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Survey: NH's Mental Health Services Are Reduced as Challenges Continue

By Matthew Gianino, Institute on Disability / UCED
November 25, 2009

A new research report from UNH’s Institute on Disability (IOD) documents both the strengths and challenges of New Hampshire’s community mental health service system. The report, “2009 NH Public Mental Health Consumer Survey Project, Summary of Findings,” provides the second year of data based on consumer ratings of New Hampshire’s 10 regional community mental health centers (CMHCs).

“In a time of cuts to state and community services, the results from the survey remind us that some of the major challenges faced by consumers are not going to go away,” says report author Peter Antal, a researcher at the IOD. “In fact, concerns that were raised in the past -- such as frequent staff turnover and lack of coordination and consistency in treatments -- are likely to increase in frequency.”

Results from the survey continue to show a wide range of experiences when consumers interact with the CMHC system. Among the report’s key findings:

  • A majority of consumers believe that CMHC services are having a positive impact on their lives: 86 percent of adult consumers, 81 percent of families, and 88 percent of youth are satisfied with their services. 

  • Social isolation among adults continues to be high, (only 57 percent of adults felt they belonged in their community), as were low employment rates (20 percent), living at or near the poverty level (84 percent earning under $30,000 per year), and poor health (38 percent in poor physical health for 15 or more of the past 30 days).

  • While there was improvement since 2008 in the percentage of adult consumers indicating that they had been asked about their alcohol and/or drug use, only 62 percent indicated that staff offered them services or made a referral to services to deal with their alcohol or drug issues.

  • Among youth, 31 percent had been suspended or expelled from school and 13% had been arrested in the past two years.

Antal notes that respondents were both approving and critical of the services they received. For example, one family member noted: “The wrap-around quality of services, the psychiatrist is very warm and asks pertinent questions. They’re good at communicating with [partner] and myself and the youth group where he’s making friends. That connection on those three levels are really supporting -- social, personal, and clinical.” 

Another more critical survey respondent shared: “The new counselor came in and wanted to do his own assessment and started over again, I would like continuity in services and people...we waited six months to see a psychiatrist...they can’t help us figure out how to get on insurance. I'd give them a big zero. They’ve done about as bad as they can do.”

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.

Reflecting on this year’s results and changes in funding for the state’s 10 CMHC's, Erik Riera, administrator for the Bureau of Behavioral Health, noted, “The results of the survey clearly highlight both the strengths of our system as well as areas that need to be improved upon. The importance of the provider system in facilitating recovery from mental illness, particularly through the dedicated staff that work so hard in providing these direct services is particularly important, as is the role consumers play in directing the focus of care and their personal recovery plans. The current budgetary challenges we are facing in the context of unprecedented increases in the numbers of people needing our services makes it more important than ever to focus on the system and developing creative solutions that will not only improve services but allow the system to survive in the wake of constrained funding.”

The 2009 Public Mental Health Consumer Survey Project had a response rate of 46 percent among adult consumers, 33 percent among youth consumers (14-17 years), and 40 percent among family members of children and youth consumers (0-17 years). The project continues to represent the best statewide consumer perspective to date on the quality and effectiveness of New Hampshire’s community mental health service system.

“What we learn from this report has a range of implications for the future directions of New Hampshire's mental health care system,” said Antal. “As just one example, we have a vast array of data on the multiple needs of children and youth and yet, both our 10-year plan and current efforts by the NH Mental Health Council do not include an actionable strategy for improving services and resources in this area.”

The report is the result of a joint project among the Institute on Disability, the UNH Survey Center, the 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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