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Saturday, December 10, 2011

Justice official says state AG’s claims about mental health treatment in NH ‘simply incorrect’

CONCORD – The assistant U.S. Attorney General and the Department of Justice were unmoved by state Attorney General Michael Delaney’s request to let New Hampshire run its mental health system without the threat of a federal lawsuit.

Delaney wrote to assistant U.S. Attorney General Thomas Perez earlier this week to refute the DOJ’s findings that the state’s mental health system is failing and relies too heavily on institutionalizing people who should be treated more effectively, and cost effectively, in the community.

Perez responded Friday and said in no uncertain terms that Delaney is wrong, that the state is failing its residents with mental illnesses and spending far too much money doing it.

Federal and state officials have been meeting for several months to find an agreeable way to satisfy the DOJ’s findings that New Hampshire is violating the Americans with Disability Act, but those talks have apparently broken down. Perez said the DOJ will now look into filing a lawsuit against the state.

“Systemic civil rights violations, such as those we outlined in our findings letter, call for prompt, concrete commitments, not general plans with indefinite timelines,” Perez wrote.

In April, a DOJ report said the state’s mental health system is “broken, failing” and in crisis. Because of a lack of community support systems, more people are institutionalized, which costs more than community treatment and is more restrictive, according to the report.

The state operates the New Hampshire Hospital in Concord and Glencliff Home, a nursing home for people with mental illness in Benton.

Delaney and state Health and Human Services Commissioner Nicholas Toumpas defended the state’s actions this week, writing that New Hampshire has only 130 psychiatric beds for a state with 1.3 million people, plus 120 beds at Glencliff. Also, the average length of stay at New Hampshire Hospital is seven days, compared with 47 days nationally, they wrote.

“The vast majority of people are served through our regional community mental health centers and area agencies, which are the backbone of the state’s community care system,” they wrote.

The state should be able to implement its 10-year plan to improve the mental health system without having to spend time and money defending a lawsuit from the federal government, Delaney and Toumpas said.

Evidently, the 10-year plan isn’t good enough for Perez and the DOJ.

Perez rejected the state’s arguments and wrote that the admission rate to NHH is 40 percent higher than national averages and readmission rates are almost double.

“Your claims that New Hampshire’s reliance on institutions is ‘entirely reasonable’ and that the state’s system compares favorably to national statistics are simply incorrect,” Perez wrote.

New Hampshire sends too many people to institutions such as NHH and Glencliff, and spends too much money there, Perez said.

“New Hampshire is spending about as much to serve 5 percent of people with mental illness in New Hampshire Hospital as it spends to serve the entire remaining 95 percent in the community,” he wrote.

Joseph G. Cote can be reached at 594-6415 or Also, follow Cote on Twitter (@Telegraph_JoeC).