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New Hampshire
Should hospital guards carry guns? New Hampshire Hospital an outlier in saying yes.
November’s fatal shootings of an unarmed security officer and former patient inside the state psychiatric hospital could lead to a major policy change that most other hospitals in New Hampshire have considered and rejected: arming security guards.
In interviews, security officers at several hospitals in the state cited concerns that a firearm in a volatile situation could exacerbate, not mitigate, safety risks to patients, visitors, and staff. And they cautioned that a gun in a hospital setting could take away from what should be a welcoming and therapeutic environment.
Even with what they described as an increased prevalence of workplace violence against staff — from verbal abuse and threats to hitting and choking — the security officials expressed a preference for other safety measures, such as stun guns, pepper spray, handcuffs, and ongoing de-escalation training.
John Duval, head of security at Concord Hospital, said the number of “code gray” calls for “aggressive, out-of-control” individuals dropped from 30 in 2017 to five in 2023, in part by increasing security “standbys” in cases where staff anticipate a problem. Officers were unarmed during those 14,870 standbys in 2023, he said.
“For me, that’s an example of, as a precautionary measure, we utilize security to de-escalate,” Duval said.
He said the hospital has at times placed an armed Concord police officer outside the room of a patient who poses a threat.
Catholic Medical Center has adopted a patient code of conduct in hopes of curbing the daily assaults and hostile comments staff are experiencing.
“Security staff assist medical staff in really close proximity to patients,” said John Patti, a retired Manchester police officer who oversees security at the hospital. “To have a firearm that close to patients, I think it’s certainly risky.”
Mental health advocates have voiced similar concerns following the deaths of officer Bradley Haas, whom many patients and families knew by first name, and John Madore, who had been a patient at the New Hampshire Hospital and worked as a peer counselor.
Susan Stearns, executive director of NAMI New Hampshire, also cited a concern that guns in treatment hospitals could retraumatize patients who’ve been involuntarily committed and transported to the hospital by armed police officers, possibly in shackles.
“There is absolute broad consensus that it would be dangerous to both patients and staff to have firearms allowed on patient units,” said Stearns. “In a situation that is volatile, the risk of a firearm being used is really significant. I am really concerned, frankly, that it would be used on a patient.”
The Department of Safety announced the security changes just 11 days after the Nov. 17 shootings, far too quickly, some have said, given that law enforcement was still investigating the incident. It is unclear, though, when the Department of Health and Human Services intends to enact the policy change and arm its security officers with firearms.
When safety officials announced their security recommendations, they said the policy change was “in progress.” Their additional recommendation that the state hospital hire armed private security guards was also in progress, they said.
Jake Leon, spokesman for the New Hampshire Department of Health and Human Services, did not provide a timeframe, saying only that the department is at the “beginning” of implementing the recommendations. It is also unclear whether security officers would carry firearms in patient areas, but that appears to be a possibility.
The hospital’s security officers, according to the department’s recommendations, would “carry firearms throughout the hospital to mitigate any threats occurring within the (New Hampshire Hospital).” The new armed private security officers would be stationed at the hospital entrance to screen patients, visitors, and staff, according to the recommendations, but also be used to assist hospital security officers “throughout” the campus.
That concerns Stearns and NAMI New Hampshire families who have visited loved ones at the state hospital.
“They talked about how intimidating it would be to have someone who’s carrying a firearm there at the door . . . and how that would have certainly added to their experience in terms of anxiety and concern,” Stearns said. “And we really want to be careful that we’re not criminalizing people with mental illness.”
Her community saw Hass as part of the hospital therapeutic team, not a security officer, she said. A NAMI New Hampshire volunteer told Stearns how helpful he’d been when she had encountered him at a security checkpoint while visiting her son.
“He talked to her about things that were OK (to bring in) and then made other suggestions of things she might want to bring next time,” Stearns said. “Just, you know, really caring.”
Leon said: “Any changes made to enhance security will be evidence-based and trauma-informed” and balance quality care and safety. The department intends to get input from a diverse group of stakeholders, he said.
