HB1372

Dear Honorable Members of the House Health, Human Services, and Elderly Affairs Committee, I urge you to reject HB 1372 because it advances a model of care that research and historical experience have repeatedly shown to be ineffective and harmful. If the goal is truly to support individuals with severe mental illness, the commission should include members with real expertise in this area. As written, the commission includes only one representative from DHHS. It is deeply concerning that this is the only member positioned to bring a public health or clinical perspective to a matter fundamentally rooted in systems of care. Community mental health providers and, most importantly, individuals with lived experience must have a seat at the table. This issue is complex and systemic, and solutions should focus on addressing root causes such as housing shortages and workforce gaps while investing in person-centered care grounded in evidence, best practices, and the voices of those most affected. Respectfully Submitted, Cara Cabral

NH’s Multi-Tiered System of Supports for Behavioral Health and Wellness (MTSS-B) is a framework that helps provide behavioral health support to our students. The three tiers of this system work together to ensure that all kids in our public schools are given positive behavioral expectations. Some children can benefit from Tier 2, which simply means they will receive coping support and skill building. This can help children who are struggling in school. The kids with the highest needs have access to individualized behavioral health services through local community health care partners. There will always be some children who need more supports to be successful, and this is a thoughtful and impactful way of helping those children. MTSS-B can reduce exclusionary practices like suspension and expulsion. It can improve instructional time by decreasing disruptive behaviors in the classroom, and it can increase academic success. This initiative had bipartisan support and was signed into law by a republican governor just a few short years ago. I am not sure why this committee is considering ending the Multi-Tiered System of Supports before we see the impact it could have on our students. Please give this framework a chance to make a difference. Please vote ITL on this bill.

Granite Staters need property tax relief. I support all efforts to support schools while giving relief to homeowners.

We have been here and done it with institutionalization and we know the horrors of it. Why on earth would we go back?

Dear Members of the House Health, Human Services, and Elderly Affairs Committee, I must express my strong opposition to New Hampshire House Bill HB 1372, which seeks to study the feasibility of reestablishing a state psychiatric hospital for adults with severe mental illness. This bill not only diverts our focus from effective and modern mental health solutions, but it also threatens to regress our progress in treating mental health issues compassionately and responsibly. A Dangerous Step Backward Reinstating a state psychiatric hospital is a glaring step backward. History has shown that institutional care often leads to systemic neglect, abuse, and a lack of individualized treatment plans. We should not be looking to repeat the mistakes of the past. Instead of investing more taxpayer dollars into facilities that can become overcrowded and dehumanizing, we should be focusing on community-based programs that prioritize real recovery and support. Community is the Key The most effective mental health treatment occurs where individuals feel safe and supported: in their communities. Community-based care provides the necessary continuity and depth of support that institutions simply cannot. Programs such as crisis intervention services, outpatient counseling, and peer support networks have proven to be life-saving for those grappling with severe mental health issues. Stand for Progress I urge you to reject this misguided bill. New Hampshire has the opportunity to lead the way in innovative mental health care by investing in community-driven solutions that are rooted in compassion, dignity, and genuine support. Let's not squander this chance to create a brighter future for our residents who are suffering. Thank you for your immediate attention to this critical issue. Sincerely, Kimberly Lawrence

I strongly oppose this bill. There are people I know that were deeply, negatively affected by the Laconia State School, it closed for a reason. I have worked in community care for over a decade and have seen firsthand how vital and effective it can be. We cannot reopen institutions. Do not pass this bill.

I'm opposed to this bill that would establish a commission to re-establish a state psychiatric hospital for adults with severe mental illness designed for long-term institutionalization.

I strongly oppose this bill! We should be looking into more resources to HELP mentally ill people, NOT LOCK THEM UP!

This is a long term institutionalization bill. This state has a knack for putting people away and not taking care of them (to save money of course). Shameful. Sununu Youth Detention Center is a good example.

I oppose HB1372 in its current form because the commission is structured around a carceral approach to mental illness rather than a clinical one. The absence of community mental-health providers, clinicians, peer specialists, and patient advocates—paired with the inclusion of Corrections—signals a shift toward institutionalization instead of strengthening the community-based services that evidence shows are most effective. New Hampshire needs solutions to ER boarding, homelessness, and gaps in acute care, but those solutions must prioritize dignity, housing, outpatient treatment, and modern standards of care. I urge the committee to amend the commission’s membership and scope to ensure that any recommendations reflect best practices in mental-health treatment, not a return to outdated institutional models.

