They are the forgotten.
For all but their families, prison inmates too often remain unseen, their voices unheard.
But a shocking report last year by the Department of Justice, on how the Massachusetts Department of Correction treats the mentally ill in its custody, opened the door on that nightmare and gave a voice to the voiceless. The stories of neglect and needless cruelty — and the violation of prisoners’ constitutional rights — are now part of a government record for all to see. The question now becomes what will be done about it — and when.
This is no small problem — Massachusetts prisons have the fourth-highest suicide rate in the nation, according to a 2015 Justice Department report. The solution, therefore, won’t be easy. It will require a comprehensive approach that must involve continuing federal monitoring, as well as legislation aimed at forcing state officials to adopt and implement well established best practices for dealing with those experiencing a mental health crisis within prison walls.
In other words, it will take a kind of two-pronged approach to setting things right in the state’s prisons.
“Reading that DOJ report, I took some clear direction from it,” said Senate Judiciary Committee Chair Jamie Eldridge, a long-time supporter of prison reforms. “DOC was simply not providing adequate supervision to prisoners in a mental health crisis. And with all due respect to corrections officers, they just don’t have the skills to do this.”
The Justice Department report found, during the period of the investigation (July 2018 to August 2019), some 900 inmates (of the system’s 8,700) were placed on mental health watch, which according to the report, meant “access to property and interactions with others are minimal.” And despite DOC policy which limits such isolation to no more than four days, 106 inmates were held more than 14 consecutive days, some were held for months.
“If someone is lonely or depressed, it’s just not a good idea to put them in isolation,” said Bob Fleischner of the Massachusetts Association for Mental Health.
“There is supposed to be engagement,” added MAMH President Danna Mauch. “It’s therapeutic.”
And so Eldridge filed a bill, one now endorsed by MAMH, that would require more involvement by mental health professionals on scene during that first 24 hours if a prisoner is deemed at “risk of imminent and serious self harm” and for the transfer to a suitable in-patient mental health facility with Bridgewater State Hospital as the ultimate back-up. The bill also would require the state Department of Mental Health to promulgate regulations requiring all state and county corrections facilities to have written suicide prevention plans, ensure all prisoners on mental health suicide watch are housed in “clinically appropriate settings,” and that all inmates needing mental health services receive treatment “consistent with generally accepted professional standards. . .”
In many ways the bill seeks to micromanage DOC policy to “ensure personal dignity,” by requiring inmates be “fully clothed,” and be provided with at least two blankets. But then DOC has given ample evidence — certainly in the wake of that DOJ report — that it is in need of micromanagement.
And as Fleischner told the Globe, “The provisions of the bill are consistent with things in the [mental health] literature. And they’re remarkably consistent with DOC’s own stated practices.”
The challenge is in actually following those practices. The Justice Department report, for example, demanded as part of its “minimal remedial measures” that DOC “Ensure prisoners are transferred to an inpatient psychiatric level of care when clinically appropriate, instead of spending prolonged time on mental health watch.”
And that’s one thing that cries out for federal intervention. That November report is still the subject of ongoing negotiations between the civil rights division of the US Attorney’s office in Boston and DOC — negotiations that could ultimately result in settlement agreement or a consent decree.
A spokesman for the corrections department confirms the “collaboration” is ongoing and that DOC is now also consulting with the Department of Mental Health to address issues raised in the report. But the unfortunate fact is that DOC has an unhappy history of doing work-arounds the state’s landmark 2018 Criminal Justice Reform Act, which among other things attempted to limit the use of solitary confinement. Even if an agreement is reached with the Justice Department, it should include an impartial court-appointed monitor — just to keep everyone honest and moving in the right direction.
But with nearly a quarter of the state’s prison population (2,100 inmates) suffering from serious mental illness, according to the DOJ report, this is not a problem that is going to go away on its own. That report described conditions and treatment of prisoners that should not happen here or anywhere else.
Eldridge’s bill would help. Legislation in combination with a court-appointed watchdog would be even better.
Editorials represent the views of the Boston Globe Editorial Board. Follow us on Twitter at @GlobeOpinion.