Court hearings from hospital

Published: 04/23/2022 14:50:09

Modified: 04/23/2022 14:48:43

Circuit courts have begun holding hearings for psychiatric detentions in emergency departments, a change New Hampshire hospitals have long fought against. However, in order to ensure that patients receive mental health care, hospitals recognize that this may be a necessary evil at the moment.

Lawyers and emergency rooms are not an ideal combination, said Lisa Madden, CEO of Riverbend, which also oversees mental health care at Concord Hospital.

“We have traumas that happen. We have injured children. We have COVID patients,” she said. “That’s not where these hearings should be taking place.”

Until last year, Granite Staters deemed to be in mental health crisis often waited days or weeks in emergency rooms for a bed in a mental institution to open without being given the opportunity to challenge the involuntary admission. The practice was ruled illegal last May when the New Hampshire Supreme Court sided with a plaintiff, identified by the pseudonym Jane Doe, who said she was involuntarily detained in an emergency department for 17 days before receiving a probable cause hearing.

The court determined that the state must either offer hearings within three days of the patient’s admission or release him.

Circuit Court Administrative Judge David King said over the past year that many petitions for involuntary emergency admissions have been denied solely because the state lacks the resources to obtain a hearing before the three-day deadline expires, a practice King calls “Doe dismissals.

This meant that people who might pose a threat to themselves or others were released without receiving psychiatric help.

“If the three days have expired and there is no new dangerous act, we really had no choice but to dismiss the petition,” he said. “We have a person who is potentially in a mental health crisis who needs help, and the only response we’re giving them is that we’re dismissing the petition because you can’t meet the deadline.”

Since switching to the new system, in which patients attend probable cause hearings virtually from the emergency room, only two of 190 AIEs have been dismissed due to logistical issues, King said.

“That seemed like the only way to meet that 72-hour deadline with regularity,” King said. “The success has been beyond what I expected.”

Madden said Concord Hospital was able to provide about 25 hearings per day in the emergency room.

“There’s still the truth that we don’t really want a lawsuit going on in the middle of an emergency department, but that’s the expectation right now,” she said. “So that’s what we make sure we do for patients so they get a regular procedure.”

Last week, the Joint Legislative Fiscal Committee voted to spend $2 million to further expand emergency hearings. The funding would create a centralized filing system and fund the salaries of circuit court judges, staff and attorneys for patients subject to involuntary emergency admission.

Melissa St. Cyr, director of legal affairs for the Department of Health, said holding hospital hearings is a temporary solution that the department hopes to phase out as fundamental mental health capacity issues are resolved. .

“It’s not the best environment for someone to receive a probable cause hearing, but it’s definitely still a good environment,” she said.

Lillian L. Pena