With the release of a fourth year of survey data, it would appear that New Hampshire’s 10 community mental health centers have been weathering a financial storm better than expected. Yet there are still many issues to address.
As part of a federally mandated survey on mental health systems, the N.H. Department of Health and Human Services has contracted with the Institute on Disability (IOD) at the University of New Hampshire to look at customer satisfaction with the community mental health centers (CMHCs). The fifth and final survey in this agreement will be released later this year.
Among positive outcomes, the survey of adults, youth and family members of children showed that general satisfaction and quality ratings remain high with 81 percent and 76 percent of adults responding positively in spite of repeated budget cuts.
“Despite some of the challenges that the system faces with funding and the availability of services,” says Ken Norton, LICSW, executive director of the National Alliance for Mental Illness N.H., “there are still a lot of dedicated staff working in these CMHCs and trying to do their best with the limited resources they are dealing with.”
A positive change in outcomes for children was also seen (from 55 percent in 2008 to 65 percent in 2011) and the majority of consumers praise the coordination between their mental health and medical providers. Youth respondents said that staff members treated them with respect (90 percent).
Some of the challenges identified include month-long delays for about half of new consumers to be seen by a professional. Plus, a third of adults with substance use concerns were never asked about it or offered treatment or referrals and one-third of consumers did not feel like active participants in their reviews. A reduction in services was reported in 9 percent of adults and 50 percent of those respondents saw an increase in symptoms.
The survey had a higher response rate this year with 53 percent of the mailed surveys returned. Still, explains Peter Antal, Ph.D., IOD researcher and author of the report, it is not necessarily representative of the entire CMHC population.
“It is important to recognize that the survey only represents 33 percent of the adults served by CMHCs. There is a good likelihood those folks that have the most severe functional limitations, are homeless or have the most severe need for repeated hospitalizations or treatment are not as well represented,” he says.
Another issue with the study, says Peter Janelle, MBA, president and CEO of the Mental Health Center of Greater Manchester, is that, like any survey, it cannot show recent changes or updates.
“There is a real delay in terms of when the people who answered the questionnaire were served. The feedback comes from folks whose experience may not be representative of the current experience,” he says.
Janelle was pleased to see that most clients responded that they know who to contact when in crisis. But he was not surprised to hear that clients had a long wait to see a psychologist or nurse practitioner.
“When you have funding reductions and case loads continue to increase, one of the unfortunate consequences is that those wait times have been extended out beyond what most of us wish it would be or could be,” he said. “So, we are doing the best with what we have.”
While individual groups focus on pieces of the study, it is important to step back and look at the big picture, adds Antal.
“I would like to see more data-based discussion and action about how people can come together to address the needs of the broader mental and physical health system, given that everyone knows what the problems are in terms of budgeting and funding,” says Antal. “How do we create a mental health system that works better than it does now with the resources we can secure? Everyone has a responsibility towards creating and sustaining a high quality health system that integrates effective mental health care.”
By Catherine Robertson Souter