Vermont Q&A

In June, we met Haley McGowan, DO, Medical Director of Child, Adolescent and Family Unit for the Vermont Department of Mental Health (VTDMH) for a Q&A discussion. The VTDMH has been using expansion funds to partner with the Vermont Program for Quality in Health Care, Inc. (VPQHC) to offer trauma-responsive care training to emergency department (ED) staff across Vermont.

These discussions allow PMHCAs to engage directly with other organizations to share information about their program wins and challenges. They also allow other PMHCAs to gain insights into their work, highlight key points, or provide real-world examples relevant to other PMHCAs.

Tell about the work you are doing in partnership with the Vermont Program for Quality in Health Care, Inc. (VPQHC).

Using PMHCA expansion funds, the Vermont Department of Mental Health is partnering with the Vermont Program for Quality in Health Care, Inc. (VPQHC) to offer trauma-responsive care training to emergency department (ED) staff across Vermont. The four-hour, on-site training consists of four interactive modules: Trauma-Responsive Care 101, Verbal De-Escalation, Reducing Traumatic Stress in Children, and Secondary Traumatic Stress, which focuses on the personal impact for providers. A team of three trainers, which includes two trauma-responsive care experts and one peer support specialist with lived experience, teach and model trauma-responsive care best practices – using didactics, role play, and discussion – to ensure that staff are equipped with the knowledge, tools, and resources they need to provide the highest quality of care. While VT’s PMHCA-funded Child Psychiatry Access Program (VTCPAP) aims to reduce emergency department presentations with a preventative, upstream approach, training in trauma-responsive care improves the downstream patient experience by helping ED staff feel more informed and prepared when caring for those in psychiatric crisis and their families.

What has been the most successful accomplishment of your PMHCA program to date?

During the first round in 2023-2024, our team provided training to 12 of Vermont’s 14 emergency departments. As demonstrated in our data summary (by evaluator Center for Behavioral Health Integration), the vast majority of participants felt the training deepened their knowledge of trauma-responsive care, increased their confidence in caring for patients with trauma, improved their understanding of the influence of secondary traumatic stress on themselves and others, and empowered them with strategies to reduce acute traumatic stress responses in emergency department patients. Based on the positive response, we have just begun a second cycle of optimized training at hospitals statewide and expanded the audience to all pediatric-facing staff.

How has your team managed challenging projects?

Organizing training for hospitals statewide is a logistical challenge! During planning, VPQHC leveraged existing relationships to make in-roads and gracefully navigated space, weather, and time constraints throughout the year. We bolstered recruitment by providing $50 gift cards to encourage participation and show appreciation for staff time. The trainers deserve great credit for providing attuned and meaningful training on emotional topics – sometimes two trainings per day.

Have you engaged in state or national associations to collaborate?

This work has been a truly collaborative effort. VPQHC did some initial outreach through the Vermont Association of Hospitals and Health Systems Emergency Directors meeting and then expanded the reach through relationships with the VT Department of Mental Health, the University of Vermont Medical Center, and other community partners.

What modes of outreach about your program have been most successful?

Direct outreach to hospital Emergency Department directors, quality improvement (QI) directors, and nurse educators has been most effective. Leveraging relationships with already established hospital partners has also been essential.

Once a provider has enrolled in your services, how does your team provide support?

In addition to the actual training, participating hospitals can access the Trauma Responsive Care Toolkit developed for this project. It serves as a centralized and structured source of information and resources for implementing trauma-responsive care strategies in a hospital setting. The training team also holds quarterly Community of Practice meetings, which allow connecting and discussing questions and challenges.

How do you keep stakeholders aware of your current and/or new services?

Outreach occurs through both individual and bulk emails. VPQHC has also published the Trauma Responsive Care toolkit on their website, where the training slides and evaluation data can be found.