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So many with mental health issues not receiving care they need

  • Published in Letters
To the editor,
I have lived in New Hampshire all my life. My father was severely mentally ill back in the 1930s to the early 1990s. In the 1950s, conditions at the New Hampshire State Hospital were deplorable. Conditions in the wards were unsafe and patients had no rights. Families and individuals were in turmoil. Sometimes police and court intervention was necessary. In the 1980s and 90s the stigma of mental illness was beginning to fade and services were improving.
Now it is 2013, and you would think with all advances in understanding of mental health issues and the impact that it has on individuals, families, and society, that funding for treatment and services would be available on par with physical illnesses. But, sadly, this has not been the case. In the last 12 years New Hampshire has fallen from an A rating to almost an F rating in the services it recently has been providing for mental health. What has happened is that many of our representatives in Concord, who live on our communities, had seen fit to cut the budget of Heath and Human Services and reduce reimbursement rates to community mental health centers such as Genesis Behavioral Health. The Philbrook Children's Mental Health facility in Concord has been closed. The number of beds available for adults patients at New Hampshire Hospital was reduced to make room for the children in need — creating a serious shortage overall. It seemed like we are falling back to the dark days of the 1950s, where the essential needs of the mentally ill are ignored or discarded. Families and the community suffer the consequences of people who are unable to successfully and safely function in society. Police are now taking more and more calls for situations that involve people acting out and potentially posing life threatening situations. Just listen and see the recent news headlines with increased crime, crisis situations involving police and helpless family members.
I have been on the front, so to speak, involved with and advocating for, two young adults that I have known for several years. I will call them David and Jame. They continue to suffer for mental illnesses with diagnosis of bipolar and other mood disorders. They are, at time, very depressed and at other times very angry and agitated.
One night, last year, David who had just returned back to N.H. was very despondent. His girlfriend had just left him. His family had turned their backs on him. He felt that he had lost all his friends. He was suicidal, and it was not the first time. I was concerned for his safety, and so I took David to the ER and LRGH. On the intake sheet he wrote, "I want to kill myself." It was late, so I went home expecting he would receive the help he needed. Instead, he waited over four hours for a doctor to see him. When he was finally evaluated by the emergency mental health doctor David was told that there was nothing that could be done. Today's psychiatric threshold is so high, basically you have to actively be trying to kill yourself or harm someone else in order to receive services or a psychiatric evaluation.
He left the ER and walked for two hours back to my home. Because he had no insurance he was told he could call Genesis Behavioral Health, but there would be a lengthy waiting period before he could have an appointment for an evaluation and follow up care.
A year later, David is next to homeless, has no insurance and owes LRGH over $2,000. He still suffers from depression and the inability to work. The State of New Hampshire cut off his food stamps because he is classified as able-bodied, so his assistance was temporary. Without personal, family or other support David is even more despondent and feeling trapped in a spiral of depression.
Last Spring, James called me saying he was coming to "get me" and said he was done with life. I was so concerned I called the police. They found him incoherent on the side of the road. They took James to the ER and LRGH, his second police escort visit. Again, he waited for a long time, and again the emergency mental health doctor was unable to do anything as James didn't pose an immediate threat to himself. If there was such a threat, then there was likely a three day waiting period for a bed a New Hampshire Hospital. The doctor's hands were tied. So, at 3 a.m. this young man was released. He walked the streets of Laconia until early morning, still distraught and feeling abandoned. 
Now, one year later, James has been living in a group home for six months. A place where it would seem that he would be receiving the help he needs. But sadly he still has not received adequate help, again because of the lack of funding and the personal dynamics of those with mental illness that create hardships for the trained and dedicated staff members to do their job. There is no full-time or emergency staffing at the home. He still suffers with suicidal thoughts and severe negativity. He is unable to sleep or eat properly and he self medicates. In March he was taken to LRGH ER by the Laconia Police. He was held under 24/7 police observance for two and a half days. The was sent to Concord. He was there only 10 days and released unready and still unstable. This made it difficult for his coordinated, follow-up care at Genesis to be effective. 
As a personal and caring friend, I have been on the front line defense for his life and do my best to help and to speak up and be heard. Also I experience first hand pain and anger that is directed my way, and personal risk, as this unfortunate young many is still crying for help. I have had many sleepless nights and have had to call friends or the police whenever I have felt threatened myself.
These two individuals are just two examples of many others who also have and continue to live their lives in self fear and mental trauma, because they are not receiving the care they need. Due to financial restraints, red tape, and lack of funding for agencies such as Genesis and Health First.
Still, over and over again the stigma and fear of those with mental illness has created a human injustice and community stress. Our local police departments and emergency room staff are concerned and often overwhelmed on how to work in a broken system. And still those with mental illness suffer, while family and concerned citizens also feel the pain and injustice of lack of funding and coordinated efforts to address a human and moral dilemma.
Mental health is like the "ugly stepsister". Consider this, young people with Downs Syndrome are supported with great community caring and support. Special Olympics as a wonderful example of the encouragement and support they receive. They are supported and accepted in our lives to reach their full potential in life. Some people who suffer with developmental disabilities receive state funded support costing many thousands a year. They are provided specialized housing. Daily activities and many support services so they can live in safety and with the support they need. Because they are our family members and children.
Currently our new governor, Maggie Hassen, has committed to some positive proposals to better meet the needs of those with mental illness, with additional funding and programs in her budget. But already the State Senate wants to cut some of these programs and spending proposals, which actually have been parts of a 10 year bipartisan proposal that is five years behind in its implementation. Those positive changes when they come will take months to be implemented. This effort to resort the state's commitment should be strongly encouraged and supported.
But right now, I believe the call to action is urgent. Our community has suffered another tragic death. We as a community must stop making excuses, passing the buck and saying "not here . . . not in my back yard" or "it's the governments fault" and so on. It is time for our community leaders, from Washington, Concord and local council members and select members, church clergy, business leaders, health professionals and staff, and caring individuals to take action and support one another to adequately serve the needs of our most vulnerable citizens and in supporting and improving the services and accountability provided by Genesis, Health First, Carey House, Cornerbridge and other community agencies that can make a difference in the lives of those who suffer with mental illness.
John P. Rogers