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Another View -- Louis Josephson: Access to mental health services is a severe problem in NH

December 19. 2012 8:35PM

We may never know why Adam Lanza killed so many innocent children in Newtown, Conn., last week. Many have commented on the availability of semi-automatic weapons. While gun availability may be an issue, so is the lack of availability of mental health services.

Think of mental health services as the bridges and roads of our state that support our families, friends and neighbors when facing an emotional crisis or raising a child with an emotional disturbance. Unfortunately, just like our real roads and bridges, the mental health system is crumbling. Years of rate cuts to providers and reductions in psychiatric beds and residences have left us unable to respond to those asking for help, let alone reaching out to people who are at risk of violence to themselves or others and must be brought into services.

Drive down Interstate 93 and you can see advertisements for urgent care centers that promise to get patients in and out within minutes. Compare that to people who are suicidal or homicidal in New Hampshire and must wait minimally for eight hours and frequently several days in hospital emergency rooms for a bed in our state psychiatric hospital. These extreme wait times for hospital beds affect care for medical patients in emergency rooms and put our staff at risk. In many communities, police officers are pulled off the beat to watch over patients waiting for a psychiatric bed in emergency rooms.

I am not the only person who thinks that New Hampshire has a problem. The Disabilities Rights Center and the federal Department of Justice have filed suit in federal court against New Hampshire, saying that our mental health system is out of compliance with federal laws for humane care for people with disabilities. Some patients are stuck in the state psychiatric hospital past when they are clinically cleared for discharge because community-based resources have dried up. Other patients (about 25 percent) are admitted and discharged in less than 24 hours because there is such pressure to admit people waiting in ERs. Still other patients languish in state nursing homes for want of community- supported housing.

Just like we need to make smart investments in our roads and bridges, so must we infuse our mental health system with the resources to help our neighbors and maintain public safety. The good news is that community mental health services are effective and cheap. One day of care at New Hampshire Hospital costs more than $1,000. A day of care in a supported community residence costs $200. The people we serve respond to therapy and medications and want to be a part of their communities. They want to work and be productive. They want their kids to graduate from high school and go on to college. Community mental health services can support families and individuals to meet these goals.

So when we have the discussion about what is needed after Newtown, let's not forget that mental health services are an effective and cost-effective safety net that needs to be in place to help prevent these senseless tragedies.

Louis Josephson is CEO of Riverbend Community Mental Health Inc. and vice president for behavioral health at Concord Hospital.

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