We are writing to express significant concerns about the state’s recent emphasis on institutional mental health treatment, rather than community-based treatment. We are members of the NH Protection and Advocacy for Individuals with Mental Illness (PAIMI) Advisory Council, a body established by federal law. We come from a variety of professions and backgrounds, and many of us have lived mental health experience. Our role is to monitor developments in the state related to the well-being of people with mental illness, and to provide independent advice and recommendations to the Disability Rights Center.

Today, we also want to share our insights with you. The State of NH has long promised that it would establish a community-based system of supports and services for our vulnerable mentally ill population, rather than rely on oftentimes unnecessary institutional care. This commitment can be found in the Community Mental Health Agreement, 2019’s Senate Bill 14, and two 10-year Mental Health Plans. We know that keeping people with mental illness in their communities is not only vastly more cost-effective, but that when people can remain in their homes, schools, and neighborhoods they lead more successful, stable and meaningful lives.

This understanding is the basis for our significant concern about the state’s use of federal funds to add more beds in hospitals around the state and neighboring states. We implore you to instead use the funds to build out the evidence-based community supports and services that we know will help people get well. We also ask you and our lawmakers to make investments with state dollars to fund things such as Child-Parent Psychotherapy (CPP), Supported Housing, Employment Counselors, Critical Time Intervention (CTI) programs at all of our community mental health centers (CMHCs), Step Up/Step Down programs, and the Multi-Tiered System of Supports for Behavioral Health and Wellness (MTSSB) Program – a framework to support social and emotional learning in all school districts.

Moreover, we have waited with frustration for over two years for the fully funded and statutorily required statewide system of community-based crisis services to be stood up. This has had dire consequences. We cannot wait that long for authorized and funded programs to be stood up when we know that suicides are occurring all over our state. Our current system is failing our residents and we cannot settle for Band-Aid solutions.

Additionally, the Americans with Disabilities Act requires that services be provided in least-restrictive environments. This is consistent with our moral obligation to help people remain in their communities. We do know that institutionalization is sometimes necessary, but we also know many folks who are hospitalized could have instead received community-based services if those services existed. We recognize and applaud some of the work that is being done to improve the community-based treatment system, but we implore you to redouble those efforts and ensure that all our residents can receive timely and appropriate care when and where they need it.

Sincerely, Dellie Champagne, Chair

Deane Kellison, Vice Chair

Holly Fenn

Andrea Jergensen

John Kitchen

Deb Yuknewicz-Boisvert

Katherine Anthony

Juli Hincks

Elizabeth Luna

Jean Lewandowski