State plans $17 million investment in inpatient mental health treatment

By: - January 20, 2022 11:35 am
Hampstead Hospital Exterior

Throughout the pandemic, Hampstead Hospital has had enough staff to open fewer than 40 of its 111 inpatient beds. (Annmarie Timmins | New Hampshire Bulletin)

The state has plans to spend approximately $17 million in federal pandemic aid to significantly expand capacity for inpatient mental health treatment for adults and children in New Hampshire.

The larger investment would provide Portsmouth Regional Hospital and its parent company, HCA Healthcare, nearly $15 million to help create a new $45 million consolidated behavioral health hospital for adults and youth in Epping. An additional $2.2 million would bring a behavioral health “strike team” to Hampstead Hospital to allow it to expand on its 16 inpatient beds for children and adolescents. It is currently the only inpatient facility for that population.

There are approximately 200 inpatient beds for adults in the state, nearly 160 of them at the state hospital, and 16 beds for children.

With both investments, the department hopes to reduce the number of people waiting in emergency rooms and elsewhere for an inpatient hospitalization, a number that has reached more than 30 for children and 50 for adults. On Thursday, there were three children and 18 adults waiting in emergency rooms for a bed and two adults waiting at correctional facilities, according to the state’s count.

The Joint Legislative Fiscal Committee is scheduled to take up both approval requests from Health and Human Services on Friday. The Executive Council must also agree.

Under its plan for Portsmouth Regional Hospital, the department would provide $15 million for “capital defrayment” costs during construction of the building, which is expected to be ready in fall of 2023.

The new hospital would provide 68 inpatient beds for adults, nearly 42 percent more than HCA Healthcare currently has, and 16 beds for geriatric patients, an increase of about 60 percent, according to the department’s request. 

The plan also calls for the hospital to expand its behavioral health treatment to children ages 12 and older with 12 inpatient beds, and add a new partial hospitalization outpatient program with 15 beds. 

All beds would be for voluntary and involuntary admissions. 

Messages to HCA Healthcare seeking more information about the project and how it will fund its portion of the cost were not returned.

Throughout the pandemic, Hampstead Hospital has had enough staff to open fewer than 40 of its 111 inpatient beds. An average of just 16 of those beds has been available to children and adolescents, too few the department said, especially as the pandemic has increased mental health care needs for that age group.

Between 2019 and 2021, the number of children seeking inpatient care increased by 75 percent and they waited longer for admission, according to the department. The department did not say how many additional children it anticipates serving with the strike team, which will include nurses, social workers, and mental health counselors.

These beds would be in addition to the 10 now available at the Brattleboro Retreat in Vermont under a December contract with the state. But those beds will be open to New Hampshire children only when the facility is not full. 

Susan Stearns, executive director of NAMI NH, said the organization backs the department’s proposed investments in Portsmouth Regional Hospital and Hampstead Hospital.

“I think there is no question that we have a need for investment right now,” she said. As the department did in its request, Stearns said boarding children and adults in emergency rooms is not only harmful to them but a further burden on hospitals struggling to keep up with the pandemic. 

But Stearns cautioned against seeing additional inpatient beds as the only or even most important investment needed. There needs to be a continuum of care, she said, that provides mental health treatment before someone is in crisis and supportive housing once people are ready for discharge but still need support.

Health and Human Services spokesman Jake Leon said these investments are part of the state’s effort to do so and fulfill the vision of the state’s 10-year mental health plan.

“Two years into the pandemic, the state continues to experience a demand for inpatient psychiatric care that exceeds current capacity for children and adults,” Leon said in an email. 

“Both of the items submitted for the (fiscal) committee’s consideration are expected to alleviate the time individuals spend waiting for services in hospital emergency departments by providing much-needed staffing at Hampstead Hospital and a build-out of inpatient services, including in specialty areas that are not commonly provided in state.”

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Annmarie Timmins
Annmarie Timmins

Senior reporter Annmarie Timmins is a New Hampshire native who covered state government, courts, and social justice issues for the Concord Monitor for 25 years. During her time with the Monitor, she won a Nieman Fellowship to study journalism and mental health courts at Harvard for a year. She has taught journalism at the University of New Hampshire and writing at the Nackey S. Loeb School of Communications.