Letter: Medical/psychiatric inpatient service needed in N.H.

Published: 10/9/2019 12:01:18 AM

Timely access to inpatient mental health care continues to be problematic for residents of New Hampshire, especially for patients with combined medical and psychiatric illness. These patients are often declined for inpatient psychiatric care as they are deemed too clinically complicated and medically risky.

The medical conditions of these patients adversely impact their psychiatric status and response to mental health treatment. This contributes to a poor quality of life, including worsening ability to perform everyday activities of daily living.

When admitted to medical inpatient services, the psychiatric needs of these patients are often undertreated, Following discharge sizable numbers are readmitted fairly quickly to emergency departments for urgent mental health assessment and the search begins for an elusive psychiatric bed.

Some patients (usually those over the age of 65) with concurrent medical and psychiatric illness are admitted to geriatric psychiatry inpatient services. However, declines still occur, particularly when the case involves one or more relatively acute medical conditions that require careful monitoring and treatment.

The establishment of a designated medical/psychiatric inpatient service located within a general medical hospital is long overdue in New Hampshire. This is a critical care need for an underserved group of mental health patients.



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