Patricia Carty, president and CEO of the Mental Health Center of Greater Manchester, sits in her office on a sunny September day. A buzz of activity surrounds as New Hampshire’s largest provider of outpatient mental health services works to provide its array of integrated care.
MHCGM assists more than 11,000 community members annually with long- and short-term treatments for mental health challenges under the guiding principles of treating everyone with respect, compassion and dignity. The private, nonprofit agency will receive the Business & Industry Association’s New Hampshire Advantage Award, sponsored by Bank of America, at BIA’s 111th Annual Dinner and Awards Celebration, presented by Eversource, on Oct. 23.
The award celebrates businesses, organizations or projects that enhance the Granite State’s special character and quality of life in meaningful ways. (For a list of past winners, visit https://bit.ly/BIAhonorees.)
“Mental health care has always been critically important,” Carty says, “but in the post-COVID world, it’s even more critical.”
Carty shares the sobering fact that people with severe mental health issues die on average 25 years younger than the general population. She also says children today experience higher and more acute levels of anxiety and depression. Carty says suicide is the second leading cause of death among those aged 15 to 34.
“We believe suicide is preventable and we work to make sure everyone knows it’s preventable,” she says. “When you notice something, ask questions and help them get the help they need.”
As the state’s designated community mental health program for Greater Manchester, MHCGM’s staff of 500 provides a broad range of evidence-based, in-person and telehealth services to people with serious and/or persistent mental illness. Forty-six percent of its individuals meet these criteria. MHCGM also operates an affiliate group practice, Bedford Counseling Associates, to serve those not eligible for those services. Care provided ranges from counseling to crisis intervention.
New Hampshire in 2022 adopted the 988 system, the phone, text and chat code for people experiencing a suicidal, mental health or substance misuse-related crisis. MHCGM had launched a mobile crisis team in 2017 and expanded it to the statewide Rapid Response system in 2022 as the need for emergency assistance grew.
MHCGM provides training for police departments to improve officers’ ability to recognize mental health issues and provide compassionate intervention. That training resulted in having officers embedded with the center’s crisis intervention team that’s available 24 hours a day every day. The team saves lives and provides timely and appropriate care. Carty says 94% of nearly 2,000 team deployments last year were diverted from emergency rooms. This is critical, she says, as patients in crisis require more intervention than ERs provide and MHCGM is ready to offer continuing individualized care.
“It’s pretty important that we do early intervention care to prevent higher levels of problems,” Carty says. “We can get patients the right combination of medicines and treatment to recover in a timely and meaningful way. The challenge is people waiting too long to get help.”
A sense of immediacy is central in treating adverse childhood experiences that can include substance misuse by their parents, domestic violence, neglect and abuse. Carty stresses that early care allows youth to better address trauma and manage residual issues to minimize the impact. To that end, MHCGM continues to expand its presence in schools and summer camps. It now has behavioral health clinicians in 21 different schools including all four Manchester high schools.
“We’re helping school personnel better understand the effect trauma has and what we can do to help students modify and be better able to learn and problem solve,” Carty says.
An integrated approach to care provides paths to more sustainable recovery that reduces costs of treating more acute problems. However, Carty says New Hampshire’s community mental health system has been underfunded for years. MHCGM is still rebounding financially from COVID’s impact as the center provided an unprecedented amount of uncompensated care. Community mental health centers cannot refuse care to people who don’t have insurance. Carty says while federal COVID recovery funds helped, that assistance ends this year.
“It’s been a tough year, and we’re starting to come out of this,” she says. “We have used our cash reserves and a bit of our endowment, but we haven’t cut services.”
MHCGM relies on Medicaid reimbursements for 85% of its revenue with the balance coming from commercial insurance. Fundraising represents a small but growing segment. The center raised a record $500,000 last year. It also relies on various grants to support programs, but Carty admits that means always plugging holes as grants end and new applications sap time and resources.
Help is on the way as New Hampshire was added to the federal Certified Community Behavioral Health Clinic Medicaid Demonstration Program this year. CCBHCs use a “whole health” approach to integrated behavioral care and a payment model for Medicaid-eligible individuals that better matches reimbursement to actual cost of delivering care. MHCGM is among three of New Hampshire’s 10 community mental health centers to be certified. The payment model could help the center fill 80 staff clinical vacancies, most of which are masters-level clinicians.
“We’ve lost a lot of employees who have left to go to private practice or left the field,” Carty says. “We just haven’t gained any ground. The worker pipeline has dried up a bit.”
Carty says MHCGM will continue to collaborate with local organizations, schools and businesses to promote mental health awareness and provide integrated care to those in need.
“The vision is an ecosystem of excellence where all of our expertise raises the level of care,” she says. “If we raise the bar from a health perspective on a community wellness scale, we raise the bar from an overall economic level.”
For tickets to BIA’s Annual Dinner, visit https://bit.ly/BIAAnnualDinner2024.
Rick Fabrizio is BIA’s director of communications and public policy.
