Back in April, the U.S. Department of Justice conducted a review of New Hampshire's mental health system in which U.S. Assistant Attorney General Thomas Perez not only called the state's system "broken," "failing," and "in crisis," but also alleged violations of the Americans with Disabilities Act (ADA).
Last week, New Hampshire's Attorney General Michael A. Delaney, and Nicholas A. Toumpas, Commissioner of the state's Department of Health and Human Services (DHHS), issued a formal written response. In a letter dated Dec. 6, claims that the state is "failing to provide services to people with mental illness in the most integrated setting appropriate to their needs" were addressed.
"New Hampshire has long demonstrated our commitment to provide comprehensive treatment and community-based services for persons with mental illness," Delaney and Toumpas wrote. However, in 2008 the state's DHHS Bureau of Behavioral Health conducted a "critical analysis" of its mental health system and concluded that improvements did need to be made.
A new plan resulted, establishing a 10-year timetable and budget to expand a series of services and programs designed to enhance community integration. According to the letter from Delaney and Toumpas, the state already has made "significant progress" implementing the plan, including:
- Eight Assertive Community Treatment (ACT) teams have been developed in areas of the state that show the highest admission and readmission rates to New Hampshire Hospital.
- Evidence based practices, including illness management and recovery (IMR), have been implemented on a statewide basis.
- A housing bridge subsidy program has been established to provide housing to people with mental illness who are homeless, to allow them to obtain their own apartments.
- All 10 CMHCs are in the process of implementing EMRs.
- BBH is working with peer support agencies to expand the peer-run crisis respite program that has proven successful in one region of the state.
- BBH is working with NHH to develop a community psychiatry program to expand psychiatry services at the CMHCs, particularly in the area of child psychiatry services.
Currently, New Hampshire is only three years into the 10-year plan. However, the letter from Attorney General Perez stated that the federal government is prepared to "take appropriate action, including initiating a lawsuit, to obtain redress for outstanding concerns."
According to Delaney and Toumpas, the state remains committed to serving people who have mental illness in a setting that maximizes individual freedom and autonomy. "We believe that the most effective way to accomplish that goal is to stay focused on the implementation of the 10-year plan," they wrote. "The threatened litigation ... will waste precious taxpayer dollars that could be better spent on providing services."