I wanted to comment on the article
"State Hospital Admissions
on Unexpected Upswing" in the February 6 issue. New Hampshire is another
state that has showed a steady increase in admissions to their state hospital,
and we are doing our best to meet this challenge.
New Hampshire Hospital (NHH), a 212-bed state hospital in New Hampshire,
has had a consistent increase in admissions for many years. In 1990 NHH had
850 admissions. In 2008 NHH had 2,260 admissions—this, with an increase
of 36 inpatient beds over that time period.
The reasons for this dramatic increase are many and include reduced
voluntary inpatient psychiatric beds, decreased community crisis-bed
availability, reduced designated receiving facility (involuntary) beds
throughout the state, reduced funding for outpatient community mental health
centers, diminished outpatient treatment options, and limited housing for our
most vulnerable mentally ill patients.
Our hospital, for which I am associate medical director, is seen as the
inpatient treatment of choice by an increasing number of patients as mental
health services are cut back and eliminated in communities. We deal with
increasingly diverse patients with complex medical and psychiatric needs. New
Hampshire Hospital's adult admission units are acute care settings where half
of all patients admitted are discharged within eight days. Rapid stabilization
and return to the community is the norm.
The state of New Hampshire and the Dartmouth Medical School Department of
Psychiatry have partnered for 20 years to provide comprehensive
patient-centered programming at NHH, and this has benefited our patients
greatly. The challenges of providing and maintaining excellent psychiatric
care, while addressing multiple demands, are many.
ALEXANDER DE NESNERA, M.D.