — and patients who do get admitted tend to be more acutely ill. Meanwhile, Albert adds, reimbursements for care keep shrinking.
"So we have three primary things that we’re trying to refocus on," Albert explains.
One is the front door. If it’s two o’clock in the morning and somebody’s in crisis, they should be able to call a place and get immediately admitted. Goal number two, when they go to the units, they need to be safe. And our units are safe. And our psychiatrists are experts."
Albert says a third new priority is to create better transitions between the hospital and community services.
The Retreat has agreed to care for fourteen patients who previously would have gone to the state hospital in Waterbury.
But with the state system in transition, the Retreat has averaged twenty-five state patients. Stays for them tend to be longer, Albert says, and their needs are often more acute.
Employees argue that the programs being cut are the ones that make the Retreat’s programs especially effective.
Standing in the picket line is Nina Wilson, a recreation therapist who’s been at the Retreat more than eight years.
Wilson says, "It’s not just activities that we’re doing. We’re teaching them the skills so that this isn’t just a revolving door — so that they can learn coping skills and stress management skills."
Wilson learned last week that she and everyone in her department would soon be unemployed
She says the hospital’s management has repeatedly referred to the therapeutic activities program as "the special sauce" that sets the Retreat apart from other facilities.
The Retreat’s Peter Albert agrees that art, music and life skills are important. He says he hopes the hospital’s nurses and mental health and social workers will provide the activities at less cost.