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State prisons failing on mental health, according to federal investigators

The Patriot Ledger - 11/18/2020

BOSTON-- Massachusetts correctional officials violate inmates' constitutional rights by providing insufficient supervision and mental health care, failing to protect them from self-harm, and frequently placing them into restrictive housing, federal prosecutors concluded Tuesday after a two-year investigation.

Citing hundreds of examples, U.S. Attorney Andrew Lelling's office and the Department of Justice's Civil Rights Division found that staff of the state's Department of Correction fail to prevent self-harm or suicide among inmates who are already on mental health watch, in many cases because of a lack of "clear and uniform training."

In some cases, they said, staff were aware of potential problems but intentionally disregarded them.

"Our investigation found cause to conclude that the Massachusetts Department of Correction fails to properly supervise and accommodate prisoners suffering from serious mental health issues," Lelling said in a statement outlining alleged violations of the Eighth Amendment, which forbids cruel and unusual punishment. "The conditions at MDOC facilities show how systemic deficiencies in prison facilities can compound each other and amount to constitutional violations."

A spokesperson for the department said it has already taken several steps to address the deficiencies.

"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," the spokesperson 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."

Among other changes, several department facilities have stopped selling razors to inmates and have expanded their training and communication protocols.

The Department of Correction oversees state prisons, while county jails are run by elected sheriffs.

Federal officials did not announce any charges and Lelling said the Department of Correction cooperated with the investigation and that his team "look(s) forward to working with state prison authorities to implement reform measures."

Investigators outlined changes the department must implement as a minimum response, including ensuring that prisoners cannot access instruments used to injure themselves while on mental health watch, enhancing training protocols, conducting daily out-of-cell mental health assessments, hiring sufficient mental health clinicians, minimizing isolation and more.

If the state does not meet those necessary conditions, the U.S. Attorney General has authority to initiate a lawsuit against Massachusetts 49 days after Tuesday's notification, which falls on Jan. 5, 2021.

Some reforms are underway, according to a report from investigators, such as expanded training and more frequent communication about which prisoners face self-harm risks.

The investigation launched in October 2018 under the Civil Rights of Institutionalized Persons Act, focusing on how Massachusetts handles the roughly 2,100 prisoners with serious mental illnesses, who comprise about 24 percent of the state's prison population.

Department of Correction facilities frequently place prisoners on mental health watch, where they are housed in more protective cells and watched under close surveillance, but the investigation found serious gaps in those practices.

Prisoners who are placed on mental health or suicide watch continue to have access to instruments such as razors, batteries and paint shards that they can use to harm themselves, investigators found.

In a 26-page report, they cited hundreds of instances of self-harm, including many suicide attempts, among inmates in DOC facilities under mental health watch, many of whom were held in that watch status for longer than the maximum four-day period outlined in DOC policy.

Report authors described several specific examples in harrowing detail, such as one incident at the Souza-Baranowski Correctional Center in which an inmate on one-on-one mental health watch cut himself badly enough to bleed on the cell floor but staff did not intervene for 45 minutes.

"Although only approximately 1% of the DOC's total population can be housed in one of its mental health watch cells at any given time, between July 1, 2018, and August 31, 2019, more than 56% of the 1,200 systemwide 'self-injurious behavior' incidents occurred in a mental health watch cell," investigators wrote.

Investigators also found that the housing conditions under mental health watch are often isolating and "unnecessarily harsh," exacerbating risks.

Lelling and the department said Tuesday that they closed a part of their investigation on restrictive housing and geriatric and palliative care.

Civil rights and prisoners' advocacy groups described the results of Lelling's investigation as alarming but unsurprising.

"Access to mental health care is not only extremely limited inside jails and prisons, it is counter-therapeutic," said Elizabeth Matos, executive director of Prisoners' Legal Services of Massachusetts. "People facing a crisis are routinely placed on mental health watch, which is widely considered worse than solitary confinement."

Noting that the investigation predated the COVID-19 pandemic, Matos warned the months-long outbreak could accelerate the dangers highlighted. PLS, she said, has observed its clients' mental health "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 coronavirus infection with no ability to prevent it."

American Civil Liberties Union of Massachusetts Executive Director Carol Rose said the investigation underscores the need to reduce the scope of its criminal justice system.

"Far too many people are incarcerated in conditions that threaten their health, safety, and human dignity on a daily basis," Rose said in a statement. "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. Above all, Massachusetts must downsize the footprint of its criminal legal system for the sake of public health and justice."

This article originally appeared on The Patriot Ledger: State prisons failing on mental health, according to federal investigators

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