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Mental health care providers seek more support from the state as wait list for help grows

Yesterday morning, 31 adults and five children in New Hampshire emergency rooms waited to be told whether they’d be getting mental health treatment at New Hampshire Hospital. Some had been waiting for days. Some will keep waiting.

“Access to timely mental health care in New Hampshire is at a crisis point,” said Kenneth Norton of the New Hampshire chapter of the National Alliance on Mental Illness at a press conference in Concord yesterday with representatives from 14 other organizations, including local law enforcement and hospital officials.

“We do not categorically delay essential treatment for cancer, heart disease, stroke or any other life-threatening medical illness,” he said. “And while it is morally wrong to do this to any person, it is unconscionable to do this to our children.”

New Hampshire’s Health and Human Services Department last month proposed adding 12 more beds at the state facility. Norton and others yesterday said it’s a step toward improving the state’s backlogged mental health system that still falls far short of curing the problem.

“The lack of beds at the state hospital is really just a symptom for what’s wrong with our whole mental health system. I think the 12 beds proposed to come online in July is a little too little, a little too late,” said Louis Josephson of Riverbend Community Mental Health in Concord.

“A lot of people have asked the mental health centers what’s the right number of beds to make this problem go away. . . . It’s hard to know the right number until we stand up robust community services and are able to take the pressure off the emergency rooms. . . . The community mental health centers are here to say we need more support and we need more resources to get the job done in the community. The answer to the problem is not just more beds, it’s more community capacity,” he said.

The state’s community mental health centers are studying how much adequate improvements could cost, he said after the event.

“We know what is needed and the 10-year plan lays out costs for different segments of the plan, but we’re also aware of the budget realities and are working on an appropriate “ask” as part of the budget negotiations,” he said.

Riverbend provides the staff for a ward at Concord Hospital where emergency department patients are kept while they wait for a bed to open up at the state facility. Yesterday, three adults and one teenager waited for room at New Hampshire Hospital, Josephson said. The two adults had both been waiting four days, he said.

Patients at Concord Hospital waiting for admittance to the state facility wait in bare, white rooms, furnished with a plastic bed bolted to the floor, a plastic cube that serves as a chair and a television behind a plastic window. If those rooms are full – and they often are, according to hospital officials – they wait in emergency beds.

While there, they don’t receive therapies that could help their mental state. Instead, they’re surrounded by flashing lights, buzzing alarms and staff rushing from room to room, said Jeffrey Fetter, president of the New Hampshire Psychiatric Society.

“These rooms were designed for patients suffering from heart attacks, not hallucinations,” he said.

Even for patients suffering mild distress when they arrive, the long waits with indeterminate ends can create trauma, said Ralph Richardson of Keene, after yesterday’s event.

Richardson describes himself as a “mental health system survivor” after his commitment to the state hospital. A recent stay at Cheshire Medical Center/Dartmouth-Hitchcock Keene turned him from patient to criminal, he said.

He waited there all morning and all afternoon for a bed at New Hampshire Hospital, and when he got tired of waiting, he told the nurse he was leaving, and he walked through the woods to a nearby creek.

The hospital called the police, who found him, arrested him and brought him back on a stretcher.

Deciding to attend the press conference and offer his story to the media was hard, he said.

“I felt it as we were driving up here. The last time I was in a car I was in the back of a sheriff’s car heading to the hospital in Concord. But I survived at New Hampshire Hospital with the help of my peers, and the people waiting and waiting for beds are being denied that peer support,” he said.

At Elliot Hospital in Manchester, nearly half of the available emergency beds were being used by mental health patients last Wednesday, lengthening the wait times of patients seeking care for chest pains, abdominal pains or broken bones, said John Seidner, a staff physician there and president of the New Hampshire chapter of the American College of Emergency Physicians.

A longer wait for emergency services is just one effect the general public feels from the current state of mental health services, the groups said.

As mental health care reimbursement rates are cut and hospitals increase the costs for other health services and as police officers leave their beat to commit someone having a violent mental breakdown, “you’re paying the freight,” said Franklin police Chief David Goldstein.

“You’re paying the overtime for my officers to work a half a shift or an entire shift to fill out paper work . . . and you’re paying the back fill for me to make sure the patrol duties are filled,” he said.

Norton was cautious and noncommittal when asked how he thought the state’s new governor, Maggie Hassan, had received his group’s pleas for increased funding in a meeting last week.

Hassan “listened very intently . . . with both her head and her heart. I was certainly very encouraged,” he said, after encouraging concerned citizens to contact their legislators.

Nancy Rollins, associate commissioner of community-based care services for the state, said yesterday the department agrees the focus should be on a long-range plan and said the proposal announced last month showed the department’s commitment to the state’s 10-year plan for improving mental health services.

In addition to the 12 additional temporary beds at the state hospital, the department proposed improving connections with local resources to help patients return to their communities sooner, and additional funding to improve housing options for patients, she said.

“We have remained faithful in keeping our eye on the ball,” she said. “We make requests and if we don’t get them, we will continue to make them. . . . We continue to do that, but we are at the very beginning stage of a long process with the state budget.”

(Sarah Palermo can be reached at 369-3322 or or on Twitter @SPalermoNews.)

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