For a system that has gone from being second in the country in 1990 as rated by the National Alliance for the Mentally Ill (NAMI), to earning a D in a revised rating system in 2006, the announcement of a 10-year mental health plan was received with bated breath by stakeholders across the state.
With input from residents, professionals, and focus groups, workgroups, and public sessions, the draft plan introduced in November begins by outlining the challenges faced by New Hampshire residents with mental health needs.
Access to services can be problematic, especially in rural areas and a shortage of mental health care professionals adds to the difficulties.
A limited number of available beds often leads to long wait times for psychiatric hospitalization and results in extended stays in emergency departments.
NAMI-NH paints that situation as dire with a daily average of 40 individuals in mental health crisis held in emergency departments waiting for access to inpatient care.
Furthermore, the overall complex system creates its own roadblocks by making it difficult for people to locate the services that do exist.
All of the issues, according to the draft plan, can be traced back to the state’s financial support for mental health care: “Underlying it all, in the minds of many,” the plan says, “is the need to increase funding for mental health.”
The plan, drafted by the Center for Behavioral Health Innovation at Antioch University of New England in Keene, calls for an immediate infusion of $24 million over the first two years, $10 million of which would be used to increase Medicaid reimbursement rates.
“The state has had the same Medicaid rates for 12 years,” explained Peter Evers, M.S.W., executive director of Riverbend Community Mental Health Center in Concord, “which has created a behavioral health workforce issue; people go elsewhere to find work.”
The plan also recommends a regional “hub-and-spoke” system with central oversight similar to one now in place to address the state’s opioid crisis treatment.
Some experts felt that the draft report is too light on details of how, exactly, the various proposed fixes will be implemented.
“The plan is to integrate all the different services,” said Evers, “but it didn’t say how. What is really needed in this plan are the next steps and the first is to secure funding. Nothing happens unless we can fund it. We cannot squeeze more blood from this stone and I would say don’t try to do all this on the back of the current underfunded system because it will collapse.”
The state hosted several public hearings in December to gather feedback.
“The public hearings were excellent. There was a huge turnout and there were a number of legislators present,” said Ken Norton, LICSW, executive director at NAMI-NH.
“We are encouraged by the collective public input process that has brought the plan to this point and we are optimistic that it will bring hope and help to our residents who have mental health conditions.”
The hearings were well-attended and the state is currently pulling the input together to create a final version of the plan to be presented to lawmakers.
“We look forward to sharing it with policymakers, community providers, and the individuals and their families who engage with the state’s mental health system,” said Jake Leon, director of communications for the NH Department of Health and Human Services. “We anticipate releasing the plan later this month.”
Catherine Robertson Souter is a freelance writer and social media agent based in New Hampshire. A contributor to New England Psychologist since its inception, she previously wrote for Massachusetts Psychologist among other media outlets.