A two-year investigation of Massachusetts prisons has found conditions that violate the constitutional rights of prisoners.
Massachusetts U.S. Attorney Andrew Lelling says the state Department of Correction has not provided adequate mental health care or supervision to prisoners in mental health crisis. He also says the DOC has violated the constitutional rights of prisoners in crisis by using prolonged mental health watch under restrictive housing conditions, resulting in some prisoners harming or killing themselves while on watch.
"Our investigation found cause to conclude that the Massachusetts Department of Corrections fails to properly supervise and accommodate prisoners suffering from serious mental health issues," Lelling said in a press release. "The conditions at MDOC facilities show how systemic deficiencies in prison facilities can compound each other and amount to constitutional violations. MDOC has cooperated with our investigation from the beginning and we look forward to working with state prison authorities to implement reform measures."
The U.S. Attorney’s Office and the Department of Justice's Civil Rights Division initiated the investigation in October 2018 under the Civil Rights of Institutionalized Persons Act, or CRIPA, which authorizes the department to take action to address a pattern or practice of deprivation of constitutional rights of individuals confined to state or local government-run correctional facilities.
The U.S. Attorney provided the DOC with written notice of the violations and ways to address them. The department can initiate a lawsuit if the state does not make necessary progress in the next 49 days.
Lelling says his office is closing the portion of the investigation related to restrictive housing and geriatric and palliative care.
“Our investigation revealed that MDOC fails to provide adequate mental health treatment to prisoners experiencing a mental health crisis and instead exposes them to conditions that harm them or place them at serious risk of harm,” said Assistant Attorney General Eric Dreiband for the Civil Rights Division. “Remedying these deficiencies promptly will ensure that we protect the constitutional rights of these vulnerable prisoners and promote public safety.”
The DOC says it has taken steps to improve mental health treatment and plans to address the recommendations in the report.
"The Department of Correction continues to work closely with DOJ and has already begun to address the issues raised in the report and maintain the significant progress we have already made," a DOC statement said. "As the report indicates, investigators found no violations in the use of restrictive housing for inmates or in the geriatric and palliative medical care provided to all inmates. The Department remains deeply committed to the health and well-being of all entrusted to our care and fully invested in protecting their physical safety and civil rights."
Gov. Charlie Baker's office has not responded to WBUR's requests for comment.
Prisoners Legal Services of Massachusetts Executive Director Elizabeth Matos notes that these findings are based on an investigation conducted before the pandemic began.
"Since COVID, our office has noticed the mental health of our clients decompensating due to the never-ending lockdowns, having limited family contact, lack of access to real programming and treatment, and the ever-present threat of contracting the novel coronavirus and having almost no ability to prevent that," she said. "Incidents of self-harm and suicidality have increased. These new COVID outbreaks will only deepen the harm that this investigation highlights."
The ACLU of Massachusetts says it is not surprised by the findings.
"Far too many people are incarcerated in conditions that threaten their health, safety, and human dignity on a daily basis. From providing adequate mental health care to slowing the spread of COVID-19, Massachusetts must do more to save the lives of people in jails and prisons," said Carol Rose, executive director of the ACLU of Massachusetts, in a statement. "Above all, Massachusetts must downsize the footprint of its criminal legal system for the sake of public health and justice."
Report Cites "Harsh" Conditions For Mental Health Patients
Lelling's investigation focused on prisoners with serious mental illness, which the 26-page report says is 24% of the prison population. Investigators looked at several Massachusetts Correctional Institutes and other prisons, including MCI-Cedar Junction, MCI-Framingham, MCI-Norfolk, the Massachusetts Alcohol and Substance Abuse Center in Plymouth, the North Central Correctional Institution in Gardner, Old Colony Correctional Center, MCI-Shirley, Massachusetts Treatment Center, and Souza-Baranowski Correctional Center.
The investigation included visits to the facilities and interviews with stakeholders, advocates, former prisoners, former DOC staff, and family members of prisoners with firsthand knowledge of prison conditions.
More than 900 prisoners were placed on mental health watch between July 1, 2018 and August 31, 2019, according to the report. Five of the 10 prisons that have mental health watch cells housed at least one prisoner on mental health watch for 180 consecutive days or longer; all but one (MCI-Shirley) housed a prisoner on mental health watch for 90 consecutive days or longer; and every facility held at least one prisoner on mental health watch for 30 consecutive days or longer.
Although DOC policy says release from a mental health watch after four days is the goal, Lelling's investigation found that during the 13 months of its review, the DOC held more than 100 prisoners on mental health watch for more than 14 consecutive days. During the investigation timeframe, the DOC reported that prisoners engaged in self harm 688 times while on mental health watch. Investigators said that treatment is not provided to prisoners on mental health watch and they are often subjected to "harsh" conditions that are essentially restrictive housing.
"These conditions often last longer than necessary — sometimes for weeks or months — and in conditions that perpetuate the prisoner’s crisis or even escalate it, all while the prisoner decompensates and continues to engage in self-harm," the report reads." Thus, prisoners in crisis placed on MDOC’s mental health watch often face a harmful experience — not a therapeutic and protective one. "
The investigation outlines several incidents at state prisons where it says detainees rights were violated. In 2019, a prisoner at Souza-Baranowski cut himself and blood began to pool outside his cell, yet it took 45 minutes for correction officers to respond before the man was taken to a local hospital. Another incident at MCI Shirley involved a man who killed himself 12 days after leaving a nine-day long mental health watch. His family had warned staff at Shirley that the man planned to kill himself.
"On October 29, 2019, SS, a gay man who had issues with incontinence because of prostate cancer, died by suicide after hanging himself in his Restrictive Housing Unit cell at MCI-Shirley," the report said. "While he was on mental health watch, MDOC did not address the underlying issues that put SS on watch in the first place, and released him without an adequate step-down process that would have provided him enhanced therapeutic engagement and may have prevented his continued deterioration from the isolation he experienced."
Lelling's investigation also faulted the DOC and its medical provider Wellpath for not having clear policies about dealing with prisoners mental health issues.
"Security staff do not always know why mental health staff place a prisoner onto mental health watch, or what happened to a prisoner while on mental health watch, which would be important information to monitor once the prisoner returns to his regular housing unit," the investigation report reads.
The report also says some reforms are underway and that the DOC has improved training and taken steps to make mental health watch safer. It recommends that the DOC make several changes to improve mental health care, including better supervision of prisoners in mental health watch, disciplinary action against officers who do not comply with policies regarding mentally ill prisoners, provide treatment, hire more mental health clinicians and reduce the "unnecessarily harsh nature of mental health watch."
If the state does not meet those necessary conditions, the Justice Department has authority to initiate a lawsuit against Massachusetts 49 days after Tuesday's notification.
This article was originally published on November 17, 2020.