COVID-19 Update

HCRS and NFI Team Up to Help Youth in Crisis

Jill (her name is changed to protect her identity) is a fourteen year old with curly brown hair, blue eyes, and finely detailed tattoos on her arms and neck. She sits on a gurney at the Brattleboro Memorial Hospital emergency room and talks with Becky, a clinician at HCRS who is also an on-call mental health crisis screener on the weekend. Jill has a large gauzy pad on her wrist that the nurse is just finishing taping up. The bandage covers four scrapes on her wrist, one that went deeper than intended and actually nicked into an artery on her wrist. “I didn’t mean to slice into my vein. I just wanted to distract myself from my other pain,” she explains to Becky.

Becky continues interviewing her, asking questions about what she was thinking when she was doing the cutting. It is clear that this was not a suicide attempt, but it was a serious call for help and a dangerous gesture that should not be ignored. The question in Becky’s mind is a simple one. Do we admit Jill to the Retreat even though she may not fully meet the criteria for a hospital level of care, or do we send her home where her foster parents are feeling overwhelmed and scared? In southern Vermont, that is a question that is often the result of a lack of alternative options. “We have no other safe place to put her other than the Retreat unless her family drives her up to South Burlington, and we admit her to the Northeast Family Institute (NFI) Hospital Diversion bed up there. That is a three hour drive and the parents are not willing to risk it,” Becky says, starting to make the call to the Retreat admissions desk.

For years, the Windham and Windsor County area has had the highest rate of youth admissions to the Brattleboro Retreat of any region in the State. And for years, HCRS and the Department of Mental Health have discussed the reasons and what to do about it. “It is very simple,” said Jennifer A. Smith, Director of the Children, Youth and Family Division of HCRS. “The Retreat is very accessible when youth are at risk, and we have no other alternative other than the Burlington program. There are no facilities supporting at-risk kids in a short-term, 24/7 program in Southern Vermont. What we need is a hospital diversion program like the NFI facility in South Burlington that will serve the lower half of Vermont.”

After three years of HCRS working in partnership with Northeast Family Institute, the Vermont Department of Mental Health, and the Division of Vermont Health Access, there will be a new hospital diversion program in Brattleboro to address this problem. The Department of Vermont Health Access has approved funding with assistance from Vermont’s Department of Mental Health to provide additional capacity to ensure expanded crisis stabilization services for youth and teens in southern Vermont.

The Southern Vermont Hospital Diversion Program is located at 945 Putney Road, the only remaining residential property on that street. For the last six months, the pine-green building with the cupola and the huge tree out front has undergone major renovations to create a new, 6-bed home for this program.

The program provides crisis stabilization, clinical consultation, and after-care planning. Adolescents collaborate with program staff to identify treatment goals which help guide the overall treatment plan. Throughout their stay, adolescents have an opportunity to reflect on the events leading to their admission, better understand coping strategies, focus on skill building, and improve communication with supports. The Hospital Diversion Program clinical team works with the adolescent, their family, and a team of providers to create a comprehensive after-care plan upon discharge.

George Karabakakis, HCRS CEO, states, “This collaboration with NFI and the Department of Mental Health will bring a needed resource to Southern Vermont and will offer quality programing. NFI has the expertise of having run a great program in Burlington, and we have the expertise of our crisis team. This is the best model of collaboration in delivering high-end behavioral health care services.”

The Program is hiring 14 additional staff for direct care and clinical roles. For employment applications, contact HCRS ( or NFI Vermont, Inc (