New Hampshire residents could face delays in accessing mental health care, such as months-long waits to see a therapist and even longer hold times for inpatient psychiatric services, if the legislature approves proposed cuts to the state’s mental health funding.

Currently, the state's community mental health programs are funded with around a $40 million annual budget.

However, on April 1, the House Finance Committee proposed reducing this amount to $31 million per year in the next state budget.

This reduction contradicts Gov Kelly Ayotte’s proposed plan to add $18 million to the existing funding, bringing the total to $58 million annually.

The proposed cuts would not only reject Ayotte’s increase but also reduce the state’s budget for mental health services even further than it is now.

Mental health advocates say the budget, as it currently stands, does not adequately meet the state’s mental health needs.

Lisa Madden, president and CEO of Riverbend Mental Health Center in Concord, said that if the cuts are approved, it’s uncertain which specific programs and contracts would have to be eliminated.

“It’s really cruel,” Madden said. “If any of these cuts happen, the impact is going to be on, obviously, a very vulnerable population that relies on these services to be able to help them be successful in the community – that may be in school, that may be at work, that maybe not employed, but certainly living successfully in the community.”

The proposed funding cuts to community mental health programs have not yet been finalized. The full House of Representatives will vote on its version of the 2026-27 state budget on Thursday, after which the budget will head to the Senate for revisions.

Setback to mental health progress

The state’s 10 community mental health centers provide a variety of essential services, including crisis stabilization units, transitional housing, in-person wellness checks and specialized support for children.

These centers also collaborate closely with the state to implement Mission Zero, an initiative aimed at eliminating the practice of boarding individuals in hospital emergency departments during mental health crises until an inpatient psychiatric bed becomes available.

The most immediate concern around the House cuts is the impact on individuals in mental health crises, said Jim Monahan, president of The Dupont Group and a lobbyist for the Community Behavioral Health Association.

“We are slowly building a system so that when people fall into a mental health crisis, we care for them as quickly as possible, where they’re not waiting for bad things to happen and deteriorate and get into hospitals,” said Monahan. “Without these investments, we’d be eroding the system and moving backwards.”

Recent investments have enabled community mental health centers to make significant strides in providing immediate support to individuals in crisis. When someone calls the Rapid Response Access Point helpline, mental health centers can dispatch mobile crisis response units staffed with professionals and peer support to assist those in need.

Additionally, these investments have made mental health therapists available to see individuals the same day they reach out for help.

But Madden worries that the proposed funding reductions could reverse these advancements, pushing the system back to the days of the COVID-19 pandemic when patients had to wait as long as six months for an appointment with a therapist.

“Waiting for mental health services is not advantageous for anyone,” said Madden. “It’s not advantageous for the individual, the community, or for the work that we want to do as professionals. We want to be responsive.”

Availability of psychiatric beds

The House Finance Committee has also proposed selling the Anna Philbrook Center for Children in Concord. One part of the building is a 16-bed adult transitional housing facility. Selling the building could exacerbate the issue of patients being held in psychiatric hospitals for weeks or months after being cleared for discharge due to a lack of transitional housing.

Susan Stearns, executive director of the National Alliance on Mental Illness in New Hampshire, said the reduction in funding will only worsen the issue of boarding mental health patients in emergency departments.

In 2023, a federal judge ordered New Hampshire to end the practice of holding mental health patients in emergency departments for extended periods, setting a deadline of May 2024. Since then, the state has received several extensions. Just last week, New Hampshire was granted an additional 90 days, pushing the deadline to June.

This recent extension comes after the judge praised the state for notable progress in reducing wait times.

“It’s a little ironic that we sit here now having designed a system where we can clearly see our investment is making a difference and when you take that investment away, then we lose ground,” Stearns said. “I think it seems very clear that the investments that were made in the current budget have been well worthwhile and have started to affect real change.”

Sruthi Gopalakrishnan can be reached at sgopalakrishnan@cmonitor.com