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Why Have our Jails Become our Default Mental Hospitals?

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A panel of experts shed light on this question at our December 2 Education Meeting, moderated by Steve Rosenfeld, president of NAMI-MASS. Michael Rezendes, Pulitzer Prize-winning Boston Globe reporter, author of the groundbreaking series on Bridgewater State Hospital; James Pingeon, an attorney for Prisoners’ Legal Services; and June Binney, Criminal Justice Diversion Project Director at NAMI Mass were our speakers.

According to June Binney, Massachusetts jails and prisons started to become the places of last resort for the mentally ill when mental hospitals were dismantled in the 1970s, with the largely unmet promise of community support. Up to 3500 prisoners in Massachusetts struggle with serious mental illness and another 3000 or so have less serious mental health issues.

Describing prison as “anything but a therapeutic environment,” June pointed out that mentally ill prisoners have a very hard time in prison, leading to longer sentences, time tacked on to their sentences when they become disruptive, and even moves from minimum to medium or maximum security prisons.

The $40,000 to $50,000 a year it costs to imprison someone would buy a lot of community support, June pointed out. “This is awful social policy,” she declared. “There are so many other options from that first 911 call to prison. NAMI is focusing through its Criminal Justice Diversion Project on the front door, training the police. It is time for us to quit asking our corrections facilities to serve as psychiatric hospitals.”

Jim Pingeon has represented incarcerated people with mental illness, from larger class actions to individual cases, for 30 years. He described two cases he had, one with a 61-year old man with bipolar disease who was doused with caustic cleaning solution by prison guards, and a class action case involving the practice of solitary confinement.

He quoted a judge who compared solitary confinement to “depriving an asthmatic of oxygen.” Half of prison suicides are committed in solitary. The settlement agreement for the solitary confinement case stipulated that mentally ill prisoners not be placed in solitary, but it was later discovered that peoples’ diagnoses were being changed to allow them to be placed in solitary. “We can win law suits,” he pointed out, “but that doesn’t necessarily solve the problem.”

Pingeon said that Bridgewater has been using seclusion and restraint more than 100 times more often than is done in other states. The size of the clinical staff at Bridgewater is less than ½ what would be necessary in a clinical setting, for the number of patients they have. When DMH has patients they can’t handle, they go to Bridgewater where they get more control, but not the treatment they need for their illness.

Although the phenomenon of jails and prisons becoming large mental institutions is a nationwide problem, Massachusetts is one of only two states that have a hospital run by a department of corrections. Part of the problem is that Bridgewater is a prison rather than a hospital, where recovery would be the main goal. After publication of Michael Rezendes’ reports, the use of restraints was reduced by 90% and solitary confinement by 50%.

The panel revealed that there is a proposal to build a new evaluation and treatment facility to be administered by DMH rather than the Department of Corrections. A study is now under way. Details are at http://www.mass.gov/eohhs/docs/press-release/strengthening-bridgewater-state-hospital.pdf

Panel on Bridgewater State Hospital Truly Informative

Panel on Bridgewater State Hospital 11.17.14
On November 17th, approximately 100 people gathered at Temple Isaiah in Lexington to listen to a panel discussion on the status of Bridgewater State Hospital, a medium-security correctional facility housing men with issues relative to mental illness. The event was cosponsored by NAMI Central Middlesex and the Mental Health Committee and the Social Action Committee of Temple Isaiah.
The panelists were Eric MacLeish, Attorney at Law with Clark, Hunt, Ahern & Embry; State Sen. Will Brownsberger, Senate Chair of the Joint Committee on the Judiciary; and Christine Griffin, Executive Director of the Disability Law Center. Danna Mauch, Ph.D, Senior Fellow/Principal Associate at Abt Associates and current Board President of the Massachusetts Association for Mental Health, served as moderator.
Attorney MacLeish, who represents multiple families in a class-action lawsuit against Bridgewater State Hospital, spoke first. He said that Bridgewater has a reputation for housing the criminally insane but that less than 1/3 of the current inmates are actually serving criminal sentences. The rest of the men housed there are being evaluated for mental competency to stand trial or have been identified as needing enhanced security while they are awaiting trial. Many of the inmates are spending needless hours in seclusion and/or restraint because of the staff’s lack of training on how to deal effectively with those with mental illness. Michael Rezendes, an investigative reporter with The Boston Globe whose series on Bridgewater State has helped keep the issues there in the spotlight, won a large round of applause when Attorney MacLeish introduced him.
Senator Brownsberger talked about Governor Patrick’s proposal to reform Bridgewater State Hospital by increasing staffing and creating a new enhanced security facility to be run by the Department of Mental Health. He said that it was too late in the legislative session for Governor Patrick to achieve much in terms of reforms and that the responsibility lies with the new executive branch administration to work with the legislature to come up with concrete reforms.
Ms. Griffin said that the Disability Law Center had done a review of Bridgewater this year and had recommended numerous changes. She said that t is is a good time to push for changes at Bridgewater, as the negative publicity and reviews of the institution have prompted the staff to reduce restraints and seclusion and to come up with an environment that is more conducive to mental health.
After the audience had an opportunity to ask questions of the panel, NAMI member Ruthann Minkin asked the audience to sign a petition asking Governor-elect Charlie Baker to work with the legislature, the Department of Mental Health, and the Department of Corrections to identify the problems at Bridgewater and to find solutions. Over 50 people signed the petition that night.
Special thanks to Pamela Andrews, Ruthann Minkin, and Francine Stieglitz [NAMI Central Middlesex] for their leadership in putting this evening together and writing this report.
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