The waiting list for inpatient psychiatric services hit zero. Will it last? 

  • New Hampshire Hospital in Concord as seen on Tuesday, July 5, 2016. (ELIZABETH FRANTZ / Monitor staff) Elizabeth Frantz

Monitor staff
Published: 6/9/2021 4:36:39 PM

This week, the number of adults waiting in hospital emergency departments for psychiatric treatment dropped to zero for the first time in more than a year. 

The state cleared the waiting list by offering a $45,000 per bed incentive for nursing homes willing to house geriatric patients from New Hampshire Hospital. This move opened up 25 beds for those waiting in hospital emergency rooms. 

The Department of Health has faced pressure to rapidly clear patients from emergency rooms after the New Hampshire Supreme Court ruled last month that psychiatric patients being held involuntarily in emergency rooms must be given a chance to contest their detention within three days of their arrival.

Often, people deemed to be in crisis must wait days or weeks in the emergency rooms for a bed in one of the state’s psychiatric facilities to open up without an opportunity to challenge the involuntary admission.

Lori Shibinette, the Commissioner of the Department of Health and Human Services, said while this record low is beneficial for patients who are no longer waiting in the emergency room, it may not be indicative of substantive changes to the mental health system.

She knows because this strategy already played out in New Hampshire last year, when the state moved juveniles from NH Hospital to new beds at Hampstead Hospital and the number of children on the waiting list dropped to zero in March.

“Within two or three months, our waitlist came back up again,” she said.

She sees this empty waiting list as a short window to quickly stand up long-term mental health infrastructure. Gov. Chris Sununu announced he would allocate $100 million to do just that.

The money will go, in part, towards funding community mental health resources.

One of the first ways DHHS plans to expand community resources is by opening 60 new transitional housing beds, six at each of the state’s community mental health centers, by Jan. 1.

The department has attempted other strategies to comply with last month’s ruling, including proposing legislation that would create a new system for the involuntary detainment of patients in emergency rooms.

The new system would allow hospitals to detain and assess patients who need help but not necessarily inpatient psychiatric care, such as elderly patients with dementia and those with substance abuse problems.

“It is meant as a tool for the provider to hold an unsafe person for up to three days whose condition is not related to a serious mental illness and get them on the right path,” Shibinette said. “That may be substance abuse rehab, that may be long-term care, or that may be a voluntary admission.”

The Disabilities Rights Center, New Hampshire chapters of the American Civil Liberties Union, and the National Alliance on Mental Illness argued that the legislation would weaken due process and result in patients spending more time detained.

On Wednesday, the Senate Health and Human Services Committee voted 4-0 against adding the language as an amendment to an unrelated bill.

“We continue to address barriers to mental health care, and are working with our partners to create new and innovative practices and programs to serve our residents long term,” Shibinette said in a press release. 

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