Opinion: Time To Investigate The NH Department of Corrections

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Most of the rooms at the Secure Psychiatric Unit are for one person. SPU is located below the Residential Treatment Unit at the state prison for men in Concord.

A local publication has recently reported the death of another inmate in New Hampshire State Prison for Men in Concord.

The person was housed in the Residential Treatment Unit referred to as “RTU,” which is a unit for inmates with behavioral health issues who are not able to be in the general population. It co-exists in an area of the prison with the Secure Psychiatric Unit. The report indicates the person was 34 years old.

According to Jeff Lyons, the Department of Corrections public information officer, the deceased person was “engaging in self injurious behavior.”

That’s a remarkable statement from Lyons in light of a reported ongoing investigation by the New Hampshire State Police. It is a stark departure from Lyons’s refusal to comment on another death that was reported in an article in the New Hampshire Business Review in September 2017.

At that time, Lyons indicated that the “department does not comment on lawsuits or individual patients.”

Litigation is pending in that case. Court documents indicate that the person had tried to overdose on the same medication once before. This is unacceptable, particularly in light of a department that resists transparency or oversight.

We should reject the absurd notion that the same department where these deaths occurred would conduct its own interval review. It defies logic and well understood quality assurance practices.

A legislative attempt has been made with House Bill 192 to require more accountability and transparency in DOC. It would compel DOC to comply with the administrative rule-making process. DOC is currently exempt from that process. The end result in the Secure Psychiatric Unit has been their own version of policies and protocols when treating people with sever mental illness.

There are stark differences between DOC and New Hampshire Hospital in some areas. Two invasive and risk laden practices, involuntary medication and utilization of restraints, have a much lower burden to initiate in DOC than in New Hampshire Hospital. The lack of parity is troubling. DOC should not be above review or accountability.

Litigation should not be the only mechanism for examination and transparency. DOC consumes massive amounts of the budget with very little transparency. In addition to correctional activities, they are also in the health care business. But they are not subject to any inspections or reviews by any outside agencies. They determine it, administer it and decide its effectiveness. The end result is an organization with a history of ongoing civil rights violations, constitutional violations, allegations of abuse and neglect, and substandard care. Now we can add “untimely deaths” to that list.

Rep. Renny Cushing has introduced legislation for the upcoming session.

House Bill 1565 FN will attempt to address the Secure Psychiatric Unit morass, once again. The core provision is for the Secure Psychiatric Unit to come into compliance with Joint Commission standards and obtain accreditation by early 2020. It also has clear language preventing the transfer of non-adjudicated civilly committed individuals from New Hampshire Hospital to SPU if they are not in compliance with Joint Commission standards or they lapse.

It also contains other provisions to provide more transparent reporting and examination of clinical standards. This most recent event demonstrates the need for a sentinel event review to occur independent of DOC.

Individuals who have been convicted and incarcerated are still protected by the Americans with Disabilities Act. The time has come for an investigation of DOC. Lives are being lost.

We applaud Rep. Cushing for his continued efforts to address this situation. Even if the legislation fails, it will keep this clinical, legal and ethical travesty in the public view.

So very long ago, Fyodor Dostoyevsky is credited with the following: “The degree of civilization in a society can be judged by entering its prisons.”

Clearly, we are not as civilized as we would like to believe.

(Beatrice Coulter and Wanda Duryea are the founders of Advocates for Ethical Mental Health Treatment.)

This editorial is the opinion of the authors and doesn’t reflect the opinion of this publication.

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