New Hampshire has one year to stop the involuntary holding of psychiatric patients in emergency rooms, a federal judge ruled, several months after declaring the state’s practice unconstitutional.
U.S. District Court Judge Landya McCafferty issued an order Wednesday after giving the state and hospitals time to submit proposals, including a timeline for how they would develop an order together. But both sides couldn’t come to an agreement. McCafferty ruled following a hearing Monday.
McCafferty also ruled the state can only hold people in emergency rooms for up to six hours before transferring them to a facility for treatment. State officials had asked for up to 12 hours. She asked for status reports from the state every four months.
New Hampshire has long struggled with a mental health system that advocates say is overburdened at every stage, from initiation of treatment to re-entry into the community. Emergency room boarding, with people in crisis waiting days or weeks for treatment, has become a flashpoint and focus of multiple lawsuits.
“For over a decade, NH adults and children have faced this inhumane practice – held against their will, stripped of their personal belongings, typically confined to a windowless room, often with nothing more than a bed on the floor – for days, sometimes weeks, with little to no treatment, and few, if any, visitors,” said the New Hampshire branch of the National Alliance for Mental Illness in a statement. “This confinement is traumatizing and, for people with serious mental illness, can often worsen symptoms, and have long-term negative impacts.”
McCafferty’s ruling in February that said the state is violating the rights of hospitals by seizing their property came after a lawsuit filed by patients who argue they were involuntarily held in emergency rooms without an opportunity to contest their detentions. A group of hospitals joined the lawsuit, arguing their rights also were violated.
As of Friday, 30 adults were waiting in New Hampshire emergency rooms for mental health treatment, according to state data, and 38 treatment beds were unavailable due to renovations or staffing constraints. The same state dashboard shows 18 children awaiting treatment, with 34 psychiatric beds unavailable.
ACLU of New Hampshire Legal Director Gilles Bissonnette, who helped to challenge the state’s ER boarding practices in federal court, praised the judge’s ruling as a step in the right direction.
“Granite Staters experiencing a mental health crisis should have a robust array of treatment opportunities that meet their needs, including the level of treatment they need, when they need it, and where they need it,” Bissonnette said in an email. “We’ll be watching closely over the course of the next year as stakeholders create the needed changes to build a successful, inclusive system for mental health in New Hampshire.”