Two weeks after a report described inadequate supply and growing demand for mental health services in the state, Catholic Medical Center in Manchester announced that it will close its 19-bed psychiatric unit.

The closure is the third of its kind in the last year, and it's a trend mental health watchers in the state consider troubling. The recent report, from the UNH Center on Disability, showed a growing demand for psychiatric hospital care, as the population grew and the availability of some outpatient care also declined. In January, a legislative commission issued a report that expressed concern about the rising need for hospital-based services. Erik Riera, the state's bureau administrator for the Division of Behavioral Health, said his own office is in the final stages of a report that will recommend expanding community access to psychiatric hospital beds.

"The system is really in crisis right now," said Kim Firth, the program director at the Endowment for Health, which has chosen mental health services as one of its areas of interest.

CMC officials said that the planned closure was because the psychiatric unit was "underutilized," and because more inpatient medical-surgical beds were needed.

"Every hospital is licensed for a certain number of beds, and so we needed to look at our needs for our medical surgical beds, which we clearly have a need for," said Gail Winslow-Pine, a spokeswoman for the hospital.

Winslow-Pine said that financial considerations were not part of the decision to close the unit.

"The inpatient psychiatric unit covered its direct costs, so that clearly was not a reason," she said.

Statewide, psychiatric inpatient beds, used to stabilize and treat the most serious psychiatric illnesses, are in short supply, even as the number of patients who need them is growing.

"What I can say based on our research is that there is a definite demand that has been increasing," said Peter Antal, a research associate at the UNH Institute on Disability, who wrote the recent report. "All the data does not point to it dropping off, but rather that demand is increasing,"

Hospital administrators said their experiences jived with the findings. When faced with a mentally ill patient in their emergency departments, several said that finding a placement could be challenging and time-consuming.

Louis Josephson, the CEO of Riverbend Community Mental Health, whose agency staffs the psychiatric unit at Concord Hospital, said that his unit is usually close to capacity. When they're full, finding a bed elsewhere can be frustrating.

"It can take a couple of hours, at least, to find a bed for someone in the state," he said.

In addition to CMC, Androscoggin Valley Hospital in Berlin closed the North Country's only inpatient psychiatric beds in June 2007, citing budget concerns. Valley Regional Hospital in Claremont closed its unit in November.

Unlike medical-surgical services, which tend to be profitable for hospitals, psychiatric units tend to be money-losers, hospital watchers said. They require high levels of staffing, have unpredictable patient volumes, and tend to house a greater proportion of patients without health insurance. Antal's report found that patients who seek repeat hospitalizations, in particular, tend not to have health insurance.

"It's not exactly a moneymaker, but it's part of the mission statement of the hospital to provide psychiatric care to the community," Josephson said.

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