The Bulletin Board

Court: Mental health disorders do not automatically qualify as insanity

By: - September 11, 2023 12:33 pm
A prison fence with a sign for the Secure Psychiatric Unit

The secure psychiatric unit within the prison houses inmates who have been convicted and need psychiatric care and individuals who have been found not guilty by reason of insanity. (Dave Cummings | New Hampshire Bulletin)

The state Supreme Court has ordered that a man serving his New Hampshire prison sentence in Montana cannot be transferred back to the state to serve his time in the prison’s secure psychiatric unit simply because he feels he is not getting adequate mental health treatment in Montana.

To qualify for transfer to the prison’s forensic hospital, a person must be diagnosed as insane, and the transfer must be conducive to both the inmate’s health and comfort and the public’s welfare, the court ruled. Mental health disorders alone do not equate with the legal definition of insanity, the court ruled. 

Insanity, the court said, requires “clear and convincing evidence that the person suffers from a mental disorder and that it would be dangerous for [the patient] to go at large.” 

The court said it took the case because it presented issues of public concern, “including the process and criteria for admission to the (secure psychiatric unit), the impact that transferring the defendant may have on staffing and patient care at the (secure psychiatric unit), and the well-being of the defendant himself.”

The secure psychiatric unit within the prison houses inmates who have been convicted and need psychiatric care and individuals who have been found not guilty by reason of insanity. The state is building a new 24-bed secure forensic hospital on the state hospital grounds for patients who have been found incompetent to stand trial or not guilty by reason of insanity. It is scheduled to open next June. 

In the case before the Supreme Court, inmate Jonathan Perfetto is diagnosed with bipolar and borderline personality disorders and antisocial personality traits, according to the order. 

Perfetto pleaded guilty in 2011 to five counts of possession of child sexual abuse images and seven counts of failure to register online as a sex offender, a requirement due to his prior convictions, including 61 counts of possession of child pornography. 

Perfetto is serving two consecutive 10- to 20-year sentences for his 2011 conviction. He’d been serving that time in New Hampshire until 2017, when he was transferred to Montana under the Interstate Corrections Compact, a program that allows prisons to exchange inmates across state lines for a variety of reasons, including the needs of an inmate or the prison, such as security concerns. 

The order does not indicate why Perfetto was transferred to Montana, and New Hampshire Department of Corrections spokesperson Jane Graham said the prison does not share that information. 

In 2020, Perfetto filed a motion with Hillsborough County Superior Court requesting to be returned to New Hampshire and allowed to serve his sentence at the forensic unit. Perfetto argued that he needed mental health treatment not being provided in the Montana prison.

Perfetto’s attorney provided the court with a report from a psychiatrist who had diagnosed Perfetto with bipolar and borderline personality disorders and antisocial personality traits. The psychiatrist concluded that Perfetto would benefit from treatment not available at the Montana prison. But he did not state that Perfetto was insane.

That was significant, the Hillsborough County Attorney’s Office argued, because placement in the forensic hospital requires an insanity finding and a benefit to transferring an inmate to the unit. The prosecutor pointed to the psychiatrist’s report as evidence that Perfetto did not qualify for transfer because he had not said Perfetto was insane.

However, Judge David Anderson approved the transfer, writing in his order that the prosecutor had agreed that Perfetto met the insanity requirement. The county attorney’s office challenged that, saying it did not agree, and appealed the decision to the Supreme Court. 

The justices have returned the case to Anderson for further proceedings to determine whether there is other information to show Perfetto meets the insanity standard and would qualify for transfer. That would require the transfer to be “conducive to the health and comfort of the person and the welfare of the public.”  

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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]