Editorial: The state owns up to its responsibilities

Last modified: Sunday, December 22, 2013
When it comes to doing the right thing for New Hampshire’s most vulnerable residents, change often comes under duress, at the order of a court. That’s been true in cases involving people with developmental disabilities, public school children from poor communities and inmates at the state prison.

It seemed for a time that the same would be true for people with mental illness – that only a federal judge would be able to force the state to do what it must to provide a humane and just system of support and treatment outside of institutional care.

But with the announcement of a settlement last week, state officials embraced the challenge on their own. It is to their significant credit that they have agreed to do the difficult and, initially, expensive work of restoring New Hampshire’s mental health system to a level of quality residents can be proud of. Indeed, Gov. Maggie Hassan’s public statement – in which she described the system as “deeply strained” and “one of the most pressing challenges facing our state” – shows how far the government has come in even acknowledging the depth of the problem.

And, in fact, it was the commitment of Hassan and the Legislature in the new state budget to increase state spending on mental health services that gave advocates some confidence that the state was serious.

At issue was a lawsuit brought against the state in 2012 by the Disability Rights Center and the U.S. Department of Justice on behalf of six plaintiffs. The lawsuit argued that because New Hampshire does not provide adequate community treatment services for people with mental illness, patients often end up unnecessarily institutionalized. Three of the plaintiffs were in the state psychiatric hospital in Concord or at the Glencliff Home, a state-run nursing facility in the northern part of the state. The other three had spent time in and out of emergency rooms and the state hospital. The lawsuit characterized them as “at serious risk of being institutionalized.”

The state has agreed to pursue several methods of keeping patients out of the hospital and helping them live independently. It will expand supported housing to include at least 450 supported housing units. It will significantly expand community treatment and supported employment programs. And it will introduce new mobile crisis services in and around Concord, Manchester and Nashua.

The new services will cost the state an additional $6 million in the current budget, and $23.7 million in the 2016-17 budget. But in the long run, helping people stay out of the hospital will be cheaper for taxpayers – not to mention far preferable for the patients involved.

Will the state keep its word – not just in the first few years, but over the long haul? Impossible to say. Two decades ago, state officials were rightly proud that they had created a mental health system that was a model for the nation. But the unwillingness of politicians to property finance it created a steep decline.

Clearly last week the state acknowledged the futility in defending the status quo; with luck, future politicians won’t have to learn that lesson twice.