After a brief respite from the emergency boarding crisis, hospitals are filling up with those seeking one of the few beds in a psychiatric treatment facility.
Earlier this month, the number of adults waiting in hospital emergency departments for psychiatric treatment dropped to zero for the first time in more than a year, which Gov. Chris Sununu said was evidence that “our immediate actions have started to show promising results.”
Recent numbers suggest the issue is far from resolved. As of Tuesday, 12 adults and 24 children were waiting for psychiatric treatment, often in hospital emergency rooms.
The Department of Health and Human Services has faced pressure to rapidly clear patients from emergency rooms after the New Hampshire Supreme Court ruled last month that psychiatric patients being held involuntarily in emergency rooms must be given a chance to contest their detention within three days of their arrival.
Often, people deemed to be in crisis must wait days or weeks in the emergency rooms for a bed in one of the state’s psychiatric facilities to open up without an opportunity to challenge the involuntary admission.
Following the ruling, Sununu signed an executive order that allowed the Department of Health to offer a $45,000 per bed incentive for nursing homes willing to house geriatric patients from New Hampshire Hospital or Glencliff Home, a long-term care facility for disabled or mentally ill adults. This move temporarily unclogged the psychiatric care system, which has been especially strained since a staff shortage forced Glencliff to close a unit, taking several beds offline.
Todd Bickford, the administrator at Glenncliff Home, hopes the temporary monetary incentive will give way to a more permanent attitude shift among nursing home administrators. This would not only ease the emergency department boarding crisis but help those with mental illness transition into the community.
He said in the past, New Hampshire nursing homes have been hesitant to take residents who have had past struggles with mental illness, even if they no longer require a higher level of care.
“People coming from Glencliff have the stigma of being mentally ill and aggressive– and they may have been that way in their past,” he said. “But when we’re looking to discharge somebody, if you didn’t know they were coming from Glencliff, they would be just like any other resident being admitted to a dementia unit.”
The $45,000 incentive, has created opportunities for his residents that may not have been accepted into traditional nursing homes before. He recalled one woman who was able to move from Glencliff to Nashua, where she was closer to her family and around staff that could speak Spanish, her native language.
“Once this additional money dries up, but again I’m hoping that they’ll realize ‘oh we can meet their needs’,” he said. “This patient may have had schizophrenia and been aggressive or loud in the past, but now their main diagnosis is really connected or something else, so that they are much more manageable at ‘normal’ nursing home.”