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0000017a-15d9-d736-a57f-17ff90890000A continuing series on The Exchange, featuring week-long looks at issues of importance to New Hampshire.New Hampshire's Workforce Challenges (Airing May 20-24, 2019)Mental Health In New Hampshire: The Patients, The Providers, The System (Aired in May, 2018)

N.H. Hospital CEO: Use of Prison Psych Unit for Severely Mentally Ill Needs Review

Dan Tuohy / NHPR

New Hampshire Hospital CEO Lori Shibinette says the state needs to tackle the question of how to treat severely mentally ill and violent patients.  

 

Currently, those patients are held at the secure psychiatric unit at the state prison, whether or not they've been convicted of a crime.

 

That practice has long been controversial.  Speaking today on NHPR's The Exchange, Shibinette says right now, there's nowhere else to put them.

 

“We need other alternatives," she said. "If we’re not going to use the secure psychiatric unit, then what are the alternatives for N.H. Hospital?"

 

Shibinette says patients at the prison's secure psychiatric unit get the same care they would at the New Hampshire Hospital.

 

She addressed the issue during The Exchange's series looking at mental health services and the state of care for Granite Staters.

 

“N.H. Hospital is considered a safe hospital but not necessarily a secure hospital," she said. "We don’t have locked bedroom doors. We don’t have furniture that’s affixed to our building. So for a patient that is prone to violence or aggression, it can be a very dangerous place for not just that patient, for other patients and staff."

 

Currently, there are no alternatives to the psych unit at the prison, she said. If the state wants to provide for another treatment or housing option, she says the state must invest in the policy, including funding and the appropriate facility. "If we want to have that discussion about whether civilly committed patients should go to the secure psychiatric hospital, we really need to talk about what are the alternatives," she said.

 

In-Depth: N.H. Hospital, Community Mental Health Health Care, and the Path to Stability

 

Shibinette was joined on The Exchange on Thursday by Noel Chipman, a clinical coordinator for Concord transitional housing services, advocate Michael Skinner, a board member of the National Coalition of Mental Health Recovery, and Dan Ventola, Assertive Community Treatment coordinator with Genesis Behavioral Health in Laconia.

The series concluded with discussion of the role of the State Hospital in responding to crises, and what happens when a patient leaves a residential setting. The four spoke of the importance of peer support, transitional help, and challenges with hiring and retaining mental health professionals and staff.

"It's a vicious circle," Ventola said of staffing. "The frontline staff tend not to be paid as well as they should. I think that's a statewide thing. So it's hard to hire and to retain staff. And the staff that are there fighting the good fight are overwhelmed."

[Explore the Exchange In-Depth Series on Mental Health Care in N.H.]

Skinner said New Hampshire was a pioneering state about 25 years ago for peer support for mental health recovery. It's since making a comeback, he said.

"The peer support piece is all too often missing," he said. "Sometimes it's just that simple act of making a human connection. That's really the magic to this."

Shibinette adds that it is important to create a discharge plan for those at N.H. Hospital. She reports progress. The number of patients waiting for discharge after more than three weeks, after being found clinically stable, dropped from 70 in December to 42 in April, she said. 

New Hampshire Hospital provides inpatient psychiatric care to children and adults and support for community-based care. It has 168 beds. 

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