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Patients Waiting in Emergency Rooms for State To Fix Mental Health System

Jack Rodolico
John Dixon stands before New Hampshire Hospital, where his son is currently a patient.

Starting October 30, Andrew Dixon spent 13 days in the emergency room at Frisbie Memorial Hospital in Rochester. And as his father, John Dixon, describes that time, you might think Andrew had committed a crime. 

"During those thirteen days he was in a twelve-by-twelve room," says Dixon. "There was just a bed and a chair. There was a guard outside the door. He didn’t understand entirely why he was there. And it just kept going."

John Dixon did what he could to keep his son calm. Andrew is an artist.

"I brought in some art supplies so he was doing watercolor pens, chalk and pastels and things."

John Dixon says his 22-year old son suffers from both a thought and a mood disorder. His temper can flare and he has irrational thoughts. Dixon brought his son to Frisbie’s emergency room because he was aggressive and possibly suicidal.

Emergency departments are often the doorstep to New Hampshire Hospital, the state’s psychiatric hospital in Concord. Andrew Dixon was eventually admitted there, but on any given day there’s an average of 28 people with acute mental health symptoms waiting to get in. And that number has been climbing, says Suellen Griffin, the president of West Central Behavioral Health.

"It is certainly symbolic of the fact that the system is broken in the state of New Hampshire," says Griffin. "And so my concern is that it becomes the norm and so it doesn’t rise to the crisis that it really is."

If you break your arm or have a heart attack, chances are you can get medical care right away. But if you have a severe mental illness – you could wait days or even weeks before you get a hospital bed in New Hampshire. Families and mental health professionals are looking to the Republican-controlled statehouse for a solution.

A painting made by Andrew Dixon while he spent 13 days in an emergency room waiting to be admitted to New Hampshire Hospital.

Driving up hill

Many legislators, including Senate Majority Leader Jeb Bradley, say the state needs to spend money to fix this. And it is – New Hampshire Hospital recently added ten beds – after cutting dozens over 20 years. The state’s also dedicating $30 million to make it easier for people get mental health care outside of hospitals. That’s to comply with a recent class-action settlement.

But here’s the problem: fixing the state’s mental health system is like pressing down on the accelerator of an old car – despite all the energy we’re burning it’ll take a while before we get up to speed.

Until then, Ken Norton, the director of N.H.’s chapter of the National Alliance on Mental Illness, says patients who are delusional or suicidal will be waiting in emergency departments. 

"I mean can you imagine that happening with a heart condition?" Norton says. "It’s really inhumane."

Norton sees one of his jobs as poking policymakers - reminding them that on any given day, as many as 50 people – including children – are stuck in emergency rooms waiting for treatment.

Jeffery Meyers, the Commissioner of the state’s health department, has been trying to better understand who exactly those people are. So far the data shows about half have already been treated for mental health needs – usually by their local community mental health center. Meyers wants all those providers to start communicating better.

Meyers: So that when they experience a mental health crisis or problem they can be treated directly by the community mental health center as opposed to showing up in the hospital ED.

Those mental health centers say they’re struggling to hire staff amidst a statewide workforce shortage – and it doesn’t help the state hasn’t increased Medicaid rates since 2006, so wages at these centers aren’t competitive.

Who's driving the car?

All this speaks to something everyone interviewed for this story agrees to: New Hampshire may be spending new money on mental health, but the state lacks a vision for where it's going, in part because it’s still reacting to past budget cuts, expensive lawsuits, and now an opioid crisis.

John Dixon says for his son’s sake he’s looking to a new governor and legislature for leadership. 

"I have to be optimistic," he says. "My son has been given a diagnosis that is a lifelong diagnosis."

So long as people are stuck in a guarded room without treatment for weeks, Dixon says the state isn’t doing enough to help people it is legally obligated to protect.

A pastel drawing made by Andrew Dixon as we waited in an emergency room for 13 days before being admitted to New Hampshire Hospital.

Before joining NHPR in August 2014, Jack was a freelance writer and radio reporter. His work aired on NPR, BBC, Marketplace and 99% Invisible, and he wrote for the Christian Science Monitor and Northern Woodlands.

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