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Editorial: Unconscionable wait for mental health care

The story on Sunday’s front page was as inevitable as it was depressing: The state set a new record last week for the number of psychiatric patients in crisis but waiting for care. New Hampshire Hospital, the state-run psychiatric hospital in Concord, was full up, so the patients, adults and children alike, were left waiting in emergency departments across the state.

The phenomenon is not new in New Hampshire. But it is one that state lawmakers and budget-writers have managed to ignore for far too long. And while there are some encouraging signs coming from Gov. Maggie Hassan’s office, the problem is too dire to wait for a new state budget, which won’t take effect until summer.

As Monitor reporter Annmarie Timmins explained, as of Feb. 4, 44 people, including 18 children, were stuck in emergency rooms across the state. They were suffering mental health crises but unable to get a bed at New Hampshire Hospital – despite the recent addition of eight temporary spots there. At their local hospitals, some were put up in hallways or in beds intended for patients with physical health emergencies.

Holding such patients in places ill-equipped to deal with them may keep them – and the rest of us – temporarily safe. But delayed care will surely make many psychiatric crises worse. Such shortages would not be tolerated with other sorts of health emergencies.

There is both a short-term and a long-term problem here. Both are unconscionable, and both deserve some speedy attention from the state.

In the short run, the state must figure out how to treat those suffering from immediate crises. In the long run, Hassan and legislators must commit to the type of effective,
community-based care that prevents such crises and keeps patients with severe mental illness from needing the state hospital. That is the humane and cost-effective course which, for reasons beyond understanding, New Hampshire has avoided in recent years.

Late last year, Health and Human Services Commissioner Nicholas Toumpas said he intended to ask legislators for an additional $10 million, for both community services and new beds at the state hospital. Officials from community behavioral health centers across the state say that’s not nearly enough. Last month, they urged the state to invest $37.6 million over the next two years. That money would go toward local counseling and housing services – and would match the promise of a 10-year state mental health plan adopted in 2008 but never funded.

All of this is complicated by a pending federal lawsuit charging the state with maltreatment of those with severe mental illness – not to mention the planned switch to managed care for mentally ill patients served by Medicaid.

For years former governor John Lynch managed to avoid this terrible problem, but there are already some signs that Hassan intends to tackle it. For starters, she’s asked to be updated daily about the delays at New Hampshire Hospital.

Hassan’s budget, expected later this week, will make clear how seriously she’s taking this problem. Her task is unenviable, considering the many, many demands on the state budget. But even before the governor lawmakers start thinking about mental health services over the next two years, they must deal with the crisis going on right now, in Concord and in communities across the state.

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