Stearns said she has already shared her thoughts.
Those include ensuring private security guards be trained in handling behavioral health crises just as hospital security officers are. Leon said in an email they would. And she’s asked the department to reach out to families and individuals who have personal experiences with behavioral health challenges.
Hospital workers in harm’s way
Fatal attacks in health care settings are rare. Between 2011 and 2018, 156 health care workers were killed at work nationwide, nearly 29 percent of them by a relative or partner, according to themost recent federal Department of Labor data. Fourteen percent of victims were killed by a patient.
Nonfatal violence and hostile words, however, are not rare.
In 2018 alone, the federal Department of Labor recorded 15,230 nonfatal workplace injuries and illnesses among health care workers. The majority of incidents took place in hospitals, particularly psychiatric and substance abuse hospitals, according to the federal data.
In describing the security needs of a behavioral health hospital, Leon cited that distinction.
“The New Hampshire Hospital is unique in the population it serves, so it is hard to compare its policies to those of other hospitals,” he said.
Patti had been with the Manchester police for years when he was named director of security at Catholic Medical Center a decade ago. He said he was “shocked” to see the behavior hospital staff were experiencing.
“An extreme outlier would be what happened up at New Hampshire Hospital,” Patti said. “On a regular basis, we have staff who get punched, kicked, bitten, spit on, and verbally abused.”
Terrence O’Hara was no less taken aback when he became director of security and transportation at Wentworth-Douglass Hospital in Dover in 2020 after 22 years as a Tucson, Arizona, police officer.
“Once I got into health care and saw it on a daily basis, I was like, ‘Holy smokes,’ ” O’Hara said. “The volatile people that come in the emergency room, whether they’re under the influence of alcohol and drugs, or suffering from a mental health crisis, or a combination of all three, the volatility and violence that you see on a daily basis . . . is certainly stunning.”
The challenge is knowing how to prepare for those incidents and how best to respond.
Security officials said those decisions require detailed data collected over time that tracks not only what, where, how, and when an incident happened but why.
Concord Hospital’s Duval said, for example, a patient who is agitated and acting out due to dementia and one acting out of anger call for different security responses.
Without that information, it’s impossible to meaningfully identify patterns of violence, security vulnerabilities, and opportunities for improvements, security officials said.
While hospitals track that information internally, according to their own procedures, there is no statewide data to understand what is happening across hospitals and how hospitals are responding.
That’s changing.
Patti helped write legislation in 2022 that created a commission to gather statewide data on the prevalence and type of hostile and violent behavior health care workers are experiencing. That commision held its first meeting last month and will report out its findings, said Duval, the vice chairperson.
Balancing accessibility and security
In a national poll last year, the American College of Emergency Physicians asked emergency department physicians to rank options for improving security in their hospitals. Communicating and enforcing security plans and increasing security measures such as cameras, visitor screening, and visibility of security officers topped the list.
Arming officers was not a suggested option, and doing so is rare in New Hampshire.
At the state hospital, an armed state trooper assigned to campus shot and killed Madore after he killed Haas. Tyler Dumont, spokesman for the New Hampshire Department of Safety, said state police have had troopers on the hospital grounds since 2022, due to a shortage of hospital security officers.
Elliot Hospital in Manchester has an armed Manchester police officer in its emergency room at all times, but that is unusual.
“At the Elliot, we have a robust security team that is supported by a partnership with the Manchester Police Department,” said hospital spokeswoman Dawn Fernald. “As an organization that is open for care 24/7, we need to balance our ability to be accessible and available to care for patients’ needs at all hours with our ability to offer a secure environment for our patients.”
At Wentworth-Douglass, O’Hara may assign two unarmed security officers to monitor a patient who clinical staff anticipate may be dangerous. Doing so can discourage violent behavior and, if a patient does act out, contain the threats with an immediate response.
