Beatrice Coulter and Wanda Duryea: Changing SPU culture will take time

Published: 9/15/2018 12:10:29 AM

The state has commenced the process of “request for information” to construct a 100-bed forensic hospital. This is a beginning for sure.

There are mounting writs of habeas corpus in the federal court, unflattering media attention, and a plethora of civil rights and constitutional violations around the Secure Psychiatric Unit. This will begin to address a number of those issues.

As the process commences, the current situation remains problematic.

From the very early stages of planning until a facility can accept patients will be several years. There are still those individuals currently housed in SPU and those who will be transferred there that need consideration. The prospect of a new facility is exciting. However, it will not immediately address some of the unintended consequences created by decades of incarcerating civilly committed individuals. That consequence is a cultural one. It is going to need to be confronted.

The current practice criminalizes seriously mentally ill individuals in New Hampshire. That has provided a misguided rationale for utilization of the prison as if it were a hospital. The practice has blurred the lines between forensic psychiatry and punitive correction-based practices. In the last couple of years we at Advocates for Ethical Mental Health Treatment have become well acquainted with numerous individuals and families that have had to endure the SPU experience. We encouraged them to speak at legislative hearings and make their presence known. All had been diminished by a system that had run amok. That is the challenge. We created a monstrous hybrid of psychiatry and corrections. The Department of Health and Human Services will be tasked with creating a facility that will treat and recognize these individuals as patients, not inmates. Long abandoned civil rights protections will need to be restored and safeguarded. Currently we have no history of that when caring for forensic patients.

As this process moves forward, we encourage the Legislature to take a page out of the DCYF reform. Bring in new leadership that has a demonstrated record of providing forensic treatment that understands, respects and protects civil rights. Create an empowered, effective Office of Patient Advocate. Mandated reporting can no longer be negotiable. Engage in transparency. The current practices are an outcropping of a system accommodating its own process failures. Demand that testimony provided to the Legislature by the leadership of the new facility is factual and honest. The Legislature depends on departments to provide them with accurate information. False narratives can no longer be tolerated. Entertain the Bridgewater State Hospital model that recently removed all corrections officers from having any direct patient contact.

The Attorney General’s Office needs to retire Champagne v. New Hampshire in a file marked “Functional Obsolesces.” Abandon punishment. Practice health care.

This will take time. Decades of behavior and culture will not evaporate in the presence of a shiny new facility. The Legislature must be vigilant to see that patterns of previously reported abuse and neglect no longer find a place in this facility. The state settling lawsuits can no longer be a substitute for substandard care.

This can be done. We recognize that Gov. Chris Sununu did not create this mess. He inherited this failed legacy. Thank you for taking the first step necessary to begin compassionate, evidence-based reform. We and the SPU families are grateful. We also would like to thank Rep. Renny Cushing for his long, lonely battle about all things SPU. We are asking that the Legislature please consider recognizing Rep. Cushing’s efforts when this facility nears completion. He has earned that honor. The “Cushing Forensic Center” is something to entertain down the road.

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

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