Rik Cornell: A new era for mental health in New Hampshire

If one good thing has come out of the past 16 months – with the pandemic’s challenges of social distancing, remote work and remote learning, and separation from family and friends – it may be a new attitude toward mental health and mental well-being in New Hampshire. It seems to us in the community mental health arena that there is more positive movement to deal with mental illness right now than there has been in our state for quite some time.

The biggest proof of this is increased funding for mental health services and programs included in the state budget that was approved in June. The governor and the Legislature made it a priority to finance mobile crisis units, transitional housing, additional psychiatric beds, and a new Secure Psychiatric Unit. The New Hampshire Department of Health and Human Services is now issuing RFPs to bring these programs to fruition.

In response to a court decision in June on the emergency room boarding crisis, DHHS also made changes to the allocation of beds at New Hampshire Hospital and opened new beds in other designated receiving facilities. The hospital ER waitlist still exists, unfortunately, but it has been significantly reduced.

Another area where great improvements are being made is in the expansion of telehealth for mental health visits – an immediate adjustment made by community mental health centers and other providers at the start of the pandemic. In a report The Mental Health Center of Greater Manchester commissioned in 2020, data collected from 1276 patients showed that flexible scheduling, no commuting to appointments, and fewer missed appointments were all seen as positive outcomes of telehealth. And the majority of respondents reported excellent experiences with both telephone and video. We believe that telehealth will be a permanent and growing part of the service delivery system for behavioral health.

Levels of depression, suicide and substance abuse spiked during COVID and that alarmed many in our state who had not been personally affected in the past. Isolation, separation from loved ones, and the stress of balancing remote schooling and work triggered serious issues for adults and children across all ages, all social strata and all areas of the state. The stigma associated with mental illness was not erased, by any means, but it became more common to hear people talk about mental health problems they were experiencing, and to ask for help.

Finally, there seems to be consistent forward movement to implement the state’s 2019 Ten-Year Mental Health Plan. When we talk about the Ten-Year Plan, we need to recognize the late Rep. David Danielson of Bedford, who was a champion for mental health in the State House and who left us far too soon, earlier this year. He was a major force behind the plan, having come to it after hearing a constituent’s story of a family member who suffered from mental illness. He was the best kind of legislator, neighbor, friend and advocate, because he listened.

The pandemic brought the mental health crisis to the forefront, but there are a number of problems to address before we can claim victory. We still need to fund the Medicaid spend down law enacted in 2020 but not included in the 2021 budget. Stigma still exists, even though COVID has helped to chip away at it. And workforce shortages are an ongoing problem across all health care systems and providers, with the associated dearth of child care resources and affordable housing. But there is a plan, and there is a new awareness, and for that we are grateful and optimistic.

Rik Cornell, LICSW, is vice president of community relations at The Mental Health Center of Greater Manchester.