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N.H. Child Advocate: 'Historic' Number of Children Awaiting Psychiatric Care

Dan Tuohy/NHPR

A record number of children in New Hampshire are on waitlists for acute psychiatric services during the coronavirus pandemic.

In an annual report released last week, Moira O’Neill, director of the Office of the Child Advocate, says more kids than ever are in emergency rooms awaiting care for a mental health crisis.

In early 2020, less than 15 people under the age of 18 were in emergency rooms on waiting lists for acute psychiatric care; last month, the daily count exceeded 30 for the first time in five years, according to O’Neill.

The increase in children’s mental health emergencies in New Hampshire mirrors a national trend during the pandemic. The CDC recently found that emergency department visits among teenagers had increased by 31 percent, compared to 2019.

But advocates say the pandemic isn’t all to blame for the spike in New Hampshire.

Just as the state began shuttering schools and services in March, New Hampshire Hospital, the state’s psychiatric hospital, was closing its children’s unit. Young people in need of a psychiatric bed are now going to Hampstead Hospital, which has approximately 40 beds.

Under its current contract with the state, Hampstead Hospital does not treat children engaged in “criminal behaviors” in the absence of a psychiatric disorder or showing signs of “sexualized behavior.” O’Neill says this criteria may disqualify some youth and contribute to the current backlog.

(Hampstead Hospital did not respond to NHPR’s interview requests).

Credit Courtesy of NAMI NH
The waiting list for acute psychiastric care has fluctuated over the last 5 years. Youth under 18 are represented by the dark blue lines.

O’Neill says that ensuring an adequate number of psychiatric beds is just one piece of the puzzle.

Advocates say one of the best ways to decrease the ER waiting list is to coordinate mobile crisis services to address kids' mental health challenges earlier.

“The question is: Why are children reaching crisis level psychiatric needs in the first place," she asks. "And what can we do to better support families at home so that they don’t end up in the emergency room?”

The state has begun this work, outlined in Senate Bill 14, but O’Neill says the process could take years.

Sarah Gibson joined NHPR's newsroom in 2018. She reports on education and demographics.
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