Expanding Access to Care

This summer, Dartmouth Health took a big step toward reducing those delays for children, adolescents, and young adults in New Hampshire. Continuing a longstanding partnership with the state, the Department of Psychiatry was chosen to take over medical direction at Hampstead Hospital, which provides comprehensive psychiatric and medical care to young people ages 6-26. As the facility is the state’s only specialty inpatient and level 5 residential psychiatric treatment hospital dedicated to treating young people, this significantly expands Dartmouth Health’s ability to provide high-quality pediatric psychiatric inpatient care across the health system and the region.

“We sought this contract out of a desire to build care that any of us would want for beloved family members, friends, and neighbors should they develop intensive need for care that cannot be met in a community setting,” says William Torrey, MD, RES ’89, D ’80, professor and department chair of psychiatry at the Geisel School of Medicine at Dartmouth and Dartmouth Health. “Our selection to lead patient care at Hampstead Hospital allows us to deepen our commitment to excellence in public sector care.”

The state of New Hampshire purchased the privately owned Hampstead Hospital in 2022 in order to better serve the mental health needs of vulnerable youth. In May, after a competitive bidding process, New Hampshire’s Department of Health and Human Services (NH DHHS) selected Dartmouth Health to lead and run clinical care at the facility.

The contract expands a trusted 40-year partnership between the state and Dartmouth Health’s Department of Psychiatry. Coupled with an existing contract to provide clinical leadership and services to adults at the 180-bed New Hampshire Hospital in Concord, N.H., this new collaboration at Hampstead significantly increases access to high-quality inpatient psychiatric expertise for people of all ages.

“Our goal is to provide high-quality, evidence-based child psychiatric care and increase our capacity to care for the inpatient mental health needs of youth,” says Jennifer McLaren, MD, DFAACAP, FEL ’10, RES ’08, section chief of child and adolescent psychiatry at Dartmouth Health and the medical director of the New Hampshire Bureau of Developmental Services. “The child psychiatry section at Dartmouth Health Children’s is a system of care across all of Dartmouth, not just at Dartmouth Hitchcock Medical Center. Hampstead Hospital will be an important part of our comprehensive system of care.”

As of July 2024, Dartmouth Health clinicians, including child psychiatrists, pediatricians, psychiatric nurse practitioners, and others, now provide psychiatric and medical services at Hampstead. This additional access, McLaren says, seeks to decrease children’s boarding time in emergency departments.

Acute care hospitals all over the country have seen a dramatic increase in the number of children coming in for mental health crises, and most of these hospitals don’t have the capacity to properly care for them. Consequently, these children end up boarding in the emergency department—meaning clinicians have determined the child needs hospital admission for mental health care but must wait in the ED for a pediatric psychiatric bed to become available.

“Nearly 99% of acute care hospitals [in the nation] are boarding adolescents until a pediatric psychiatric bed opens up, which is distressing for patients, their parents, and clinicians,” says JoAnna Leyenaar, MD, PhD, MPH, a pediatrician and the vice chair of research for pediatrics at Dartmouth Health Children’s and the Geisel School of Medicine, who published these findings in two recent papers. “Increasing the availability of pediatric psychiatric beds will decrease children’s wait time, so kids who need inpatient care can get it sooner.”

To learn more about the new partnership with Hampstead Hospital at dartgo.org/hampstead or contact Polly Antol at 603-646-5316 or at Polly.Antol@hitchcock.org.