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Sunday, February 19, 2012

NH in denial over mental health suit

Telegraph Editorial

A true measure of a society’s civility is how it treats its helpless citizens. Does it protect and defend people incapable of fending for themselves or does it push them aside as useless and annoying pieces of trash?

Earlier this month, the Disabilities Rights Center of New Hampshire sued Gov. John Lynch and the state on behalf of adults suffering with serious mental illness for what it described as their “needless institutionalization.”

“New Hampshire’s failure to provide adequate community mental health supports has led to a dramatic rise in the prolonged, unnecessary and repeated institutionalization of people with mental illness in this state,” said DRC lead attorney Amy Messer.

The lawsuit follows last April’s U.S. Department of Justice finding that the state was failing to place people with mental disabilities in the most integrated setting as required by law.

Since then, the state and the federal government have been working on a settlement. However, things got ugly in December, when New Hampshire Attorney General Michael Delaney rejected the Justice Department’s timetable for remediable action, saying, in essence, the state could handle its own affairs.

U.S. Assistant Attorney General Thomas Perez’s response was swift and stern.

“New Hampshire’s mental health system, as currently configured, not only violates the (federal law) but also is an inefficient use of state resources and is bad policy,” Perez wrote. “Your claims that New Hampshire’s reliance on (the state hospital and the Glencliff Home for the elderly) is ‘entirely reasonable’ and that the state’s system compares favorably to national statistics are simply incorrect.”

Perez pointed out the state’s own 2008 investigation determined its mental health system was “broken” and “in crisis.” He noted as well that admissions to the state hospital are nearly 40 percent higher than the national average, and re-admissions are nearly double.

While it’s state policy to keep hospital stays short, there aren’t enough community services available to support released patients. As a consequence, too often they end up being institutionalized again and again and again.

What transforms an otherwise sad story into a tragedy is that it didn’t have to be this way.

Two decades ago, New Hampshire had one of the best mental health care systems in the country. It consistently received high marks from mental health care advocates and was held up as an example for other states to follow.

Today, it’s “One Flew Over the Cuckoo’s Nest” all over again.

By some estimates, New Hampshire could treat six people in their communities – where they would have access to friends, families and employment – for what it spends on one patient at the state hospital.

But residential treatment programs and community centers have been all but eliminated. Where once there were 150 beds locally, today there are about 24. Half the state doesn’t have access to community treatment teams capable of responding to people in crisis.

The pure shame in all this is the state’s unmitigated arrogance that everything is under control and lawsuits filed against it are unnecessary and distracting complications.

It’s a lonely view.