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Cruel and all too usual: State fails inmates with mental illness

Only a consent decree and federal monitor can assure state prisons make reforms called for in a Justice Department probe.

A corrections officer performed a routine head count inside a special treatment unit for prisoners with mental health issues at Souza-Baranowski Correctional Center in Shirley.Suzanne Kreiter/Globe staff

Massachusetts prison inmates suffering from serious mental illness — and that’s about a quarter of all inmates — are subject to such horrifying conditions that it violates their constitutional rights, federal prosecutors have concluded. And the evidence the feds amassed is overwhelming.

An investigation undertaken by the Justice Department’s Civil Rights Division and the US attorney’s office in Boston found “reasonable cause” that the state Department of Correction “fails to provide constitutionally adequate supervision to prisoners in mental health crisis; fails to provide adequate mental health care to prisoners in mental health crisis; and uses prolonged mental health watch under restrictive housing conditions, which violates the constitutional rights of prisoners in mental health crisis.”


Their report, made public last week, includes tales of neglect and deprivation and human callousness so disturbing as to be unconscionable in a modern prison setting. It describes a system where inmates in the throes of mental health crises are locked away in solitary cells (average size: 93 square feet) for 23 hours a day, without access to mental health treatment, and watched over by guards who have been known to fall asleep or, even worse, “taunt and encourage” inmates to self-harm.

All of this comes in the wake of a state criminal justice reform bill passed in 2018 and intended in part to deal with issues posed by the chronically mentally ill. It also aimed to reduce the use of solitary confinement generally. Prisoners’ rights advocates maintain the DOC has done everything it can to thwart the aims of that law.

Much in the Justice Department report supports that contention — and that means that ultimately state correction officials, with their track record, can’t be trusted to fix the myriad issues raised by prosecutors without federal court supervision and an independent monitor appointed by the court to bird-dog needed reforms.


Some 2,100 of the system’s 8,700 inmates are considered to be suffering from serious mental illness. During the period of the investigation, some 900 inmates were placed on mental health watch — a status that, according to the report, means “access to property and interactions with others are minimal.”

The report continues, “Prisoners are often initially placed in smocks and only have access to books, radio, or recreation at the discretion of the staff.” Any interaction with a mental health clinician — if it happens at all — is often a 10- to 15-minute conversation through a crack in the cell door.

Solitary confinement by any other name is still solitary confinement.

While DOC policy says four days is the standard for such mental health holds, federal investigators found that, during the 13 months of their probe, 51 prisoners were on mental health watch for a month or more consecutively, 16 for more than three consecutive months, and seven spent six consecutive months or more under such conditions.

And if the object was to keep an inmate safe from self-harm, investigators found numerous examples of how that often did not work:

▪ “On July 10, 2019, CC, housed at Souza-Baranowski Correctional Center, cut himself so badly that blood can be seen pooling on his cell floor in the video obtained by the Department. The video captures correctional officers standing outside his cell door without intervening for 45 minutes — while he is on constant 1:1 [one to one] mental health watch — before he is finally transported to an outside hospital.”


▪ “On October 29, 2019, SS, a gay man who had issues with incontinence because of prostate cancer, died by suicide after hanging himself in his Restrictive Housing Unit cell at MCI-Shirley. His death occurred just 12 days after being released from a nine-day mental health watch stay. . . . We learned that he had been ‘tormented’ by peers and officers for being gay and for having to wear a diaper.”

▪ “BB spent 77 consecutive days on mental health watch at Souza-Baranowski Correctional Center. He had been on mental health watch for 50 consecutive days, when, on May 15, he attempted to hang himself with his security smock tied around his neck. . . . During the next 27 days he continued to harm himself.”

The response to the report from the DOC has been tepid. It has stopped selling razors to some inmates at some facilities and has implemented additional staff training. A statement from a department spokesman said DOC “continues to work closely with DOJ.”

The on-site DOJ investigation was completed before COVID-19 hit the state and its prisons. The pandemic has put further strains on the system, both increasing the isolation of inmates and exacerbating staff shortages.

All of which means that, despite an imminent change in administrations in Washington, this investigation must not be allowed to gather dust on a shelf. A similar finding by DOJ about the Hampton Roads Regional Jail Authority in Virginia this summer led to a consent decree between the Justice Department and that prison, approved by the federal court, along with the appointment of an independent monitor to assure that all the terms and conditions of the agreement would be met over the ensuing five years.


That’s something that should happen here in Massachusetts, too. US Attorney Andrew Lelling, who, in a letter to Governor Charlie Baker, expressed the hope for a “cooperative approach,” should settle for nothing less than a consent decree and an independent federal monitor. The DOC has shown in recent years that it cannot be left to reform its own practices without a watchdog to keep it honest. Lelling can and should make sure that happens.

Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.