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NH hospitals, state health department resolve lawsuit over ‘ER boarding’ of psychiatric patients

Concord Hospital
Zoey Knox
Emergency Department at Concord Hospital in Concord, NH. Zoey Knox photo 2023 / NHPR

In a resolution released Wednesday, hospitals and the state of New Hampshire announced an agreement to resolve litigation around the practice of holding psychiatric patients in hospital emergency rooms, known as “ER boarding.”

Under the terms of that deal, New Hampshire will have to eliminate waitlists for inpatient mental health care by May 2024. That deadline was originally set in an opinion issued by a federal judge earlier this year.

Initially, state officials said they needed two years to make that change — but they have since agreed not to appeal the judge's order. In exchange, the hospitals suing over the practice agreed to drop other claims and not seek attorney’s fees.

The hospitals, the state Department of Health and Human Services, and the New Hampshire Hospital Association issued a joint statement July 12 about meeting that one-year deadline.

Read the full announcement here.

New Hampshire Hospital Association President Steve Ahnen called the decision an important step to ensure patients in crisis “will get the specialized care they need, when and where they need it.”

Lori Weaver, interim commissioner of New Hampshire's state health agency, said she is "committed to eliminating this state’s waiting list."

"We will achieve this important milestone by working with our partners throughout the healthcare system to increase access to mental health services for all residents," she said.

The state has taken additional, previous steps to address young patients in New Hampshire who are experiencing a mental health crisis. That included, earlier this year, opening a renovated health facility in Hampstead.

As of July 12, there were 47 adults waiting in New Hampshire emergency rooms for mental health treatment, and 51 beds were unavailable due to staffing constraints or renovations, according to the state’s dashboard. There were four children awaiting treatment, and 42 beds were unavailable due to staffing issues or renovations.

Susan Stearns, who leads the National Alliance on Mental Illness’s New Hampshire chapter, welcomed news of the agreement. Being confined to an emergency department for days or weeks can be traumatizing, she said.

“To bring an end to this practice means that our loved ones will be able to receive the care they need, when they need it,” she said.

Eliminating the need for psychiatric boarding will require more than just inpatient beds, she said. Expanding community-based services like transitional housing, crisis stabilization units and peer respite would keep more people from having to be in the hospital in the first place.

“We want to avoid folks needing that level of care,” she said.

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Updated: July 12, 2023 at 6:01 PM EDT
This story was updated with additional comments from the National Alliance on Mental Illness’s New Hampshire chapter.
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
Dan is a long-time New Hampshire journalist who has written for outlets including Foster's Daily Democrat, The Citizen of Laconia, The Boston Globe, and The Eagle-Tribune. He comes to NHPR from the New Hampshire Union Leader, where he reported on state, local, and national politics.
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