The Exchange: In-Depth

A continuing series on The Exchange, featuring week-long looks at issues of importance to New Hampshire.

Right now, the series is taking a look at mental health in the Granite State. Do you have questions? Submit them on the form below:

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Dan Tuohy for NHPR

About half of all Americans in prison have a severe mental illness, according to the American Psychiatric Association. The numbers are even higher for those in local jails. On the front lines, New Hampshire police say they've tried to become more knowledgeable about mental health.

More training has helped, along with public awareness and the state's mental health court system. Still, it's a complex interaction. Too often, says Strafford County Attorney Tom Velardi, people with mental illness and substance abuse end up incarcerated.   

"In our local jail, we estimate about 70 percent of the people have a co-occurring disorder. How do you deal with folks that have these diagnoses? First, it's to not force them into a criminal justice system that's not designed to deal with their issues, " he said on The Exchange.

"What we've designed in Strafford County are some systems to try to help identify mental health issues, to not criminalize or escalate mental health issues, and to get people diverted out of the system." 

See highlights from the conversation below (edited slightly for length and clarity). For audio of the full Exchange conversation, as well as additional reading and resource materials, visit here.

Dan Tuohy / NHPR

New Hampshire Hospital CEO Lori Shibinette says the state needs to tackle the question of how to treat severely mentally ill and violent patients.  

 

Currently, those patients are held at the secure psychiatric unit at the state prison, whether or not they've been convicted of a crime.

 

That practice has long been controversial.  Speaking today on NHPR's The Exchange, Shibinette says right now, there's nowhere else to put them.

 

NHPR

Our series on mental health in New Hampshire concludes with a look at the role of the state psychiatric hospital in responding to crises, and at what happens once a patient leaves, including what's available in terms of treatment, jobs, housing, and community support. 

The Exchange

The Exchange: In-Depth:  It's only in recent years that New Hampshire has begun to seriously address the mental health needs of children. Under a 2016 law, the state is supposed to provide a more coordinated system to help children with mental health needs that have been intensified by the opioid crisis and a troubled DCYF system. Suicide remains a top cause of death for N.H. teens.

Schools are now playing a major role in helping to identify problems -- using "trauma-informed" techniques to help children cope with psychological stress and challenges that can interfere with academics and learning.   

NHPR

The Exchange: In-Depth

Our series continues with a  look at the criminal justice system.  Many incarcerated Americans are behind bars due to some form of mental illness, and in recent years, the courts and police have been trying to adapt. We're examining the complex intersection between the mental health and legal systems. 

Dan Tuohy / NHPR

In the first of our four-day In-Depth series, The Exchange explored whether mental health care in New Hampshire has improved since the state agreed to invest more in the system  — part of a 2014 legal settlement. All agreed there's been progress. There's more help for people in crisis and more transitional housing.

But there's still plenty of room for improvement, including on permanent-housing arrrangements and reimbursement rates for struggling community mental health centers.  

Dan Tuohy / NHPR

John Broderick has spoken at more than 80 schools and driven some 46,000 miles as co-chair of the Campaign to Change Direction NH.

He urges teens to know the five signs of mental illness. He shares his family's personal story—and offers assurance that help is available. Bottomline, he says, a different conversation is necessary to reach this younger generation.  WATCH Broderick discuss the issue after speaking at Timberlane High School.

In Depth: Mental Health Care For N.H.'s Children

May 21, 2018
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The Exchange: In-Depth. Our series continues with a focus on children. Research shows many cases of mental illness begin by age 14 and that addressing trauma early can help prevent some disorders. Meanwhile, the state is required by law to provide better care for youth. We'll find out how the system is working from teachers, providers, and parents.  

In Depth: Examining N.H.'s Mental Health System

May 18, 2018
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The Exchange: In-Depth

On the first of our four-day series, we get an overview of mental health care in New Hampshire, including efforts to bolster the community support system, as required under a 2013 legal settlement.  We'll also find out how a new 10-year plan for mental health is shaping up, and how it differs from the last 10-year plan.  Among the issues yet to be solved: long emergency-room waits for people in crisis, an average of 37 people daily, according to the N.H. chapter of the National Alliance on Mental Illness. 

Critical Care

May 14, 2018

THE EXCHANGE FEATURES EXTENDED CONVERSATION ABOUT NEW HAMPSHIRE’S MENTAL HEALTH SYSTEM  

Sara Plourde for NHPR

Under a legal settlement in 2013, the state of New Hampshire was obligated to make improvements in how it cares for people with mental illness – finding ways to keep people out of institutions and living more independently, with community-based care.