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.
New Hampshire
Commission sets sights on UNESCO recognition for Mount Washington – NH Business Review
Ice coats instruments, buildings and rock fields atop Mount Washington. The peak’s extreme weather is one reason members of the Mount Washington Commission say they are seeking potential UNESCO World Heritage Site status for the peak. (Photo by Charlie Peachey, courtesy of the Mount Washington Observatory)
Australia’s Great Barrier Reef, Egypt’s Great Pyramids, Arizona’s Grand Canyon … and New Hampshire’s own Mount Washington?
At their April meeting, the group of institutions that steward the Northeast’s tallest mountain voted, 9-1, to take a preliminary step toward pursuing UNESCO World Heritage Site designation for the peak. The process may take years to decades, but if it is successful, Mount Washington could become the first site in New England to rank on the internationally recognized list.
The possibility requires unique considerations, commission members said, including the need it would create to manage increased visitation that is already straining the summit’s alpine ecosystem and infrastructure.
Mount Washington Commission Chair Rob Kirsch believes the designation would be a boon for the mountain, bringing in not only more visitors but also more funding to invest in making the peak more resilient to traffic. Kirsch said he sees the application as a chance to showcase the wonder of Mount Washington at a grander scale.
“It will lead to an improved experience for people, generally,” Kirsch said. “It will give the state something to really be proud of.”
A property must meet at least one of 10 criteria to be considered for World Heritage Site status, according to the United Nations Educational, Scientific and Cultural Organization (UNESCO). Mount Washington could invoke several categories in its application, including one for sites that “contain superlative natural phenomena or areas of exceptional natural beauty and aesthetic importance.”
There are many steps before Mount Washington could potentially be added to that list. The motion approved at the April 17 meeting of the Mount Washington Commission was the first: At that meeting, the commission approved pursuing “Tentative List” status for the mountain. One site is selected from that national list each year for submission to the United Nations World Heritage Committee.
To move ahead, the application must receive support from the federal government. The commission has engaged with federal officials, and U.S. Sen. Jeanne Shaheen has been supportive of the project, commission members said.
“Mount Washington’s unique natural environment, scientific significance and rich history deserve global recognition,” Shaheen said in a statement to the Bulletin. “I am proud to support the Commission as they work to have our region’s most iconic peak designated a UNESCO World Heritage Site.”
From here, Kirsch said, the process may take decades. UNESCO designation typically boosts visitorship to a site, and proponents generally point to the associated regional economic boost as a benefit of the status. But the list has also been criticized as contributing to overtourism that can degrade sites or harm the communities around them. While it can boost public awareness of a place, there is no funding attached to the status itself.
The Mount Washington Commission is guided by a 2022 master plan for the mountain’s stewardship and conservation. In November 2025, the commission reviewed preliminary results from an assessment conducted as part of that plan, showing that crowds and climate change were large factors in the strain on the summit’s delicate natural environment and aging infrastructure.
With significant investment, the summit could readily accommodate significant crowds, said Kirsch, who is also an environmental lawyer, former weather observer at the Mount Washington Observatory, and a member of the observatory’s board of trustees. It’s not clear yet where the money for those investments will come from, but Kirsch said he hoped the UNESCO designation would help.
“You can bring as many people as you want to Mount Washington as long as you make sufficient infrastructure investment to protect the environment,” he said.
The commission is still waiting for more results from the summit’s environmental assessment, but Kirsch said the boost to visitation would not affect the environment if the commission adheres to the guidelines laid out in the Master Plan. Rather, he said, the investments he hopes designation would help secure could help prevent any danger from overcrowding and ensure the mountain’s environment is protected.
He added that the benefit of a UNESCO designation would go beyond the businesses operating on the mountain — which include the Mount Washington Auto Road and the Mount Washington Cog Railway — to boost others throughout the North Country.
This story was originally produced by the New Hampshire Bulletin, an independent local newsroom that allows NH Business Review and other outlets to republish its reporting.
New Hampshire authorities said Thursday that they have resolved their investigation into the death of a woman nearly 20 years ago.
On Feb. 24, 2007, 25-year-old Carrie Hicks was found dead from two gunshot wounds to the head at the Acworth home of Wayne Ring, who was found alive in the same room with a single gunshot wound to the head.
Ring died at the age of 57 on May 26, 2012.
Investigators officially determined Ring fatally shot Hicks before attempting to take his own life.
If you or someone you know is in crisis, call or text 988 to reach the Suicide and Crisis Lifeline or chat live at 988lifeline.org. You can also visit SpeakingOfSuicide.com/resources for additional support.
People who knew Hicks and Ring told authorities that they had formed a suicide “pact” and openly discussed suicide.
“Witness testimony revealed that Ms. Hicks had specifically instructed Mr. Ring to shoot her twice so she would not be left alive,” the office of Attorney General John Formella wrote in a press release.
