The state has spent millions of dollars expanding mental health care over the past two years. Still waiting for those who need it. Several days in the emergency room. Mobile Her Crisis Her team is at home over an hour away. for counseling appointments. For housing after psychiatric hospitalization.
Mental health advocates say lack of care has consequences. Patients who put off cancer or heart treatments during the pandemic have gotten worse. And the same is true for those who do not get timely mental health treatment.
“It’s like telling a pregnant woman to ‘cross your legs and wait,'” says Maggie Pritchard, president of the New Hampshire Community Behavioral Health Association and chief executive officer of the Lakes Community Mental Health Center. said. “If someone has a psychotic episode and needs help, it really can’t be done.”
The association’s 10 community mental health centers, which treated about 60,000 people last fiscal year, most of which are covered by Medicaid, have asked Gov. said it would require an additional $28 million in costs. To cover the cost, they proposed that the state increase Medicaid reimbursement rates, which fund about 70% of the center’s budget and fully cover the cost of providing care. I have not.
Roland Lamy, Executive Director of the Association, said: “Inflation is inflation and we can quickly see that we are not affected by it.”
The budget increase, which would require a 21.5-23% increase in reimbursement rates, would support two key needs, Lamy said.
With about 340 clinical vacancies, the center is asking for $26 million to $28 million to raise wages, Lamy said, 7 to 43 percent higher than national wages reported by the Federal Bureau of Labor Statistics. I’m late. The median annual salary for psychiatrists at the center is about $68,000 less than the national average. A registered nurse makes about $13,000 less a year, and a psychologist makes her $40,000 less.
The center also requested an additional $1.5 million to add 60 community-based “step-down” beds for people who do not require hospitalization but are not yet able to live independently. With all housing options in short supply, New Hampshire hospitals are unable to release homeless patients who are ready for discharge. Department of Health and Human Services spokesman Jake Leon said 50 patients were awaiting discharge, each requesting a bed. 44 adults were waiting inpatient treatment.
The center will receive Sununu’s reply on February 14, when it plans to announce its proposed two-year budget. If he included a request for about $30 million, the funds would face months of budget negotiations between the House and Senate.
Untreated mental illness is associated with increased risk of other illnesses, substance abuse, homelessness, incarceration, and challenges at work and school. People who don’t get treatment are also at higher risk of suicide, and it’s the second leading cause of death for granite starters from age 10 to age 14 and age 25 to age 34, according to the Centers for Disease Control and Prevention.
The pandemic has exacerbated barriers to mental health treatment and has forced many people to quit their jobs, prompting more people to seek help. brought in the funds.
With Sununu’s endorsement, the Department of Health and Human Services spent $15 million to purchase Hampstead Hospital to expand inpatient and outpatient care for children and adolescents. A year ago, the state launched Rapid Response Access Point, a 24/7 call center for people seeking mental health and substance abuse treatment. You can contact us at 833-710-6477, national hotline number 988, or online. nh988.comIn its first year, the call center handled nearly 22,000 phone calls, text messages or chat messages, Leon said.
All 10 mental health centers in the area now have mobile emergency response teams that respond to people’s whereabouts as an alternative to emergency rooms. In his first six months of 2022, the team has made nearly 8,400 stabilization visits to him.
Leon said the department is renovating a 15-bed unit at Hampstead Hospital and will serve children and adolescents. It also expanded its treatment team to include a nurse, a mental health his counselor with a bachelor’s degree, and an assistant counselor to reach out to more children.
The center received funding in its final budget to begin expanding step-down housing in the community. He also spent nearly $45 million in federal pandemic assistance on employee bonuses, salary adjustments, benefits and training. We expect this investment to help retain employees and drive new hires.
Staff at Riverbend Community Mental Health in Concord received gift cards, new desk chairs and wellness activities. Car detailing for staff visiting local customers outside the office was particularly popular.
Riverbend CEO Lisa Madden said: “They felt honored and respected to work on their cars.”
Connecting families with support and resources but not treatment, said Susan Stearns, executive director of NAMI NH, saying these investments, especially in call centers, are a meaningful step forward. .
“I realized there was still work to be done to build that system,” she said. “But it gives me great hope. So I know we can do hard things, and I have real hope from things like that, it’s just that the need is so great.”
Stearns knows that families, health care providers and advocates are frustrated that investments haven’t removed barriers to treatment.
“It doesn’t mean it’s taking longer than expected, because system transformation takes time,” she said. “The problem is that I don’t have time.”
Center leaders say the need cannot be addressed without overcoming a paralyzing labor shortage. They say they can’t do it without an increase of $26 million to $28 million a year for a raise. Additionally, Madden said the student loan forgiveness available to clinicians with master’s degrees should be extended to bachelor-level clinicians.
Madden is filling 40 vacancies, 37 of which are in patient-facing clinical positions. The turnover rate for new hires is particularly high, she said. 45% left within her first year and 22% within her one to two years.
Like Madden, Pritchard said job postings can go on for weeks.
“In the old days, if there was higher demand, we would just hire more staff,” said Pritchard. “Right now, there is no one to bring to the door.” Instead, clinical staff should meet increased demand by taking on additional clients or extending the time between client appointments. It is said that
Lamy said this has allowed the center to see more clients despite a reduced number of clinical staff, but it has also increased the risk of staff burnout.
“I’ve been doing this for a long time, and the sadness I see on the faces of providers who know they can’t keep up with demand isn’t from lack of effort or lack of desire,” Madden said. “It’s true. It strips you of your professional core, and it’s painful to watch.”
Thank you for your hard work, customers.
“There’s no question that the number one thing we get called on is that it’s hard to get an initial reservation,” Stearns said. You can talk to someone who says they can do it, and some say, “Call me back every day until there’s space.” Some say, “I don’t think it will be open at any point in the future that we can foresee.” “
Concord’s mother and 15-year-old son, whose names have been withheld to protect their privacy, have been hit particularly hard by the labor shortage.
He has been in the emergency room at Concord Hospital since January 6, awaiting one of the 55 beds at Hampstead Hospital, the state’s only inpatient pediatric care. he wasn’t alone.
Monday, 11 additional children waiting for bed55 adults and children were waiting to enter, partly due to a staff shortage. Leon said nine of his beds at Hampstead Hospital are closed due to staff vacancies. New Hampshire Hospital, the state’s largest behavioral health hospital for adults, is cutting 31 beds for the same reason, leaving about 150 empty, he said.
The 15-year-old’s mother said the wait was longer than usual because the hospital asked him for a private room. He was first admitted to Hampstead last summer after an amphetamine psychosis caused by his ADHD medication.
She said he became belligerent and irritable, both out of his character. A deep anxiety followed. “It’s really kind of scary,” said the woman. After waiting a year for her Riverbend practice, he began counseling, she said.
Her son called 911 on January 6 and said he was worried he might get hurt. He went to Concord Hospital that day.
Holding areas called “yellow pods” are not meant to hold someone for days, let alone weeks. The boy’s mother did not receive prescribed medication until days after her arrival and was being monitored by people untrained in mental illness, she said. I don’t know how,” she said. “The smallest becomes the largest.”
Still, she said her son hasn’t asked to leave the hospital.
“He’s come to understand the fact that this is a means to an end and this is what he has to do. He knows the system is broken. He I feel like I understand that.”