Commitment to Treatment and Care: the History of New Hampshire's Mental Health Commitment Law
| Jurisdiction | New Hampshire,United States |
| Citation | Vol. 54 No. 2 Pg. 0024 |
| Pages | 0024 |
| Publication year | 2014 |
Fall, 2013
Dr. Alexander de Nesnera and Hannah Baldwin.
New Hampshire law allows for the commitment (known in legal terminology as a non-emergency involuntary admission) of individuals deemed a danger to themselves or to others as a result of mental illness to the New Hampshire Hospital for a maximum of five years.[1] The benefits of this law have been described, [2], [3] but there is no literature on the historical development of New Hampshire's commitment law. Here, we illustrate the changes that have occurred over time, providing a richer understanding and appreciation of the law's genesis and evolution.
THE EARLY YEARS: 1714-1841
No facility existed in New Hampshire to care for people suffering from mental illness until 1842. People suffering from symptoms of mental illness were cared for by families in private homes or in almshouses, if they did not have family or financial resources.
In 1714, an act was passed in the province of New Hampshire providing selectmen or overseers of the poor in a particular town with the power to provide for the care of individuals that become "non compos mentis" (not of sound mind) at the charge of the town. A justice of the peace could order the disposal of the estate of the person found non compos mentis (except housing and lands) to provide for the relief and safety of that person, and a New Hampshire Superior Court justice could license the sale of the person's house or land to provide for his support, relief, and safety, "as long as the person shall live, or until he or she be restored to sound mind."[4]
In 1767, the province allowed a judge of probate to assign a guardian for a person deemed "an ideot or non compos, " directing the guardian to take care of the person's estate, both personal and real. Specific guardian duties were delineated in this act, [5] and expanded upon in laws passed in 1776[6] and 1791-[7]
In 1822, a new law gave authority to the superior court to commit a person who was acquitted of a crime by reason of insanity or mental derangement to prison, "to be detained till he or she be restored to his or her right mind, " if the court believed the person was a danger to citizens or the peace of the state. The superior court could discharge the person if the court believed he or she was no longer dangerous. Finally, this act gave the superior court, upon application of friends of a lunatic person, authority to commit to the custody and safe keeping of such friends the lunatic person, provided the friends give bonds with sufficient surety for payment of all damages, which any person may sustain by reason of the acts and doings of the lunatic person.[8]
During the early 19th century, states began building asylums for the care of the mentally ill. New Hampshire was no exception, and in 1832 Governor Samuel Dinsmoor asked the New Hampshire Legislature to look into the number and condition of the insane in the state. The deplorable conditions under which these individuals were cared for led to a movement to build a facility to care for them. Two towns, Concord and Portsmouth, vied for the opportunity to have the asylum built in their town. Concord was chosen, mostly due to its contribution of a 123-acre parcel of land. A number of legislative initiatives establishing funding for an asylum were undertaken from 1832 to 1841, setting the stage for its development.
ESTABLISHMENT AND CENTRALIZATION: 1842-1908
The New Hampshire Asylum for the Insane was officially established by the state legislature in 1842. Twelve trustees were appointed by the governor. They were instructed to plan necessary buildings, establish costs for the management of the asylum, and make regulations pertaining to the admission and care of patients. If a person was deemed a danger to the public, the probate court could (if there was a petitioner) order the person to the asylum. Either the selectmen of the town where the person resided or his or her guardian needed to be notified if the person was admitted to the asylum. Any insane person confined in jail could be sent to the asylum by the court of common pleas, and any person could be sent to the asylum by family, guardian, or friends, with the consent of the trustees. Thus, from the very start, two ways of commitment were established: one via court commitment, if a person was deemed dangerous due to mental illness, and another b y consent of the hospital trustees.
Towns were mandated to support an insane pauper brought to the asylum in the same manner as the town supported the pauper when they were living in the town. Finally, a person could be discharged from the asylum by any three of the trustees or by a superior court judge "whenever the cause of commitment ceases or a further residence at the asylum is in their opinion not necessary."[9]
In 1845, the Legislature granted authority to the Governor and Council "to remove to the NH Asylum for the Insane, to be kept there at the expense of the state, any person confined to the state prison who is now or may hereafter become insane" and if such person is "restored to his right mind before the expiration of his term, " he was to be sent back to the state prison.[10] The Legislature also placed responsibility on town selectmen to examine claims of any indigent insane person and pay his expenses if he were sent to the asylum.[11]
In 1854 an attempt was made to involve the federal government in providing federal lands to individual states via federal legislation that would have set aside 10 million acres of land for the building and maintaining of asylums for indigent insane persons.[12] Spearheaded by Dorothea Dix, a strong advocate for the humane treatment of mentally ill people, this legislation passed both houses of Congress, but was vetoed by President Franklin Pierce in 1854.[13] President Pierce felt that social welfare issues were the domain of individual states, not of the federal government. His veto set the precedent for New Hampshire and other states to proceed with independent, state-funded initiatives to care for their mentally ill citizens.
In 1881, a New Hampshire commission was established by the Legislature to examine how mentally ill paupers were treated throughout the state. Almshouses and county asylums that purportedly cared for insane paupers were not seen as providing any remedial treatment, which led to legislation establishing a Board of Lunacy. The act granted authority to this board to inspect almshouses and county asylums without prior notice, to take people from these establishments and place them in the NH Asylum for the Insane for remedial treatment, and to discharge patients when treatment at the asylum was no longer needed. The Board of Lunacy did not have authority to fix problems it found with local almshouses and county asylums, despite being granted authority to inspect them. Finally, this legislation stated that only "insane paupers" could be admitted...
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