In 2022, the hospital adopted a patient code of conduct that warns patients there will be consequences for physical and verbal threats; assaults; sexual and vulgar words; and disrupting another patient’s care.
O’Hara said patients get a warning and a hardcopy of the policy after a first offense. Depending on the circumstances, they may be discharged after subsequent offenses, he said. Catholic Medical Center has similar warnings throughout its building.
“Just because they’re in these four walls of the hospital, it doesn’t mean that they can act whatever way they want to. They are still expected to behave in a certain way, with civility and respect,” Patti said.
Concord Hospital rewrote its security policy in 2022 and focuses on awareness and readiness and teaches staff techniques on how to respond to hostile words and threats.
“The more that employees are individually empowered to react, I think that’s the most powerful strategy,” Duval said. “The cameras, access control, all those are great tools and we have our share of them here, but even those resources are limited. When you empower each employee to be ready as an individual and with a variety of choices, to me that’s the strength of how to respond to workplace violence in conjunction with the other things that are certainly valuable.”
New Hampshire Bulletin is part of States Newsroom, a network of news bureaus supported by grants and a coalition of donors as a 501c(3) public charity. New Hampshire Bulletin maintains editorial independence. Contact Editor Dana Wormald for questions: info@newhampshirebulletin.com. Follow New Hampshire Bulletin on Facebook and Twitter.
Local News
Investigators partnered with a nonprofit genetic genealogy analysis organization to identify the man who the remains belonged to.
After nearly four decades, a man whose skull was discovered in the New Hampshire woods has been identified.
Warren Kuchinsky was born in 1952 and was last known to be alive in the mid-1970s, New Hampshire Attorney General John Formella and New Hampshire State Police Colonel Mark Hall said in a statement. In 1986, his skull was found in a wooded area in the town of Bristol.
At the time, investigators weren’t able to identify whose skull it was, according to officials. Last year, however, the Office of the Chief Medical Examiner partnered with the DNA Doe Project, a nonprofit organization, to solve the case using forensic genetic genealogy techniques.
Kuchinsky’s identity was confirmed through DNA testing of a surviving family member, according to officials. There is no evidence that his death was caused by foul play, according to the statement.
Founded in 2017, the DNA Doe Project partners with law enforcement, medical examiners, and volunteer genealogists to apply investigative genealogy to John and Jane Doe cases. By analyzing DNA profiles and building family trees from publicly available genetic databases and historical records, the organization has helped solve more than 250 cases nationwide.
“We are honored to have partnered with the State of New Hampshire on this case,” DNA Doe Project Team Leader Lisa Ivany said in the statement. “Through the power of investigative genetic genealogy and the dedication of our volunteer genealogists, we were able to develop a critical lead in less than 24 hours. We truly hope that this identification brings long-awaited answers to Mr. Kuchinsky’s family.”
Initial DNA testing turned up only distant matches, so the DNA Doe Project selected the case to be worked on at a virtual retreat in May 2025, according to the organization’s case profile. Over the course of a weekend, more than 40 genealogists from the U.S., Canada, England, and Scotland collaborated virtually to work on the case.
Within hours, the team discovered that the unidentified man had roots in New Hampshire and Quebec, according to the profile. They later zeroed in on Kuchinsky, who had attended school in Plymouth, N.H., but had no official proof of life past 1970.
“This identification reflects the power of partnership and scientific advancement,” Formella said in the statement. “The dedication of the Office of the Chief Medical Examiner, the investigative support of the New Hampshire State Police, and the extraordinary work of the DNA Doe Project have restored a name to an individual who had been unidentified for nearly 40 years. We are grateful for their professionalism and commitment.”
New Hampshire
New Hampshire House Advances One of The Nation’s Most Extreme Transgender Bathroom Bans
The proposal would fine transgender people up to $5,000 for using bathrooms aligned with their gender identity.
