Record number of patients waiting for state hospital beds

Last modified: Monday, February 11, 2013
There were 44 people, 18 of them children, lingering in emergency rooms this week, suffering a mental health crisis and waiting for a state hospital bed. Mental health advocates said it’s a new high, especially among children.

And those numbers come after state hospital officials recently added eight temporary beds by converting four visiting rooms into patient rooms.

Still, on Friday, advocates said they were told there would likely be no openings at the state hospital until later this week, leaving emergency rooms to put patients in hallways or in beds intended for people with medical emergencies.

Those waiting include a 9-year-old boy who by Friday had been at Concord Hospital’s emergency room for five days, said Louis Josephson, chief operation officer at Riverbend Community Mental Health.

The boy, a sexual assault victim, had been sexually assaulting others and had become so distraught at the emergency room he needed to be restrained and medicated, Josephson said. “It just feels like it’s 1939 again,” Josephson said, “where we are restraining people and injecting people with medication.”

Another child, who had reported both homicidal and suicidal feelings, was waiting in the Concord emergency room until his mother left because she wasn’t feeling well, according to information Josephson received from emergency room staff. The police were informed and were looking for the boy.

Messages left with the Department of Health and Human Services, which runs the state hospital, were not returned Friday.

Mental health advocates like Josephson have long been monitoring the waiting list at the state’s emergency rooms, and have sounded an alarm in the past, mostly recently in March when a then-record 21 people were awaiting a state hospital bed.

Now there is someone else watching the waiting list too: At her request, Gov. Maggie Hassan has been receiving a count of people waiting each morning. Mental health advocates hope that interest is a sign that Hassan will include money in her budget for the community-level services they say will keep people from needing emergency hospitalization.

Marc Goldberg, Hassan’s spokesman, declined Friday to reveal what initiatives Hassan will put in her budget, to be released Thursday. But he said Hassan takes the concerns of mental health patients and advocates seriously.

“Gov. Hassan has asked for regular counts because she believes that the state of our mental health system is a pressing challenge and wants access to the most up-to-date information,” Goldberg said in an email Friday. “The governor is currently working to finalize the difficult decisions needed to balance the budget while protecting New Hampshire’s priorities, including providing access to mental health and health care services.”

There’s a dispute over how much money the state should allocate now to mental health care.

Health and Human Services Commissioner Nicholas Toumpas said in December he would ask lawmakers for an additional $10 million to increase local community services and to add 12 beds at the state hospital.

The Community Behavioral Heath Centers, which includes Riverbend and its peers across the state, have said that’s not enough. And they’ve pointed to the increasing numbers of people waiting in emergency rooms as a reason for urgency.

In January, the group said the state needed to invest $37.6 million over the next two years to improve the kind of community level care that costs less than a state hospital admission and has proven to be more effective.

The group said that level of investment – in local counseling services and housing – would get the state up to date on the 10-year plan it adopted in 2008 to improve mental health care.

On Friday, Josephson said he and others community mental health leaders had recently provided Hassan a list of their top priorities. That list was not available Friday.

“I don’t think that there is anyone that can say the inpatient crisis doesn’t need to be addressed,” said Jay Couture, executive director of the Seacoast Mental Health Center. “It’s not acceptable. One of the ways to deal with that is to make sure we have adequate outpatient services in the community.”

Josephson, Couture and other mental health advocates met with Hassan about two weeks ago, before sending her their list of priority investments. “I do know the governor is very concerned,” Josephson said. “I heard it in her voice and I think she’s very sincere. I think it’s a question of what to do and where is the money?”

Like many others hoping to see more money from the Legislature this year, Josephson said he’s wondering whether Hassan will included revenue from a casino in her budget, and whether that would help her increase mental health investments. Hassan has said she favors a single casino in the state, but lawmakers haven’t yet debated bills seeking to legalize a casino.

One bill anticipates the state receiving $80 million for the license to run a casino.

Goldberg wouldn’t say Friday whether any of that anticipated revenue would appear in Hassan’s budget on Thursday.

“The governor supports bringing one high-end, highly regulated casino to New Hampshire because it would create thousands of jobs and help the state invest in priorities that are critical for success in an innovative economy,” Goldberg wrote in an email. “She appreciates the work being done by members of the Legislature to develop a casino plan that protects New Hampshire’s brand as a family-friendly state with a great outdoor economy, and she looks forward to working with them as the process continues.”

(Annmarie Timmins can be reached at 369-3323, atimmins@cmonitor.com or on Twitter @annmarietimmins.)