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Editorial: What Keeps Me up at Night

Published Tuesday Apr 23, 2019

Author Robert P. Steigmeyer, President and CEO, Concord Hospital

Editorial: What Keeps Me up at Night

If I could transport you to the Yellow Pod in Concord Hospital’s Emergency Department and you could look into the eyes of a person suffering from an acute behavioral health crisis, only then might you begin to understand that mental illness is a disease. You might understand that someone in acute crisis does not make a choice to be ill.

They do not choose to come to our Emergency Department to be held in a locked unit while they await admission to an acute psychiatric facility – a facility that was created to provide care and treatment for our state’s most fragile and, perhaps, most neglected population.  

As Concord Hospital’s President and CEO, I am deeply concerned; this is what keeps me up at night. Our hospital has become the backdrop for one of our state’s most pervasive health issues and our Emergency Department has become ground zero for New Hampshire’s behavioral health crisis. Each year for the past five, the number of people who wait for an acute behavioral health bed in New Hampshire has grown.

On any given day, there are between 30 and 70 adults and children in hospital emergency departments throughout the state in crisis and, typically, one third are at Concord Hospital.     

Like any disease, mental illness requires a continuum of care that ranges from prevention to treatment and ongoing support. Key to that care continuum is timely intervention and inpatient treatment for those suffering an acute crisis. It wouldn’t be acceptable for a person suffering a heart attack to be kept waiting in an emergency department because the system lacks acute care inpatient beds; so, why is it acceptable to treat people with acute mental illness this way?

While elected officials and onlookers’ debate whether or not additional acute inpatient beds for behavioral health patients are needed, Concord Hospital clinical professionals compassionately provide support and treatment in a setting that is truly sub-optimal, a setting never meant to be used in this manner. Ours is a most amazing staff, providing both care and caring every day. And, while those most impacted are people with mental illness, make no mistake; this crisis affects everyone, including hospital staff and general medical patients, because it challenges our ability to ensure safe, timely care.

As New Hampshire rebuilds its behavioral health system, a system to provide a full continuum of services to support all phases of mental illness, we must all pull in the same direction. We must listen to clinical professionals who understand this disease and support the journey of those with mental illness through intervention and treatment.  These professionals are the ones who look into the eyes of people with acute mental illness every day; they know better than anyone what it will take to overcome this crisis. 

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