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Tuesday, February 26, 2013

Study of N.H. hospitals shows patients sometimes wait for days for psychiatric care

CONCORD – Because of a shortage of beds at the state hospital, and few other options, people who go to emergency rooms seeking psychiatric help are forced to often wait for days at a steep cost, according to a report released Thursday.

The Foundation for Healthy Communities conducted a study from October through December of 15 of the state’s 26 hospitals with emergency departments. The study involved 575 patients of varying ages and income levels who had gone to the emergency rooms seeking psychiatric treatment. ...

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CONCORD – Because of a shortage of beds at the state hospital, and few other options, people who go to emergency rooms seeking psychiatric help are forced to often wait for days at a steep cost, according to a report released Thursday.

The Foundation for Healthy Communities conducted a study from October through December of 15 of the state’s 26 hospitals with emergency departments. The study involved 575 patients of varying ages and income levels who had gone to the emergency rooms seeking psychiatric treatment.

Nashua’s two hospitals – Southern New Hampshire Medical Center and St. Joseph Hospital – declined to participate in the study, according to its author, Shawn LaFrance, executive director of the foundation.

Neither hospital was able to provide a response to the study for this story despite being contacted Friday morning.

Among the findings:

Nearly one in three patients seeking mental health treatment waited more than 24 hours in a hospital emergency department, with an average wait among this group of 2.5 days.

More than half of all patients recommended for an involuntary emergency admission for psychiatric care waited more than 24 hours in a hospital emergency department.

More than three out of four patients – 449 of the 575 – required constant observation while waiting in the emergency department and almost one half of the patients required special security.

Many of the same problems were uncovered in a 2008 study. However, little progress was made in the last four years, LaFrance said.

People involved in mental health care were hearing anecdotes about long waits and lack of care for people seeking mental health treatment, and it seemed the problem was worsening, LaFrance said.

The study was an effort to support the anecdotes with statistical evidence, he said.

“We felt that by documenting it over a period of time, we could bring attention to the seriousness of the situation,” LaFrance said.

As for the anecdotal evidence, one hospital emergency department cited the case of a woman brought there by police as a possible suicide risk. After her diagnosis, the patient was observed in the emergency department for 51⁄2 days until she was transferred to New Hampshire Hospital for psychiatric care evaluation, according to the report.

It cost $26,310 in personnel hours to have the patient observed in the emergency department for 130 hours by one physician, one registered nurse and the technician assigned to her, according to the study.

This figure includes time for the paramedics and security team who were called 14 times to the emergency department to assist the nursing staff when the patient became agitated, according to the study.

There is no other serious medical condition that patients are forced to wait for so long for treatment, LaFrance said.

He likened it to having to wait for days to be treated for a heart attack.

The difference is, “sadly a stigma is still attached to mental illness,” LaFrance said.

That’s despite the fact that mental illness is not uncommon, he said.

“You don’t have to look too far into your family or friends to find a person with mental illness. It’s just not talked about,” LaFrance said.

Unlike the stereotype, not all the people who sought psychiatric care at hospital emergency room were homeless, he said.

The study showed a number of them carried insurance, which LaFrance said speaks to the diversity of the patients.

Patrick Meighan can be reached at 594-6518 or pmeighan@nashua
telegraph.com.