News Primer
6:00 am
Tue January 21, 2014

News Primer: Fixing New Hampshire’s Mental Health System

Attacks by two psychiatric patients awaiting treatment at Manchester’s Elliot Hospital last year underscored the well-documented problems with New Hampshire’s mental health system.

In December, the state agreed to settle a federal lawsuit filed in 2012 on behalf of six plaintiffs who had cycled in and out of emergency rooms and the state mental hospital. The state has agreed to spend $30 million over the next three years to re-build its community-based system of care, once considered a national model.

Related story:  Six Months After Attack, A Family Works To Recover

WHAT BROUGHT ON THIS LAWSUIT?

In April 2011, the Department of Justice released the results of an investigation that found the state had failed to provide services to people with serious mental illness that would have prevented their “needless and prolonged institutionalization.”

When negotiations failed to resolve the situation, the DOJ joined the Disabilities Right Center in filing a class-action lawsuit, alleging violations of the Americans with Disabilities Act.

WHAT DID THE CASE REVEAL ABOUT THE STATE’S MENTAL HEALTH SYSTEM?

In 2010, for example, more than 17 percent of adults discharged from New Hampshire Hospital were readmitted within 30 days – an admission/readmission rate that was twice as high as in 1990. Of the 1,800 adult admissions, 800 were re-admissions within 180 days.

In 2011, 45 percent of patients at the state hospital been there for more than a month, and 16 percent had been there more than a year.

According to the lawsuit, “For most of these individuals, NHH provides little more than custodial care. They suffer a loss of autonomy and choice. They have no contact with their non-disabled peers, except for paid staff, and lack privacy in their living and sleeping arrangements. Their most basic rights are curtailed.”

WHAT MUST THE STATE DO NOW?

The settlement requires the state to provide “robust community services,” including:

  •  around-the-clock mobile crisis teams in Manchester, Concord and Nashua to prevent unnecessary hospitalizations;
  •  Assertive Community Treatment services to at least 1,500 people;
  • 240 scattered-site, permanent housing units this year, and another 360 by June 2017;
  • employment services to an additional 1,000 people.

THIS IS A DONE DEAL, RIGHT? 

Not quite.

The settlement has to be approved by a judge. A hearing has been scheduled February 12* before U.S. District Court Judge Steven McAuliffe.

Meanwhile, state health officials are currently discussing how to implement the changes they agreed to in the settlement agreement. They say they need about $32 million, including an additional $6 million this year from the state’s General Fund and another $23.7 million for the 2016-2017 biennium.

The state is also on the hook for $2.4 million to cover the plaintiff’s legal fees.

Correction: The original version of this story incorrectly reported the date of the settlement hearing.