(The Center Square) — A federal judge is giving New Hampshire more time to end its practice of ‘boarding’ mental health patients in emergency departments for extended periods while they wait for beds in mental health facilities.
The decision by U.S. District Court Judge Landya B. McCafferty is the latest extension of an order she issued last year requiring the state to end the practice by May 2024. Her initial ruling held that psychiatric patients shouldn’t spend more than six hours in the emergency room before getting into treatment. McCafferty has given the state several extensions to implement the changes.
The ruling stems from a legal challenge by the New Hampshire Hospital Association, which intervened in a 2018 class-action lawsuit over the boarding issue, arguing that they were being forced to hold involuntarily committed patients and provide them with board, medical care and security. The association has agreed to the latest extension of McCafferty’s order, citing ongoing progress by the state.
“In light of the progress achieved and the work that continues, as well as our belief that the ED boarding crisis must end in order to provide our patients and their families with the care they need and deserve when in acute psychiatric crisis, we agreed to an extension of the compliance deadline into next year,” Steve Ahnen, the association’s president, said in a statement.
Mental health advocates say a shortage of beds in state-run facilities means that patients are often “boarded” in emergency rooms in private hospitals for weeks – even months – as they wait for an opening.
Under New Hampshire law, patients are already required to have a court hearing on their commitment within three days. However, the state Department of Health and Human Services has argued that that requirement meant the three-day period kicked in once patients were checked into a psychiatric facility.
A 2018 lawsuit filed in federal court by the American Civil Liberties Union of New Hampshire argued that the practice of involuntarily detaining people who may be experiencing mental health crises in hospital emergency rooms violates their civil rights.
The New Hampshire Supreme Court issued a landmark ruling three years later that psychiatric patients who are involuntarily held in New Hampshire as a result of a mental health crisis are entitled to due process, including a speedy court hearing. The ruling, which survived an appeal, requires the state to hold court hearings for mental health patients within three days of being involuntarily committed for evaluation.
The state Department of Health and Human Services Commissioner rolled out a plan to tackle the boarding issue earlier this year, called Mission Zero, which seeks to address the roots of the problem by creating more inpatient beds in psychiatric facilities, improving community-based mental health services, and building more housing for people struggling with mental illness.
Despite the state’s progress, psychiatric patients are still being boarded in hospital emergency rooms. As of Oct. 15, there were an average of 27 patients awaiting beds in state facilities, according to state data.