NH Senators Sherman and Whitley: A desperate need for mental health care
May 14, 2021
This week’s Supreme Court decision, Jane Doe v. Commissioner of the NH DHHS, illustrates yet again the significant mental health crisis we continue to face in New Hampshire. Following the decision, Governor Sununu released an emergency order to address the mental health system of care, particularly looking at the options to increase bed capacity.
While we agree that this is a crisis worthy of the full attention of the Executive branch, why didn’t the Governor issue an Executive Order when the number of people waiting in emergency rooms for mental health care spiked last summer? We were experiencing a mental health crisis before the pandemic and the need for treatment has only increased. There remains a desperate need to rebuild the community-based system for mental health treatment in our state that could have been addressed long before the crisis grew to such heartbreaking levels.
In the decision, the court recognized that New Hampshire has neglected to provide adequate mental health treatment to meet the needs of Granite Staters and as a result, patients continue to languish in emergency rooms waiting for appropriate treatment. In February of this year, we had 51 children sitting in our emergency rooms waiting for services and we typically have 40 adults waiting for care even today. There is no other medical condition where we would leave a patient in a medical crisis waiting so long for treatment. Why is it that we treat patients with a heart condition differently than patients with a mental illness? It’s not right, and we cannot continue to fail the citizens of our state by having them wait for the care they so desperately need. This system failure is harmful, expensive, and unnecessary.
As a result of bipartisan work in the last biennium and the leadership of the then Democratic majority legislature, we created the statutory framework to fully address this crisis and for the first time, fully funded those reforms. The 10-year Mental Health Plan created the blueprint and timeline for improving pediatric and adult mental health treatment in New Hampshire, with required annual reporting and plan updates. SB 11 dealt directly with the emergency room boarding crisis, expanding funding for hospital beds, transitional housing and an additional mobile crisis team. SB 14 stood up and funded a comprehensive system of care for children suffering from mental illness and required statewide access to mobile crisis and stabilization services. And the compromise budget passed in 2019 provided the funding, both in the budget and in increased Medicaid reimbursement, to fully implement these initiatives.
The Supreme Court’s decision in Jane Doe only underscored the critical need - both from a human and legal standpoint - for full implementation of these services. While the COVID pandemic has delayed implementation, the Department of Health and Human Services (DHHS) is back on track to building both services and adequate capacity for any New Hampshire resident at any stage of their mental and emotional illness. But we could have already mitigated the impacts of the ongoing crisis if the reforms in the last biennium had been stood up with the necessary urgency by Governor Sununu.
The message from the Supreme Court is clear – the current situation is unlawful, and it is up to the executive and legislative branches to fix it. The good news is that we have the statutory framework in place to do just that, but the bad news is that the budgets recently sent to the Senate from both the Governor and the House would either keep Department of Health and Human Services funding flat or slash it with a $50 million cut.
Defunding the Department of Health and Human Services as we near the end of a public health crisis, as proposed in the House budget proposal before us, only perpetuates the current unlawful and medically unethical human tragedy that is emergency room boarding. The Governor and the Republican majority controlling the budget need to demonstrate both the leadership and the will to fully stand up the reforms from the last biennium and fund an array of mental health services to alleviate the ongoing crisis. People cannot wait any longer. Doing so will save lives, build a healthier, stronger New Hampshire, and in the long run save taxpayer dollars.