My Turn: To give patients the care they deserve, build a new SPU

For the Monitor
Published: 5/1/2019 12:15:21 AM

For decades, New Hampshire’s approach to mental health services has consistently exposed the human and economic costs in not meeting basic needs to ensure that people get care that is both high quality and delivered with dignity.

We would not stand for this type of delivery system to treat any other illness. This is a collective failure that rests with all of us. And so, too, does the solution.

A comprehensive approach is needed to address the failures and shortcomings of the past. Yet, a solution to our state’s mental health crisis is within our grasp. Do we have the will to seize the opportunity for a comprehensive solution?

As the former commissioner of the Department of Health and Human Services, I had long encouraged elected officials to act. Often, the resources simply were not available, but now the resources to bring a much-needed overhaul to the Granite State’s mental health system are now there and the components of a solution are within sight.

Left out of the traditional discussion on the building blocks for a new system is a Secure Psychiatric Unit (SPU). Stakeholders throughout New Hampshire’s mental health community of providers and patients agree that a new SPU is a critical component for providing quality, dignified care that people deserve. This vital asset is an essential element and the absence of it compromises system change efforts.

In his budget proposal, Gov. Chris Sununu offered a thoughtful and well-considered approach to fund the creation of a new SPU. This serves to fulfill several critical goals outlined by the state’s 10-year Mental Health Plan. The investment would allow for the construction of a new 60-bed forensic facility on the grounds of the New Hampshire Hospital, while also building 50 new transitional beds around New Hampshire. An investment of $40 million in the fiscal year 2020-21 budget does more than just fund the construction of one hospital. Rather, it represents a foundation upon which New Hampshire’s entire mental health system benefits.

It’s disappointing that the New Hampshire House of Representatives recently opted to forgo the governor’s proposal and instead appropriated just $1.2 million to further study the design of a new SPU. We need action, not a study.

As I write this, people in need of mental health treatment continue to be warehoused in the hallways and emergency rooms of New Hampshire hospitals for weeks on end. That alone is unconscionable, but civilly committed individuals, who are neither accused nor convicted of any criminal behavior, are housed in cells and behind barbed wire fences at the New Hampshire State Prison. This is just wrong. This is not a matter for politics. This is a matter of doing what is right for the dignity of people and their families.

Recently, some in the Legislature have proposed moving children out of the New Hampshire Hospital to a new facility and using that space to instead house the civilly committed population. This proposal misses the mark.

In my years at DHHS, I was required to sign off on any transfer from the N.H. Hospital to the SPU. These individuals had very, very complex conditions and need a facility specifically designed with their needs in mind.

All that remains to improve the treatment, care and lives of our friends, neighbors and family members living with unmet mental health needs is for legislators to act. We must speak up and let our voices be heard.

The state of New Hampshire’s mental health crisis has been studied by legislators in Concord since 1980, and yet little substantive action has been taken. It is only through action – not continued studies – that progress will be made to resolve New Hampshire’s mental health crisis and provide our patients with the care they deserve. I urge the Senate to allocate the full $26 million, as passed by the body in an amendment just weeks ago, in its budget to build a new SPU.

(Nick Toumpas is the executive director of Connections for Health. He served as commissioner of the N.H. Department of Health and Human Services from 2007 to 2016.)




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