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Emergency room crowding is a crisis, advocates for mentally ill say

New Hampshire Union Leader

January 07. 2013 11:03PM

CONCORD - Mentally ill people, many of them suicidal, depressed or in a manic state, are languishing untreated in hospital emergency rooms for days, advocates said Monday.

Advocates, treatment professionals, law enforcement, hospital officials and government officials said the emergency room crowding is the symptom of a failed system - fewer in-patient psychiatric beds than needed and underfunded community-based supports for the mentally ill.

On Monday morning, 31 adults and three children were in New Hampshire hospital emergency rooms waiting for admission to a psychiatric hospital or ward, said Ken Norton, executive director of the National Alliance on Mental Illness, New Hampshire chapter. That broke a record of 26 adults in waiting, set last October.

"It should be as easy and as quick to get a mental health appointment as it is to purchase a firearm," Norton said.

Dr. P. Travis Harker, president of the New Hampshire Medical Society, said patients he refers to a psychiatrist have to wait 2 1/2 months for an appointment.

An appointment at the local mental health center can take four to 10 weeks.

"If we were talking about cardiac care, we wouldn't be talking about what number is the right number (to spend). We'd be talking about what's the right thing to do," he said.

Speakers said the mentally ill can be disruptive and damaging in emergency rooms. They said hospital care is costly. And the lack of community based care - which includes treatment teams, housing, and jobs support - means that people are pushed into expensive hospitalization.

A day at the New Hampshire Hospital can cost $1,000, compared to less than $200 a day at Riverbend Community Health Center, said Louis Josephson, chief-executive at the Concord-based Riverbend.

The state has said it will add another 12 beds to the New Hampshire Hospital and improve community-based care, starting July 1. But Norton said the state is in a crisis. Waiting until July is not acceptable, he said.

He said NAMI spoke to Gov. Maggie Hassan Friday - her first full day in office.

"I felt like she listened with both her head and heart. I was certainly very encouraged," he said.

Still, the state is fighting a class-action suit filed by the Disabilities Rights Center and backed by the U.S. Justice Department to force improvements in the system. Norton said he'd rather see money spent on services than legal bills.

The Disabilities Rights Center said the 12 new beds are a Band-Aid solution.

"A community mental health system with sufficient supports would divert people from hospitalization in the first place," the center said in a statement.

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