Please oppose this bill and instead, I ask and encourage you to consider changing the focus of HB 1372 to study our need for community resources, such as transitional housing for the patients in the state psychiatric hospital for adults that are stable and medically ready to be discharged but have nowhere to go. Our state does not need more inpatient psychiatric hospital beds. However, we do critically need more community resources so that people ready for discharge from the state psychiatric hospital can live, work, and thrive in their community. I would like to share a chart from NH DHHS showing the amount of people at New Hampshire Hospital who are ready for discharge every day but have no place to go. The legend at the bottom of the chart shows you what each line represents, Stable Patients, Stable Patients Three Months Moving Average. You can click this link to view the chart: https://wisdom.dhhs.nh.gov/wisdom/dashboard.html?topic=mental-health&subtopic=mission-zero-adult-mental-health&indicator=mission-zero-inpatient-discharge-barriers#tabnavbarid As you can see from this page, the average number of patients medically stable and ready for discharge at our state psychiatric hospital is 100-115 per day out of 185 total beds. We have plenty of hospital beds, we just don’t have appropriate resources for the patients who are ready to leave the hospital. I am not sure if you are aware, but it costs the state of NH about $1,600/day/person when a person is stable at New Hampshire Hospital as their insurance cannot be billed. That calculates to about $160,000/day for the patients waiting to be discharged. Another important fact is that the numbers reported are only for people ready for discharge that have been waiting at least 15 days. So, 100 patients who are stable, and ready for discharge but do not have a place to go, if they are waiting a minimum of 15 days, that is $2.4 million! Wouldn’t it be much more cost effective to study the feasibility of creating more resources, i.e. housing for the folks who are ready for discharge, allowing all those beds that are now occupied by people who do not medically need to be there for the patients who critically need care, some of whom are boarding at emergency rooms around the state. Finally, I would also like to encourage and ask you to consider adding up to four more people on the commission, that would include, at the very least, a patient representative and a representative from the medical and/or a mental health profession. I urge you to please consider the above important information. I know this committee would not want to waste time on something that absolutely isn't needed and instead focus this feasibility study on critical needs for our NH residents. Thank you.

Long term institutionalization of mental health patients has never worked in the past and will not work in the future. Let's work on providing community based support for these individuals deserving of our care and concern.

This Bill establishes study commission on developing new psychiatric hospital for long-term institutionalization, never a good option.

Testimony Against New Hampshire HB 1372 I stand in strong opposition to New Hampshire House Bill 1372. While the intention behind this bill—to establish a commission to study the feasibility of reestablishing a state psychiatric hospital for adults with severe mental illness—may appear noble, the history and implications of such a move are fraught with danger and potential harm to those we aim to assist. Historical Context: Laconia State School The Laconia State School, once a beacon of mental health care in New Hampshire, serves as a cautionary tale in our approach to psychiatric facilities. Founded in the early 20th century, it was intended to provide specialized care for individuals with developmental disabilities and mental illness. However, over time, it became a place where patients faced neglect, abuse, and systemic failures. The closure of Laconia State School in 1991 highlighted the urgent need to shift from institutionalized care to community-based services. This shift was pivotal in embracing a more humane approach to mental health, which recognizes the dignity and autonomy of individuals. Unfortunately, HB 1372 threatens to reverse this progress by considering a return to a model that has proven damaging to vulnerable populations. Risks of Reestablishing State Psychiatric Hospitals 1. Stigmatization of Mental Illness Reopening a state psychiatric hospital could reinforce negative stereotypes about mental illness. It risks perpetuating the image of mental health patients as dangerous or incapable of integration into society. We must prioritize initiatives that foster understanding, rather than those that isolate individuals within institutional walls. 2. Reinforcement of Inadequate Care Models Establishing a commission to reopen a psychiatric hospital may divert attention and resources away from improving community-based mental health services. Community care allows for tailored, inclusive, and dignified support, fostering recovery in a way that institutions often cannot. 3. Ignoring Current Trends and Needs Current data show a need for better mental health crisis intervention, prevention, and rehabilitation services rather than a return to outdated institutionalized models. A focus on blanket institutional solutions disregards the complexities of mental health needs today. Conclusion The proposed bill gives little consideration to the lessons learned from the history of poorly managed psychiatric institutions such as the Laconia State School. We must resist the allure of establishing facilities that echo a past marked by neglect and suffering. Instead, let's invest in proven community-based mental health strategies that honor the dignity of those with mental illness and foster their integration into society. As you consider the implications of HB 1372, I urge you to reflect on our commitment to a more effective, compassionate, and modern approach to mental health care in New Hampshire. Thank you for your attention.

Libraries should be controlled by the people and not by the government--to preserve critical thinking and avoid authoritarianism.

We've known as a society for many decades now that institutionalization often does more harm that good. Hospital delirium is well known to any health care provider. The goal should always be to shorten stays in institutions, not research ways to extend them.

This is for the sake of all NH voters.

Deinstitutionalization is here to stay!

Please leave these poor children alone!

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