CONCORD, N.H. — The state broke ground Thursday on a new $49 million forensic hospital that’s expected to open in 2025.
It will be the first of its kind in the state, responding to what advocates and state officials agree is a longstanding need to provide care outside of a prison environment to people with a psychiatric condition who haven’t committed or been convicted of a crime.
That includes people who have interacted with the criminal justice system and were deemed not guilty by reasons of insanity, incompetent to stand trial, and people who haven’t committed a crime but are deemed dangerous enough to themselves or others to require more security than a regular hospital can offer.
Right now, some of the population the new hospital will serve reside in the Department of Corrections’ Secure Psychiatric Unit, which is part of the men’s prison in Concord.
Neither the state nor advocates believe this is an ideal arrangement.
“Right now, essentially, those individuals are residing in the correctional system without actually being convicted of a crime,” said Ellen Lapointe, the CEO of New Hampshire Hospital, which will run the new facility.
“It is behind prison walls,” said Susan Stearns, the executive director of New Hampshire’s National Alliance on Mental Illness. High security can make it difficult for visitors, plus the old building wasn’t designed to be accessible to people with mobility issues or disabilities, Stearns said. And women who need this level of care end up having to go to a men’s prison to receive it.
In a May request from the Department of Health and Human Services for an additional $4.8 million to fund hospital construction, commissioner Lori Weaver said it is more appropriate for those people to receive care in a forensic hospital, from both a legal and clinical perspective.
Lapointe said New Hampshire Hospital, which is run by the state, will be better equipped to provide services given its staff of licensed psychiatrists, licensed psychologists, nurse practitioners, and psychiatric social work staff.
“I really think that transitioning folks into more of a healthcare-based environment as opposed to a correctional environment allows for not only maintaining that safety and security, but also having the focus be on treatment and rehabilitation,” she said.
Advocates said there’s more regulatory oversight at New Hampshire Hospital compared to the Secure Psychiatric Unit.
According to Beatrice Coulter, a co-founder of Advocates for Ethical Mental Health Treatment, there would be more safeguards for patients at New Hampshire Hospital, which is licensed and accredited.
But there are other concerns for patients who would be transferred to the forensic hospital. Use of force is one. Trained police officers would have tasers at the facility, Lapointe said at a recent event.
Availability of beds is another. The forensic hospital will have 24.
As of May, there were 39 people in the secure psychiatric unit, NHPR reported, and 17 were there through the civil involuntary admission process. According to the New Hampshire Department of Corrections, there are now 39 patients at the Secure Psychiatric Unit, and 25 are under a civil commitment.
Lapointe said the state will prioritize people who are civilly committed as they transition people from the Department of Corrections to the 24-bed hospital. But it’s not a guarantee.
“Based on our advocacy work and working with these families, we know the civilly committed population frequently surpasses 24,” Coulter said.
Still, advocates believe a forensic hospital is a positive development.
“I think it’s heartening to see the groundbreaking is happening today,” Stearns said.
“There’s a whole host of reasons why the forensic hospital is important,” she said. “I think, ultimately, we as a society have a duty to provide appropriate care for these folks who are very ill.”
This story has been updated to include information from the New Hampshire Department of Corrections on the number of patients at the Secure Psychiatric Unit.