N.H. 10-bed unit could happen sooner

By Rivkela Brodsky
March 1st, 2014

As a means to ease an emergency room crisis, state lawmakers hope to accelerate the timetable on a plan to add a 10-bed stabilization unit to New Hampshire Hospital.

The state’s Senate Capital Budget Committee in January approved $375,000 in additional funds for the $2.1 million project that was originally slated to be completed in 2016, says committee chairman Sen. David Boutin, (R-Hooksett).

The additional funding is meant to get the unit finished faster. “At the end of the day, [the project] gets moved up about a year. That’s a big help here in the state. It provides some relief for emergency rooms,” he says.

A shortage of beds at the state’s only public psychiatric hospital has created a situation where individuals dealing with a mental health crisis must wait in emergency rooms to be seen and for a bed at the state hospital to open up. That situation has become dangerous for hospital emergency rooms.

There were two violent incidents at Elliot Hospital’s emergency room in Manchester over the summer. “We had an incident in the early part of the summer where a patient there attacked one of the workers,” Boutin says. “We had another incident later in the summer. Both staffers were hurt pretty badly….We need to move this up so we can provide more beds in a crisis situation.”

The two incidents over the summer “put a light on a problem people already knew was going on,” says Alexander de Nesnera, M.D., associate medical director at New Hampshire Hospital and associate professor of psychiatry at Dartmouth’s Geisel School of Medicine.

“Many people see [additional beds] as part of the solution of the overall problem that the state of New Hampshire faces,” he says. “You have people being seen in emergency rooms who need to be treated, but there is no room at New Hampshire Hospital to accept them. At the same time, the other issue is there are not enough voluntary beds in New Hampshire, either.”

Individuals admitted to the hospital are typically at a point of being a danger to themselves or others and are often brought to the hospital involuntarily, although they are not treated involuntarily, Nesnera says. Often they are dealing with schizophrenia, bipolar disorder, PTSD, or major depression.

New Hampshire Hospital has 160 beds and almost 2,400 admissions per year. The average stay at the hospital is eight days, Nesnera says. “We are very much an acute care facility that gets people treated hopefully quickly and then we can get them out back to the community and back home.”

The new unit at New Hampshire Hospital will help provide quicker treatment, he says. “What we perceive will happen is that it will be a 10-bed facility that will be able to take care of patients that are in crisis, that need perhaps more rapid stabilization than necessarily staying eight days. We are hoping that we could treat people for a shorter term than an eight-day period.”

Specific plans and a timeline for the new unit have not yet been finalized, Nesnera says.

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