I am a board-certified psychiatric nurse practitioner. I have been in psychiatric nursing for over 10 years, working both with your typical outpatient population and also in hospital and correctional settings with individuals with severe and persistent mental illness.
It is all too often that my patients have a mental health crisis, restabilize in the hospital and then are left afloat without enough support to return to the community once they discharge. Patients and parents are often feeling like they’re right back in the spot they were before entering a mental health crisis, unable to afford their medications and/or without enough middle-acuity care to adjust back to daily life.
There is a lot of work to be done to repair our broken system, but Senate Bills 498 and 647 would be great steps in the right direction.
SB 498 proposes a wrap-around program that would help patients get the mental health care they need after hospitalization. Middle-acuity care is what will ultimately help drive down the number of patients boarding in the ED for limited inpatient beds by giving people more resources outside the hospital. This program being considered is specifically for teens and children, but I would like to see these services expand to adults. I can think of many patients who would have had a higher chance of success reintegrating into their daily lives if they had post-hospitalization supports. Wrap-around services are not covered by private insurance, and until they are, we need our state to support our most vulnerable if we expect our children to thrive.
SB 647 offers critical support to New Hampshire residents having difficulty affording medications. It is distressing to me how often my patients have to go without the medication that is best suited for their condition. Patients often have to cope with unpleasant side effects or a reduction in effectiveness when out-of-pocket costs for the ideal medication are too much to bare. Their psychiatric condition suffers when we have to settle for the runner up (or even third line) solution. Also, when my patients can’t afford their medications for their physical conditions, whether it’s chronic or acute medical issues, their mental health also suffers in a way that psychiatric treatment cannot address.
The crisis of high-cost medications has innumerable negative downstream effects to our community, our economy and our own personal lives. There are some options for savings on drug costs, but they don’t go far enough. Most coupon discount programs from the drug manufacturers exclude Medicare and Medicaid plans. Most of those same programs require insurance to cover the medication to some degree. GoodRx can provide savings that may help, but patients have to pay fees to get the most out of that program.
Having a statewide program that all residents can access fills a massive gap in care and keeps our community healthy & safe.
Also: Buying medications online from pharmacies outside of the U.S. is a very dangerous thing to do. And yet, people do it all the time because they can’t access the care they need. And the consequences can be extreme when the medication is fake or otherwise isn’t safe for consumption. (Please note, I am talking about online orders, not legitimate pharmacies when traveling or living abroad.) Patients are desperate and they think because they’re ordering a medication they’ve taken before, it won’t hurt them. And that can be a fatal mistake.
It’s pretty simple: Allowing residents of New Hampshire access to affordable medications and wrap-around services will improve the health and wellness of our community. Please support these bills.
Aslynn J. Romano is a psychiatric nurse practitioner and the founder of Neurospace: Affirming Psychiatry & Counseling. She lives in Concord.