Mentally ill patients in ER for weeks
CLAREMONT – Sullivan County Sheriff John Simonds reported to the county board of commissioners Monday, detailing department expenditures on prisoner transports and other expenses. Among the prisoner transports the department does, Simonds said, he found taking mentally ill subjects to be seen at Concord Hospital, which has a behavioral health unit, to be a concern.
“We do a number of these IEAs — Involuntary Emergency Admittance — a month,” said Simonds. “It varies.
“There's a huge problem with the lack of beds at the state hospital,” he said.
Evers said although the movement to close state psychiatric hospitals in the 1970s and 80s was well-meaning, not all mental illness is appropriately treated on an outpatient basis. “Some people believe nobody should be in a mental hospital, but you wouldn't really say that about a heart attack, would you?”
Currently, there are 62 people in the state waiting for a bed in a psychiatric treatment facility. Sixteen of them are in the Concord Hospital emergency room.
“It is not the right place for someone with mental illness,” said Evers. At the New Hampshire Hospital, there are 168 long-term beds, and another 40 in designated receiving facilities that can keep patients for up to 10 days. While mental illness is treatable and has better long-term recovery rates than other serious diseases, treatment can take a long time.
“If you go to the state hospital, you're usually pretty sick,” said Evers. “We need to properly resource this disease and treat it like what it is, a disease. Mental illness has a similar course in terms of acuity to many other serious diseases, but it is treatable.”
According to the Centers for Disease Control, effective treatment of mental illness requires 50 beds per 100,000 people. In New Hampshire, the capacity is 11 per 100,000.
Ad-hoc treatment of the mentally ill in emergency rooms also affects the care of patients coming in with other issues, puts stress on people working in ER, and diminishes the standard of care for everybody.
“It's a problem all over,” said Evers. “I've worked in Boston, where there are more beds than you can shake a stick at, and there are still difficulties depending on the patient's diagnosis. But in New Hampshire, it's everybody, whether they're insured or uninsured.”