NHH marks 170 years of psychiatric treatment

by Colby Ye | 11/6/12 11:00pm

Last week, New Hampshire Hospital celebrated its 170th year of caring for the mentally ill with memorabilia displays highlighting the institution's history and a speech by New Hampshire Gov. John Lynch. Despite shifts throughout the hospital's history, NHH continues to treat patients while focusing on preserving dignity and respect, according to NHH Assistant Medical Director and Geisel School of Medicine professor Alexander de Nesnera.

The state-funded hospital focuses on stabilizing patients who require an advanced level of care so they may return to their home communities, de Nesnera said. After providing short-term treatment, NHH discharges patients to one of its 10 community mental health centers located throughout New Hampshire, at which they can receive long-term care.

"When the patients end up coming here to us, we are able to develop treatment plans that ultimately end up helping them to get care in the community that they deserve," de Nesnera said.

NHH first opened its doors in 1842 as a private hospital funded by the state of New Hampshire for the treatment of mentally ill patients, according to NHH Chief Psychologist Paul Shagoury. Prior to the hospital's opening, many mentally ill individuals in the state were treated in jails or received no care in the communities.

The state government appropriated approximately $20,000 to establish an institution for treating mentally ill patients who might be "restored to reason," Shagoury said. The hospital's treatment model resulted in a high success rate many patients were effectively treated and few were readmitted.

In the 1960s, psychiatric treatment shifted its focus from large, state-level hospitals like NHH to local mental health centers, Shagoury said.

"This was a fundamental shift that led to improved treatment in many ways," Shagoury said.

Although recent budgetary constraints have limited the hospital's resources, CEO Robert MacLeod said that NHH has made changes to improve the efficiency of its care and operations. The hospital now assigns psychologists to patients on a case-by-case basis rather than by broad areas of expertise in order to address specific patient needs, he said.

The hospital consistently has a waitlist for admittance and is looking for ways to increase its capacity, MacLeod said.

"We have one patient area that's not occupied at this point," MacLeod said. "We're looking at securing funding so that we can reopen that patient area and accommodate an additional 12 patient beds."

The hospital has long worked closely with the Geisel School to promote better care and medical education, de Nesnera said. Since the 1980s, many psychiatry residents from the Geisel School's psychiatry department have done their two-month rotations at NHH.

The partnership between the hospital and the Geisel School has encouraged advances in patient care and medical research, according to Geisel School psychiatry department chair Alan Green. Clinical care at NHH benefits from opportunities to conduct research and apply its results to treatment, he said.

NHH is unusual in that care is provided by academic psychiatrists, while most state hospitals are run solely by the government, Green said.

Dartmouth and NHH established a formal agreement in 1989 because the state hospital was struggling to attract qualified psychiatrists, according to Geisel School professor David Folks. The agreement stipulates that NHH psychiatrists are also employees of the psychiatry department at the Geisel School and provides for residency training for a certain number of Geisel School students during each rotation, he said.

The hospital has evolved into a major teaching institution for psychiatry students and residents, as well as students and interns in other health-related disciplines, Folks said.

"At the time that Dartmouth got involved, it was understood that this was a great opportunity for education but also an opportunity to engage in scholarship and research," he said.

Advertise your student group in The Dartmouth for free!