A new research report from UNH’s Institute on Disability (IOD), commissioned by the New Hampshire Bureau of Behavioral Health (BBH), documents some of the strengths of New Hampshire’s community mental health service system and identifies multiple critical issues that need to be addressed in order to ensure timely access to high-quality care. The report, “New Hampshire Public Mental Health Consumer Survey Project, Summary of Findings 2012,” provides the fourth year of data based on consumer ratings of New Hampshire’s 10 regional community mental health centers (CMHCs).
The random survey of adults, youth, and family members of consumers of the state’s CMHCs assessed general satisfaction levels with services, access to services, participation in treatment, quality of treatment received, cultural sensitivity, and treatment outcomes. Results from the survey highlight both positive areas of effective supports as well as areas of concern:
- Despite repeated CMHC budget cuts, general satisfaction and quality of services ratings have remained fairly high (81 and 76 percent among adults, respectively).
- Families reported a significant increase in child outcomes, from 55 percent (2008) to 65 percent (2011).
- The majority of consumers surveyed are reporting coordination between mental health providers and primary care providers (62 percent of adults, 52 percent of families, and 62 percent of youth).
- Close to one half of new consumers (in the past year) reported that they waited one month or more to have an appointment with a psychiatrist or nurse practitioner (68 percent, 43 percent, and 53 percent).
- One in three adults with substance use concerns did not agree that substance use issues were addressed in their treatment plans, that they received treatment from their CMHC, or that staff offered them referrals (32 percent).
- Only two-thirds of consumers felt they were active participants in their quarterly reviews (66 percent, 76 percent, and 67 percent).
"The ongoing financial challenges of the mental health system raise important questions about the long-term impact on consumers’ abilities to access high quality care and maintain a successful recovery,” said Peter Antal, IOD researcher and author of the report. “Concerns about access to care are reflected in consumer comments and in the substantial number of clients who report waiting a month or more to access care. When services are reduced, we found that a substantial percent of adult consumers report that their symptoms increased in severity (48 percent agreement), or that conflicts with others have increased (24 percent). As our State continues to grapple with tightening mental health care budgets and reduced capacities, we can't lose sight of the fact that the long term costs of some of these changes may be higher than any short term savings."
“New Hampshire is coming out of one of the worst economic recessions seen in decades,” said Erik Riera, administrator of the Bureau of Behavioral Health. “As the state recovers and all systems compete for scarce resources, our mental health system continues to demonstrate resiliency in meeting the needs of N.H. citizens while coordinating systems of care, improving access to treatment, and supporting active participation of consumers in treatment.” These goals are incorporated in the new Medicaid Managed Care model, which begins this winter for most N.H. Medicaid recipients. The performance-based contracts with the managed care organizations (MCO) and new benchmarks for both the MCO and the CMHCs will expand the array of evidence-based practices and this fall a children’s task force will release its report, which will be used to enhance children’s mental health services. N.H. also received two federal grants to implement services to improve consumers’ health and provide training for service staff to improve outcomes and reduce costly institutional care. Riera noted that “as these initiatives get underway, we will look forward to using future surveys to gauge their effectiveness.”
The Public Mental Health Consumer Survey Project, funded by a grant from the Substance Abuse and Mental Health Services Administration, is a joint initiative among the Institute on Disability, the UNH Survey Center, the Bureau of Behavioral Health, and New Hampshire’s 10 CMHCs. For more information and to download a copy of the report, visit www.iod.unh.edu/pmhs.
The Bureau of Behavioral Health is the state mental health authority, responsible for overseeing the community mental health system in New Hampshire. BBH seeks to promote respect, recovery, and full community inclusion for adults who experience a mental illness and children with an emotional disturbance. BBH works to ensure the provision of efficient and effective services to those citizens who are most severely and persistently disabled by mental, emotional, and behavioral dysfunction.