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Following Loss In Court, Sununu Says N.H. Will Make Changes To Mental Health System

Photo of Sununu speaking at microphone
Dan Tuohy / NHPR

Gov. Chris Sununu is ordering a review of the state’s system for treating people in severe mental health crises, after the New Hampshire Supreme Court ruled this week the state was violating the statutory rights of those held against their will.

Sununu announced Thursday he will sign an executive order aimed at increasing the number of emergency beds for people in crises statewide, and that the state-run New Hampshire Hospital in Concord will look to immediately expand its capacity.

On Tuesday, the court ruled in favor of a woman identified as Jane Doe who languished inside a hospital emergency room for more than two weeks awaiting transfer to a speciality psychiatric hospital due to a shortage of available bed space. During that time, she was unable to challenge her confinement, which she didn’t believe was necessary, despite a state statute that says people in her situation must be awarded a hearing within three days.

The New Hampshire Attorney General’s office argued the state was not in violation of the statute, claiming the three-day window for a hearing doesn’t begin until the person is transferred out of an emergency room setting. But the justices unanimously rejected the state’s position.

The ruling essentially requires the government--both the executive and legislative branches--to take action to remedy a long-standing challenge facing the state: an underfunded and overstretched mental health system.

At a press conference Thursday, Sununu said the state was “absolutely embracing” the ruling.

“There is an urgent need for the state to accelerate its work in increasing the number of available beds for emergency psychiatric patients,” Sununu said.

The number of patients awaiting a bed in a speciality care facility in New Hampshire has ebbed and flowed since the backlog first emerged in 2012. During the pandemic, the waitlist for services skyrocketed to more than 80 adults and children waiting inside of hospital emergency rooms.

Sununu said the solution doesn’t lie just with the state, but will also involve hospitals and other care providers taking on a greater role in offering emergency psychiatric care.

“The Supreme Court’s decision saying ‘You must’ -- right, it kind of gives us the backing to say, well, ‘We must,’ so here we go,” he said. “And we don’t want to hear from the lobbyist saying, ‘It can’t be done.’ I don’t want to hear from the providers saying, ‘Sorry, we like the idea, but…’ ”

Hospitals have scaled back psychiatric services in recent decades, citing a range of factors from low reimbursement rates to a shortage of trained staff to provide specialized services. The New Hampshire Hospital Association filed an amicus brief in the recent lawsuit, siding with Jane Doe.

“This week’s ruling by the New Hampshire Supreme Court has made it very clear that this problem must be resolved now,” the Hospital Association said in a statement. “All parties should see this as an opportunity to sit at the table together and formulate both short and long-term solutions so that patients suffering an acute psychiatric illness are able to get the care they need.”

While Sununu said he was presenting a sweeping, strong response to the court ruling, the details he offered Thursday were limited. He said New Hampshire Hospital will look to quickly expand its capacity, and that money will be provided to ensure more services at other hospitals in the state, though it wasn’t immediately clear how quickly those beds may be brought online.

He also said he would order a review of “all mental health services” in the state and see if private healthcare providers - both in and out of state - were equipped to meet the challenge posed by this week’s court ruling.

Todd started as a news correspondent with NHPR in 2009. He spent nearly a decade in the non-profit world, working with international development agencies and anti-poverty groups. He holds a master’s degree in public administration from Columbia University.
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