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N.H. Murder Raises Concerns Over Mental Health System

Laconia — The 19-year-old man charged Monday with killing a fellow resident at an Laconia apartment house for the mentally ill had been discharged from the state hospital Friday after an overnight stay, his sister said. But Debra Riley said her brother, Kasey Riley, who spent two days last week at Lakes Region General Hospital awaiting the state hospital bed, did not seem dangerous or agitated after his release.

“I spoke with him several times over the weekend,” Debra Riley said in a written statement. “There was no indication he was dangerous or was going to hurt anyone.” The last conversation with her brother that Debra Riley described occurred at 9 p.m. Sunday, about five hours before the police say Kasey Riley strangled Zachary March, 27, to death. Debra Riley said her brother, whom she described as struggling with mental illness for years, told her he’d had a good day at the beach Sunday and was headed home.

She expressed sympathy for the March family and issued a plea for increased mental health services in New Hampshire, while also acknowledging that her brother has sought and received treatment all his life. The Laconia home he was living in provides housing and some support to people with mental illness who have also been homeless.

“I pray for every family who is affected by mental illness that they are blessed with strength and patience to love and nurture their family members who suffer,” read the statement, which Debra Riley released through the state chapter of the National Alliance on Mental Illness. She declined further comment.

Kasey Riley was arraigned yesterday in Laconia’s district court on a charge of second-degree murder. He is being held without bail at the Belknap County jail. Neither the police nor the state attorney general’s office provided additional details about the death of March, who was found at 24 McGrath St. at 1:42 a.m. Monday.

The property, owned by Genesis Behavioral Health, offers apartment-style housing and some support and supervision from Genesis staff. But there is not supervision 24 hours a day, and no employees were present when March was killed, said company spokeswoman Kristen Welch.

Welch declined yesterday to comment on the death or say how long Riley had been living at the property. Debra Riley provided the most information yesterday in her statement.

She said her brother, who according to his Facebook page grew up in Gilford and attended Gilford High School, has been in and out of hospitals for his mental illness for much of his life. On June 4, Kasey Riley went to the emergency room of Lakes Region General Hospital in Laconia seeking help, she said.

There, Kasey Riley was confronted with what advocates for mental health services say has become a major barrier to help: There were no beds available at the state hospital. Instead, there were 16 adults and nine minors across the state already waiting for a state hospital bed by 7 that morning, according to New Hampshire Hospital.

Kasey Riley spent two days in the Laconia emergency room, which provides a safe place for people awaiting a state hospital bed but does not have the resources or space to provide treatment, said Ellen Wolf, the hospital’s chief nursing officer. She declined to comment on Kasey Riley but said last week was especially busy in the emergency room. It has just 17 beds for all emergency room patients, and on Wednesday there were eight adults and two children awaiting a state hospital bed, she said.

Debra Riley said her brother was transported to the state hospital last Thursday when a bed became available. She said she traveled to Concord about 4:30 p.m. to visit her brother and was concerned that he “appeared disheveled,” according to her statement. She did not elaborate. Kasey Riley was released from the state hospital the next day, his sister said, adding she did “not know the circumstances for why he was released.”

There were 14 adults and eight minors across the state waiting for a state hospital bed Friday morning, the day Riley was released. In her statement, Debra Riley did not express concern about her brother’s release after such a short stay. She instead said that he did not seem angry or dangerous.

‘Only a Step’

Robert MacLeod, chief executive officer of New Hampshire Hospital, said Tuesday he could not comment on Kasey Riley’s stay or confirm that he had been admitted to the state hospital. He did say stays of just a day are not unheard of. Last year, about 7 percent of the hospital’s patients were discharged after 24 hours. And most patients are discharged in fewer than 10 days, he said.

MacLeod said state hospital staff are mindful of the number of people waiting for a state hospital bed each day but do not factor the waiting list in when deciding when to discharge someone. He said staff deem someone ready for discharge when they are stabilized.

The hospital will review this case, hospital spokeswoman Kris Neilsen said, because the Laconia home where March and Riley were living receives money from the state Department of Health and Human Services.

Ken Norton, executive director of the mental illness alliance in New Hampshire, on Tuesday called March’s murder and Kasey’s arrest a tragedy for everyone involved: March’s family, the Riley family and the treatment providers. Norton has joined other advocates for mental health services this year in calling on lawmakers to invest more money in rebuilding the state’s mental health system, citing long waits at emergency rooms for a state hospital bed.

For the first time in years, lawmakers have obliged: The governor, Senate and House have agreed to spend $28 million over two years on expanding mental health services. The budget has not yet been finalized, but that investment is expected to survive budget negotiations. And separate from that money, the state hospital just opened up about a dozen additional beds that MacLeod hopes will eliminate or at least shorten the wait.

“That is a huge step for our state,” Norton said of the $28 million budget plan. “But we have to recognize that it’s only a step. Given the cuts we’ve had, it doesn’t bring things back to where they were before. We have to keep addressing this and looking at the challenges.”

Jay Couture, executive director of the state New Hampshire Community Behavioral Health Association, said yesterday the proposed budget for additional mental health services will especially benefit people who are trying to manage their mental illness while still living in the community. For one thing, Laconia’s Genesis Behavioral Health, one of the state’s 10 community mental health centers, will get money for an Assertive Community Treatment team for people in need of extra attention, she said.

The teams, which don’t yet exist in much of the state, allow a group of treatment providers to carry a lower caseload and focus their attention on the most volatile or fragile patients in their region. “It really allows you to wrap services around the person who is most in need,” Couture said, “with the outcome being that they don’t need to be admitted to the hospital at all or as often.”

Couture said a case like Riley’s makes the greater public aware of what patients, their families and advocates for mental health services have been concerned for years as the state has cut mental health services.

“I think that when you have a system in crisis, crises happen,” Couture said. “And our system is in such a crisis at this moment, it’s just becoming more visible to the larger community. And more visible than it was in the past.”