November 5, 2009

New Hampshire's Prescription for Mental Health Care: Comprehensive, Integrated, and Coordinated Health Care

This article was written by Peter Antal, Ph.D., Institute on Disability, University of New Hampshire. In this article, Antal writes that the provision of mental health care in New Hampshire is far from ideal. Many of those living with mental illness report a lack of coordination among those providing mental health, physical health, and substance use services. Many physicians in the state report a lack of mental health expertise, and yet are responsible for prescribing psychotropic medications. Many New Hampshire hospitals do not have on-site trained mental health personnel or have inadequate access to mental health specialists, but are making determinations regarding appropriate care and services for individuals with serious mental illness. While inpatient hospitalizations for mental illness continue to rise with population growth, the utilization of hospital emergency departments by those with a primary mental illness diagnosis is increasing at a much faster rate. Additionally, New Hampshire's Community Mental Health Centers are projecting significant increases in the demand for their services at the same time that their operating budgets are being severely cut. To effectively care for those with mental illness, there is a need to better understand the interactions between physical and mental health.

New Hampshire residents living with mental illness have traditionally been served through distinctly separate programs. This "silo" approach to services is often counterproductive and makes it difficult to provide optimum care and treatment. Those with mental illness need a consistent and effective screening process, open and frequent communication between their mental health and physical health providers, greater access to behavioral health services, and improved coordination of care. The nationally recognized IMPACT and PRISM-E projects have demonstrated that models utilizing a more comprehensive and integrated approach to health care can have significant and lasting positive impacts on the life and well being of individuals living with mental illness.