Needs for children not met by New Hampshire's mental health care system


Monitor Staff

Published: 02-13-2023 5:05 PM

Lisa Colburn, a schoolteacher who lives in Weare, woke up to a knock on her front door and bright blue lights flashing outside.

On a Saturday night in December two years ago, the police had come to ask for her daughter. She had texted a friend about killing herself, and her worried friend called the police.

That was the start of the family’s harrowing mental health journey.

Colburn said she is best friends with her 14-year-old daughter. They paint, do makeup and journal together. But providing the right treatment for her daughter’s mental health strained their relationship, and Colburn found herself taking on the role of concerned mother more frequently than usual.

As friends, it seemed like they could talk about anything. But when it came to discussing mental health needs, her daughter was a little reluctant. It frustrated Colburn when her daughter couldn’t say what was causing her to hurt herself over and over again. All Colburn wanted was to find a way to help her daughter.

“She wants to get better. It’s not like she’s enjoying the feelings that she has,” said Colburn. “We’ve been talking to her a lot about how she has to work on herself as well and it can’t be just us (parents) doing all the work for her.”

Over the next few months, her daughter saw several area mental health professionals, and on occasions the counselors either left the practice, canceled appointments or simply said they couldn’t help manage her symptoms. Her daughter continued to harm herself, and Colburn sought assistance from the New Hampshire Rapid Response Access Point Helpline several times to help her daughter at times of crisis. Oftentimes, Colburn felt lost but she didn’t give up.

The rapid response helpline dispatches the state’s mobile crisis response team for New Hampshire residents experiencing immediate behavioral health emergencies. Prior to the helpline’s launch, all mental health emergency calls would be handled by police.

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On the advice of the mobile crisis team, Colburn decided to have her daughter admitted to an inpatient treatment facility. But her daughter was transferred from hospital to hospital and was placed on long wait lists.

New Hampshire’s mental health system is currently overwhelmed, and the situation only worsens for children with mental health difficulties. The only facility that will accept children for inpatient treatment is the state-run Hampstead Hospital.

In an annual report released earlier the month, the New Hampshire Office of the Child Advocate, whose primary role is education on existing systems and referrals to services, called for immediate action on the state’s mental health system due to a lack of resources.

“The increase of child needs, coupled with the already overwhelmed mental health system, have created a bottleneck, preventing children from receiving appropriate care in a timely manner,” the report stated on the newly established children’s health system, which will take time to fully implement.

Cassandra Sanchez, the state child advocate, said that if children with mental health needs do not receive adequate care at the community level, their needs escalate to the point where they end up in emergency rooms waiting for placement at Hampstead Hospital.

After sleepless nights and countless phone calls to healthcare providers, Colburn hoped her daughter would improve, if not feel completely better, when she was finally admitted to Hampstead Hospital. But she was disappointed by the level of care.

Colburn described their hospital stay as a “daycare for teenagers,” with no proper treatment or counseling provided. The entire time at the hospital was completely pointless, she said.

“We need more than just one facility for children,” said Colburn about the state’s mental health treatment facilities. “And we need that facility to be 100 times better than what it actually is.”

According to a statement from Hampstead Hospital, each patient is assigned a treatment team comprised of a psychiatrist or nurse practitioner, a social worker and a case manager. When necessary, a behavioral analyst is also assigned to the team.

“Within eight hours of admission, the treatment team initiates a customized treatment plan,” the hospital stated.

Less than a month after her daughter was discharged from Hampstead Hospital, she began overdosing on pills. Colburn had to go through another round of counselors, psychiatrists and hospital wait lists to get her daughter more help in an attempt to save her life.

Colburn said she heard every excuse when was she called treatment facilities in the state.

“We don’t take children under 16.”

“We have a waitlist.”

“We’re full.”

“We’re not accepting new patients.”

“We don’t take insurance.”

One problem is a lack of staffing.

Roland Lamy, the executive director for the New Hampshire Community Behavioral Health Association, said that state facilities had approximately 337 open clinical positions across their mental health centers as of December.

“It has begun to taper off a little bit, but we still have challenges getting people back to work and working with them in hybrid settings,” said Lamy.

In some instances, professionals with sought after expertise or skill set have gone to neighboring states for employment, which pay more, said Sanchez.

“We need to make sure that the pay is substantive so we can keep the people in New Hampshire and also bring people into New Hampshire,” Sanchez said.

With no availability of treatment options for her daughter, Colburn decided to look for treatment options outside of New Hampshire. After nearly a year of hopping from hospital to hospital, her daughter began to receive treatment at a Massachusetts facility, which finally started to help.

In Massachusetts, there was a similar waitlist, but Colburn said doctors were more hands-on and communicated better about treatment options. If she didn’t have private insurance, she often wonders how she would have helped her daughter. The thought terrifies her.

“I feel like New Hampshire is doing a huge disservice to our children,” Colburn said. “I know there are a lot more resources in place for adults who are having mental health issues in our state and there’s barely anything for children.”

The difference between New Hampshire and neighboring states is that New Hampshire’s child-care system is less developed, explained Sanchez. Massachusetts has had a child care system for a long time, and by moving in the right direction, they are able to build on what they have. Meanwhile, New Hampshire’s system will take time to demonstrate through data that the services are effective, she said.

After being treated in a crisis management center in Massachusetts, Colburn says her daughter is doing much better.

She is now in a step-down program in Connecticut that is less intensive than a lockdown facility. She is not isolated, receives therapy, has a group of friends and works with horses.

Once her daughter is out of the program in Connecticut, Colburn plans to drive her 90 minutes back and forth to Hopkinton, Mass., where she found a therapist who could help her daughter.

Looking back on her family’s journey, Colburn said she is exasperated by the lack of treatment options in the state.

“I’ve always loved New Hampshire, and I am incredibly disappointed and disgusted that in order to get help for my daughter, I have to leave the state because there is nothing here in New Hampshire to help kids with mental health needs,” said Colburn.