THE US DEPARTMENT of Justice has concluded in a scathing report that the state Department of Correction is violating its constitutional obligations by failing to provide adequate mental health services to prisoners.
The 28-page investigation is rife with horrific stories of prisoners seriously harming themselves while correctional officers failed to intervene – in some cases even egging them on.
As a result of these failures, the report finds that prisoners in mental health crisis have seriously injured themselves or died while on mental health watch, a status that involves extra observation because prisoners are likely to harm themselves.
The two-year investigation concluded that the Department of Correction fails to adequately supervise prisoners in mental health crisis and fails to provide them with adequate mental health care. The report says the department also violates the rights of prisoners by placing them under prolonged mental health watches in restrictive housing conditions. The Department of Justice says this violates the Eighth Amendment of the Constitution, which prohibits cruel and unusual punishment.
Massachusetts US Attorney Andrew Lelling said in a statement that the state Department of Correction “fails to properly supervise and accommodate prisoners suffering from serious mental health issues.” Lelling said conditions in the DOC “show how systemic deficiencies in prison facilities can compound each other and amount to constitutional violations.”
Jason Dobson, a spokesman with the Department of Correction, said in a statement that the department “continues to work closely with DOJ and has already begun to address the issues raised in the report and maintain the significant progress we have already made.”
The department has stopped selling razors to inmates in several facilities and has implemented new training for correctional officers, including those in mental health housing units. Correction officials meet regularly to develop strategies to intervene with particular inmates who have a history of self-harm.
“The Department remains deeply committed to the health and well-being of all entrusted to our care and fully invested in protecting their physical safety and civil rights,” Dobson said.
The DOJ investigation was based on interviews, prison tours, and reviews of documents, including policies, mental health records, investigative and incident reports, and disciplinary reports.
The investigation alleges that the department lacks consistent guidelines for how to monitor suicidal prisoners. The report says instruments that can be used for self-harm are not removed from cells and security staff are not trained in preventing self-harm. Rather than treating suicidal prisoners, the prison places them in segregated housing, in conditions that are “restrictive, isolating and unnecessarily harsh,” says the report.
During a 13-month period in 2018 and 2019, the corrections department put 106 prisoners who were on mental health watch in segregated housing for periods of 14 consecutive days or longer – despite stated policies restricting the use of segregated housing to four days, according to the Justice Department. Sixteen prisoners were placed in segregated housing for periods of three months or longer. These prisoners are often isolated for 23 hours a day.
The report found that these mental health watch cells are not sufficient to prevent harm. Since 2018, four of the eight prisoners who died by suicide were on mental health watch at the time. One of them had attempted suicide multiple times. Three other prisoners died by suicide just after being released from mental health watch, after correction officials failed to treat their mental health problems.
Although mental health watch cells can house only 1 percent of prisoners, 56 percent of the 1,200 reported incidents of self-harm between July 2018 and August 2019 occurred in these cells. These include prisoners cutting themselves, eating foreign objects or putting objects into their body, or attempting to hang themselves.
The cells are small – on average 93 square feet – and prisoners have limited access to books, radio, or recreation. They receive, at most, a 10 to 15 minute mental health assessment daily, sometimes through a crack in their cell door, although a correctional officer regularly walks past their cell to check on them. No therapy is offered.
“Prisoners in crisis placed on [the Department of Correction’s] mental health watch often face a harmful experience—not a therapeutic and protective one,” the report finds.
The report found that objects like razors and batteries were not removed from suicidal prisoners’ cells, and three prisoners reported that correctional officers gave them razors “specifically to self-harm.”
In one instance, the report says, after a prisoner on mental health watch at Souza-Baranowski prison cut himself and had blood spurting from his arm, a correctional officer stood outside his door for 45 minutes before intervening. Another prisoner at Souza-Baranowski cut himself multiple times and said officers did not care. An MCI-Norfolk prisoner cut himself with paint debris on 15 separate days, all while on mental health watch.
Correctional officers assigned to constantly watch a prisoner would regularly fall asleep on duty, according to the report. It said some officers refuse to call for medical attention when a prisoner harms himself or intentionally delay calling. Prisoners report that officers actively taunt them to self-harm, for example, telling a prisoner who was cutting himself, “You can do better.”
One prisoner at MCI-Cedar Junction reported that he had been on mental health watch for close to 11 years – an assessment that a corrections official said sounded accurate – and had been let outside for recreation just six times. Correction officers watched the prisoner bang his head against the wall, drink his own urine, and try to kill himself – but had no plan for treating him and moving him to less harsh conditions.
Another patient, who spent 63 days on mental health watch at Souza-Baranowski, harmed himself 21 times during that period, including cutting up his stomach with a razor blade, then swallowing it.
The Department of Justice gave the Department of Correction a list of remedial actions that it is required to take to fix the problems. These include vastly improving mental health care for prisoners, hiring new mental health clinicians, providing more training for offices, bringing disciplinary actions against officers who fail to comply with policies, and improving the conditions for prisoners on mental health watch to minimize isolation and provide more privileges. The department, which cooperated with the investigation, will have 49 days to take those actions, or the federal agency could file a lawsuit.
Elizabeth Matos, executive director of Prisoners’ Legal Services, said the findings are not surprising. Matos noted that many prisoners enter the system having already undergone trauma. According to the report, 24 percent of the state prison population, or 2,100 prisoners, have serious mental illness.
“Access to mental health care is not only extremely limited inside jails and prisons, it is counter-therapeutic,” Matos said in an email. “People are routinely placed on mental health watch when they are experiencing a crisis, which is widely referred to as worse than solitary confinement.”
The investigation was conducted before the COVID-19 outbreak. Matos said since COVID-19 hit, her staff have seen prisoners’ mental health decline due to lockdowns, limited family contact, lack of access to programming and treatment, and the threat of contracting the coronavirus. Incidents of self-harm and suicidality have increased, she said. Prisoners’ Legal Services has been advocating for the department to release prisoners due to the pandemic.
Carol Rose, executive director of the ACLU of Massachusetts, said similarly that while the ACLU is “deeply concerned” by the findings, it is not surprised. “Far too many people are incarcerated in conditions that threaten their health, safety, and human dignity on a daily basis,” Rose said in a statement. “From providing adequate mental health care to slowing the spread of COVID-19, Massachusetts must do more to save the lives of people in jails and prisons.”