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