Editorial: An urgent need to rebuild mental health system

Last modified: Tuesday, April 16, 2013
The Monitor’s recent series on the slow-motion collapse of the state’s once-renowned community mental health care system was titled “In Crisis.” The name comes from the description of the system used by the federal Department of Justice when it joined a lawsuit against the state over its failure to adequately care for people with a mental illness. The stories, by reporters Annmarie Timmins and Sarah Palermo, were alternately heart-wrenching and inspiring. The pain of the mentally ill was palpable, the tribulations of their families seemed never-ending. But then there was the story of Pam Brown, the mother of an adult son with a mental illness, who joined with others to open a family-run, peer-supported clubhouse in Manchester to give the mentally ill a place to meet, make friends, get support that includes help securing employment and help each other manage their illnesses.

Many more such efforts like Brown’s Granite Pathways are needed, but to survive long term, they will require some degree of state and federal support. Budget hawks should stifle their groans. Every dollar invested in mental health care in the community saves $7 in avoided hospitalization, incarceration, police expenses and other costs, according to the National Association of State Mental Health Program Directors.

The series showed, yet again, that what New Hampshire created as a model mental health system in the 1980s, a system based on providing those in need of mental health services maximum treatment and support in a community setting as opposed to an institution, is what’s needed again today. Patients, providers and lawmakers have known that all along, yet year after year, for want of state support, the once-great system unraveled. Now it must be rebuilt. We applaud Gov. Maggie Hassan for her willingness to commit $28 million towards the task. We wish it were more, and fear that it won’t be nearly so much, given the state’s unwillingness to raise revenue.

It’s nearly impossible, even for well-grounded people, to preserve mental health in isolation. What people with a mental illness need is what all but the most devout loners need: contact with fellow human beings and emotional support. Community-supported housing like the many group homes that have closed for want of funding provide that support. So do programs like Granite Pathways and, in Concord, Riverbend’s Step Up day program that helps the mentally ill develop the supports and life skills needed to live independently.

The governor’s budget proposal includes many measures contained in a 10-year plan to rebuild the mental health system that was never funded. All of the measures – more short-term beds for people in a psychiatric crisis, group homes, peer-support organizations, and funding for community mental health center services – deserve lawmakers’ support. Needed too, is more help on the federal level. The Affordable Care Act, by making many more adults eligible for mental health services under Medicaid in states that expand access, will help. But legislation like the Excellence in Mental Health Act, introduced last month by Michigan Democratic Sen. Debbie Stabenow, is also a must.

The act sets national standards and an oversight system for the community behavioral health clinics that treat the one in five Americans who suffer from a mental illness or an addiction. It calls for integrating mental health and substance abuse care with all other medical care to remove barriers that currently work to the detriment of each. In exchange, it gives the clinics access to increased federal funding. The act has bipartisan support because mental illness and addiction are not partisan issues. Each could strike in any family. New Hampshire’s congressional delegation should support Stabenow’s proposal. And state lawmakers should find the funds necessary to do right by their neighbors with a mental illness.


Friday’s editorial included an incorrect figure for the cost of a recent auto repair bill paid by state Rep. Marjorie Porter. It was $780.