Patient Wait Time Hits New Record

Despite a renewed commitment to funding mental health services in the state budget, passed two months ago, a record number of people suffering a mental health crisis waited overnight for a bed at New Hampshire Hospital.

Last Monday, 47 people waited in local emergency rooms for a bed to become available at the state hospital.

The previous record was set in February, when 44 people, 18 of them children, lingered in emergency rooms.

Waiting in an emergency room often exacerbates the mental health crisis that drove a patient there in the first place. An overload of such patients also causes ripples of tension in emergency rooms, as beds and personnel, including security, are occupied by their needs.

Late last week, after the waiting list had fallen to 31, one adult and one child waited at Concord Hospital to be transferred to the state facility. But last weekend, there were 11 psychiatric patients waiting — in an emergency department designed to support six, said Camille Kennedy, director of behavioral health services.

The surge in need is especially concerning for mental health experts in the state because of the timing. Providers expect the wait list to grow in October, particularly among children with mental illnesses as they adapt to the first few months of school.

“That’s something that has been historic, something we know is a trend that has existed and the mental health centers have tried to address,” said Roland Lamy, executive director of the New Hampshire Behavioral Health Association. “The fact that we have this spike now and we’re just approaching what we think is the real spike is very troubling.”

Members of the association met Wednesday to discuss the situation, and decided they need more data before they can establish a plan, Lamy said.

The group plans to connect with members of the state hospital association to assess demographic and diagnostic information about people who are seeking or being committed to care, and look at potential regional trends and solutions.

“We’re looking for, are there specific diagnoses or trends that are happening that we’re not used to, or is it just a sheer spike in the number?” Lamy said. “Are more people coming from a particular region because of the community services aspect, and do we need to work more collaboratively among ourselves to help with community services?”

Lamy said while the number was saddening, it was not surprising.

“This is, I hate to keep saying the same thing over and over, but this is part of what we saw coming when we developed the 10-year plan in 2008,” he said. “When we said in 2008 this was a matter of life and death, we were not being provocative. We were telling what we expected to happen.”

The 2008 plan called for 12 assertive community treatment (ACT) teams to respond to patients in crisis and prevent hospitalizations. Most of those teams were never established or never funded for 24-hour coverage. The plan also called for 132 new residential treatment beds, which haven’t been established, either.

The state budget increased funding for mental health services by $28 million over the next two years. Part of that funding is responsible for a new 10-bed unit expected to open in Franklin in October and increased ACT team availability in most of the state. However, most of the funding increases become effective in the second year of the biennium.

“We thought about asking to move some of those dollars to the first year,” Lamy said, “but the unfortunate reality is the state is in a tough economic situation. Maybe that’s the solution, maybe that’s something we need to ask for, but we wanted to be careful in the ask, so that those people who make the decisions have all the data that they need, and that’s something we don’t yet have.

“We really appreciate the support the governor’s given us this year but ... we knew this was coming. We did everything we could to educate people about what was needed, and we are still working because this is not a one-year effort, and it’s not a two-year effort. It was a 10-year plan for a reason.”