US report confirms N.H.’s mental health system failing
CONCORD, N.H. — A new report from the federal government confirms what New Hampshire officials have acknowledged for years: The state’s mental health system is broken, failing, and in crisis.
The US Department of Justice’s civil rights division recently investigated the state for possible violations of the Americans with Disabilities Act. It concluded that the state is violating the federal law by failing to provide adequate community-based services to people with mental illness, leading to needless and prolonged stays at New Hampshire Hospital, the state mental hospital, and Glencliff Home, its nursing home for those with serious mental illness or developmental disabilities.
“Reliance on unnecessary and expensive institutional care both violates the civil rights of people with disabilities and incurs unnecessary expense,’’ Assistant Attorney General Thomas Perez wrote in a report sent to the state last week. “Community integration with appropriate services and supports will permit the state to support people with disabilities, including mental illness, in settings appropriate to their needs in a more cost effective manner.’’
As the report noted, the state has long acknowledged most of the failings and offered detailed plans to fix them in a 10-year plan it developed in 2008. But progress has been slow, and lawmakers also are considering cuts to the community mental health system that could make enacting the plan more difficult.
Under the budget recently passed by the House, the state would save $6.7 million a year by reducing the number of adults eligible for mental health services and $5.8 million a year by changing eligibility rules for children. The state’s 10 community mental health centers say that will eliminate treatment for 3,500 children and more than 4,000 adults.
The federal report concluded that the community mental health centers should be seeing more patients, not fewer. It said the average cost of institutionalizing someone at the state mental hospital is $287,000 per year, while serving someone in the community costs $44,000. Too many people end up at the hospital because community resources are lacking, the report said, and they stay longer than necessary because there are not appropriate settings in which to continue their care after they leave.
The report was particularly critical of the Glencliff Home, which it said puts virtually no focus on discharge planning. In recent years, far more residents of Glencliff have died annually than have been returned to their communities.
“Other than age in some cases, it does not appear that the individuals at Glencliff present any novel or different set of disabilities than their peers at [New Hampshire Hospital] — all of whom are at least nominally in the active, state-endorsed pipeline toward placement in a more integrated community setting,’’ the report said. “Given this, it is unclear then why similar placement efforts are not, and have not been, underway for the individuals at Glencliff.’’
Perez also wrote that he is concerned that the state relies too much on group housing once people leave the hospital. About 10 percent of those discharged last year were sent to homeless shelters, jail, or other institutional settings, he said.
A spokeswoman for the state Department of Health and Human Services said yesterday that officials were reviewing the report and had no immediate formal response.