A trial program has begun that offers Vineyard residents immediate access to detox services on the mainland, leaders at Martha’s Vineyard Community Services and the Island hospital announced this week.
The pilot is thanks in part to an anonymous donor and marks a first-of-its kind collaboration between Community Services and the Martha’s Vineyard Hospital aimed at improving treatment services for people suffering from drug and alcohol addiction.
The two health and human service providers signed a memorandum of understanding on Nov. 2 that will make detox beds available for Islanders at Gosnold in Falmouth and Stanley Street Treatment and Resources in Fall River. Under the agreement, any person who voluntarily chooses to receive detox services and is assessed by staff at the hospital or Community Services will go immediately to the top of the list for a bed at one of the two facilities.
A $30,000 anonymous gift is helping to make the program possible by acting as an insurance policy of sorts, guaranteeing payment for the bed in the event that something goes awry. Protocols are in place to help guide transportation and placement, and include the involvement of trained recovery coaches, a new program facilitated by Community Services.
As part of the early trial, to date five patients have successfully used the program.
“We’ve committed to doing this for a year,” Joe Woodin, president and chief executive officer at the Island hospital said.
“We want to be careful with the opportunity to make it work,” said Julie Fay, executive director of Community Services.
Both met with the Gazette Tuesday afternoon to discuss the agreement and also the newfound collaboration between the Island hospital and Community Services.
Treatment for drug and alcohol addiction is a many-layered and at times precarious process that can involve detox, stabilization and longer-term therapies including sometimes residency in a sober living facility. Managing treatment can be further complicated by the logistics of living on an Island.
The agreement with the hospital and Community Services also spells out a protocol for the specially-trained recovery coaches who will be available to help guide and support individuals seeking treatment.
Ms. Fay described the coaches as a key cog in the system, because they can help shepherd a person who is entering recovery through a gauntlet of obstacles along the way — for example passing liquor stores on their way to treatment.
And January is high season for addiction problems on the Vineyard.
“We are expecting a surge of admissions in the next few weeks,” Ms. Fay said.
The agreement grew out of a forum held on the Vineyard last spring to address the problem of opioid and alcohol abuse and addiction in the community. Since June a working group has been meeting regularly.
A top priority has been better access to detox facilities on the mainland, since there are none on the Island.
The number of people seeking treatment on the Island is relatively low by mainland standards, with about 80 people each year seeking detox and other forms of treatment. About half of them come through the hospital and Community Services. (The number of people suffering from addiction is known to be much higher, but for a variety of reasons, including the nature of the illness, many do not seek treatment.)
The hospital has been a target for criticism because it has no detox facility despite the fact that it is a full-service hospital with acute care, maternity, a 24-hour emergency room and an array of services affiliated with Partners Health Care in Boston. Mr. Woodin, who took the helm last spring, said establishing a detox facility is complicated and expensive, but he also said bluntly that money is not the primary obstacle.
“We could spend the money to create a detox but you would not be able to . . . maintain quality because you don’t have the volume,” he said.
Ms. Fay agreed, also noting that detox, which typically is short term, lasting from five to seven days, is just one small part of a long road to recovery for people suffering from addiction. “Detox is just one point on the path,” she said.
Community Services, the umbrella social service agency founded more than half a century ago, is the sole provider of comprehensive mental health care services on the Island. Ms. Fay called it both a blessing and a burden, since the services can never pay for themselves due to the small population base. “The good news is that we’re a monopoly, the bad news is that we’re a monopoly,” she said.
The services are critically needed, especially in winter when depression, substance abuse and other mental health disorders are as prevalent as the flu against a backdrop of isolation and high unemployment due to the seasonal economy. Many Islanders seek treatment, and many more do not.
Mr. Woodin, who came to the Vineyard from Vermont with a long background in rural hospital administration, concurred that the need for better mental health care is acute and said the hospital has an obligation to do everything it can to help. The emergency room provides services for people in crisis but those services are stopgap at best. And he said pointedly that the U.S. health care system in general does not respond to mental illness as it does other illnesses. “The health care system is lacking when it comes to this,” Mr. Woodin said, adding: “You can come into the ER with chest pain and there will be an immediate response and protocol that kicks in. A person in mental health crisis is not considered acute enough for the same kind of response.” He said he knew of one case at a mainland hospital where a child with a psychiatric crisis spent 11 days in an emergency room, waiting for a bed. “This is what America does,” he said.
Meanwhile, he and Ms. Fay said they are committed to doing better on the Vineyard and also working as a team. The two leaders meet regularly and are discussing other ways to collaborate. A plan to turn over the so-called Red House on the hospital campus to Community Services for a short-term stabilization center is now back on the front burner. The project was begun under the previous hospital administration, but Mr. Woodin said he was forced to put it on temporary hold when he arrived because no plan was in place for where to relocate the hospital business administrators who work in the Red House. Mr. Woodin said he expects the project can move forward again in a few months.
And both he and Ms. Fay said the pilot detox program is reason for cautious optimism.
“It’s exciting,” said Mr. Woodin. “And this is a tough issue that’s going to go on.”