Court rules against state in emergency room boarding case

CONCORD, N.H. (AP) — Psychiatric patients being held involuntarily in emergency rooms must be given a chance to contest their detention within three days of their arrival, the state Supreme Court ruled Tuesday.

State law requires probable cause hearings for such patients within three days of an “involuntary emergency admission," but the state has argued the clock doesn’t start until someone is transferred to an inpatient facility. However, those facilities often have no available beds, leaving patients “boarding” in emergency departments for weeks at a time.

Tuesday’s decision reaffirms a lower court ruling in favor of a woman who spent more than two weeks at Dartmouth-Hitchcock Medical Center’s emergency room before being transferred to the state psychiatric hospital. Justices agreed with the lower court, which said the state has a duty to provide hearings within three days of when a doctor signs off on an involuntary emergency certificate.

“Nothing in the statutory scheme allows a person to be held indefinitely pending delivery to a receiving facility,” the court said in Tuesday’s ruling.

In recent days, more than 80 mental health patients, including record numbers of children, have been waiting in emergency departments for inpatient beds, said Ken Norton, executive director of the New Hampshire chapter of the National Alliance on Mental Illness. Such boarding often aggravates rather than helps mental health conditions, he said, and stands in contrast to the quick treatment provided to those suffering from other illnesses.

Norton said he hopes the state sees the ruling as a call to rapidly improve a mental health system that is overburdened at every stage, from entry to treatment to re-entry into the community.

“During the past eight years thousands of Granite...