Commentary: State has created a mess with SPU, and now is the time to clean it up

Exterior gate of the SPU

The Secure Psychiatric Unit has prison problems, including violence and substandard care. (Courtesy of Wanda Duryea)

Late last week the Department of Health and Human Services held the first information session via Zoom about the proposed forensic hospital on the New Hampshire Hospital campus. A representative from New Hampshire Hospital and the Department of Public Works were present to discuss plans thus far and answer questions. We at Advocates for Ethical Mental Health Treatment also joined the call.

It was apparent from the questions, concerns over safety, traffic, and possible adverse impacts on property values were front and center for those living close to the proposed site. As the state officials fielded these questions, there was one question that was not asked by local residents: Why after decades of incarcerating civilly committed individuals in the Secure Psychiatric Unit in the men’s prison does a facility need to be built in the next two years?

We will attempt to answer that question.

The state Legislature codified statutes to allow civilly committed individuals to be sent to the state prison in the late 1980s. Members of the legal and psychiatric community testified back then that it was not the appropriate environment for the population. It fell on deaf ears. The state had now found a way to house the forensic population without hospitalizing them.

Security was and remains one of the main talking points around managing this population. By not creating the appropriate facility, the state has saved millions through the years. However, it was not the right solution. One just has to look at some of the more public incidents and litigation that have occurred in SPU over the years.

The most recent is the death of a young man who was involved in a violent altercation with corrections officers in 2017. A lawsuit filed by his family last year states he died on the floor of SPU. Sexual assaults, suicide, and death are part of the SPU story. A recent court ruling stated that individuals subject to this practice are denied adequate due process. The New Hampshire Advisory Committee to the United States Commission on Civil Rights recently examined this practice. They also noted their concerns over due process and civil rights violations in the report they released in April 2021. 

The state has created a mess. Now they are trying to clean it up.

SPU is a prison psych unit. Despite past false claims from the Department of Corrections claiming it is a “forensic hospital,” it is a prison. SPU has prison problems, including violence and substandard care. Another bizarre DOC claim is the repeated statement that SPU has a “separate door.” Yes, a  door that leads into the prison.

As we have stated before, magical thinking abounds when it comes to SPU and attempts to legitimize its utilization for civilly committed individuals. The state continues to embarrass itself with such absurdities, and the public needs to reject them as such.

This project has some issues. First, the capacity is too small. Twenty-four beds are proposed in the current design. The number of civilly committed individuals in the prison regularly surpasses 24. This will not dramatically increase capacity. It will simply allow the state to reduce the population in the prison. The second issue is the statutory scheme that allows this practice. There are a number of administrative rules in addition to the statutes that allow civilly committed individuals to be incarcerated, even in the absence of any justice involvement or conviction. As long as the state retains that option, it will most likely utilize the prison to manage a population that is growing in both number and acuity.

They all need to be repealed. Until such time, this population will not be safe from the state incarcerating them. There is a  strong likelihood there will remain a population of civilly committed individuals in the prison even after the completion of this facility given the limited capacity.

For the community members concerned about safety, we do not believe this will be an issue. There is already a forensic population housed in New Hampshire Hospital that has been there for quite a while. Some of those individuals have committed serious crimes. However, serious mental illness has resulted in them being deemed incompetent to stand trial or not guilty by reason of insanity.

The true challenge for the community will be to recognize this is a hospital and not a prison. These individuals are seriously ill and need treatment. Years of utilizing the prison has also contributed to how these individuals are viewed by the public. Not as patients, but as criminals. Their classification as de facto inmates by the Department of Corrections, complete with inmate numbers, has also contributed to the public perception of this population.

New Hampshire is far behind other states when it comes to treating this population. It will need to abandon its old, tired mantra of criminality and embrace one of recovery and hope. Part of that new mantra needs to be transparency when dealing with members of the public and their concerns over this project. The Department of Health and Human Services needs to see this as an opportunity to educate the community and themselves. Traversing the line between the states’ complicit role in this situation and being transparent as to why this facility is needed will remain a challenge moving forward.

This truly is a second chance for the state to redeem itself for its decades long failure to treat this population with dignity.

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Beatrice Coulter
Beatrice Coulter

Beatrice Coulter is a co-founder of Advocates for Ethical Mental Health Treatment.

Wanda Duryea
Wanda Duryea

Wanda Duryea is a co-founder of Advocates for Ethical Mental Health Treatment.