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State should examine solitary confinement

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The allegations in the latest Spotlight follow-up, based on a Prisoners’ Legal Services report, are serious enough to merit a state investigation into whether prison officials may have circumvented a state policy against placing mentally ill prisoners into solitary confinement. Based on the group’s findings, it would appear that prison officials put eight prisoners with documented histories of mental illness into solitary by changing or downgrading their original diagnoses to less severe conditions in all but two of the cases. That practice could potentially be unethical for a medical professional; it may also violate state law.

As a result of a lawsuit filed 10 years ago, the state entered an agreement promising to send inmates with diagnoses of mental illness to specialized mental health units instead of the regular solitary confinement if they misbehaved. The practice, which was eventually enacted into a statute, works: it reduces self-harm and aggressive and destructive behavior. Inmates get therapy, more outside time, and privileges and incentives, like earning the ability to be unshackled or free of handcuffs when they’re outside their cells.


But at least eight disturbing cases reviewed by PLS, a watchdog and inmates advocacy organization, show a different story. Those eight inmates, housed in two state prisons, have clear histories of suicide attempts and serious illnesses like schizophrenia and bipolar disorder. Despite that, they were sentenced to regular solitary confinement for months for disciplinary offenses, with some prisoners adding concurrent sanctions that amount to years in confinement. One inmate had been diagnosed with bipolar disorder before prison; yet prison system doctors changed his diagnosis to unspecified anxiety disorder and steroid addiction, a dubious downgrade that made him eligible to be placed in regular solitary confinement.

What’s worse, two of the eight prisoners did have a designation of a severe mental illness and, in apparent violation of state law, they were sent to solitary. One of them, still in segregation, was told over a year ago that he would be transferred to the specialized unit. He was also told that he would get additional mental health services while in the regular isolation unit. So far, PLS reported, that has consisted of only an extra 15 minutes of time with his mental health clinician — per week.


“We’re basically spending money on cruelty,” said Leslie Walker, the executive director of PLS. Solitary confinement, as a practice in correctional facilities, has proved to be not only ineffective and expensive but also detrimental. A special report by the United Nations stated that any time longer than 15 days spent in solitary confinement is torture, citing studies that show that it causes some lasting mental damage.

Walker adds that for years her group has been calling for an independent agency to oversee the placement of mentally ill people within the state’s prison system. “There is no oversight” of the Department of Correction outside the government, Walker added. The prison system should not have the ability to change an inmate’s diagnosis arbitrarily. An independent and informed body, such as the Massachusetts Association for Mental Health, could launch a review into whether those moves were fitting or not.

In the short term, though, the Baker administration also must look into these eight cases to determine if they involved medical malpractice, a violation of state law, or both.