The Marshall Project

Sent to a Hospital, But Locked in Prison

They’re not charged with a crime, but these patients still end up in jumpsuits and solitary.

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.

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