(March 9, 2017) The Granite State once had a mental health care system that was a model not just for the rest of New England, but the country. Now, New Hampshire is in the midst of a deepening crisis. One just need to take a glance at newspaper or turn on your radio ("Mental health crisis deepens For patients awaiting scant hospital beds," New Hampshire Public Radio, March 4) to come across another news account of patients forced to wait in emergency rooms for days or weeks, waiting for a psychiatric bed to become available.
New Hampshire was among the first states to deinstitutionalize people with developmental disabilities or mental illnesses in favor of community-based treatment. While they experienced early successes getting patients out of hospitals and closer to their homes, years of neglect through insufficient funding by the Legislature have rendered that community-based system incapable of providing timely care.
Four years ago, mental health advocates were alarmed by the fact that on average, nine people a day sat in New Hampshire emergency rooms waiting for a bed to open at the state psychiatric hospital. On one day alone this past February, the number of people experiencing a mental health crisis necessitating hospitalization but forced to wait in an emergency room instead hit a record high of 68. In some cases, they had been there for weeks.
Everyone agrees that New Hampshire’s mental health system is in crisis, but there is disagreement over the solution. Is the answer found in providing more beds in state psychiatric hospitals or increasing funding for community-based care?
Budget cuts over the last five years at the state psychiatric hospital and the shuttering of psychiatric units in private hospitals due to workforce shortages have left the underfunded community health centers unable to cope with the influx. Forcing patients into “psychiatric boarding” situations where they languish in emergency rooms ill equipped to handle their needs, often for weeks on end.
For now, the state is concentrating its efforts on community care. As part of a 2014 mental health settlement over a lawsuit alleging patients were needlessly institutionalized because they could not get mental health treatment in their own communities, New Hampshire Gov. Chris Sununu has proposed adding $3 million to the state budget. The funds would expand community-based response (including mobile units) to people in crisis, with the hope of avoiding hospitalization through treatment at home. But there’s no provision in the budget to increase the number of beds. It may take a similar lawsuit to bring that about. In addition, the proposal does not address the need for a secure facility, or at least a secured wing of the New Hampshire Hospital, that will be required to stop the much-criticized practice of placing civilly committed patients at the Secure Psychiatric Unit at the Concord prison.
While we applaud Gov. Sununu’s efforts to support community based-treatment, New Hampshire still faces a severe shortage of beds. As the Concord Monitor recently editorialized ("NH mental health system needs more beds now," Concord Monitor, March 4), we also encourage him and lawmakers to make the tough decisions needed to find additional funding now, before a court forces them down that road. And before more New Hampshirites needing treatment suffer in the process.
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