Emma Rose Sheldon is a licensed clinical mental health counselor.
BRATTLEBORO-I feel compelled to speak about serious concerns regarding how people experiencing mental health crises are treated in emergency departments, particularly here at Brattleboro Memorial Hospital.
In my clinical practice, I have worked with individuals who express fear and reluctance about seeking emergency psychiatric care, even when an assessment indicates they need a higher level of support.
Some have shared previous hospital experiences that left them feeling frightened, disrespected, or inadequately supported.
Beyond what I have heard in my professional practice, I have also witnessed firsthand interactions within the emergency department which have raised serious concerns about the quality of compassionate, trauma-informed care being provided.
When people are afraid to seek potentially life-saving care because of how they anticipate being treated, something needs to change.
People arriving at an emergency department during a mental health crisis are often experiencing some of the most vulnerable moments of their lives. They may be overwhelmed, frightened, struggling emotionally, or simply trying to find help before things become worse.
Many are not actively attempting to harm themselves. They are reaching out because they need support, assessment, and care.
Yet the experience of seeking that help can sometimes feel more like entering a correctional facility than a place of healing. Restrictive procedures, security involvement, loss of personal autonomy, and an atmosphere focused primarily on control can leave people feeling powerless rather than supported.
A mental health crisis is not a crime. A person asking for help is not a prisoner.
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I fully recognize the responsibility hospitals have to protect patients and staff, particularly when there are concerns about suicide or immediate safety. These precautions matter.
But they should be based on each person’s actual needs and level of risk, rather than treating everyone experiencing a mental health crisis as though they present the same danger.
Physical safety and emotional safety should never be treated as competing priorities.
As a trauma-informed clinician, I understand how profoundly people can be affected by situations that leave them feeling powerless, threatened, or stripped of control.
For someone with a history of trauma, these experiences can deepen distress rather than relieve it.
When someone gathers the courage to ask for help, the last thing we should want is for that experience to leave them feeling more traumatized or less willing to seek help again.
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We must also recognize the needs of neurodivergent individuals and people with sensory sensitivities. Bright lights, loud environments, repeated questioning, unfamiliar procedures, and unexpected demands can quickly become overwhelming.
Someone struggling to communicate, regulate their emotions, or tolerate sensory stimulation should not automatically be viewed as difficult or uncooperative. Simple accommodations, such as quieter spaces, clear explanations, reduced stimulation, and compassionate communication, can make a meaningful difference.
These are not special privileges. They are part of providing safe, individualized healthcare.
I want to be clear: This is not about blaming individual healthcare workers. I recognize the tremendous pressure emergency department staff face and the challenges of working within an overwhelmed healthcare system. Many dedicated professionals are doing their very best.
But systemic challenges cannot become an excuse for practices that may cause additional harm.
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I am calling on Brattleboro Memorial Hospital’s leadership and board of trustees to take meaningful action, including:
• Required, ongoing training for all emergency department staff, including medical providers, security, and administrative personnel, in trauma-informed care, de-escalation, compassionate communication, and neurodiversity-affirming, sensory-informed practices.
• A thorough review of psychiatric emergency procedures to ensure that safety measures are individualized, clearly explained, and as minimally restrictive as possible.
• Access to calming spaces, reasonable sensory accommodations, and qualified mental health professionals who can provide compassionate support throughout the evaluation process.
• An independent review of current practices, of opportunities for patients and families to share their experiences safely, and of public accountability for improvements.
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Trauma-informed care cannot simply be something we talk about. It must be reflected in how people are actually treated.
Much of my work involves helping people rebuild trust, feel safe in their bodies, and find the courage to ask for support. It is deeply concerning when the very systems intended to help them may instead reinforce fear, shame, or helplessness.
People experiencing mental health crises deserve to feel cared for, not simply controlled.
I know these concerns are not unique to Brattleboro Memorial Hospital. Emergency departments across the country face similar challenges. But meaningful change has to begin somewhere, and we have an opportunity to begin right here in our own community.
I urge hospital leadership to listen to patients, families, and local mental health professionals, acknowledge these concerns, and commit to measurable improvements. A community forum would be a meaningful first step toward rebuilding trust and working together.
Our community deserves a hospital where compassionate, trauma-informed care is not the exception, but the standard.
The time for meaningful systemic change is now.
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