Mission Zero: An Introduction

One of the most pressing challenges to New Hampshire’s mental health system is the boarding of individuals in emergency departments while waiting for inpatient psychiatric services. For over a decade, individuals in need have been held, with little to no treatment provided, for days or even weeks while waiting for an appropriate placement in designated receiving facilities across the state, causing harmful delays in crucial treatment. The ripple effect of this crisis cannot be overstated, affecting the individual, their family, and our community at large. The problems driving this crisis are multifaceted, and no one solution will solve it. A comprehensive solution to ensuring that people get the care they need, when and where they need it, will take the work and dedication of our whole community.

Mission Zero, a NH Department of Health and Human Services (DHHS) initiative, is a collaborative effort to eliminate emergency department boarding for adults waiting for an involuntary emergency admission. While Emergency Department (ED) boarding reduction is already a top focus for NH and DHHS, as outlined in NH’s 10-Year Mental Health Plan, Mission Zero brings new attention, resources, and urgency to this complex challenge, built upon close collaboration with community stakeholders.

Ending ED boarding requires work and investment at every stage of the problem. It involves getting people the care they need in their community before a crisis starts, so that fewer folks need to go to an ED in the first place. Further, for those who are in crisis, expanding availability of services and ensuring proper coordination and oversight of referrals is necessary. Finally, we need to provide access to appropriate support within our communities, including supportive and transitional housing as well as peer supports, to enable discharge for those who no longer require inpatient psychiatric care. Through systems intervention, community investment, and further implementation of the 10-Year Mental Health Plan, Mission Zero is poised to address these problems across the spectrum of care.

Solving the challenges facing our communities means strengthening the resources available to them. In taking on this challenge, one fact remains clear: no one entity can do it alone. Instead, it will take the combined efforts of New Hampshire’s entire mental health system to reach Mission Zero.

“NAMI NH looks forward to working with the hospitals, NH DHHS, our community mental health partners, and individual and family advocates to bring an end to ED boarding in our state.  We are inspired by the courage of the many Granite Staters who have shared their own experiences with ED boarding and carry each of you in our hearts as we do this work,” stated Susan Stearns, NAMI NH Executive Director.

To learn more about Mission Zero, visit NH DHHS, read the Mission Zero Primer, and watch the recording of Mission Zero and Care Traffic Control: A Collaborative Effort to Eliminate Emergency Department Boarding from Onward NH.