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Lack of access to mental health services concerns health execs

State House Bureau

April 24. 2017 10:15PM
New Hampshire Hospital (Union Leader file)

CONCORD — Executives from six of the state’s largest health care systems wrote to Gov. Chris Sununu on Monday to express their “deep concerns” about access to mental health services in the state, and the backlog of patients in emergency rooms awaiting admission to the state’s psychiatric hospital.

“Given the state’s insufficient investments in additional bed capacity at New Hampshire Hospital, our emergency departments have become a boarding place for behavioral health patients in acute crisis,” states the April 24 letter from Dr. Travis Harker, chief medical officer at Granite Health, a collaborative involving Catholic Medical Center, Concord Hospital, LRG Healthcare, Southern NH Health, Exeter Hospital and Wentworth-Douglas Hospital.

The Senate is expected to hold a public hearing Tuesday on a bill to expand community mental health beds in the hope of easing the strain on New Hampshire Hospital and local emergency rooms, but the letter calls that an inadequate response.

“Expanding community care alone is not enough to eliminate the growing wait list,” writes Harker.

In addition to more beds at New Hampshire Hospital, the letter recommends investing in workforce development to “train and retain” psychiatric providers, add mobile crisis units and create incentives for private investment in so-called “designated receiving facilities.”

The amendment that the Senate will review on Tuesday includes funding for a new mobile crisis unit, as well as new beds at “designated receiving facilities” — a phrase used to describe licensed mental health beds outside of New Hampshire Hospital.

The state recently added 10 beds to the state hospital, but that has had minimal effect on easing the backlog of individuals waiting in hospital emergency rooms, which at times has exceeded 50 patients statewide.

Gov. Sununu toured Concord Hospital on Friday and later met with the media to describe the state’s response to the growing crisis.

Concord Hospital at one point in February had 22 patients waiting for admission to New Hampshire Hospital, with only six beds designated for that purpose.

“The six rooms are full and you can see the beds lining the hall,” Sununu said on Friday, when 12 patients were being accommodated at Concord Hospital.

“This is not New Hampshire Hospital, and the fact that we have this logjam, and a logjam of actual people, is the real scary point here,” Sununu said. “These are people with families, moms bringing their kids in. They just want services and help for their loved ones. We have to make sure we understand that, and are doing anything we can to create a new long-term solution for this state.”

The letter from the Granite Health consortium suggests local hospitals have reached the limits of what they can do individually.

“Community hospitals are working to do their part to resolve the crisis, even amid continued financial pressure from low public payer reimbursement,” wrote Harker. “However, meeting the community need will undoubtedly take a community effort.”

The state is already struggling to comply with a $30 million court-ordered settlement triggered by inadequate mental health services for adults in the state.

“It’s eye-opening when you walk down the hall and see the line of beds that you know will be filled this weekend to maintain a place for these individuals who are not getting the help they need,” said Sununu after his Friday tour. “We’re just housing them and maintaining them until we have space at New Hampshire Hospital; we are going to have to get aggressive about long-term solutions.”

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