Dirty Little Secret

New Hampshire does things that other states do not. We’re the only state with a 424 member volunteer legislature. We’re the only state that funds our state park system with user fees. There’s a reason other states don’t do these things – they don’t work. 

NH is also the only state where people who have been civilly committed to the state psychiatric hospital can be transferred to the Secure Psychiatric Unit (SPU) at the state men’s prison even if they haven’t been charged or convicted of a crime. If they are considered a danger to themselves or others, they can be transferred to the men’s prison, even if they’re women. Once there, the patients intermingle with the inmates.

The state prison is home to male inmates. The SPU is part of the prison. NH is the only state in the union that imprisons people with mental illness who have committed no crime; just because there is no place else secure enough for them.

This practice began 30 years ago. It was touted at the time as a temporary solution. Thirty years ago, the mental health system dismantled by Ronald Reagan and his acolytes. Institutions were emptied, with no planning for the now de-institutionalized patients. A month before Reagan was elected, President Carter signed the Mental Health Systems Act, which proposed to continue the federal community mental health centers program, and funded federal grants. This was all trashed when Reagan took office. Meanwhile, the folks who had been institutionalized often wound up living on the street, with no supports or treatment.

In 1986, the NH Supreme Court ruled that putting people in the SPU was not a violation of their constitutional rights. It was all too easy to forget all about those folks. If there’s one thing that the legislature hates, it’s spending money. And so, the practice of putting non-criminals behind bars in the name of treatment was ignored for a couple of decades, while the legislature blithely kicked the can down the road.

In 2004, there was an audit, and in 2005 a House study committee. In 2010 there was another study committee. For some years, State Representative Renny Cushing has been filing legislation to try to end this practice, as he did again this year. A few weeks ago a story in Fosters quoted Speaker of the House Gene Chandler as saying that lawmakers weren’t familiar enough with the situation to speak about changing it. It’s only been going on for 30 years.

In that same Foster’s story Associate AG Anne Edwards claimed that patients aren’t treated like inmates at all. The patients have prison numbers, can’t use the phone, and visitors have to go through background checks. Nothing I have ever read or heard suggests that patients at SPU are not being treated like prisoners. They are locked in wire cages for “therapy sessions.”  They are civilly committed to a prison. If this were normal, if this were considered therapeutic, other states would be doing it. 

They don’t. Only NH does this. 

In Colorado, psychiatric patients in crisis can be held in a jail for 24 hours if there are no psychiatric beds available. Colorado is a big rural state, and that 24 hours began to turn into 48 hours, or more. Sheriff’s tried to have the hold time lengthened. The governor vetoed the bill. A task force was created to look at the problem, and it actually did – and that work led to change. It’s now against the law to hold anyone in a county jail for a mental health problem. A bill was passed to increase funding for community based mental health treatment. Much of the funding will come from the state’s marijuana tax.

The difference, of course, is that in Colorado there was law enforcement and legislative support for ending the barbaric practice of imprisoning the mentally ill. In NH, there is no support for change. NH is perfectly happy to continue to sweep the criminalization of the mentally ill under the rug.

It’s been our dirty little secret for a long time. Social media can be a force for good, and in the case of SPU it has been. Nancy West of InDepthNH.org, an online news site, got a grant to investigate the SPU, and has been covering it for some time. Those stories led to coverage in the mainstream NH media. A young man named Andrew Butler is currently incarcerated in the SPU, and his case is getting a lot of attention. The legislature is finally paying attention, and recently moved to require the Department of Corrections to have the SPU accredited as a behavioral prison unit.

This is not a solution; it’s a way of normalizing the practice of incarcerating the mentally ill, in the 21^stcentury, in the state of New Hampshire, the seventh wealthiest state in the nation. Shame on us. 

Published as an op-ed in the May 25, 2018 edition of the Conway Daily Sun Newspaper

Edited to add this press release that the Treatment Advocacy Center sent to me. This is a snippet:

"New Hampshire's treatment of people with serious mental illnesses makes it a poster child for hypocrisy," Treatment Advocacy Center executive director John Snook added. "Instead of 'live free or die,' their credo should be 'go to prison and die'. The Governor and the Legislature need to fix this."

Using prevalence rates for schizophrenia and severe bipolar disorder, the Treatment Advocacy Center estimates that there are 36,000 people in the Granite State with serious mental illnesses. In the event of a psychiatric crisis, however, there is virtually no place for that population to receive inpatient care. As of 2016, New Hampshire had a total of 158 state hospital beds, or less than 12 per 100,000 people, which falls far below the minimum standard of 50 beds per 100,000 people.

Please read the whole thing.