Republican Gov. Chris Sununu on Friday called for additional beds at the state psychiatric hospital as part of a larger effort to re-engineer New Hampshire's mental health system.
Sununu spoke to reporters after touring the emergency department at Concord Hospital, which is frequently full of patients waiting to be admitted to New Hampshire Hospital for inpatient psychiatric care. On the busiest day, in February, 22 psychiatric patients were waiting for beds in a space designed for six.
"When you have this kind of logjam, when you let it get to this kind of crisis, it's one of those things where if you don't pay for it in the beginning, you're going to pay five times as much down the road," he said. "We did not deal with this. We let this become a crisis, so unfortunately that puts the onus on us to have to pay two, three, four, five times as much, not just financially, but in terms of effort, in terms of facilities, in terms of finding workforce. The problem has really compounded upon itself."
The state had been working to improve its mental health services since settling a federal lawsuit over inadequate care in late 2013. In July, a new 10-bed crisis unit opened at New Hampshire after almost a year of delays, but emergency rooms around the state still are often left caring for patients waiting for those beds.
Concord Hospital President and CEO Robert Steigmeyer said he and others are eager to work with Sununu's administration to rebuild a system that was one of the nation's best two decades ago.
"Twenty years later, I think the system has been dismantled gradually. Funding is a piece of it, and we've lost beds ... and then when you overlay the substance abuse crisis on top of it, it accelerates," the problem, Steigmeyer said.
Sununu said he's been working with lawmakers on a proposal that will be released next week to increase capacity at New Hampshire Hospital, though he did not specify how many new beds or what that would cost. Longer term, he said he wants to improve community-based services so fewer inpatient beds are needed.
The Senate Health and Human Services committee will consider an amendment Tuesday that would allow for an additional 20 "designated receiving facility beds" for up to two years. Under current law, hospitals, community mental health programs, nursing homes and other facilities can apply for such a designation to care for those subject to involuntary admission.
The sponsor of the bill, Republican Sen. Jeb Bradley, also proposes up to 40 transitional and community residential beds for patients transitioning from the state psychiatric hospital or other designated receiving facilities.
Other changes under consideration include increasing the number of mobile crisis units and expanding their role to include working with smaller rural hospitals and building an urgent care receiving facility at New Hampshire Hospital so patients would start there instead of in emergency departments, Sununu said.
"We have to get aggressive about how we're going to deal with the backlog and then create the long-term solution," he said.