NH Sued for Mental Health Rights Violations

Ken Braiterman

May 17, 2012

People with mental illness who could live in the community with supports are being confined in the Glencliffe Nursing Home in northern New Hampshire against their will.  The NH Mental Health Authority admits it.

They admitted last year, in a report after a year-long study by a blue-ribbon panel, that the state’s mental health system is “broken.”  They blame the Legislature for under-funding community-based treatment, forcing them to use institutions.

They also admit that the federal Americans with Disabilities Act and the Supreme Court’s “Olmstead decision” require states to enable people with disabilities to live in the “least restrictive environment.”  Glencliffe Home is a long-term state institution, way up north in rural New Hampshire, a half-day’s drive each way from most of the families of the residents.

The NH Disabilities Rights Center has brought a class action lawsuit in federal court (Lynn E. v. Lynch) against the state mental health authority. The Disabilities Rights Section of the U.S. Justice Department’s Civil Rights Division and the Bazelon Center for Mental Health Law have joined the suit against the state.

The DRC claims the state has not provided enough money to treat people properly in their communities, even though community treatment is much cheaper and less disruptive to people’s lives than long- or short-term institutionalization.

NH Hospital in Concord, the state’s short-term acute psychiatric services inpatient hospital, is also part of the case.  The suit claims their admission rate is 40 percent higher than the national average, and their readmission rate is double the national average.

In 2010, more than 15 percent of NH Hospital’s patients discharged by the hospital were readmitted within 30 days, reports say. Nearly a third were readmitted within 180 days, and some patients are essentially in and out of the hospital all year.

Kevin Landrigan, Statehouse reporter for the Nashua Telegraph newspaper, filed this story February 9. 2012, the day the suit was filed:

http://www.nashuatelegraph.com/newsstatenewengland/949612-227/disabilities-rights-center-sues-nh-over-institutional.html

Since the law and the facts are not disputed, the decision for the court is whether the state’s unfunded 10-year plan to release those people to the community is sufficient response for people who have already been confined against their will for several years.

This case has major implications for the state, and the national mental health civil rights community as well.  The Glencliffe case could determine how much lattitude the federal courts will allow government mental health authorities when compliance with the ADA and Olmstead is inconvenient or too expensive for a county or state mental health authority.

That concerns the national mental health civil rights community.  I’ll be writing about it in this space as it develops.

 

Ken Braiterman

Getting Well, Staying Well, Making Systems Well: A long-time journalist and advocate of recovery-oriented services, Ken Braiterman writes about overcoming adversity, and adverse systems of care.

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4 thoughts on “NH Sued for Mental Health Rights Violations

  1. There is no explanation for the re-admission rate , so it is impossible to determine whether this is good or bad. Part of the information is missing.

    Are they murdering people’s minds by giving them chemical lobotomies like all the other institutions? If not the readmission thing is a good thing? The chemically lobotomized are more stable of course.
    Or is there another reason for the instability?

    Maybe the complaint is backed by Big Pharma.
    What is the real skivvy here?
    Gen us up.

    • I’m a consultant at the state hospital. I teach recovery principles to inpatients and new staff.

      It’s a good medical model hospital, which is not a complete oxymoron. People go there in crises and come out better than they went in, stable on medication, usually in two months or less. They get referred to community mental health centers, about 35% on conditional discharges. They also get referred to peer support centers, but attendance there is not required.

      I don’t think anyone keeps data that will answer the question why the re-admission rate is so high. I could ask. Someone might answer anonymously, if no one talks on the record. It’s a good question. I just learned about the re-admission rate writing about this case.

      One possible reason for the quick re-admission rate, I believe, is because they release patients to long waiting lists for outpatient treatment. They run out of meds, go into withdrawal, and get re-admitted while waiting for a first appointment in a mental health center. That’s an educated guess. I’ve seen it happen to a couple of people.

      Another possible reason is people getting re-admitted for violating conditional discharges. The community mental health center has a lot of discretion on what to do when a person fails to take medicine. One CMHC violated a client for talking about going off her meds. That person took the CMHC to the state Supreme Court a few years ago, and won.

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