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Editorial: Delayed Treatment; Fixing the Mental Health System

Utter indifference is no longer official state policy in New Hampshire when it comes to providing adequate services to the mentally ill, thanks to changes made by Gov. Maggie Hassan and the Legislature this past year. That the state cannot quickly undo the damage that was done before the change was made was clear in yesterday’s story about the record number of people suffering a mental health crisis but being forced to wait for appropriate medical treatment.

According to the Concord Monitor story, the number of people in hospital emergency rooms around the state waiting for transfer to the New Hampshire Hospital hit 47 people last Monday, eclipsing a previous record of 44 set in February this year. Particularly worrisome is the likelihood that those numbers will grow in the very near future: October tends to be a bad month because the challenge of adjusting to a new school year can trigger crises among students who have mental illnesses.

Hospitals are in the business of caring for sick people, of course, but few have the resources to handle large numbers of people in the throes of a mental health crisis. Being forced to do so amounts to a drain on their staff and facilities, but it is particularly unfortunate for the patients who must wait for a transfer. Delayed access to appropriate treatment doesn’t merely postpone a return to health; it can make a patient’s ongoing crisis more severe.

For the first time in a while, New Hampshire residents can take some solace in the knowledge that improvements are in the works. The New Hampshire Hospital recently expanded its number of beds by 12 — increasing its capacity to 142, still a far cry from the 250 beds that the facility had available just three years ago — and Health and Human Services Commissioner Nick Toumpas has initiated several other changes to shore up the system. More encouraging was the commitment made by the Legislature, which voted to increase spending on mental health services by $28 million over the next two years. A substantial portion of that funding will go toward improving community-based services that offer the best hope of providing the sort of help needed to avert the crisis situations that require hospitalization.

But it will take time before the people who need these services actually benefit from the state’s renewed commitment — not just because much of the increased spending won’t take place until the second year of the budget cycle, but also because it takes time to restore a system that has been allowed to fall into disrepair and dysfunction.

New Hampshire Behavioral Health Association Executive Director Roland Lamy traces the current crisis back to 2008 when the state put together a 10-year plan for addressing its shortcomings in mental health care but then chose not to fund it. “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,” he said. “It was a 10-year plan for a reason.”

Advocates have considered asking that more funding for expanded services be shifted to the first year of biennium, but are reluctant about pushing too hard because of the state’s budgetary circumstances — and also because they want to have good data to support any such request.

To which we say: Don’t be shy; people are suffering, and the state needs to know — or, more accurately, be reminded of — how far short it is falling in providing adequate treatment.