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Bathroom bans targeting transgender people have been spreading rapidly across the United States. In previous years, adult bathroom bans in public buildings were limited to a handful of states with extreme laws. This year, they have become one of the primary vehicles for anti-trans legislation nationwide. Kansas was the first to act, passing a bathroom bounty hunter system and invalidating transgender people’s IDs. Idaho and Missouri began advancing their own bills. Now, the New Hampshire House of Representatives has passed its own version — one of the most extreme in the United States, which states that a trans person using the bathroom of their gender identity is a crime under the state civil rights act, violations of which carries hefty penalties. The bill passed 181-164 on Wednesday night, just weeks after Governor Kelly Ayotte vetoed a separate bathroom ban. Republicans are now sending her something far more aggressive — raising the question of whether they are trying to move the goalposts or simply daring her to veto again.
“Notwithstanding any other provision of law, with the exception of RSA 21:3, RSA 21:54, and paragraph II below, all multi-user facilities, including bathrooms, restrooms, and locker rooms located in buildings owned, leased, or operated by any municipality shall be used based on the individual’s biological sex,” reads the new bill. This prohibition is expansive: it applies to parks, rest stops, airports, civic buildings, and more, and could leave transgender people struggling to find a public place to use the restroom across the state.
The bill contains a novel enforcement mechanism not seen in any other state. It declares that a transgender person “asserting” that their gender identity allows them to use the bathroom is against the law under the state civil rights act, turning civil rights protections that were meant to be protective of transgender people into a weapon against them. “It shall be unlawful for any person to assert that their gender identity is a sex other than that defined in RSA 21:3 for the purposes of accessing places or services restricted on the basis of sex,” reads the bill. Such violations could result in fines of up to $5,000 per incident and even jail time if a person violates a resulting court injunction by continuing to use the restroom.
The bill also contains provisions for private businesses. It permits any owner or operator of a “place of public accommodation” — a category that under New Hampshire law includes hotels, restaurants, theaters, retail stores, bars, and concert venues — to restrict bathrooms by assigned sex at birth. The bill then immunizes those businesses from discrimination claims: “Adoption or enforcement of a policy pursuant to this section shall not be deemed discrimination under RSA 354-A or any other state law,” it reads.
A separate bill, HB 1217, also passed on Wednesday. That bill permits governmental buildings and businesses to classify bathrooms and locker rooms by assigned sex at birth — similar to the bathroom bans Ayotte has already vetoed. It passed by an even wider margin, 187-163. It contains no enforcement mechanism, but rather, states that bathroom bans and sports bans are not discriminatory towards transgender people under New Hampshire law.
The bills are part of a larger movement towards bathroom bans for transgender people. Just last month, Kansas passed a bathroom ban that allows every citizen in the state to become a bounty hunter, where reporting transgender people in bathrooms can net them $1,000 per trans person caught. This law also invalidated trans people’s drivers licenses in the state. Meanwhile, Idaho and Missouri are both advancing extreme anti-trans bathroom bans of their own, with Idaho’s ban even applying to private businesses, making it against the law for a private business to allow a trans person to use the bathroom that matches their gender identity.
The bills are substantially more extreme than the one vetoed by Governor Ayotte just weeks ago. In a veto statement of a bathroom ban last month, Ayotte stated, “I believe there are important and legitimate privacy and safety concerns raised by biological males using places such as female locker rooms and being placed in female correctional facilities… At the same time, I see that House Bill 148 is overly broad and impractical to enforce, potentially creating an exclusionary environment for some of our citizens.”
It remains unclear why Republicans are pushing an even more extreme version of a bill their own governor has already vetoed three times. The bill still needs to pass the New Hampshire Senate and be signed by Ayotte to become law. One possibility is that the more extreme HB 1442 is designed as cover for HB 1217 — making that bill appear moderate by comparison and improving its chances of earning a signature. Another is that Republicans believe they can pressure Ayotte into signing, or are simply laying the groundwork for an override attempt down the line. Regardless, HB 1442 is one of the most extreme bathroom bans moving through any state legislature in the country, and transgender people across New England will be watching closely as it advances to the Senate.
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