A federally funded watchdog group is demanding sweeping reforms at troubled Bridgewater State Hospital, charging that prison officials are not qualified to run the mental health facility and that guards and clinicians routinely violate safety rules and the rights of patients.
The changes outlined by the Disability Law Center go well beyond a recent plan to revamp practices at Bridgewater announced by Governor Deval Patrick. Both Patrick’s plan and the report were triggered by a Globe story in February about the death of a mental health patient as guards subdued him and strapped his wrists and ankles to a bed.
The center’s report portrays Bridgewater as a place where staff members are more concerned with punishment than patient care and sometimes harm patients already scarred by mental illness, traumatic brain injuries, sexual abuse, or intellectual disabilities.
Lawyers for the center, who spent six weeks at the Bridgewater complex reviewing records and interviewing patients and staff, said prison guards and clinicians do little to treat patients and often take a “one size fits all approach” to patients’ problems — secluding or restraining them for everything from feelings of anxiety to refusing medications to getting into fights.
“At its very core, however,” the 23-page report concludes, “the excessive restraint and seclusion is symptomatic of a more fundamental problem: these patients with serious mental illness are being held and ‘treated’ within a correctional facility rather than within a mental health facility.”
The Legislature is already considering Patrick’s proposal to reform Bridgewater State Hospital, which, despite its name, is a medium security prison.
Center officials praised the governor’s plan, but said it doesn’t go far enough because it would leave the Department of Correction in charge of the institution.
Massachusetts stands virtually alone in assigning a correctional department to run its mental health facility for patients who have had contact with the criminal justice system. In every other state except Iowa, these so-called forensic hospitals are run by mental health departments.
“It is time for Massachusetts to join the other 48 states that provide care and treatment to this population through a state mental health agency rather than a correctional agency,” the center said in its report, which was obtained by the Globe.
A spokeswoman for Patrick emphasized that the governor’s proposal would move all Bridgewater patients except those serving criminal sentences to other facilities run by the Department of Mental Health, adding that it would double the number of clinicians at Bridgewater and make physical improvements to the complex.
“The Patrick administration, in partnership with the DLC and other stakeholders, has proposed a comprehensive plan to ensure that mentally ill individuals receive appropriate care in appropriate settings,” the spokeswoman said in a statement. “We look forward to continuing to work with all stakeholders to ensure that Massachusetts has a 21st century approach to care for the mentally ill in our criminal justice system.”
On Friday, Patrick signed a state budget that includes $13 million to support his proposal. Separately, he filed a $10 million supplemental budget request to dramatically increase Bridgewater’s clinical staff.
The Boston-based Disability Law Center, designated under federal law to investigate complaints about the abuse and neglect of disabled people, delivered its report to Patrick on Friday morning. A major focus of the report is the excessive use at Bridgewater of seclusion and four-point restraints, which strap a patient’s wrists and ankles to a bed.
The Department of Correction says it has cut the use of restraints by more than 90 percent over the last several months, and the use of seclusion by more than 60 percent. But the center said these improvements are likely to be temporary unless the facility is turned over to the Department of Mental Health.
“When the spotlight is dimmed, those numbers will inevitably climb back up due to the essential nature of a correctional facility filled with men with serious mental illness,” the center’s report said.
Like Patrick, the center concluded that Bridgewater doesn’t have sufficient resources to run the complex safely, noting that, as the guards have reduced their reliance on isolation and restraints to control patients, assaults on staff and other patients have been on the rise.
That is a clear sign, the center said, that reforms at Bridgewater will remain incomplete without a shift in management, additional staff, and physical improvements such as the creation of quiet rooms where agitated patients can calm down.
“There’s nowhere to go to read a book, nowhere to go for peace and quiet,” said Christine M. Griffin, the center’s executive director, in an interview. “It’s in no way conducive to effective treatment.”
Bridgewater State Hospital houses a wide range of male mental health patients, including violent convicted criminals, those who have been found not guilty by reason of insanity, and others who have been accused of minor crimes and referred to the facility for psychiatric evaluations. Many have never been convicted or served time in a state prison.
Bridgewater’s population generally hovers around 325 men, including about 50 who are assigned to work details and are not mental health patients. But recently the census has dropped to about 250, Griffin said.
The center’s investigation followed a series of Globe stories highlighting the rampant use of restraints and seclusion at Bridgewater, including a detailed account of the 2009 death of Joshua K. Messier , a young mental health patient who died as guards were forcibly subduing him and putting him in restraints.
Messier’s death was ruled a homicide, but none of the guards was prosecuted or disciplined until the first Globe story was published earlier this year, prompting Patrick to suspend three of the guards, fire one correction official, and discipline two others, including Commissioner Luis S. Spencer.
Lawyers for the center who visited Bridgewater reviewed patient records and interviewed 75 patients as well as medical and mental health clinicians, and prison guards. But the center said its investigation is incomplete because Department of Correction officials have yet to turn over crucial documents, and that it filed its report early for the benefit of state lawmakers considering Patrick’s legislative proposals. The Legislature’s formal session is scheduled to end on July 31.
Among its 29 recommendations, the center calls for the appointment of a “human rights officer” to ensure the rights of patients, and a two-year monitoring period during which patient complaints and internal reports on uses of force and patient deaths would be referred to the center on a quarterly basis.
If the center finds that its recommendations are not followed, it could file a federal lawsuit to force changes, as it has in the past.
In 2007, the center sued the Department of Correction after alleging that the state’s prison system was subjecting mentally ill prison inmates to cruel and unusual punishment by placing them in solitary confinement for prolonged periods.
The department made significant concessions to end the suit, agreeing to minimize use of isolation for mentally ill inmates and provide specialized housing for mentally ill inmates who may be violent. The settlement followed a Globe Spotlight Team investigation, which found that inadequate care for mentally ill prisoners often resulted in suicides.
Stan Eichner, the center’s litigation director, said the organization is more interested in encouraging reforms at Bridgewater than in pursing legal action against the state. But he also said, “We are a legal organization. If that’s what it takes get these men the rights they are entitled to, that’s a possibility.”