NH Mental Health Lawsuit

I suspect that professionally, as I work for the mental health system of the State of NH, I am not allowed to have a public opinion on certain aspects of the the Department of Justice bringing suit against us.  Which is fine, as I have mixed opinions anyway, and don’t have enough real information to comment on most of it.  The standard hopefulness is that this might be a good thing from the POV of funding, as it took lawsuits to close Laconia State School (for the developmentlly disabled) and improve prison conditions, both decades ago.  That’s just how the system works, that reasoning goes.  It could be.  I don’t know if there are important differences or not. I am also, and always, suspicious of any group that claims to have only the best interest of patients at heart.  Whatever side of the argument, I’m not buying that, and I find it offensive for people to even say that out loud.

But you know me and reasoning – it bothers me when someone makes a bad argument, even if it’s for a good cause.  So I will just highlight, in intentionally imprecise manner, a line of argument that keeps making the papers but I think obscures some important information. Numbers are being put forward that readmission to the state hospital is higher in NH than in other states, and this is considered evidence that the community mental health centers aren’t doing their jobs.

Well of course it’s higher.  We have a condidtional discharge law that no other state in the union has, which allows us to readmit some patients (who have been through a special probate court proceeding) before they have decompensated.  They might be brought back if they have stopped medication or stop going to appointments, for example.  The idea is to prevent a longer hospitalization by nipping it in the bud.  I don’t know if that difference in the law fully explains the difference between NH admission rates and national averages or not.  I could probably get the data and work it out, but I doubt I could release it publicly.  That’s for the state’s lawyers to do anyway.  I also don’t know if the statute actually does what it is designed to do, avoiding long-term stays by having a low bar for shorter ones.  Again, I could probably find that out but not tell you.

Just be alert for apples-to-oranges comparisons on this.  This is also an area where I wonder if the adversarial system at law is the best, with one side’s attorneys making things look as good as possible, obscuring the need for improvement, while the other side makes things look as bad as possible, obscuring important explanations.  And playing it out in the newspapers, the political game being seen as important as the legal one.