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Many Bridgewater inmates need medical care, not prison

A Bridgewater State Hospital mental health worker makes his rounds in the Intensive Treatment Unit, where patients are secluded for their own safety, in 2007.

file 2007/the boston globe

A Bridgewater State Hospital mental health worker makes his rounds in the Intensive Treatment Unit, where patients are secluded for their own safety, in 2007.

A national movement to curtail the use of seclusion and restraints of mentally ill prisoners has bypassed Bridgewater State Hospital, where patients are 200 times more likely to be placed in restraints or isolation than at a well-run mental health facility serving a similarly difficult population in Connecticut. Such excessive use of restraints is a clear sign of an institution that is failing to fulfill its awkward dual role as a prison for dangerous criminals and a provider of mental health services.

A series of reports by the Globe’s Michael Rezendes highlighted abuses at Bridgewater — which is actually a prison under the control of the Department of Correction — including the 2009 death of a 23-year-old mental patient, Joshua Messier, who died while correction officers were placing him in four-point restraints. Messier’s autopsy revealed injuries consistent with a beating. A subsequent investigation indicated that some of the correction officers involved in the case claimed to lack even the most basic knowledge of mental illness. Last month, attorneys for three mentally ill patients at Bridgewater State Hospital filed a class-action lawsuit charging that more than half of the roughly 300 patients are being held under “harsh conditions’’ even though they are not serving criminal sentences.

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Under intense pressure, Governor Patrick and state public safety officials are starting to demand changes at the troubled institution. Correction officers are receiving training on how to avoid using restraints. Both the use of seclusion and restraints dropped dramatically in May. It may be possible, still, to bring 21st-century care to Bridgewater without sacrificing public safety. But the history of reform at Bridgewater is one step forward and two steps back.

Bridgewater patients who are not serving criminal sentences — about half the population — would fare better in a true medical setting. The longer such individuals are exposed to prison-like conditions, including solitary confinement, the more agitated they become and the greater the need for correction officers to restrain them. It’s a vicious cycle, and one the state has known about for a long time.

Bridgewater would benefit from better classification of its inmates. It currently houses convicted criminals who are too psychotic to be imprisoned elsewhere, dangerous men found not guilty by reason of insanity, and individuals referred by a district court to determine if they are competent to be charged with a crime. Some of those in the latter category were sent to Bridgewater after attacking staffers at state hospitals for the mentally ill. But few, if any, are likely to go on trial. Like Messier, they are being held primarily for evaluation.

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Some of these patients could be absorbed into mainstream state mental health facilities. But the Patrick administration can’t escape the need for a specialized hospital unit for noncriminal, violent patients who need the kind of therapeutic setting that no prison can ever provide. Size and cost must still be determined. But the state Department of Mental Health, not the state prison system, should be in control of the facility.

In the 1980s, violent but noncriminal mental health patients were routinely confined at Bridgewater. But several preventable deaths and a lawsuit ended that practice. Under pressure, the state created a special secure unit at Taunton State Hospital where violent patients could be sent in lieu of prison. But budget problems and an ideological bias against large state hospitals contributed to the closing of the unit in 2003. Reviving the Taunton facility would make immediate sense. There are reasons why few states place forensic hospitals like Bridgewater under the control of departments of correction: It’s impractical and dangerous to all concerned.

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