One in five people have a mental illness and most can be treated effectively by their primary care provider and without the need for hospitalization. Most people who receive treatment function well in their families and at their jobs. However, like other serious medical conditions, mental illness in its most severe form can be difficult to treat and potentially life threatening.
According to a recent poll*, an overwhelming public majority -- 92% -- believe that mental health services are fundamental for overall health. Yet despite this, and a strong evidence base of effective treatment and programs, access to mental health care is a significant problem in New Hampshire and nationally.
Mental health services in New Hampshire have deteriorated to a crisis point where our community mental health centers have substantial waiting lists for outpatient appointments and where our most vulnerable adults and children who need inpatient admission are being boarded in Emergency Departments for days without proper treatment. On Monday Feb 4, 2013 there were 18 children and 26 adults waiting in emergency departments for an inpatient psychiatric bed. This practice is wrong medically, legally, ethically, morally and economically.
It is medically wrong because people don’t receive timely treatment to reduce their suffering and promote speedy recovery. It is also medically wrong because it delays treatment for people with other medical conditions who need emergency treatment. For people being involuntarily admitted, it is legally wrong because NH law establishes due process and other legal protections which are currently being ignored. It is ethically wrong because it places medical providers in the untenable position of failing to uphold the standard of care to “do no harm.” It is morally wrong because we don’t categorically deny treatment to patients with heart disease, diabetes or any other medical condition. And it is economically wrong because emergency departments are one of the most costly hospital services. People could receive more effective and less costly
treatment in other settings.
New Hampshire once had a proud tradition of caring for people with mental illness and during the 1990’s our state was rated number one in the US for our mental health service delivery system. Resolution of the current crisis will mean rebuilding comprehensive community supports for people with mental illness. We also must do a better job of providing treatment for substance use disorders which often co-occur with mental illness.
As a state and as a society we need to recognize and treat mental illness for what research has demonstrated it is – a medical condition. We need to end discriminatory insurance and other practices that limit access to necessary treatment. We know the best outcomes occur when health care providers promote early detection and treatment and utilize an integrated model of care that addresses mental and physical wellness together. Lastly, if we are to be successful in getting timely and effective treatment for people with mental illness we need to examine and change our attitudes and how media portray mental illness. We have overcome the shame, fear and stigma that surrounded other medical conditions like cancer and HIV/AIDS, we can and we must do the same with mental illness.
*2006 U.S. poll by Parade and Research America