Chemical restraints, isolation often used at Bridgewater State Hospital, new report says

A new report shows clinic workers at the Bridgewater State Hospital often use chemical restraints and seclusion on people held there in violation of state law.

Despite the Baker administration's reforms at Bridgewater State Hospital, the report says the facility has significant structural problems, and that staff members are improperly restraining those with severe mental illness.

The hospital is the state’s secure institution for people with severe mental illness, and most admitted there are involved in the criminal legal system. About 200 men are currently held there.

The report, issued by the Disability Law Center, found that staff from the hospital's clinical services provider, Wellpath, often use medication to restrain those in custody, and that the hospital's policies on restraints are in violation of state law. The Center monitors state care for people with disabilities. It also reviews conditions at Bridgewater State Hospital as part of a legal settlement.

"Spending time inside BSH is not safe for anyone," the report said.

Prodded by a 2014 lawsuit, Gov. Charlie Baker implemented reforms at the hospital in 2017. The reforms involved contracting with the private vendor Wellpath to provide clinical services at Bridgewater.

Although the hospital is operated by the Department of Correction, correction officers only monitor the outside of the building.

"Wellpath is now subjecting (person served) to all forms of restraint and seclusion in unsanctioned circumstances, particularly the use of manual holds, seclusion and chemical restraint," the report said. "DLC also found that there is significant underreporting of restraint and seclusion, with Wellpath failing to report at least 80 instances of restraint and seclusion to the BSH Superintendent and the DOC  Commissioner, as required."

Between June and November last year, the report found that 370 so-called "emergency treatment orders" were issued, which would allow for the use of medication. Tatum Pritchard, DLC litigation director and interim executive director, said she visited the hospital and spoke with several men there who reported widespread use of chemical restraints to subdue those in custody.

"Many report either being subjected to this themselves or to witnessing others in their units being subjected to this kind of forced medication pretty regularly," Pritchard said. "And it's something that really, for obvious reasons, affects them. They're in a facility where they're being sent purportedly for care and treatment — where they're supposed to be able to stabilize — and instead many of them are terrified."

Baker has often highlighted the reforms made at Bridgewater State Hospital since he took office. During his State of the Commonwealth speech last month, Baker said his administration has " brought care and compassion to Bridgewater State Hospital after decades of national embarrassment."

As for the new DLC report, the governor's office referred questions to the Department of Correction. In a statement, a spokesman for the DOC said the department "looks forward to reviewing the report and its recommendations."

A Wellpath spokeswoman did not respond to repeated requests for comment.

Structural problems are also an issue, according to the DLC report. It found pervasive mold in the hospital, as well as potential exposure to asbestos. An independent agency tested the mold and indicated that asbestos was likely in pipe wrappings in the mechanical rooms that house the hospital's HVAC units. The agency said the type of mold found poses health risks for those who live, work and visit Bridgewater.

This isn't the first time the DOC has been asked to deal with the mold in the hospital. After a 2019 DLC report citing the mold problems, the department said the issues had been corrected. But the new report said the DOC has "largely ignored" the previous recommendations, that the hospital's HVAC systems are "horrible," and that "inaction has caused the mold problems to become worse in certain areas observed and potentially more harmful to those who work and live in the facility."

"Our monitoring confirms that, while certain specifics may have shifted over the years, many of the pillars of BSH's inadequacy remain," the report says. "Concerns about the economic toll and health and safety risks resulting from physical plant conditions; providers' failure to comply with legal requirements concerning administration and documentation of (person served) restraint and seclusion; the prevailing culture of intimidation; and the lack of immediate and robust programming upon admission are all reminiscent of the deficiencies that gave rise to DLC's initial investigation and settlement agreement in 2014."

The report makes several recommendations including mold remediation, improved documentation on the use of restraints, better training and supervision, and integrating peer support specialists. It also strongly recommends building a new facility — run by the Department of Mental Health and not DOC — for those with severe mental illness who are in state custody.

"Every report DLC has issued since 2018 has made clear that the state of the physical plant and infrastructure at BSH warrant the facility's closure," the report said. "The Commonwealth must immediately place BSH, as well as the planning construction and oversight of a new facility under the authority of DMH."

The report is the latest in a series of controversies facing the DOC. The department is negotiating a settlement with federal officials over a 2020 Justice Department report that found the DOC violated the rights of some mentally ill prisoners. Two pending lawsuits allege that prisoners were mistreated at the Souza Baranowski Correctional Center.

Recent legislation established an independent DOC ombudsman, largely to monitor efforts to deal with the coronavirus in state prisons. The first ombudsman appointed was fired after officials learned of his involvement in a wrongful death lawsuit. The current ombudsman, Lauren Andersen, took the post last year.

Despite the scathing DLC report, Pritchard said there have been improvements at Bridgewater since the 2014 legal settlement. Those in custody are no longer secluded for long periods of time, she said, but the coronavirus pandemic has resulted in increased staff turnover. And workers are now accustomed to detainees being largely confined to their cells.

"We did see progress and then we saw the progress begin to halt and and now we've seen things sort of go downhill again," Pritchard said.

The report has been sent to state lawmakers for review. State Sen. Jamie Eldridge, Senate Chair of the Legislature's Joint Judiciary Committee, said the report is being reviewed by his committee and was sent to the DOC ombudsman. Eldridge and Judiciary Committee House co-chair State Rep. Michael Day describe the report as "disturbing" and say they expect to talk about it with DOC officials.

“I am deeply disturbed by the latest report on Bridgewater State Hospital, which highlights chronic problems at that facility," said Day. "The Legislature specifically provided the Disability Law Center with the authority and funds needed to investigate the Administration's management of Bridgewater and, in the wake of these findings, we are now evaluating what measures are needed to fix this. All options are on the table at this point in time.”