Sent To A Hospital, But Locked In Prison

Andrew Butler, who needed psychiatric care, was transferred from a hospital to a prison last year in New Hampshire. Photo by Wyatt Farwell. Photo courtesy of Doug Butler

Andrew Butler, who needed psychiatric care, was transferred from a hospital to a prison last year in New Hampshire. Photo by Wyatt Farwell. Photo courtesy of Doug Butler

Andrew Butler’s hallucinations and paranoia began last summer. When they persisted into the fall, his father agreed to have him civilly committed — involuntarily sent to the state psychiatric hospital to receive treatment. A few months into his stay at New Hampshire Hospital, Butler was transferred.

To a prison.

National advocacy groups say New Hampshire is the only place in the country where the ward for people at risk of hurting themselves or others, called a secure psychiatric unit, is located in a prison.

In other states, psychiatric hospitals have units for people who need closer scrutiny, such as severely suicidal or potentially violent patients. New Hampshire Hospital, which was built in the late 1980s, does not have a secure wing. The secure psychiatric unit at the prison has remained the only option for those high-need patients.

There, men and women who have not been charged with a crime are dressed in prison jumpsuits, photographed and held in isolation up to 23 hours a day. They live side-by-side with convicted inmates who have significant mental health problems, people found not guilty by reason of insanity, and people undergoing evaluations to determine if they are competent to stand trial. They are guarded by state corrections officers and can be shocked or held in four-point restraint — strapped to a bed by their arms and legs — if they refuse medication, relatives say.

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