Massachusetts remains an outlier in how it runs mental health services for its prison population.
Abdul was being held in a locked interview room at Bridgewater State Hospital when he was ordered into seclusion. At the height of what followed, four staffers designated as Therapeutic Safety Technicians -- an Orwellian title if ever there was one -- dragged him into a seclusion room as nine other staffers, including one with a hand-held video camera, looked on. In the seclusion room, the four "technicians" held him face down on a four-point restraint bed and pulled down his pants.
"He screamed as a nurse administered multiple intramuscular injections into his buttocks," according to a report slated for release to the public on Wednesady by the Disability Law Center. He was secured to the bed for the next hour. "Throughout the altercation, Abdul often screamed and cried," the report stated, and he had cuts and abrasions on his hands and arms from his "therapeutic" encounter.
DLC monitors Bridgewater -- a men's prison mental health hospital run by the state Department of Correction but staffed largely by the private prison health care giant Wellpath -- on behalf of the Legislature. Its most recent report is replete with stories like Abdul's (the report uses pseudonyms for the men) and of the "regular use of violent force by staff in the administration of involuntary medication" of the men housed there. DLC used on-site visits and interviews -- along with what it called the "extremely delayed" release of 10 DOC-produced videos -- to report on the "often dehumanizing experiences" of dealing with the Therapeutic Safety Technicians. Those technicians are Wellpath security staffers who enter cells dressed in riot gear and wielding plexiglass shields.
Bridgewater is a medium-security facility, one where increasingly its designation as a "hospital" for those criminally charged or civilly committed seems more euphemism than reality. Staff have tough, dangerous jobs, and there are sometimes legitimate reasons for use of force -- but the report flags incidents that appear excessive.
Frank, described as a "small, older man" had been walking around his room, gesturing and talking to himself, for about 20 minutes. Then he kicked his room door, "sat down on his bed and, after five minutes, got under the covers facing the wall in a fetal position," according to the DLC report. He remained under the covers even after the "therapeutic" technician team arrived. According to the report, all four technicians held him on his side as a nurse administered the drug cocktail that constitutes chemical restraint. "Frank appears to be crying and in distress, and he lies there coiled up in bed after he is left alone in his room," the report states.
As DLC points out, in instances when the "emergency" used to justify chemical restraint has passed -- as in Frank's case -- medical restraint actually violates the law.
"What can possibly be the justification for men in riot gear to rush in at that point and give him a shot," said Tatum Pritchard, director of litigation for DLC. "This wouldn't happen at a Department of Mental Health facility."
Singled out as being particularly problematic for their treatment of those newly arrived at the facility were units Bradford 1 and 2, where many men are sent for court-ordered mental competency evaluations. Now keep in mind these people have not yet been found guilty of anything.
They included people like Jamie, in his late teens and newly arrived from a county jail. He described himself as being on the autism spectrum and had been living at a group home for individuals with developmental disabilities when he was arrested for assault based on allegations by a staff member. "Jamie stood at the door of his locked room, stiff and seemingly nervous, quietly telling DLC that it was so loud here he couldn't sit still" and that he was largely ignored by staff.
Those particular units have generally come under criticism for offering little in the way of treatment and far too little out-of-cell time, with many men confined for well beyond 11 waking hours a day. "This is inconceivable in a supposed psychiatric hospital setting," the report said.
In response to an advance copy of the report, Correction Commissioner Carol Mici wrote in a letter to DLC that the department has retained a Qualified Mental Health Professional to oversee "delivery of day to day services" and "is dedicated to those currently being treated at BSH." She also noted that Wellpath, which is under contract to run services within the hospital through June 30, 2026, had "submitted revisions to the Seclusion and Restraint Policy and Involuntary Psychotropic Medication Policy to ensure" they are "as closely aligned as possible" with the law and Department of Mental Health policies.
That in turns begs a question: Why not just turn the facility over to DMH -- or better yet build a new one better suited to the delivery of mental health care in a secure setting, similar to the forensic unit at the Worcester Recovery Center and Hospital run by DMH?
"DMH has secure facilities," Pritchard said. "They can and do manage pretty much the same populations as Bridgewater. Keep in mind there's no DOC hospital for women. They go to a DMH hospital."
The Bridgewater facility itself, where some buildings date to 1974, cries out for a replacement in the wake of ongoing documentation by a consultant retained by DLC of "abnormal and unacceptable mold growth" in nearly all of the buildings, including the medical building. (The mold was first reported by the same consultant in 2019.) The consultant also reported "filthy HVAC system ductwork" in most of the buildings, which continued to spread "black dust" from dirty basements upward.
DOC, which will soon be under the leadership of a new commissioner (Mici has announced her retirement), has not been a good steward of the facility or the patients it serves. The idea of turning the care of its population over to DMH isn't a new one. But it has gathered steam during this legislative session.
"Such a legislative change would place Massachusetts in line with the rest of the nation," according to a recent report prepared for the Massachusetts Association for Mental Health. "In nearly every other US state, the maximum-security forensic hospital is operated by the state mental health agency."
Massachusetts, which was a pioneer in the delivery of mental health services, should be no exception. Today it has a real opportunity to do better by those totally dependent on the state for their care. They must not be forgotten.
-- Boston Globe. March 13, 2024.