A bipartisan bill heard by the State Senate Wednesday seeks to quickly implement changes to child mental health services as the number of people on the waitlist for inpatient psychiatric beds reaches startling peaks.
Mental health advocates have argued the Department of Health and Human Services has been too slow to act on a new law passed in 2019 that was proposed to rectify the state’s 10-year mental health plan that made little mention of children, despite the fact that the CDC estimates 1 in 5 children lives with mental illness.
The law spelled out 12 provisions to improve New Hampshire’s psychiatric system for children. Most notably, it allocated funding for mobile crisis teams, a 24/7 hour service that dispatches a clinician and a “peer support specialist” – someone recovering from their own mental illness – to the child in need. Whereas typically parents have to send their children to the emergency room to wait for psychiatric help, mobile crisis teams bring help to their doorstep, clearing hospital waiting rooms, and offering children assistance from the comfort of their homes.
The bill was signed into law in June of 2019 with bipartisan support and about $20 million was allocated from the budget to fund the efforts. The process to seek contracts to build this elaborate network was supposed to start promptly after the bill became law. However, the initial calls for proposals were not released by the Department of Health until Oct. 2020, more than a year later.
The new bill would extend the funding to give the state more time to implement the mental health programs as well as fund positions that would help alleviate the administrative burden of enacting these new policies.
Erica Ungarelli, the Director of the Bureau of Children’s Behavioral Health, could not answer how much of the original funding for these programs had already lapsed, though Moira O’Neill, the director of the N.H. Office of the Child Advocate, said she was aware of the lapse of more than $5.5 million in the first year of the biennium.
Sen. Becky Whitley, the primary sponsor of the new bill and co-author of the original legislation, has been a vocal critic of the state’s handling of the boarding crisis.
“This is not a lack of funding issue,” she said in October. “We have a solution here. Where is it?”
Nathan White, the Director Bureau of Contracts & Procurement, said initiating new programs has been stalled partly due to the pandemic, which requires staff to focus on the state’s vaccination and testing efforts.
“Our work load has essentially doubled,” he said. “My team has not taken any vacations, they all seem to work overtime and sometimes on the weekends. It’s been a delicate balance between finding the appropriate time to devote to the ongoing projects.”
Ungarelli said the department has worked throughout the pandemic to get started on all of the various pieces of the new law — not just the mobile crisis units but other prevention and treatment programs.
Ken Norton, the Executive Director of NAMI New Hampshire, said the pandemic has intensified the need for the swift rollout of programs like the mobile crisis teams.
The state is facing high numbers of children waiting in the emergency room for mental health treatment, a situation very similar to the one the law was proposed to avoid. Over the last couple of months, mental health advocates have watched as the number of children waiting for beds grew — during some fall months, kids comprised more than half of the waiting list. Last week, 48 children were waiting for inpatient psychiatric beds, the highest number of children on the list in the 8 years since emergency department boarding began.
“We’re able to stand up emergency inpatient units and vaccine distribution sites, as we should, to fight the pandemic,” Norton said. “We seem to lack the political will in a truly life threatening situation that is devastating to these children.”