Governor Charlie Baker will announce on Tuesday a substantial shift in how the state's criminal justice system handles mentally ill people, moving the troubled Bridgewater State Hospital away from a prison model and toward a more clinical approach.
The administration plans to shift mentally ill inmates convicted of state crimes out of the state prison in Bridgewater and into a separate facility, leaving behind other mentally ill inmates charged with sometimes minor crimes but not convicted.
Baker would also beef up mental health services and place sharp limits on the contact that correctional officers have with inmates — contact that proved deadly in the case of 23-year-old Joshua Messier, who died in 2009 as guards wrestled him into restraints.
A Boston Globe article detailed the Messier case two years ago in the first of a series of stories exposing mistreatment at Bridgewater State.
"I've read all the reports, I've read all the news stories, I know the experiences of individuals with serious mental illness and their families," said Marylou Sudders, Baker's secretary of health and human services, in an interview with the Globe. "There's no question in my mind that this [plan] really lays out a very different expectation of treatment and services."
Mentally ill inmates would get what state officials hailed as a new level of care. Every inmate would receive an individualized treatment plan within 10 days of admission. Those on psychiatric medications would quickly see a psychiatrist. And electronic record-keeping would allow for easier evaluations of past care.
"It will look and feel more like a psychiatric hospital," said Sudders.
Advocates for the mentally ill said the plan, detailed in a request for proposals from vendors who would provide the new services starting next year, is an important inflection point in a decadeslong effort to overhaul Bridgewater State.
"I'm very excited about this," said Christine Griffin, executive director of the Disability Law Center. "I want to applaud [the administration] for doing as much as they've done in the amount of time they've been there."
But Griffin cautioned that the change can go so only far as long as Bridgewater State remains under the control of the Department of Correction. She said she would continue to press for a transfer to the Department of Mental Health.
"It really needs a whole culture change," she said, of the facility. "Right now, everyone has a prison mentality."
Sudders said it would be difficult for the Department of Mental Health to take control of a Department of Correction site in the short term. But she said the state is studying the possibility of creating a new facility in the long run.
Bridgewater State Hospital, despite its name, is not a hospital. It is a medium-security prison.
All the inmates — 257 at last count — have been charged with a crime. But just a portion — 45 as of this week — have been convicted of a state crime.
Some of the other inmates have been found not guilty by reason of insanity. But many of them have been committed after being found incompetent to stand trial or determined not responsible for their actions.
The Globe story on the death of Messier, who died after two guards pushed down on his back as he sat in leg irons and handcuffs, prompted intense public scrutiny of Bridgewater State Hospital.
Subsequent Globe stories detailed two other deaths and a suicide at the facility. And the state has entered into an agreement with the Disability Law Center designed to limit the use of restraints and isolation at Bridgewater.
Roderick MacLeish Jr., an attorney representing the families of former Bridgewater patients suing to curb the same practices, said Baker's plan to restrict correctional officers to perimeter security and sharply limit their interaction with patients could have a significant effect. Prison guards, he said, are ill-prepared to deal with severely mentally ill inmates.
"The governor has recognized this mix is toxic and can't go on," he said.
Daniel Bennett, Baker's secretary of public safety and security, said the administration plans to transfer over 180 Bridgewater correctional officers to other institutions, leaving 36 to guard the outside of the facility and serve in an on-site courtroom.
Correctional officers will remain in charge of day-to-day security for the state-sentenced inmates who are transferred out of Bridgewater and into Old Colony Correctional Center, just 500 yards away on a sprawling state campus.
State officials say Baker's plan to overhaul Bridgewater, with more robust mental health services, will mean added costs. But they have declined to estimate how much, or to mandate a specific staff size, preferring to see what contractors propose in their bids for the service.
MacLeish said he has some concerns about that open-ended approach.
Reaching certain staffing levels will be crucial, he said, to providing the sort of treatment inmates need.