A discussion of the state’s efforts to develop a new 10-year mental health plan drew a crowd of several dozen to the Keene hospital Tuesday night, with many attendees speaking about their personal or professional connection to the issue.
The event, in a conference room at Cheshire Medical Center, is the first of several forums throughout the state in which N.H. Department of Health and Human Services officials are describing the broad outlines of the plan and seeking public feedback.
The plan is about “laying out the foundations that we think would help build a stronger mental health system in New Hampshire with more community supports,” Health and Human Services Commissioner Jeffrey A. Meyers said.
As explained Tuesday night, the plan envisions a centralized mental health portal — a hotline for people seeking information or treatment — which would then refer them to local services.
It also aims to bolster the state’s mental health workforce and to strengthen various aspects of the “continuum of care” — the range of services a person can move through, from hospitalization to outpatient support.
Officials spoke of expanding the use of peer supports, increasing prevention and early intervention, adding mental health beds for people in crisis and supporting them as they transition back into the community.
The goal, said Julianne Carbin, director of the Bureau of Mental Health Services, is “to ensure that individuals and families who are affected by mental illness can access care and treatment when and where they need it.”
The draft plan is slated to be released next month, in advance of an Oct. 25 public hearing in Concord on it.
Several people at the Keene event praised parts of the plan as described, but said it all hinges on whether the state’s leaders are willing to fund it.
“We can have the best plan in the world, but if we don’t have leadership — but mostly money — to implement it, it’s not happening,” said Joe Schapiro, a Keene social worker running for state representative in November.
Meyers said he and his staff will testify before the Legislature and push for funding during the budget process.
“We are gonna make a very strong effort to ensure that what happened back in 2008 doesn’t happen in 2018, in 2019,” he said, referring to the state’s last 10-year mental health plan. “That we get a commitment from the Legislature to fund important aspects of this plan.”
The 2008 recommendations included building up both inpatient and intensive outpatient treatment capacity, developing a more robust mental health workforce and helping people with mental health issues access housing, which can provide stability and prevent unnecessarily prolonged hospitalization, the plan noted.
On Tuesday, Meyers said the recession kept the 2008 plan from being fully funded.
And challenges noted a decade ago remain. A report commissioned by Health and Human Services and released late last year found that the waitlist for mental health beds has continued to increase; a year ago this week, 70 people were waiting for admission.
People interviewed for the 2017 report advocated for more outpatient services to reduce the demand for inpatient space, and some of them also pushed for a “modest increase” in the number of beds.
Access to transitional housing remains an issue as well, Meyers said Tuesday.
“We have 20 or 30 people tonight at New Hampshire Hospital who do not need to be at New Hampshire Hospital, but there’s no place for them to go,” he said.
Workforce struggles also came up. The topic resonates locally — in 2016, Cheshire Medical Center closed its inpatient mental health unit because of staffing shortages.
Peter A. Starkey, the executive director of the Monadnock Area Peer Support Agency, said he has employees living in poverty who deserve higher wages.
Celia G. Oliver, a Peterborough psychologist and the president of the N.H. Psychological Association, said she and her colleagues are “overworked tremendously.”
Some in the audience shared wrenching personal experiences.
Jennifer Bellan of Winchester recounted long, frustrating phone calls, trying to get information about accessing mental health services.
She urged Health and Human Services officials to make sure the centralized portal is user friendly — especially considering the population it’ll serve.
“A person who is dealing with a mental health issue who is trying to access the system — you cannot assume a level of control that’s not there,” she said. “… If I’m in the middle of a panic, everything gets lost in the shuffle.”
Diana Damato of Keene stressed the importance of education and reducing stigma, also a part of the state’s new plan.
“With employers, for instance, it’s so scary to give any hint or indication of your background for fear that it will affect whether you get a job or not,” she said. Once, she recalled, she felt anxious about submitting health-related paperwork to a longtime employer, for fear of how she’d be viewed.
Another Keene resident asked about training for law enforcement and other first responders.
She talked about a recent episode in which her adult son had “a mental break at 4 in the morning.”
The woman, who asked not to be named to protect her son’s privacy, said she was hesitant to call 911.
“I was scared for him in part because he had been traumatized by a former involuntary hospitalization, and I knew that he wasn’t gonna willingly go,” she said, “and because I hear on the radio stories about the confrontational approach that police are trained in.”