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N.H. Senate To Take Up Mental Health

Valley News - 4/23/2017

Concord Monitor

Concord — Republican Senate leaders unveiled a proposal on Friday to dramatically expand the number of mental health treatment beds in New Hampshire. The proposal comes in response to the growing number of psychiatric patients who have been forced to wait days or weeks in hospital emergency rooms before getting help.

The measure calls for the state to contract with private hospitals and nonprofits to setup 68 new beds that will range in care, from patients in psychiatric crisis who are committed involuntarily to those who are transitioning back into the community.

“We’re obviously not trying to warehouse people, but the reality is so many people are in emergency rooms, we have got to have some beds,” said Senate Majority Leader Jeb Bradley, the proposal’s prime sponsor. Though the measure’s full cost has yet to be finalized, Bradley estimated the total at $6 million.

New Hampshire has struggled in recent years with a growing waitlists for entry into the state psychiatric hospital and other beds authorized for patients with the most serious mental health needs. The list reached a record high this winter when 68 people in psychiatric crisis languished in emergency departments around the state waiting for beds to open.

Under a settlement agreement, the state has been funneling millions of dollars into community mental health supports, which are meant to keep people out of the hospital. A growing number of providers and advocates say the state needs to add more beds to address the waitlist crisis.

Health professionals suggest states should have at least 40 to 50 psychiatric beds per 100,000 people. New Hampshire has just 11.9, according to the Treatment Advocacy Center. Due to budget cuts and a workforce shortage, between 2005 and 2013 the state’s psychiatric bed count fell from a total of 526 to 384, according to the Foundation for Healthy Communities. Over the last decade, New Hampshire Hospital’s bed count has gone from over 200 to roughly 160 now, state officials say.

The measure wouldn’t add more beds at New Hampshire Hospital, but call on the state to contract with private entities. Twenty beds would be for people who are deemed a danger to themselves or others and need to be involuntarily committed. Forty would go to transitional and community residential beds, specifically for those who have recently left New Hampshire Hospital. And eight would be “peer crisis respite beds,” meant to take pressure of emergency rooms. The legislation would also set up another mobile crisis unit, which treats patients in their own homes, instead of at the emergency room and state hospital. The measure will come up for a public hearing on Tuesday.

The bill’s text debuted on Friday, hours after Republican Gov. Chris Sununu visited the emergency department at Concord Hospital, where 12 patients were waiting for a bed to open up at the nearby state psychiatric hospital. At one point recently, 22 of the emergency department’s 37 beds were occupied by patients with mental health issues.

After the visit, Sununu called for more beds at the New Hampshire Hospital as part of a “long-term redesign and reengineering” of the mental health system. He voiced support for Bradley’s bill.

“We have to get aggressive abut how we will deal with that backlog,” he said. “If you don’t pay for it in the beginning, you are going to pay for it five times as much down the road.”