By Eike Blohm, MD
After two years of negotiations between the federal Department of Justice (DOJ) and the Massachusetts Department of Correction (DOC), an agreement was reached on December 20, 2022, to fix atrocious mental health care in state prisons, which the Feds consider so “cruel and unusual” that it violates the Eighth Amendment rights of state prisoners.
On November 17, 2020, at the conclusion of a two-year investigation by its Civil Rights Division, DOJ issued a notice finding DOC in violation of the Civil Rights of Institutionalized Persons Act, 42 U.S.C. §1997, by allegedly failing to provide constitutionally adequate supervision and care of prisoners in mental health crisis. [See: PLN, May 2021, p.29.]
While state prison officials denied any wrongdoing, they entered negotiations with DOJ to avoid litigation. The agreement reached grants DOC 18 months to rewrite its policies and train staff accordingly, as well as hire additional guards and mental health staff.
Specifically, the agreement requires DOC to hire sufficient guards to ensure prisoners in mental health crisis can still get escorted to out-of-cell activities such as recreation and therapy.
Importantly – incredibly even – the agreement also spells out that guards must not sleep while providing observation to suicidal prisoners.
Moreover, mental health staff must be available to guards by phone on nights and weekends. Mental health staff – not guards – will also make determinations whether those in crisis can participate in activities, including exercise or taking a shower.
Mental health workers will evaluate any prisoner in crisis within an hour – or the next business day on weekends – and prisoners will no longer get punished for asking to see mental health. In fact, rather than putting prisoners into observation cells naked or in a safety smock – also known as a “turtle tuxedo” – staff must let prisoners keep their clothes, unless they use clothing to harm themselves.
The agreement also says that books must be made available within 24 hours of request, that lights must be turned down for sleep, and that showers must be offered every two days. Even individuals on constant observation can go outside accompanied by a guard.
Rather than placing prisoners in crisis in solitary confinement, DOC agreed to create Intensive Stabilization Units where prisoners can de-escalate and receive therapy three times a day, as well as engaging in group activities.
Implementation of these changes will be supervised by Dr. Reena Kapoor, associate professor at Yale University. However, the agreement expires after four years, carrying the risk that things then will regress to the current sorry state of affairs. See: Agreement Between U.S. and Mass. Dep’t of Corr.
Additional source: WBUR
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