Ongoing Granite State crisis: Keep mental health issues on New Hampshire’s candidates’ radar
Earlier this month, Northern Human Services and the nine other non-profit community mental health centers (CMHCs) which make up the NH Community Behavioral Health Association (CBHA), sponsored a Mental Health Candidates Forum at the Institute of Politics at St. Anselm’s College in Manchester. The intent was to offer CMHC board members, staff and our health care partners the opportunity to engage with candidates for the offices of US Senate, Congress, Governor, Executive Council, and legislative leadership and to express to them our most critical concerns around behavioral health and access to care.
The fact that 12 candidates participated in this forum – which was only announced and organized a short month ago – was extremely encouraging to the CMHCs. It speaks to the very real commitment of candidates and policymakers from both sides of the aisle to the issues of mental health and substance use, and the stigma around them. We want to sincerely thank all the candidates and campaign staff who attended the Forum, as well as those who could not make it in person but kindly submitted comments via video. We also want to thank the leadership and staff at the IOP for providing an excellent venue for CBHA to host this event.
We sent a summary of key policy concerns to the campaigns in advance of the Forum to give them some sense of what the CMHCs’ concerns are and what to expect for questions. These ran the gamut of stigma, telehealth, workforce shortages, substance misuse, gun violence, and parental rights. Some of the candidates came with prepared responses to these issues; others chose to answer questions from the CBHA representatives who introduced them. In all cases, the conversations with the candidates and members of the audience were illuminating, and our hope is they will lead to policy and funding proposals on the state and federal levels that answer unmet needs. The areas of discussion included:
Telehealth: This has been proven to be an effective modality of care and was the reason the CMHCs were able to consistently provide care during the past two years of pandemic. Candidates were asked how they will commit to ensuring that this is a permanent modality and sustainable for the long term.
State v. federal requirements: Candidates were asked how they will help to ensure that federal rules and regulations do not interfere with state policy and thereby create barriers to access. CMHCs are sometimes overlooked when federal laws and rules are enacted. For example, electronic health records are recognized and funded for nursing homes, FQHCs and hospitals – not for CMHCs.
Stigma: We need to break down stigma around mental health and substance abuse disorders. Candidates were asked for their view of the importance of programs to address mental health and substance abuse disorders in their communities, and their commitment to supporting those programs.
Workforce: As of August, the ten CMHCs had a workforce vacancy rate of 393 total positions and 345 clinical positions. CBHA and the CMHCs are working with health care partners and other stakeholders to address the workforce with investments in the student loan repayment plan (SLRP) and an increase in Medicaid rates. Candidates were asked to describe their plans to improve the current state of the mental health workforce, their commitment to increased SLRP investments and Medicaid rates, and any additional strategies they have to address the workforce crisis.
Gun violence: Mental illness is very often the scapegoat when there is a mass shooting, school shooting, or other gun violence episode, anywhere in the nation. This is not based on accurate data, perpetuates stigma around mental illness, and avoids the real problems that lead to these tragedies. Candidates were asked whether they support a “red flag” law that would allow family members to go through a process to request that guns be turned over to law enforcement when they recognize that an individual’s behavior becomes threatening or dangerous.
Parental rights: A contentious and much publicized topic in NH and other states is “parental rights.” Candidates were asked how they answer the question of how to balance protecting children with keeping parents informed. How would you address honoring the confidentiality of interactions of school nurses, guidance counselors and teachers with children who may not have support at home?
Our audience of more than a hundred and the candidates who spoke at the Mental Health Candidates Forum were reminded that scores adults and children were waiting in hospital emergency rooms for psychiatric beds on that beautiful October day. The mental health crisis in New Hampshire is ongoing. Our public officials need to keep these issues on the front burner now and beyond November 8th
Suzanne Gaetjens-Oleson is CEO of Northern Human Services in Conway. She lives in Lancaster.