Good News for New Hampshire, Not So Good News for Vermont

This writer keeps monitoring for positive developments in the realm of mental health reform and there are more than a few beginning to materialize around the country.

Of brief note is the fact that yesterday, Congress began finally to take positive legislative forward movement on Representative Tim Murphy’s “MHealth Care for Families…” bill to move it toward the Senate and the President’s signature. It is a huge step in the right direction.

Another positive development of note is that New Hampshire, according to a news report by KSL.com, “State hospital opens 10-bed mental health crisis unit,” on its online site for the states’ KSL TV channel, of July 5, 2016, reported that “A new 10-bed mental health crisis unit is open at New Hampshire Hospital after almost a delay of years.” The unit opened in Concord NH but illustrated immediately the enormity of the need in “little ol’ New Hampshire,” as we might say here in the South. On the day after it was opened it already had a waiting list of 23 people for emergency admission.

The article also mentions quite significantly that this entire effort was prompted by the state’s need to comply with a federal lawsuit over these very issues that had been initiated in 2013.

This observer sadly notes that even noble catch-up efforts in the nation’s and states’ mental health reform effort that are need, all good, and well intentioned, often are behind even when they get started but at least we are finally going in the right direction in places now.

But in the neighboring state of Vermont, things are not good. For months there has been well-deserved focus on something one does not hear much about anymore, since President Reagan broke the air controllers’ strike in the 1980’s and the decline of “organized labor” and “unions’ began in this country. Another striking feature of this situation has been that this new labor against management movement has involved healthcare professionals and mental healthcare professionals, which is truly almost totally anState opens new mental health crisis unit unheard of this country. This story has been a gathering storm since last year. It seemed to start in this writer’s mind a few years ago when whichever torrential “Nor’easter” storm savaged its way up the East Coast and into inland New England which is a bit of a rarity. That storm wiped out the state’s only public mental health hospital. Vermont has been limping along borrowing/leasing psychiatric inpatient beds in the state’s small private psychiatric inpatient hospital world. The state has relied most heavily on the Dartmouth Medical School’s inpatient psychiatric services for temporary relief.

This seemed at the time the best solution that could be had on a sort of moment’s notice state of urgency and emergency. But there was trouble in paradise so to speak. Labor problems began within months and built to the point where psychiatric nurses and psychiatrists themselves were fed up with working conditions which I am not privy to at all and began to voice their concerns at the state political level. Apparently, not much was responded to and too little positive corrective action appeared.

So they began to talk of work stoppages, strikes and other things that this writer associated with the United Mine Workers’ and United Steelworkers’ and Teamsters’ unions of the 1960’s and 1970’s that were every few years regular events. It was like Yogi Berra summarized in his most famous quote, “Deja vue all over again.” I personally know of psychiatrists through indirect sources that the psychiatrists were not just posturing to wangle higher wages, but were so serious that they were actively looking for jobs elsewhere, so strongly did the group of them feel about the deficiencies of patient care and availability. And Dartmouth and the State were caught in the middle I suppose, trying to generous and even-handed about all this.

This is yet another symptom of how bitter and unfortunately rancorous the processs of advocating for change can be anywhere, in any system, when the vehicle being ‘recalled and repaired and retooled’ can be at present when we attempt both short term and long term fixes that neither come easily nor rapidly enough. Again this writer will follow this story closely. I for one have never been on strike, though I went through them as a child decades ago as both my parents worked in the mining industry and this a regular every so many years event. And in the spirit of transparency, I know I could not do this and abandon my own patients.

 

 

 

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Author: Frank

I am a older child, adult, geriatric teaching psychiatrist with over 30 years' practice experience in North Carolina, first at Duke as clnical teaching faculty, then in Western NC as a primary child psychiatry specialist. I have taught and supervised child psychiatrists and psychiatrists in training and many other mental health professionals and taught at two medical schools. I have served in many public and private practice settings. My primary interest is in observing and documenting the ongoing mental health reform efforts in the State of North Carolina and documenting its sucessess and failures at all levels. My favorite pastime among many others is spoofing my friends and kids with my deadpan sense of humor.

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