Melissa Hinebauch donned a hospital gown Monday evening to call on state leaders to fund solutions to the mental health crisis that leaves too many adults and children waiting in hospital emergency rooms for appropriate treatment.
“Whether you are a patient or a parent, it can be a horrifying experience to be in the emergency room when you feel such abject terror, pain, despair and confusion,” Hinebauch said. “These situations are dire. They’re truly life or death, and the fact that your loved one could be stuck in the emergency room for days or weeks is completely unacceptable.”
More than 200 people filled an auditorium on the grounds of the former state hospital for the final public hearing on the state Department of Health and Human Services’ proposed 10-year mental health plan. The plan calls for one-stop access to a broad spectrum of mental health services and supports, and proposes melding the behavioral health system with the state’s new hub-and-spoke model for substance use disorder.
DHHS Commissioner Jeffrey Meyers hosted Monday’s hearing, vowing, “I’m prepared to stay here tonight for as long as I need to, to hear from everybody who wishes to speak.”
And for the next two-and-a-half hours, Meyers and his DHHS colleagues Julianne Carbin, director of mental health services, and Erica Ungarelli, director of children’s behavioral health, did just that, listening intently and occasionally taking notes. Dozens of individuals shared heartbreaking stories about their families’ struggles with mental illness, and Meyers personally thanked each person who spoke.
Carolyn Letellier of Gorham called for mental health courts to be expanded statewide. In October, her son attempted suicide and ended up arrested and in jail, where he was over-medicated and suffered physical and mental ill effects, she told Meyers. “If there was a mental health court in this state for every county, my son would not have gone through the pure torture he has experienced for the last month and a half,” she said.
Arthur Gardiner of Hanover urged officials to invest in supported housing for individuals with serious mental illnesses, a much cheaper solution than a hospital stay. He worries what will happen to his 27-year-old son in the future, he said. “Is he going to be able to find a useful and happy and supportive environment when I’m gone?” he asked.
Melissa Bernardin of Concord thanked DHHS for the care and work that went into the plan, and urged those in the room to lobby their legislators. “I think the biggest challenge here is the political will to adequately fund this system of services to get folks the mental health care they need,” she said.
“We in this room are all taxpayers,” she said. “We pay taxes so that government can provide the services we need to live full, vibrant lives, so that we can be productive at work and so that people can be healthy and happy.”
Jody Vaillancourt said hospital emergency room personnel are not trained to deal with serious mental illnesses, and a stay there often ends up doing more harm than good. “If we can’t get our state government behind these people, who can be very highly functioning, contributing members of society, then shame on us,” she said. The room erupted with applause.
But the warmest applause came after a young man named Patrick Dowling shared his own struggles with mental illness that on several occasions landed him in emergency rooms. For his transfer to New Hampshire Hospital, he said, he was put in shackles. “So I feel like I am more a criminal than someone who is undergoing a mental break,” he said. “Should I have to feel like a criminal for something that I live with?”
Scott Watson, a Manchester business owner, struggled to maintain his composure as he thanked state health officials for including peer support in the plan. He deals with depression, he said. “If it wasn’t for peer-to-peer support and having the help of people that go through the same thing that I do every single day, … I would not be here today,” he said.
DHHS officials also heard from experts who praised them for the vision and breadth of the proposed plan but stressed the importance of funding the recommended services.
Steve Ahnen, president of the New Hampshire Hospital Association, said the waiting lists for appropriate placement — there were 28 adults and four children waiting in emergency departments last Friday — are “a red flag of system stress,” he said. “We do not have enough resources across the system.”
“Those caregivers come to work every day with one goal in mind: to help all of their patients get better,” Ahnen said. “They want nothing more than to help them get the care they need.”
Peter Evers, CEO of Riverbend Community Mental Health in Concord and president of the New Hampshire Community Behavioral Health Association, pressed leaders to increase Medicaid reimbursement rates to address a critical workforce shortage, and to improve parity for insurance coverage of behavioral health services. He noted a 10-year plan proposed in 2008 had many of the same goals as the current plan, but was never funded after the recession hit New Hampshire hard.
“But these are different times,” he said. “The proposal before you marks the beginning of a process to see some real and much-needed change in our system of care.”
Ken Norton, executive director of NAMI (National Alliance on Mental Illness) New Hampshire said the plan “really reflects hope and help across the lifespan, from early childhood to older adults.” He said his organization hopes to create a mental health caucus in the Legislature to push for implementing the recommendations.
Donna Stamper of Grantham, who leads a support group for NAMI-NH, was wearing a button reading “Transform Mental Health.” It dates from the last 10-year plan, she said. “Hopefully this plan will produce more than a button,” she said.
DHHS is accepting written public comments through Dec. 10. Meyers said he expects to deliver the final proposal to the governor and legislative leaders in early January. Submit comments to: 10yrMHplan@dhhs.nh.gov.