Beatrice Coulter and Wanda Duryea: New Hampshire needs a forensic hospital

Published: 6/16/2018 12:14:52 AM

There’s some good news out of the Secure Psychiatric Unit for a change. The young man who filed a writ of habeas corpus has been released from SPU. His incarceration captured national attention, including a march from the prison to the federal courthouse.

Sandra Bloomenthal, his attorney, filed two briefs with the U.S. District Court. In her second one, she alleged regulatory violations under a federal statute known as “EMTALA.” She cited specifically the practice of transferring individuals from a licensed facility that is eligible for federal reimbursement to an unlicensed facility violates EMTALA. The prison is unlicensed. EMTALA violations carry remarkable fines. What was alleged in both briefs includes a host of violations, including due process, cruel and unusual punishment, civil rights violations, EMTALA violations and clinical disparity. She challenged the state about not exhausting all state remedies as this was an “extraordinary” situation.

Apparently the state agrees. He has been released.

The state did not have a legitimate legal, ethical, clinical or regulatory argument to defend this practice. If they did, he would still be in there.

Freedom from unlawful incarcerations should not be limited to those who have the resources to hire competent counsel. Civil rights and constitutional protections are guaranteed for all individuals.

Department of Corrections Commissioner Helen Hanks was interviewed by NHPR recently. She is quoted as saying that it “does not matter what setting we put them in,” referring to those transferred to SPU. Clearly, it does matter. A prison unit and a hospital are not interchangeable entities.

New Hampshire Hospital CEO Lori Shibinette recently stated, also on NHPR, “We need other alternatives.” A study conducted by Dartmouth in 2017 reported 51 transfers from NHH to SPU in 2015.

We need an appropriate forensic facility.

Individuals languish for years in SPU. The state justifies this practice because there is no other alternative. They have had 35 years to create an alternative. This simply was a cheaper way to house the needs of this population.

The lack of awareness about this practice has allowed it to exist with limited challenges for decades. That is changing. Awareness is growing. It is evident this practice does not reflect the will of the people of New Hampshire. New Hampshire needs a forensic hospital.

The time has come to embrace the models used in other states.

Other civilly committed populations in SPU such as “not guilty by reason of insanity” and “incompetent to stand trial” are individuals housed in forensic hospitals in other states. There will always be certain populations that will need to be hospitalized as it is the most appropriate level of care. An appropriate facility would not be a new expenditure. This expenditure has always existed, but was ignored or dismissed. Now is the time to begin planning.

The reality about this practice is making itself known. Its persistence reveals much about us. We cannot undo history, but we can design the future.

(Beatrice Coulter and Wanda Duryea are the co-founders Advocates for Ethical Mental Health Treatment.)

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