Riverbend works to keep mental health services running as hospitals prep for bed demand

Concord Monitor staff, Published: 3/25/2020 3:24:25 PM

As hospitals push to free up potentially-needed bed space in the face of the coronavirus, one Concord provider has a message for mental health patients: We’re still open.

Riverbend Community Mental Health – the nonprofit that serves the bulk of area residents with mental health or substance use issues – has continued to offer its services through the crisis.

“Riverbend never closes,” said John Barthelmes, the interim CEO who took the reins from Peter Evers last month. “We need to get the message that we have a whole lot of different alternatives. People that need help on their terms.”

But as health care workers brace for a potential surge and swathes of Granite Staters hunker in their homes, addiction and mental health responders at Riverbend are changing the way they operate.

First, they don’t want to put patients at risk in order to keep receiving needed care.

And second, they don’t want to overwhelm already-taxed hospitals with mental health patients whose conditions could have been addressed without the emergency room.

“For mental health patients that we care for – our clients – we want to make sure that they don’t become COVID-19 patients,” said Dr. Jeffrey Fetter, the Riverbend chief medical officer. “We want to make sure that they’re not utilizing beds and services that could have been avoided.”

To get that balance, Riverbend leaders say they’re doubling down on tactics that have been shown to help treat mental health early on – keeping patients and providers less exposed.

That includes sending staff into the community to help those with mental illness handle day-to-day tasks while living independently. It means stepping up certain therapies to mitigate the effects of severe depression.

It means administering Clozapine, an antipsychotic medication that helps with schizophrenia and suicidal behavior, and setting up drive-thru blood testing sites for those on Clozapine who need monitoring.

To the extent possible, the organization, which is affiliated with Concord Hospital, is delivering its services remotely. Everything from group therapy to peer-to-peer counseling is being done over the phone.

Other services, like delivery of medication-assisted treatment for those with opioid addictions, are still being offered, Riverbend officials say.

Meanwhile, bigger concerns loom. There’s a question of what impact potential extended period of joblessness and forced isolation will have on residents’ mental health – and substance use – in the long run.

For mental health patients, officials have grim conclusions.

When it comes to alcohol and opioid use, the nationwide isolation could prove a barrier too.

And then there are practical matters of how to deal with what could be a surge of COVID-19 cases on the horizon. On Monday, Gov. Chris Sununu said the state is working with hospitals and other entities such as colleges and even hotels to set up eight “flex areas” that could host overflow beds should hospitals become overwhelmed.

Riverbend executives, who are acutely aware of the effect that New Hampshire’s mental health crisis has had on hospital bed availability, say they’re sticking to their priority: mental health and substance abuse patients.

But they said they were in talks Tuesday with Concord Hospital and state officials to come up with a contingency plan for beds that helps incorporate that.

As for Riverbend’s effort, the long term effects remain to be seen.

“I think it’s too early to tell if these innovative measures are diverting people from the hospital,” said Christopher Mumford, the chief operating officer. “I think it’s fair to say that (they) are helping the continuity of service delivery to stay intact. And all these services are known to keep people out of the hospital.”

(Ethan DeWitt can be reached at [email protected], at (603) 369-3307, or on Twitter at @edewittNH.)