Hospital asks Board of Health not to cut contribution to human service agencies

With the island experiencing an increase in the number of suicides over the past two years, physicians and social workers from Nantucket Cottage Hospital and directors of the island's social service agencies made an appeal to the Nantucket Board of Health last week not to cut the town's contribution to the island's mental health and human service agencies. The town contributes around $330,000 a year to human service organizations that provide a range of services from fuel and rental assistance to mental health services.

With the increase in adult and youth suicides and attempts at suicide, hospital workers are concerned that a decrease in funding to mental health and human service agencies may contribute to what some describe as a "contagion" or suicide epidemic.

"There have been eight suicides and two undetermined deaths," said Peter MacKay, Nantucket Cottage Hospital director of social services, of the number of suicides between 2000 and 2008.

The state average over the past three years is 6.9 suicides per 100,000, yet on Nantucket, the average would be 26.6 suicides per 100,000, when extrapolating the numbers.

"What is unusual and unique to Nantucket is the age - 50 percent are 20 years of age and younger," said MacKay. "The hospital staff, clinical staff, social workers and mental health workers are scrambling. We are having a hard time."

The clinical staff at Nantucket Cottage Hospital is seeing a 78 percent increase in patients with depression, an 80 percent increase in suicide ideation and a 33 percent increase in suicide attempts, said MacKay.

"For every one patient either thinking, attempting or completing suicide, there are five to 10 people directly affected, not to mention the community at large and free- floating anxiety," said Dr. Margot Hartmann, Nantucket Cottage Hospital director of the Emergency Department and staff physician."By the time someone gets to the ER, there has been a failure. The ER is the safety net of the last resort."

While the hospital is prepared to handle mental health emergencies, Hartmann expressed concern that community agencies would not be able to provide the same level of service should they not receive town funding.

Peter Swenson, executive director of Nantucket Behavioral Health told the Board of Health that since November 1, his agency has seen more clients to date than in a three month period.

NBH, which receives state grants, has lost two and one-half social worker positions and one support staff position in the last six months.

"Fifty-five people have come to us with significant life problems since Nov. 1. They can't go to the next town. We are beginning to see people we would not see two years ago. We are beginning to triage: Are you thinking of killing yourself or are you struggling with major depression and alcohol or drug abuse? We have people coming out of the woodwork desperately seeking help."

Rev. Georgia Snell, president of the Interfaith Council, which oversees the island's food pantry and fuel assistance, said her organization had two emergency meetings last month.

"We've been able to assist three families to leave [the island]," said Snell. "Many other local Nantucketers are struggling with lack of employment, unable to pay their rents on part-time pay, and to buy food. If there ever was a time to increase funding for human services, this crisis would be it." I