AdvocacytoSupport BehavioralHealth Concord Hospital recognized that our community faces a serious, and worsening public health crisis and went to state leaders in 2017 to ask for help to address it.The community and the Hospital have long been concerned by the increasing number of patients with behavioral health conditions who arrive in our Emergency Department (ED) in crisis because they have nowhere else to go. As a result, the Hospital engaged in an unprecedented initiative to create awareness of the crisis and persuade lawmakers to help expand behavioral health services. Partnering with Concord Emergency Medical Associates (CEMA) physicians, we reached out to elected officials, including the Governor, the House Speaker, the Senate President, the Department of Health and Human Services Commissioner and others through personal conversations and tours of the affected areas in the Hospital.The addition of $20 million in state funding allocated to support behavioral health initiatives was due in part to Concord Hospital’s advocacy. Concord Hospital is strongly positioned as a leader on this issue and in health care overall. Elected officials continue to seek Concord Hospital’s counsel and experience on health issues affecting New Hampshire. MobileCrisis Intervention/Services Riverbend Community Mental Health continues to change and save lives by responding promptly to help those in our community facing behavioral health emergencies.Through Mobile Crisis Intervention, a program it began in 2015, a Mobile CrisisTeam is available 24 hours a day to provide care and steer people, as appropriate, away from an emergency department. As of October 2017, 32 clinicians and 16 peer support specialists were helping vulnerable people with mental illness.TheTeam also has four beds for respite and treatment, which supports appropriate diversion from higher level inpatient psychiatric care. Having the beds available has been an important tool in Mobile Crisis diversionary goals. In 2017, Mobile Crisis Services appropriately diverted 1,710 people from Concord Hospital Emergency Department’sYellow Pod. Mobile Crisis Intervention is a crucial service, in that New Hampshire is in the midst of a crisis in meeting the increasing need for inpatient psychiatric beds at New Hampshire Hospital and designated receiving facility hospitals around the state. It is not unusual to have more than 60 patients waiting in emergency departments for a bed in these facilities. Most often, the largest number of such patients are in Concord Hospital, either in the ED, overflowing to the medical ED rooms or on medical units after overdoses and suicide attempts. Being able to divert anyone struggling with a behavioral health crisis away from the ED avoids long waits they can endure until a bed in the state system becomes available.This is a relief for patients, but also for those who care for the people on the waiting list. Diverting appropriate patients from the ED also lowers the possibility of negative outcomes that often are associated with long waits in enclosed areas. Even with Riverbend’s success in diverting patients from the ED, Concord Hospital sees more behavioral health patients in the ED than any other hospital in the state. One factor is that patients are transported to Concord Hospital from all over the state because Concord Hospital’s ED is perceived as a portal to New Hampshire Hospital, given that the state facility is less than a mile away. 64 Affiliations and Partnerships CrisisPatientsSeeninAlternativeSettings InsteadoftheEmergencyDepartment 180 160 140 120 100 80 60 40 20 0 81 Apr 2017 May 2017 Jun 2017 July 2017 Aug 2017 Sept 2017 Nov 2016 Dec 2016 Jan 2017 Feb 2017 Mar 2017 Oct 2016 135 111 167 167 154 138 167 145 123 161 161 NUMBER OF PATIENTS