State takes steps for mental health services
CONCORD - A dozen beds will reopen at the state hospital, a key part of an improvement plan for mental health services announced Tuesday by the state Department of Health and Human Services.
Since 2009, three adult units with a total of 60 beds were closed at New Hampshire Hospital because of budget cuts. That, along with the shutdown of local hospital inpatient psychiatric units, has led to a waiting list for patients seeking care.
Sometimes, the patients spend days in emergency rooms at local hospitals because a bed is not available at the state hospital, according to state and federal officials.
State health officials said the plan, announced on Tuesday, was not in response to a class-action lawsuit filed in March that claims the state does not do enough to care for the mentally ill.
The U.S. Justice Department has intervened in the suit and argued some of the points made Tuesday - that people in a crisis can languish for days in a hospital emergency room.
"This is of critical concern to me personally and DHHS as an organization," said Commissioner Nicholas Toumpas in a prepared statement. "It is unacceptable for someone experiencing a psychiatric crisis to have to wait this long for critical inpatient care - for both the individual as well as their concerned family members."
State health officials will seek additional funding in the next two-year budget to accelerate the progress of its existing 10-year plan to improve mental health treatment in the state, he said. He also wants to fund innovative programs that support individuals so they can live in their communities.
Community mental health centers said the announcement represents an acknowledgement that adults and children with serious mental illness are waiting for treatment in local hospital emergency rooms.
The New Hampshire Community Behavioral Health Association said it has cautioned that patients waiting in emergency rooms are at risk of harming themselves, hospital staff and other patients,
"The added bed capacity at New Hampshire Hospital is a stop-gap. The larger problem is too little state investment in community supports," said Jay Couture, president of the association.
"Building the community (mental health treatment) capacity is essential to keeping people out of the hospital and getting people who are there out," said Amy Messer, legal director of the New Hampshire Disability Rights Center, which brought the lawsuit against the state.
Assistant Commissioner Nancy Rollins said a 12-bed unit will reopen as a temporary measure.
The said cuts totaled $5.3 million over the past two budget cycles, which resulted in the additional loss of $2.2 million in federal funds. She said the 12 beds will cost $2.3 million annually.
The state plan, Rollins said, is in response to increasing concerns related to the numbers of people waiting in emergency rooms for a bed to open. She said the day-to-day count varies from a low of 4 to 5 people to as high as 15 people.
DHHS plans to:
-- Track all individuals waiting for a bed at the state hospital on a daily basis.
-- Have state hospital psychiatric staff consult with local emergency room physicians in managing patients' behavioral health crises.
-- Add another seven teams to its Assertive Community Treatment Teams for a total of 17 statewide.
-- Expand its peer-run services to help another 400 adults annually.
-- Nearly double the size of the Housing Bridge Subsidy program, which helps discharged, stabilized patients find and pay for housing, from 110 to 210 units.
-- And add another 48 supervised residential beds in the community.
"Let me be clear, we cannot do this on our own," said Toumpas. He said coordination is needed from community mental health centers, family and consumer groups, advocates, local police and local hospitals.
Twenty months ago, the U.S. Justice Department faulted the state for not living up to its 10-year plan to meet the needs of the mentally ill. The New Hampshire Community Mental Health Centers Association said the state had less capacity in January than in August 2008, when the 10-year plan called for additional investment.
Last March, the Justice Department intervened in the class-action Lynn E. v. Lynch lawsuit. At that time, U.S. Attorney John P. Kacavas said New Hampshire residents in crisis spent days in local emergency rooms at great cost and then were transported to the state's psychiatric hospital.
"This costly and traumatic process could be avoided if New Hampshire offered proven and effective services in the community to prevent and de-escalate crises, help people maintain safe housing and assist them in finding and holding employment," Kacavas said at the time.
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Pat Grossmith may be reached at firstname.lastname@example.org.
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