A review of the autopsy report this year, along with a forensic reconstruction of bloodstain patterns, demonstrated that it was “medically and physically impossible” for Hicks to have fired the second shot she sustained, officials said. They added that, beyond a reasonable doubt, she could not have inflicted either injury on herself, and that Ring fatally shot Hicks before turning the gun on himself.
Formella said that if Ring were alive, there would be sufficient evidence to prosecute a first-degree murder case against him.
“We hope that the conclusion of this investigation brings a measure of clarity and peace to the loved ones of Carrie Hicks,” he said in a statement. “This resolution underscores the commitment of the New Hampshire Cold Case Unit. By thoroughly re-examining the forensic evidence, witness statements, and autopsy records, our investigators have finally established the truth behind this tragic loss of life.”
More than 2,100 new patients signed up with New Hampshire’s Therapeutic Cannabis Program last year, bringing the total registry to nearly 17,000, according to new state data.
That increase — about 14.5% from the year prior — is the largest since 2021.
Likely driving the growth were changes to state law in 2024 that allowed more people to qualify for medical marijuana use. They can now join the program at doctors’ discretion — which covers any debilitating or terminal condition or symptom, as long as their medical provider agrees the benefits of cannabis could outweigh the risks — or with a diagnosis of generalized anxiety disorder.
More than 900 patients list anxiety as their qualifying condition, according to the report issued this week by the state Department of Health and Human Services, which oversees the program.
“There was certainly an uptick in growth after those bills took effect in late 2024. It hasn’t skyrocketed, but has somewhat accelerated the growth of the program,” said Matt Simon, a lobbyist for GraniteLeaf Cannabis, one of three licensed cannabis providers in the state. “Where we’ve been, this extremely tiny program that was tiny for years, it is steadily growing.”
With 16,846 people, about 1.2% of the population are either certified patients or designated caregivers, who are authorized to buy cannabis on behalf of a patient. That’s close to one in every 84 Granite Staters.
The data released by the state was collected in June 2025. Simon estimates roughly 1,000 more people have joined since then.
The Therapeutic Cannabis Program, established in 2013, is the only way to lawfully consume marijuana in New Hampshire, as recreational use remains illegal. Patients require a doctor’s approval to join and receive a state-issued card that licenses them to buy medical cannabis products from seven dispensaries across the state, operated by three producers: GraniteLeaf Cannabis, Sanctuary Medicinals and Temescal Wellness.
The new data comes as the Trump administration reclassified medical marijuana last month as a less dangerous drug, effectively legitimizing programs run in 40 states, including New Hampshire’s. The change opens the door for more cannabis research and potential tax breaks for producers.
In New Hampshire, program demographics skew older. Nearly a quarter of patients are between 55 and 65 years old, and almost 70% are over 45. Pain is far and away the most common condition that people aim to treat with cannabis.
Patients are concentrated in southern New Hampshire and in towns with dispensaries, also called alternative treatment centers. There are seven across the state in Chichester, N.H., Conway, N.H., Dover, N.H., Keene, N.H., Lebanon, Merrimack, N.H., and Plymouth, N.H.
Concord has between 300 and 734 patients, according to the state data. Manchester has the most patients out of any municipality, at 1,150.
Despite the program’s growth, cost and accessibility remain a challenge. Jerry Knirk, a retired surgeon and state representative who now chairs the state’s Therapeutic Cannabis Medical Oversight Board, said New Hampshire’s strict regulatory environment plays a role.
“Part of the issue is we have a very high-quality, highly regulated program with testing of all products and lots of restrictions and things, and that does make things more expensive, but it’s how you keep the quality to be really high,” Knirk said. “We want to have really good quality. Unfortunately, it does make it a little bit harder.
One family of three spent $548 after discounts on a six-week supply of their medicine, which they use for chronic pain and other ailments, the Monitor reported last year.
Limited retail locations also mean that in some parts of the North Country, patients must drive upwards of an hour to obtain their medicine.
“The lack of dispensary locations, well, yeah, that is a problem,” Knirk said.
The oversight board, joined by other advocates, has pushed for laws to alleviate those concerns. Some of the biggest include allowing patients to grow their own medicine at home and allowing dispensaries to use outdoor greenhouses to cut electricity costs.
That legislation is introduced in the State House almost every year but is often torpedoed by Republicans’ concerns over security protocols.
While advocates expected little movement on marijuana policy under Gov. Kelly Ayotte, who opposes legalizing recreational use, the bill to allow greenhouse cultivation is nearing the finish line this session. Former governor Chris Sununu vetoed a similar bill two years ago; Ayotte hasn’t indicated whether she’d sign it.
Simon said that while cost and accessibility are still challenges, patient satisfaction with the program is improving.
“We started in a tough place with a lot of people really not liking the law and the program,” he said. “I think it’s been steady growth and steady improvement. Prices have come down somewhat, and the vibes are better.”
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