Jean Lewandowski is chair and Deb Yuknewicz-Boisvert vice chair for the PAIMI Advisory Council.

The Protection and Advocacy for Individuals with Mental Illness (PAIMI) Advisory Council (PAC) invites readers to join us in recognizing May as Mental Health Awareness Month. This observance was established in 1949 to increase public understanding of challenges, end age-old stigmas, and recognize the many accomplishments of those who live with mental illness and advocate for the emotional and mental well-being of every person.

The PAC is part of the Disability Rights Center New Hampshire (DRC-NH), whose mission is to protect, advance, and strengthen the legal rights and advocacy interests of all people with disabilities. The PAC is a group of volunteers from around the state who have lived experience and/or expertise in health care, education, and legal services relating to mental health. We use our knowledge and experience to help inform DRC-NH’s priorities relating to people with mental illness.

One of those priorities is to advance statewide policies and practices that support a continuum of care for people with mental illness, as detailed in the state’s most recent 10-year Mental Health Plan, adopted in 2019, with an emphasis on community-based services. One of DRC-NH’s and the PAC’s paramount priorities is to expand access to community-based services and to avoid institutionalization whenever possible.

New Hampshire’s continuum of care should enable people who experience mental illness to access services within communities where they live, work, and attend school, thereby reducing the need and frequency of disruptive, expensive, and traumatizing emergency room visits and hospitalizations. The continuum of care should also include services that facilitate transition from more intensive care environments when those are needed to community-based services for successful re-integration into homes and communities.

Another priority for DRC-NH and the PAC is prioritizing community-based services over institutional care for children with emotional and behavioral challenges who are in the state’s foster care system or otherwise are in the state’s custody. The need for this legislation became tragically clear recently, as information came to light about neglect and abuse of children in residential placements. The state must establish the presumption that remaining in the family home is in the best interest of children. But, if remaining in the family home is not in the child’s best interest, preference must be given to homes of other relatives or people with whom the child has a relationship. If there are no suitable options, then the state may consider other community-based alternatives, such as foster family homes.

We believe that children should not be placed in institutions unless they require such a placement to meet their needs. Institutional placements must also be viewed as time-limited and only for the purpose of providing needed treatment and services, with a goal of returning the child to their community as quickly as possible. Further, the Department of Health and Human Services (DHHS) must closely monitor the care that these children are receiving and the facilities where they’re placed.

Residential facilities are the most restrictive setting and are appropriate only for children whose treatment needs cannot be met safely in the community. The best interest of the child must be the paramount consideration; a shortage or lack of foster homes or community-based resources is not an acceptable reason for placement in a residential facility.

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The state must reduce out-of-home and institutional placements and instead focus on helping families and protecting children. This is both best for individuals and cost-effective for the state, as residential placement and hospitalization are by far the most expensive settings for any kind of care.

The NH legislature is currently considering legislation to address some of these issues in SB 417 and other bills. We ask readers to join us in contacting your elected representatives, the NH Department of Health and Human Services, and the Office of Child Advocate to support adoption and funding for policies that honor the responsibility to care for the most vulnerable among us and support the health of every Granite Stater.

Contact information is at The General Court of New Hampshire (gencourt.state.nh.us/). Your testimony and advocacy have a powerful influence on their decisions.

Residents of NH seeking advice, support, or legal assistance concerning the rights of people with disabilities can contact DRC-NH at drcnh.org; (603) 228-0432; TDD 1-800-834-1721; FAX (603) 225-2077; mail@drncnh.org. All services are confidential and free of charge.