Investigation finds Mass. Dept. of Correction violates rights of prisoners with mental health issues

An inmate at MCI-Cedar Junction at Walpole, Mass. on Tuesday, June 28, 2011.Jessey Dearing for The Boston Globe

Mentally ill inmates in Massachusetts prisons have harmed themselves or even died because the Department of Correction has failed to provide them with proper care, violating their constitutional rights, according to a federal investigation released Tuesday by the US attorney’s office.

Investigators found “reasonable cause to believe” that the department does not adequately supervise inmates in mental health crises, does not provide them adequate mental health care, and uses “prolonged mental health watches under restrictive housing conditions,” the office of Massachusetts US Attorney Andrew E. Lelling said in a statement.

The failure to properly supervise and treat prisoners is a potential violation of the Eighth Amendment, which bars the government from inflicting cruel and unusual punishment, Lelling’s office said. The lack of proper supervision has led some Massachusetts inmates to harm themselves, causing serious injury or even death, while on mental health watch, according to the investigation by the US attorney’s office and the Justice Department’s Civil Rights Division.

A spokesman for the Department of Correction said it is working closely with the Justice Department “and has already begun to address the issues raised in the report and maintain the significant progress we have already made.”

According to the Justice Department report, the Department of Correction lacks “clear and uniform policies” and does not provide security staff with appropriate training for dealing with prisoners attempting to harm themselves.

The department’s “staff have long been on notice of the serious harms experienced by prisoners on prolonged mental health watch. There have been many instances of self-harm inflicted by prisoners on mental health watch, and in some cases, repeated identical kinds of self-harm and even suicide," the report said.

During a 13-month period between July 2018 and August 2019, the department held 106 prisoners on mental health watch in an isolated cell for 14 consecutive days or longer — when the department’s policy states prisoners should be on mental health watch for a maximum of four days, the report states.

Of those prisoners, 51 remained on mental health watch for more than a month; 16 remained there for more than three consecutive months; and another seven spent six consecutive months or more in isolation.

Since 2018, four of the eight department prisoners who died by suicide were on mental health watch at the time, or in the days prior to their death.

“This is alarming given that [the department] supposedly provides prisoners on mental health watch with heightened supervision, including one-on-one observation, and enhanced treatment to prevent suicide,” the investigators said.

Lelling said in the statement that conditions at Department of Correction “facilities show how systemic deficiencies in prison facilities can compound each other and amount to constitutional violations.” He added that the department “has cooperated with our investigation from the beginning and we look forward to working with state prison authorities to implement reform measures.”

In a Tuesday letter to Governor Charlie Baker, Lelling and Eric S. Dreiband, an assistant attorney general for the Civil Rights Division, said the state had 49 days to address the issues the Justice Department identified or the US attorney general can sue the state.

“We hope, however, to resolve this matter through a more cooperative approach and look forward to working with [Department of Correction officials] to address the violations of law we have identified,” Dreiband and Lelling wrote.

A spokeswoman for Baker deferred a request for comment to the Department of Correction.

“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 spokesman for the Department of Correction said in a statement. “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.”

The Justice Department has presented the Department of Correction with notice of the conditions uncovered in the investigation and “the minimum remedial measures necessary to address them,” Lelling’s office said.

The remedial measures outlined in the report include monitoring prisoners on mental health watch and ensuring they cannot access objects they can use to harm themselves, training correctional officers on proper monitoring, providing “meaningful therapeutic interventions” for inmates on mental health watch, minimizing isolation, and increasing the number of mental health clinicians and security staff.

In 2016, the Globe’s Spotlight team, in a report on mental illness, found numerous shortcomings in the treatment of inmates. It said in the previous year more than one third of the 15,000 prisoners released from Massachusetts jails and prisons suffer from mental illness.

Prisoners’ rights groups have long criticized the conditions at the state’s prisons, and a decade ago a team of advocates sued the Department of Correction for human-rights abuses in federal court. The lawsuit led to a landmark agreement forcing the department to restructure the way it cares for prisoners with severe mental illnesses, for instance by creating specialized treatment units for those in need of mental health care.

Leslie Walker, a longtime prisoners' rights advocate, said the new units — allowing prisoners more programming and out of cell time — proved successful in treating inmates who had been in isolation for months, if not years.

The lawsuit also led to 2018 reforms in state law that required new policies on how the department places prisoners in segregation units and for how long, for instance by giving prisoners more opportunities to challenge their placement in segregation units.

Advocates have complained that the department has failed to live up to those new policies, and has fought against other proposed reforms in the past, including the 2012 agreement.

“There’s an incredible resistance to change, even if it makes perfect sense and is backed by evidence-based best practices,” Walker said. “People who have substantial disabilities, who have serious mental illness, should not suffer in prison cells for months if not years without proper treatment or care.”

Elizabeth Matos, executive director of Prisoners' Legal Services of Massachusetts, said many people behind bars have already suffered a trauma, but they have little chance to get help.

“Access to mental health care is not only extremely limited inside jails and prisons, it is counter-therapeutic,” Matos said in a statement. “People facing a crisis are routinely placed on mental health watch, which is widely considered worse than solitary confinement.”

Carol Rose, executive director of the American Civil Liberties Union of Massachusetts, said in a statement that the organization was “deeply concerned” about the allegations.

“Far too many people are incarcerated in conditions that threaten their health, safety, and human dignity on a daily basis," Rose said. "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.”

The Justice Department began its investigation in 2018 under the Civil Rights of Institutionalized Persons Act, which empowers the department to take action when the constitutional rights of inmates at state or local government-run correctional facilities are violated, Lelling’s office said.