Calls for mental health reform

New report paints a bleak picture of a ‘failing’ system

Published Sept. 23, 2008 in the Keene Sentinel
By Casey Farrar
Sentinel Staff
A task force made up of community mental health care providers and state health officials says that the state needs to invest in mental health care at local levels to prevent costs from shifting to other areas of government.

“We are on the mend,” Jue said. “But it’s meant making some tough decisions and restructuring some programs to help us break even. And we couldn’t have done it without community support.”

Jue said that for the last two months, with the help of an increase in private donations and grant money, the agency has managed not to spend more than it makes.

The agency has received more than $60,000 in private donations since it went public with its financial woes in May, Jue said.

Starting Oct. 1, the agency has promised to bump its employees’ salaries back up nearly to the levels they were before the cutbacks, Jue said.

But when an audit of the agency’s finances from the 2008 fiscal year, which ended June 30, is finished later this month, Jue expects it to come in at least $550,000 over budget.

To deal with the budget shortfalls, the agency has begun restructuring programs.

It has been beefing up children’s programs, which are supported by federal and state money, and shrinking the agency’s adult outpatient counseling services by eliminating six counseling positions and shortening the length of care for people who can’t pay and aren’t considered a danger to themselves or others, Jue said.

“We’re still able to see as many people as before, but we will have to prioritize and be more measured in the care we can provide,” Jue said.

The agency has been seeking partnerships with other nonprofit organizations in the region that could provide long-term treatment options, but money is tight everywhere, Jue said.

And Jue said while he understands that the state government is tackling its own budget shortfalls, it is important to bring the problems in the mental health system to lawmakers’ attention.

“When it comes down to it, the state has to come forward and help out with this,” Jue said. “We’re still under-funded for 24-hour crisis care, we’re still under-funded for psychiatric services and there still aren’t enough residential beds to meet the need in the state.”

Several of the recommendations in the task force report, which will be presented to executive branch, legislative, judicial and local public officials, draw on proposals outlined in a 23-year-old plan to restructure the state’s mental health system that state health officials say were never implemented.

The 1985 report focused on scaling back a reliance on inpatient mental health care at state facilities like New Hampshire Hospital, and building treatment programs in communities.

But while programs were cut at the state hospital, community programs didn’t grow enough to meet the need, over-burdening the New Hampshire Hospital with nearly twice the number of admissions over the past 15 years, according to the report.

By increasing programs to help mentally ill people get and maintain affordable housing, adding 132 new inpatient beds in community residential facilities and developing teams of community-based outreach workers, fewer of the state’s mentally ill population will need to seek help at the state hospital, according to the report.

“Ultimately, the success of this new investment strategy will be measured in the improved quality of care for N.H. citizens,” said Roland P. Lamy Jr., executive director of the New Hampshire Community Behavioral Health Association, a group formed by the state’s 10 local centers.

Casey Farrar can be reached at 352-1234, extension 1435, or cfarrar@keenesentinel.com.

Findings from an 18-month study, unveiled in a report Monday, showed that local law enforcement, hospital emergency rooms, the court system and county jails shoulder the burden of under-treated mental health conditions, according to Nicholas Toumpas, commissioner of the N.H. Department of Health and Human Services.

“(The state’s) mental health care system is failing and the consequence of these failures is being realized across the state and its communities,” Toumpas said.

The report prepared by the task force, a collaboration among the state health department, the New Hampshire Hospital Bureau of Behavioral Health and the Community Behavioral Health Association, recommended a multi-year plan to overhaul the system that includes more community-based housing for treatment and more money for maintaining qualified staff.

Kenneth Jue, CEO of Monadnock Family Services, a community mental health center serving the Monadnock Region, echoed the findings in a recent interview with The Sentinel.

The agency is beginning to come out of a financial crisis this year that has resulted in the loss of at least 12 employees and caused staff pay and benefits to be slashed by nearly 7 percent in May, Jue said.

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