Editorial: N.H. mental health system needs more beds now

Sunday, March 05, 2017

Life being what it is, all but a fortunate few have experienced the enormous anxiety of waiting for news of a loved one overdue or in danger, or for the results of a medical test with life-or-death consequences.

All but a fortunate few have descended into sorrow and depression over the end of a relationship or the death of a family member or friend. Now magnify that feeling exponentially and imagine that you were forced to suffer that anguish while locked for an indeterminate time in a tiny, sterile room furnished with nothing but a mattress and a small television protected behind shatterproof plastic.

That’s what it’s like in the cell-like rooms on Yellow Pod, the Concord Hospital unit where people suffering from severe mental illness must stay while waiting for a bed to open up at the state hospital.

If the Yellow Pod is full, patients stay in beds set up in a hallway. It’s hard not to think of the experience as torture.

Last month, in these pages, Monitor reporters Allie Morris and Ella Nilsen described the sorry state of New Hampshire’s once-exemplary mental health system. It’s not the first time this paper, and others, have told the story.

New Hampshire is not the only state that does a poor job of caring for people with a mental illness. In fact, the state, in that regard, is about average – and that’s a crime.

“What other illness would we allow people to suffer like this without treating them?” said Ken Norton, head of the state chapter of the National Alliance on Mental Illness. “It’s absolutely inhumane.”

The New Hampshire State Hospital’s 120-acre campus once formed one of the state’s larger villages. Its population, in the 1950s, peaked at 2,750. Today the campus is a state office complex that includes a 168-bed mental hospital built in 1989.

New Hampshire was the first state to almost completely deinstitutionalize people with a developmental disability or mental illness in favor of treatment in the community. The plan worked. Until, that is, the Legislature, year after year, failed to provide the financial support necessary to maintain a community-based system capable of providing timely care.

One day last month, 68 people suffering a mental health crisis were forced to wait in hospital emergency rooms for space to be available at the state hospital. Some of them had been waiting for weeks.

The Treatment Advocacy Center, a nonprofit that advocates on behalf of the mentally ill and their families, says states should have 40 to 50 psychiatric beds per 100,000 population. New Hampshire has 11.9, not counting the beds in the state prison’s Secure Psychiatric Unit. The national average is 11.7 per 100,000.

New Hampshire’s population is just over 1.3 million. At the lower 40-bed figure, that means the state should have 520 beds, not 168. Last year, the hospital added 10 beds, but that didn’t make up for the closing or downsizing of mental health units in several of the state’s community hospitals. It also barely dented the waiting time for people in severe distress.

Gov. Sununu, in his proposed budget, added $3 million to expand community-based teams that, by responding to people in crisis, could avert the need for hospitalization. But his budget contained no money for more beds at the state hospital or elsewhere. Expanded funding for community-based mental health treatment was a response to a lawsuit filed on behalf of patients who weren’t receiving timely care. A similar lawsuit over the long wait for beds in a psychiatric facility for those who need them seems inevitable.

Lawmakers should begin now to find the money to increase the system’s capacity, perhaps not to 500 beds, but certainly to half that, and soon.