Mistreatment persists at Bridgewater State Hospital, report says

There are continuing problems at the Massachusetts Department of Correction mental health hospital, according to a new report from the agency that monitors the facility for the state.

The report, from the Disability Law Center, found patients at Bridgewater State Hospital were subjected to illegally forced medication injections, violence from staff, lack of medical care, inappropriate medication for opioid use disorder and mold contamination. The report recommends that the state transfer control of Bridgewater State Hospital from the Department of Correction to the Department of Mental Health.

"Massachusetts must cease involuntarily committing people with complex mental health needs and disabilities to a state prison facility where they will foreseeably face countertherapeutic conditions and suffer violations of their legal rights by those meant to provide them treatment," the report's authors urged.

Bridgewater State Hospital houses more than 200 male prisoners and other people with serious mental illnesses who are charged with crimes.

Department of Correction officials said they have taken steps to address some of the concerns raised in the report, such using daily video reviews of instances of physical restraint, and hiring Dr. Debra Pinals, a former Department of Mental Health official, to review the hospital's practices and policies.

"The DOC has enhanced staff training and increased independent oversight by behavioral and mental health experts who have reviewed policies to ensure alignment with Department of Mental Health policies and regulation," correction officials said in a statement responding to the report.

The report reviewed Bridgewater State Hospital over six months, from June 2023-December 2023. The Disability Law Center has been monitoring the facility for a decade and said although some improvements have been made, there are ongoing problems with the care provided to patients and the condition of the buildings.

"The treatment and conditions at Bridgewater State Hospital are simply not acceptable, and they don't meet the needs of the Bridgewater State Hospital population," said Tatum Pritchard, director of litigation for the Disability Law Center.

Among the issues outlined in the report is the use of security staff from Wellpath, the Department of Correction's health care provider, to forcibly inject patients with medications. Disability Law Center investigators talked with patients and reviewed video footage and policies on forced medications. They found Wellpath staff in riot gear were utilized to subdue patients, and that "involuntary medication and prison practices merge to produce violent, often dehumanizing, experiences" for patients.

"DOC and Wellpath must cease, as a rule, using teams of security staff in riot gear to
implement by force involuntary medication orders, including medication restraint," the report's authors wrote. "To the extent such a practice would ever be acceptable, it must be reserved for exceptional circumstances."

The investigators also cited instances where patients were not provided medical care they needed and were not given appropriate medication for opioid use disorder. The Disability Law Center asked Dr. Evan Gale, associate medical director of the Addiction Consult Team at Massachusetts General Hospital and its director of inpatient training for the Addiction Medicine Fellowship, to review Wellpath’s practices regarding addiction medications.

According to the report, Gale's review found the hospital's care for those with opioid use disorder raised "significant concerns."

"Dr. Gale found BSH providers conflate mental health symptoms with withdrawal symptoms and, based on the stigma of both and lack of management of medication options, provide substandard care," the report said.

Additionally, the investigators reported that the Department of Correction has not followed previous recommendations from the Disability Law Center about mold control and remediation, making the facilities unhealthy for patients and staff.

"These inactions have caused the mold problems to become worse in certain areas observed and potentially more harmful," the report said.

The report has been sent to lawmakers for review. It comes as the legislature considers a bill to transfer oversight of Bridgewater State Hospital to the Department of Mental Health. Wellpath's contracts to provide medical services in all state prisons and at Bridgewater State Hospital expire in June.