By Wanda Duryea and Beatrice Coulter, co-founders of Advocates for Ethical Mental Health Treatment

CONCORD – Sadly, another individual has lost his life in the Secure Psychiatric Unit referred to as “SPU.” This is the third “untimely” death since 2015 that we are aware of. In 2015 Charles Mealer died secondary to an overdose of antidepressants. He was able to hoard medications due to the unsafe medication administration practices by the nursing staff.  In 2017 Phillip Borcuk lost his life in a disturbing event after a confrontation with corrections officers. Now Jason Rothe, yet another confrontation with corrections officers. What is clear to us is these deaths are not so much untimely, as they were preventable.

A subsequent press release describes the Secure Psychiatric Unit as a “separate institution that is overseen by a medical director.”  Separate from what? Recognizable standards of psychiatric care in an appropriate milieu? That it is what it is separate from. SPU is a prison psych unit. It functions with no oversight by any external regulatory body. It is a bleak, deteriorating building on the prison campus, not unlike so many other buildings on the prison campus. It delivers and determines what is acceptable care. There are few public documents available. That is by design. It is a prison psych unit like many across the country. What makes it different is it houses individuals that are not inmates.

For decades and currently, the state persists in sending civilly committed individuals, pretrial detainees, women and individuals with developmental disabilities to this unit. You can be transferred from a licensed state hospital to a prison unit for treatment.

Any regulatory guardrails are now gone. The Department of Corrections runs the show. Non-inmates receive an inmate number and are subject to DOC regulations. You are subject to prison culture and prison violence. You are commingled with inmates. You become a defacto inmate.

The attempt to spin it as something other than what it is continues. For many years the false narrative was it was a “forensic hospital.” It is simply part of the state prison for men. Nothing else. SPU has no license to deliver the level of care it does nor is it recognized by any accreditation body.

A new forensic facility is in the works. It is now slated for a 2025 opening. While a 24-bed forensic facility is a step forward, the inadequate capacity clearly shows the Legislature has not reckoned with what a mess they have created. As long as these transfers continue, no one is safe. Once that facility is operational, the statutes that allow these transfers need to be repealed.  Capacity is going to remain an issue. That is clear.

The state is mum regarding what Mr. Rothe’s status was and how he was placed in SPU. There is no confirmation he was an inmate. It has been reported that the autopsy was “inconclusive” and further testing is pending. We hope the debunked junk science finding of “excited delirium” does not find its way into this case. It was the finding in the death of Phillip Borcuk in the 2017 incident after a confrontation with corrections officers. Excited delirium is not recognized by any medical or accreditation body. It provides a simple fix for complex situations. It is the medical equivalent of qualified immunity. It obscures truth and the opportunity for reform. For the state, it allows the defense of the indefensible, limits accountability and shields liability during litigation.

SPU is a political third rail. With exception of the late Rep. Renny Cushing politicians do not want to publicly acknowledge the civil rights and constitutional violations that are a part of SPU. That may explain why the state is silent on Mr. Rothe’s status.

The fate of these three individuals can be met by any citizen of the state struggling with serious mental illness. You can find yourself locked up in a prison in the absence of a conviction. We have spoken to dozens of individuals and family members that describe the trauma of dealing with SPU. It is the stuff of nightmares.

Let’s remember Charles, Phillip and now Jason. They are the victims of incompetence, failed policy, political spin and deliberate indifference.

At some point these individuals were deemed “dangerous” and sent to this dysfunctional unit. What is clear now, is SPU is also dangerous.

We are a grass roots organization that has been advocating to remove non-convicted individuals from the SPU at the NH State prison for men since 2016. Advocates for Ethical Mental Health Treatment has been bringing awareness about the Secure Psychiatric Unit. Specifically, we believe the state should cease from sending non-inmates to SPU.

Wanda Duryea

Beatrice Coulter

co-founders of Advocates for Ethical Mental Health Treatment

Editor’s note: The opinions expressed are those of the writers. InDepthNH.org takes no position on the matter, but welcomes diverse opinions at nancywestnews@gmail.com