Psychiatric problem years in the making
Concord MonitorFeb 27, 2017
Monitor staff
Four years ago, mental health workers called a press conference to ring the alarm. On any given day, nine people sat in
“Access to timely mental health care in
Last Monday, 68 people were waiting – the latest record high. No one sent a press release, no one called a news conference. The wait list for admission to
“What other illness would we allow people to suffer like this without treating them?” Norton said last week. “It’s absolutely inhumane.”
While there’s agreement on the problem, the mental health community is divided over the fix. Should the state spend to build more beds, or fund only community-based care meant to keep patients out of the hospital?
Right now the state is pouring most of its resources into the latter to comply with a 2014 mental health settlement. The agreement resolved a lawsuit alleging patients were needlessly institutionalized because they couldn’t get mental health treatment in their own communities.
A group involved in the suit says fully implementing those community services, like supportive housing and mobile crisis teams, will “dramatically” reduce the needs for beds at a fraction of the cost.
“We really don’t think the answer to the psych boarding problem is to increase the bed capacity,” Disability Rights Center –
But a consensus is growing among providers that expanding community care alone isn’t enough to solve the wait list crisis – the state needs more beds.
“Part of the solution is more inpatient beds, whether people want to hear it or not,”
In his budget plan, Republican Gov.
Health and Human Services Commissioner
“We do have to take a serious look at adding some additional inpatient beds in the state of New Hampshire,” he said. “Those don’t have to be at
Across the country, the reliance on so-called psychiatric boarding is up as the number of inpatient beds has declined.
The wait list at
Health professionals suggest states should have at least 40 to 50 psychiatric beds per 100,000 people.
Between 2005 and 2013 the state’s psychiatric bed count fell from a total of 526 to 384, according to the
No beds are left in the North Country after
The state’s community mental health centers treat roughly 50,000 patients a year, according to the association. But the centers have also struggled to recruit workers and say the state hasn’t increased their
The wait time for an appointment at one of the 10 centers can be weeks or a month. During that period, patients’ conditions can worsen and land them in the emergency room.
The state is making some strides, but slowly. After a year-long delay, the new 10-bed crisis unit is up and running at
The state is spending roughly
Advocates say the state can’t fix a problem overnight that has been building for years.
“The system is so weakened it is very difficult to produce these new demands,”
As the number of people waiting to get into
But first he had to wait three days for a bed to open. He spent the time bouncing between the bustling hallway of Concord Hospital’s emergency room, a windowless psychiatric holding pod where a video camera in the corner monitored his every move, and the pediatric wing. Instead of treatment, Meister got stress.
“I was feeling really nervous inside,” Meister, who was diagnosed with a mood disorder, said about the ordeal. “I was always moving.”
Not all mental health patients in the emergency room end up in
Almost all patients sent to the state hospital are involuntarily committed, meaning doctors deemed them a danger to themselves or others. Once an involuntary determination has been made in the emergency room, the patient can’t be released.
The wait time puts pressure on emergency room physicians and nurses, who must spend hours of staff time monitoring potentially suicidal patients. For patients, the days or weeks spent in a sparsely furnished holding room or in a noisy hallway can exacerbate a psychiatric crisis.
The weeklong wait at
“It sucked,” said Ryan, who declined to give his last name for privacy. “Being stuck in a room isn’t really going to make me feel better. I spent most of the week with the door closed, the lights off and the TV on.”
For parents, the long waits are just as frustrating.
“My daughter is an amazing kid who has a huge future ahead of her, only if she can get the help she needs,” she said. “All the times she spends sitting in a bed in the ER is just taking away from her future.”
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