Cheshire Medical Center/Dartmouth-Hitchcock Keene to Close Inpatient Psychiatric Unit

May 5th, 2016

Cheshire Medical Center/Dartmouth-Hitchcock Keene (CMC/DHK) has announced that it will be closing its inpatient psychiatric service effective July 1, 2016.

The closing will be the result of an inability to recruit permanent psychiatrists to treat patients and manage its inpatient Adolescent and Adult Mental Health Unit (MHU). CMC/DHK has worked vigorously with national search firms, Dartmouth-Hitchcock recruiters, and local agencies and organizations to recruit psychiatry staff since 2013. A national shortage of psychiatrists has negatively impacted these efforts.

“The decision to close the service was very difficult because the Medical Center is committed to providing care for this vulnerable patient population,” states Don Caruso, MD, MPH, CEO/President and Chief Medical Officer. “We deeply regret that it has come to our being forced to close the unit, but we have exhausted every option available to maintain inpatient services. We are grateful to our dedicated Mental Health Unit staff and our local psychiatry partners for their commitment to meeting the needs of our patients. Supporting our staff and our patients during this difficult transition is our priority.”

Maintaining the Adolescent and Adult MHU requires two psychiatrists, as well as additional psychiatrists for on-call coverage for evenings and weekends, and to make rounds each weekend day and holidays. Consistent and predictable coverage by psychiatrists is needed to provide safe, quality psychiatric services for patients, and it is increasingly difficult to provide this necessary psychiatric coverage for the MHU.

The CMC/DHK Mental Health Unit is licensed to treat a total of 12 adult and 6 adolescent voluntary psychiatric patients. In 2014, the daily inpatient census was averaging 9 adult and adolescent patients. With current psychiatric coverage challenges, admissions have been limited, resulting in an average daily census of 3 to 4 adult patients.

In order to ensure that patients have behavioral health support when they seek care at Cheshire Medical Center after July 1, CMC/DHK will provide a new consultative service model through a Psychiatric Nurse Practitioner and on-call psychiatry coverage. In addition, a team of other providers will be available to assist in the care of the patients while in the facility and provide care coordination to assist with transitions back to the community or to another inpatient or outpatient behavioral health setting.

A total of 33 employees will be impacted by the closing of the inpatient Mental Health Unit. This includes 21 full-time and part-time, and 12 per diem employees. Severance packages will be available for all eligible employees, including on-site outplacement service support, and the Employee Assistance Program is available to employees. Continued employment opportunities for these employees include reassignment to other areas, new open positions on the consultative service team, and opportunities to apply for open positions within the organization.

In addition to the new consultative service, CMC/DHK is working toward an opportunity to collaborate with Dartmouth-Hitchcock and local agency partners to develop a new initiative that will support Medicaid patients with behavioral health and substance misuse needs in our community. This potential new initiative is based on funding (1115 Waiver) that will be offered by the NH Department of Health and Human Services.

The shortage of psychiatrists is evident across the nation. The Association of American Medical Colleges reports that 59 percent of psychiatrists are 55 or older, indicating that many may soon retire or are reducing their workload. The American Medical Association found that the total number of adult and child psychiatrists rose by only 12 percent from 1995 to 2013. During that time, the U.S. population increased by about 37 percent; meanwhile, millions more Americans have become eligible for mental health coverage under the Affordable Care Act.

About Cheshire Medical Center/Dartmouth-Hitchcock Keene

Cheshire Medical Center/Dartmouth-Hitchcock Keene is a nonprofit community hospital and clinic with a mission to lead our community to become the nation's healthiest through our clinical and service excellence, collaboration, and compassion for every patient, every time. Founded by CMC/DHK, Healthy Monadnock 2020 is a community-wide health initiative designed to actively engage the citizens of Cheshire County in the process of becoming the nation's healthiest community by 2020. Cheshire Medical Center is a Dartmouth-Hitchcock affiliate hospital. To learn more, call (603) 354-5400 or visit