Foundation for Healthy Communities Report on Access to Mental Health Care in NH (2/22/13)
CONCORD – The Foundation for Healthy Communities has issued its findings regarding people seeking mental health care in New Hampshire, and the challenges that confront them in receiving the right care in the right place.
The issue has recently been brought into sharp focus by efforts to restore more psychiatric beds at the New Hampshire State Hospital and by appeals to provide more community-based services in order to alleviate the pressure on hospital emergency departments that struggle to provide safe, adequate care for patients who cannot find access to the psychiatric treatment they require.
Using data from a three-month study with input from 15 of the state's 26 community hospitals involving 575 patients, the Foundation's report lists several key findings.
- Nearly one in three patients seeking mental health treatment waited more than 24 hours in a Hospital Emergency Department (ED). The average wait was 2.5 days among this group.
- More than half of all patients recommended for an Involuntary Emergency Admission for psychiatric care waited more than 24 hours in a Hospital ED.
- More than three out of four patients – 449 of the 575 – required constant observation while waiting in the ED and almost one half of the patients required special security.
In addition to statistical analysis contained in the report, hospitals offered anecdotal evidence of the disruption that occurs in EDs. One cited the case of a woman who was brought to the ED by police "for an evaluation of mania and suicidal ideation."
According to the hospital, after her initial diagnosis, "The patient was observed in the ED for approximately 130 hours (5.4 days) until she was transferred to New Hampshire Hospital for psychiatric care evaluation. It cost $26,310 in personnel hours to have the patient observed in the ED for 130 hours by one physician, one registered nurse and the ED tech assigned to her. This figure includes time for the paramedics and security team who were called 14 times to the ED to assist the nursing staff when the patient became agitated and escalated."
Shawn LaFrance, executive director of the Foundation for Healthy Communities, is the primary author of the report.
"We began working on this report months ago," he said. "Dating back to last summer, we were hearing more stories than ever about the influx of mental health patients at emergency rooms, and it was happening all over the state.
"We felt that by documenting it over a period of time, we could bring attention to the seriousness of the situation," he added. "Bear in mind that this is a small sampling. It covers a three-month period with just 15 hospitals taking part, so it's really just a snapshot of the potential unmet need that exists.
"In summary, our report indicates a failure to fulfill the promise for many people seeking help for mental health problems in New Hampshire," LaFrance said. "Leadership and action are urgently needed to achieve the promise."
To read the full report, click here...
The Foundation for Healthy Communities is a nonprofit corporation that exists to improve health and health care in New Hampshire. The Foundation's partnerships include hospitals, health plans, clinicians, home care agencies, public policy leaders, and other organizations.