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Survey: N.H. Residents Need Better Access to Effective Mental Health Resources

December 3, 2008

A new research report from UNH’s Institute on Disability (IOD) finds that although a majority of consumers receiving services at the state’s community mental health centers (CMHCs) rate their care positively, insufficient staffing and other issues are hindering patients’ recovery. The report, “2008 NH Public Mental Health Consumer Survey Project, Summary of Findings,” provides the first state-wide consumer review of New Hampshire’s 10 regional CMHCs. 

“Recovery from mental illness and managing that illness effectively is a challenge in the best of circumstances,” said report author Peter Antal, a researcher at the Institute on Disability (IOD). “Supports from the community, access to best practice procedures for treatment at one of 10 regional community mental health centers, and finding the right mix of medications can all be critical components to successful recovery. However, without an effective and consistent staff to implement and follow through with consumer treatment plans, we are putting up roadblocks to recovery.”

Despite hundreds of consumer compliments about individual staff and positive experiences with their centers, the number-one recommended improvement among all surveyed concerned staffing, particularly in relation to staff turnover and the qualifications of staff available. In the words of one respondent, ‘[Agency] doesn’t even have enough doctors to go around and that’s ridiculous. And how do they expect you to improve while you're being switched around. How do they expect us to be stable when they aren’t?’

For the report, the IOD and the UNH Survey Center conducted and analyzed findings for a consumer satisfaction survey of adults, youth, and family members of youth receiving services from New Hampshire’s 10 CMHCs. Individuals were asked for feedback in a number of areas, including general satisfaction with services, access to services, participation in treatment, quality of treatment received, cultural sensitivity, and treatment outcomes. 
Among the report’s key findings:

  • A majority of consumers believe the CMHC services are having a positive impact on their lives; close to 80 percent of adult consumers are satisfied with their services, and perceive them as high quality.

  • A range of issues need follow-up, including: greater utilization of substance use treatment services, transition planning for youth, ensuring continuity of care during incarceration, and implementing effective approaches for improving outcomes among consumers.

  • Service providers need to pay more attention to the broader contexts that are likely to shape successful outcomes among consumers. For example, among adults, social isolation was particularly high, as were low employment rates, living at or near the poverty level, and experiencing poor health. Among youth, more than one in three had been suspended or expelled from school in the past two years, and nearly one in five experienced difficult side effects from their medication.

  • Despite previous research which documented a high co-occurrence of mental illness and substance use among New Hampshire residents, survey results point to an ongoing need for more discussion between staff and consumers about co-occurring disorders, and providing integrated treatment for substance use disorders.

  • Families and youth, in particular, expressed concerns about the lack of after-school and weekend appointment times. Respondents recommended that waiting rooms be set up in ways that better fit the needs of children, teens, and families. Improving access to services would also help families be more involved in their children’s treatment process.

The 2008 Public Mental Health Consumer Survey Project had a response rate of 57 percent among adult consumers, 47 percent among youth consumers (14-17 years), and 55 percent among family members of children and youth consumers (0-17 years). The project represents the best statewide consumer perspective to date on the quality and effectiveness of New Hampshire’s community mental health service system. 

 “Release of this report is particularly timely in that it comes on the heels of the recently announced plan to improve mental health services in the state and several policy reports on mental illness services that have been published during the past year,” says Antal. “As changes are implemented and the state develops accountability measures for itself and for the CMHCs, the results from future surveys like this one can be one of the tools used to determine whether the changes made a difference in the lives of New Hampshire residents living with mental illness.” 

The report is the result of a joint project among the Institute on Disability; UNH Survey Center; New Hampshire Department of Health and Human Services, Bureau of Behavioral Health; and New Hampshire’s 10 CMHCs. The project is part of a federally mandated annual survey of the nation’s Community Mental Health Centers. For more information, go to www.iod.unh.edu/pmhs.html.

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