NH Considers New 100-Bed Forensic Psychiatric Hospital

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Nancy West photo

Secure Psychiatric Unit at the men's prison in Concord

By Nancy West, InDepthNH.org

After fighting to change New Hampshire’s policy of incarcerating mentally ill people who haven’t been charged with or convicted of a crime at the prison’s Secure Psychiatric Unit, advocates say they are pleased the state is looking to change.

The state has put out a Request for Information to build a 100-bed forensic psychiatric hospital for patients currently receiving care at the Secure Psychiatric Unit, the New Hampshire Hospital, both in Concord, and the Laconia Designated Receiving Facility.

“The envisioned facility would consolidate forensic care within one location and provide a comprehensive program for the forensic patients,” according to the request posted on the Department of Health and Human Services’ website.

The population served would include civilly committed individuals found not guilty by reason of insanity, incompetent to stand trial, patients deemed too dangerous to themselves or others to be housed in the state’s psychiatric hospital, forensic patients that are also diagnosed with developmental disability, and others who would benefit from a comprehensive forensic program.

“It’s exciting. I take this as a very positive step,” said state Rep. Renny Cushing, D-Hampton, a longtime advocate for change at the men’s prison unit. It’s a first step, but the proposal must get through the legislative process to get funded, he said.

“I can’t help but think this is DHHS’ response to the recent flurry of court filings to head off a possible class-action lawsuit,” Cushing said.

Court action

He was referring to a half dozen petitions filed in federal court demanding Secure Psychiatric Unit patients be transferred to a licensed psychiatric hospital, a federal lawsuit alleging patient mistreatment including tasering, and patient families fighting the state’s attempts to take away their guardianship.

Several of the petitions were filed with the help of Advocates for Ethical Mental Health Treatment, a citizens group co-founded by Wanda Duryea and Beatrice Coulter.

“We have fought really hard and I am glad to see this step in the right direction,” Duryea said.

Coulter added: “Hopefully, in the long term it will create an environment that fosters evidence-based best practices and civil rights safeguards.”

Lawmaker support

The Secure Psychiatric Unit has been the target of public scrutiny as more advocates, patients and their families have taken court action and spoken publicly to the press and at legislative hearings.

Duryea, Cushing, and Rep. Peter Schmidt, D-Dover, waited at the New Hampshire Hospital on Thursday to support Nancy Heath of Milan, who is fighting to maintain guardianship of her adult son, Tony Heath, who has been civilly committed to the prison’s Secure Psychiatric Unit deemed incompetent to stand trial.

Tony Heath, who filed a civil lawsuit claiming he was tasered for refusing a routine blood draw, was transported to the New Hampshire Hospital Thursday for the hearing wearing a prison uniform, leg chains and handcuffs. He struggled to eat a hamburger while handcuffed during the three-hour wait for the hearing that was ultimately cancelled.

Nancy Heath and Tony both support having Duryea, Cushing, Schmidt and InDepthNH.org present for the continuation of the confidential guardianship hearing at the small courtroom on the hospital grounds as allowed by RSA 494-A:8. Judge Barbara Maloney has previously denied opening the hearing to anyone but the participants.

Andrew Butler’s case also drew public attention as the popular former high school athlete’s friends rallied around him. The 21-year-old from Hollis was released from the Secure Psychiatric Unit in June, but is still under the control of the state because he was originally committed to the New Hampshire Hospital for two years.

He hadn’t committed a crime, but was transferred from the New Hampshire Hospital to the Secure Psychiatric Unit after a violent outburst, which his father, Doug Butler, blamed on medication. Doug Butler wants Andrew to obtain treatment from a private psychiatrist.

Members of the Hollis community raised funds for Andrew and held a march from the prison in Concord to the federal court to protest him being held in a prison.

Wait lists

The state is also hoping to solve another serious problem with the delivery of mental health services – the backlog of people who spend days and sometimes weeks awaiting treatment in hospital emergency rooms.

“Through this collaboration and development of a new facility, the added inpatient capacity is expected to reduce the number of psychiatric patients waiting in hospital emergency rooms for inpatient treatment at New Hampshire Hospital,” the request states.

The request was issued by the New Hampshire Department of Health and Human Services, New Hampshire Hospital and the Department of Corrections, and the Secure Psychiatric Unit to solicit information regarding the construction and/or operation of a forensic hospital.

Forensic licensing as a healthcare facility in the state and initial Joint Commission accreditation will be required.

The request says the state is considering all available solutions that would ensure the wellbeing of the patient population including:

  • Option #1 – Construction and Operation of a New Facility.
  • Option #2 – Renovation of Existing Facility and/or Addition of New Facilities and Operation of Facilities.
  • Option #3 – Construction of a New Facility which the State of New Hampshire will then Operate.
  • Option #4 – Renovation of Existing Facility and/or Addition of New Facilities.

The Department of Health and Human Services oversees the New Hampshire Hospital, the state’s psychiatric hospital as it stands now. But the Secure Psychiatric Unit at the men’s prison is part of the prison and run by the Department of Corrections.

The New Hampshire Hospital provides acute, inpatient psychiatric services for children, adults, and the elderly who need active treatment and other essential supports within a continuum of community-based care.

“The proposed facility would be constructed and operated in accordance with the Joint Commission Accreditation for Acute Psychiatric Hospitals,” the request states. It also says it is not a guarantee the facility will be built.

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