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New Hampshire could put up $15 million to spur development of new mental health hospital

A headshot of Jeff Fleischer, the head of New Hampshire's Division for Children, Youth and Families.
NHPR
In an Aug. 26 request to the Fiscal Committee, Department of Health and Human Services Commissioner Lori Shibinette said the new hospital would help “address the mental health crisis in New Hampshire that has been exacerbated by the pandemic.”

For the second time this year, New Hampshire health officials are proposing to use $15 million in federal funds to help a private health care system stand up a new behavioral health hospital.

Under the plan, SolutionHealth — which includes Elliot Hospital in Manchester and Southern New Hampshire Medical Center in Nashua — would build a 130-bed mental health facility somewhere in south-central New Hampshire.

The total construction cost is estimated at $50 to $55 million. If this plan is approved, the hospital could be up and running in 2024, according to the state’s initial proposal.

The Joint Legislative Fiscal Committee approved funding for the new proposal Friday. It will also require Executive Council sign-off.

In an Aug. 26 request to the Fiscal Committee, Department of Health and Human Services Commissioner Lori Shibinette said the new hospital would help “address the mental health crisis in New Hampshire that has been exacerbated by the pandemic.”

New Hampshire has long struggled with a shortage of inpatient psychiatric care, causing some people in mental health crises to be held in emergency rooms for days or weeks until beds open up. Shibinette said in her funding request that wait times have increased during the pandemic.

As of Thursday, 33 adults were in hospital emergency departments waiting for a psychiatric bed, according to the state’s tracker, along with two in correctional facilities. Fourteen children were also on the waitlist.

The SolutionHealth plan is the second such proposal brought forward this year. In January, the Fiscal Committee approved spending $15 million to help Portsmouth Regional Hospital and parent company HCA Healthcare build a 96-bed mental-health facility in Epping, also using federal funds from the 2021 American Rescue Plan Act.

But the health department withdrew that request from the Executive Council’s agenda in March. DHHS spokesperson Jake Leon said the state “could not reach an agreement with HCA” and is “not moving forward with that proposal at this time.”

The plan is one of several ways the state has sought to build out New Hampshire’s mental health infrastructure over the past few years. That has included launching mobile crisis response teams; buying Hampstead Hospital, which provides in-patient care to youth; and expandingpeer-support services.

Susan Stearns, the executive director of NAMI-New Hampshire, a mental health advocacy group, welcomed news of the proposed hospital. She said expanding bed capacity could reduce the number of people who have to spend days in the ER waiting for treatment.

“The practice of boarding people in emergency departments is wrong on multiple levels, and certainly not cost effective, and doesn't provide folks with the treatment that they need, when they need it,” she said.

But she also hopes the state continues to invest in other mental health services, including community-based supports to help people stay out of the hospital in the first place.

“That level of care, such as an inpatient psychiatric stay, should really be that last resort,” she said.

Last year, Gov. Chris Sununu directed DHHS to take various steps to improve the state’s mental health system, including finding ways to increase the number of beds available for involuntarily committed individuals. The order came days after the New Hampshire Supreme Court ruled the state had to start promptly holding court hearings for patients held against their will in emergency rooms.

Shibinette said in her funding request that officials have tried other ways to expand that capacity, with limited success. That includes offering hospitals around New Hampshire funding to set up psychiatric beds for involuntarily committed patients, but there were no takers. The new hospital is expected to provide 25 such beds.

Other units would treat children and adolescents, young people with developmental disabilities or autism, seniors, voluntarily admitted adults, and people with co-occurring mental health and substance use disorders. The facility would also offer outpatient substance use treatment.

As part of the negotiations, the state expects to reach an agreement under which SolutionHealth would commit to providing certain levels of service over 10 to 12 years, officials said at Friday’s Fiscal Committee meeting.

SolutionHealth spokesperson Kelly Scargill said the health system is committed to expanding access to behavioral health care, and is in the “early stages of exploring opportunities and refining our plans” for the new hospital.

People experiencing a mental health crisis can call or text 833-710-6477 forNew Hampshire’s Rapid Response Access Point, or 988 for theNational Suicide & Crisis Lifeline.

Paul Cuno-Booth covers health and equity for NHPR. He previously worked as a reporter and editor for The Keene Sentinel, where he wrote about police accountability, local government and a range of other topics. He can be reached at pcuno-booth@nhpr.org.
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