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State mental health cuts shift costs to communities

Involuntary emergency admission process now takes much longer

June 02, 2011
COUNTY — County Attorney Thomas Dewhurst sent a letter to the New Hampshire Attorney General recently, outlining the difficulties and costs to hospitals and police departments throughout the county posed by cuts in mental health services, most notably cuts to New Hampshire Hospital.

A reduction in beds at New Hampshire Hospital and cuts to community health programs makes it difficult to evaluate and place patients who are a danger to themselves or others in a timely manner according to state statutes. "Patients have rights," said Dewhurst, "and there are glitches in the system."

Dr. Bob MacLeod, director of New Hampshire Hospital, said another unit of up to 24 beds, is scheduled to close down on June 3. Patients will be reassigned to other units, and he has a draft plan to limit the reduction by just six beds through reorganization of other units. He says also that he's heard that there may some restoration of funding to community mental health agencies, but the fact remains that an already strained system will continue to have negative effects on local municipalities.

Wolfeboro Police Chief Stuart Chase reported to the town's police commission at its May 12 meeting that a working committee representing health professionals from Huggins Hospital, Memorial Hospital and Carroll County Mental Health, and law enforcement, from the Carroll County Sheriff's Department, Wolfeboro and County Attorney Dewhurst has been established.

Dewhurst said the resulting list of "serious issues" associated with the involuntary emergency admission (IEA) process should be "part of an overall analysis of the effect of what's going on with the state budget."

A process that used to take police around six hours to complete now can stretch as long as three days and occasionally even longer according to Dewhurst, and the local hospitals are not set up to care for violent or suicidal patients. Security must be provided.

Huggins Hospital has a contract with the Wolfeboro Police Department (WPD) to hire officers for special details to provide round-the-clock security. Chase says that protracted stays put a strain on his scheduling, and when he has to send one or two additional officers over to restrain a violent patient, suddenly he's short-staffed.

Officers from Tuftonboro and surrounding towns, who bring in a mentally unstable person in the course of regular duty, are in the same position. They are out of their towns and unable to attend to other duties.

"There's a lot going on in Concord," says Wolfeboro Police Department's Lt. Dean Rondeau, "where people are not considering the second, third and fourth order effects of the budget cuts…If we're lucky, the process takes 24 hours. It's a lot longer than the six it used to take."

MacLeod puts the wait time for admission for civil commitments (involuntary admissions) anywhere from 12 hours to one to two days for adults and three days for children. He noted that when the hospital was established in 1989, there were 220 beds and about 850 admissions a year. Currently there are 158 beds and 2,500 admissions a year. He said the community health system has been instrumental in shortening the average length of stays.

Huggins Hospital President Dave Tower was unavailable at press time to provide the amount of unfunded liability the hospital accrues in providing security for individuals who are admitted involuntarily for emergency psychiatric issues in Huggins Hospital while waiting for evaluation and eventual placement in New Hampshire Hospital.

AJ Coleman
Varney Smith
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