Officials outline preliminary plan for $30 million, 24-bed hospital for forensic patients

By: - October 8, 2021 5:45 am
Exterior of the state prison in Concord

The new $30 million hospital will house forensic patients who have been involved in the criminal justice system but found incompetent to stand trial or not guilty by reason of insanity. This population is currently held in the prison’s Secure Psychiatric Unit. (Dave Cummings | New Hampshire Bulletin)

Patients with mental illness being held at the prison’s forensic hospital for security reasons could be moved to a new 24-bed hospital on the state hospital grounds by late 2023, state officials said Thursday. 

The hospital will be managed by the Department of Health and Human Services – not a private company – and a future expansion is not in the works but is a possibility, they said.

Heather Moquin, CEO of New Hampshire Hospital, and Ted Kupper, administrator of the state Bureau of Public Works, shared preliminary details of the project via Zoom Thursday evening at the first of several public sessions scheduled through the end of 2022. (The presentation will be available on the Health and Human Services website; questions and comments can be submitted to [email protected].)

The new $30 million hospital, approved by the Legislature this year, will house forensic patients who have been involved in the criminal justice system but found incompetent to stand trial or not guilty by reason of insanity. This population is currently held, often for several years, in the prison’s Secure Psychiatric Unit, which is not accredited for mental health services.

A timeline of new hospital
State officials expect the design and construction of a new 24-bed secure forensic hospital will take more than two years and are aiming to open the new facility in late 2023. (Source: N.H. Department of Health and Human Services)

An April report from the New Hampshire Advisory Committee to the U.S. Commission on Civil Rights said housing patients with mental illness in a prison “could be dehumanizing to those seeking mental health services.”

During its research, the committee heard testimony about staffing issues at the prison’s forensic hospital. “Psychiatric staff … have been noted to misdiagnose obvious mental health symptoms in patients and cannot always maintain psychiatric medications that may be best practices,” the report said. 

Moquin and Kupper were able to share a timeline for design and construction and assurances that the new site will be a secure treatment hospital, not another prison facility. And they fully expect it will be built on the state hospital grounds because the governor’s office told them to use that location, Kupper said. But all other details, including the name of the design firm the state has selected, can’t be shared yet or aren’t known, they said. 

The two kept their presentation short and spent most of the 90-minute session answering audience questions. Several people asked about security and whether “murderers and child rapists” would be among the patients. Yes, Moquin said, but no patients will be able to leave the locked hospital or roam the grounds alone.

“We do understand that there is a dangerous component to these patients,” Kupper said. “And that’s why we’re building a facility intended to house them and treat them.” He added, “These are people that have mental issues, they have psychological issues that need to be treated. They’re held in this facility until it’s determined by a medical professional that it’s safe for them to transition back into the community.”

Department of Health and Human Services officials advocated during the legislative session for a much bigger hospital with at least 60 beds, saying anything smaller would not accommodate the 24 patients in the state hospital’s forensic unit and the 35 patients being held at the prison at that time. Gov. Chris Sununu agreed and included $40 million in his budget for a 60-bed facility.

Lawmakers cut both, allotting $30 million and capping beds at 24.

A graphic showing the possible location of the new hospital
Gov. Chris Sununu has directed state officials to locate the new 24-bed secure forensic hospital on the state hospital grounds. The shaded A and B sections are the two options currently under consideration. (Source: N.H. Department of Health and Human Services)

Moquin said she isn’t sure if 24 beds will be enough when the doors open in 2023. The state hopes its new investment in more community-based services will reduce the number of people who need hospitalization. If more beds are needed, Kupper said the hospital would most likely be expanded upward, not outward. 

The possibility of expansion was good news to Wanda Duryea, who, with Beatrice Coulter, founded Advocates for Ethical Mental Health Treatment six years ago to bring attention to what they say are civil rights violations of patients at the prison’s forensic unit. Neither believes 24 beds are close to what the state needs. 

In an interview prior to the forum, they said the size of the new hospital is only half the problem. They are concerned existing state laws and Health and Human Services rules will allow the department to continue using the prison hospital if they are short on beds in the new forensic hospital. 

“They have a system where they move people between New Hampshire Hospital and SPU as if they are the same thing,” said Coulter, who worked briefly as a nurse in the prison’s secure forensic unit. “And they are not.”

Moquin said the department will work with its lawyers to identify which law changes will be needed to allow the state to treat forensic patients in the new hospital. She said the department does not plan to continue using the prison’s forensic hospital but said she does not yet know for certain.

The repeated questions from the audience about negative impacts on neighboring property values, safety risks, and dangers posed by patients left Coulter thinking the state needs to use its future public forums to educate the public not just about the appearance, size, and security of the new hospital but also the needs and rights of the patients. 

The questions reflected concerns that are to be expected from individuals not acquainted with forensic patients and the process around their treatment,” Coulter said. “The state is walking the line between selling this project to local residents without explaining clearly why these individuals need to be treated elsewhere.”

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Annmarie Timmins
Annmarie Timmins

Senior reporter Annmarie Timmins is a New Hampshire native who covered state government, courts, and social justice issues for the Concord Monitor for 25 years. During her time with the Monitor, she won a Nieman Fellowship to study journalism and mental health courts at Harvard for a year. She has taught journalism at the University of New Hampshire and writing at the Nackey S. Loeb School of Communications. Email: [email protected]