Outside Review Says State Lagging in Some Key Areas of Mental Health Reform

Jul 17, 2017

Three years after the state reached a major legal settlement meant to reform its mental health system, both the outside reviewer hired to monitor the state’s progress and the advocacy organization that sued on patients’ behalf say there’s still significant work to be done.

The state is required to submit to regular outside reviews of its mental health offerings as part of a multi-million dollar settlement reached three years ago, as a result of a class action lawsuit brought by the Disability Rights Center of New Hampshire.

The latest of those reports, dated June 30 but just publicized by the state last week, notes several important achievements: The state has launched mobile mental health teams and crisis apartments in several cities. It’s also offering supported employment to more people in need than what the settlement requires.

But the report also says the state’s falling behind on a big part of the settlement: Assertive Community Treatment teams. That model involves a team of professionals offering round-the-clock outpatient help in psychiatric care, treatment for substance use disorders, case management and other supports.

Right now, there’s one of these at each community mental health center – but they’re not fully staffed and not serving the number of people they’re supposed to, under the terms of the agreement.

Ben Sahl, legal director for the Disability Rights Center of New Hampshire, says his organization agrees with the expert reviewer’s assessment that “there remains work to be done on outstanding implementation and compliance issues.”

“There are particular concerns about Assertive Community Treatment services, and meeting the benchmarks set forth in the Community Mental Health Agreement,” Sahl said. “At the Disability Rights Center, we remain committed to working with the state to ensure the full implementation of the settlement agreement.”

In a letter responding to the report, Health and Human Services Commissioner Jeff Meyers acknowledged the state is falling behind its targets on the ACT teams, but said the state isn’t seeing a large demand for those services.

Meyers also said workforce shortages are making it tough for the state to meet the settlement’s expectations.