Monitor Says Massachusetts Prisons Will Not Meet Settlement Deadline for Mental Health Reforms
by Chuck Sharman
Massachusetts prisons are not going to meet a December 2026 deadline to achieve substantial compliance with the terms of a 2022 settlement agreement covering the provision of mental healthcare to state prisoners. That was the key takeaway from the most recent progress report delivered on March 24, 2026, by the monitor overseeing the agreement between the state Department of Correction (DOC) and the federal Department of Justice (DOJ).
The DOC agreed to the settlement after a 2020 DOJ report that summarized a two-year investigation. Among its findings: that prisoners on mental health watch were routinely isolated in restrictive housing for longer than the DOC’s four-day limit—up to six months in some cases, as PLN reported. The DOJ investigation also found that guards observed alarming instances of prisoner self-harm without attempting to intervene and, according to a least three prisoners, some guards offered them razors to encourage their suicide attempts. [See: PLN, July 2021, p.26.]
Problems weren’t limited to guards, though, as the latest compliance report recalled: “Suicide risk assessments were cursory, prisoners were almost universally shackled when interacting with mental health professionals (MHPs), and ‘treatment’ too often took the form of worksheets and puzzles.” Since then, mental health staffing has increased 65%, and incidents of self-harm while prisoners are isolated in Therapeutic Supervision (TS) have fallen 11%. Progress has also been made toward compliance with the DOC’s own four-day goal for keeping prisoners in TS, with the average stay falling to 4.1 days.
Nevertheless, mental healthcare delivery continues to suffer from the DOC’s persistent shortage of guards to provide escorts to and from treatment, with a 24% guard vacancy rate noted in the compliance report. Though steadily increasing the number of areas in the settlement agreement with which substantial compliance has been reached—from eight in the monitor’s first report to 51 in this most recent update—the DOC remains only partially compliant in 65 other areas and noncompliant in two more. That’s an overall compliance rate of just 41%, according to the Monitor, Dr. Reena Kapoor, leading to her pessimism that full compliance can be met by the agreement’s deadline on December 20, 2026. See: Agreement Between the United States and the Mass. Dep’t of Corr., DOJ (Dec. 20, 2022); and Mass. Dep’t of Corr. Complaince Report No. 6, Dr. Reena Kapoor, MD, Designated Qualified Expert (Mar. 24, 2026).
Just before the Monitor’s report was released, the DOC announced a series of related changes sparked by an audit that was ordered after a rash of suicides claimed a half-dozen prisoner lives in 2025. Some of the issues identified by that auditor, Dr. Sharen Barboza, were the same as those identified by the DOJ years earlier. Her recommendations included some that were quickly echoed in Kapoor’s report—like a call for better performance from the DOC’s private for-profit mental healthcare provider, VitalCore Health Strategies, as reported elsewhere in this issue. [See: PLN, May 2026, p.12.]
What happens when the deadline arrives and compliance has not been reached? According to Dr. Kapoor, the DOC has three options: “whether the Agreement will be extended, modified, or terminated after December 20, 2026.” However, any of those options requires the DOJ to make an effort at continued enforcement of the Agreement, a proposition not at all sure under the leadership of acting Attorney General (AG) Todd Blanche; he was appointed by Pres. Donald J. Trump (R) in April 2026 after the President fired former AG Pam Bondi, allegedly “over her handling of [files linking Trump to convicted sex trafficker Jeffrey Epstein] and her failed efforts to prosecute his political enemies,” the New York Times reported.
As for the DOC, a spokesperson told Advance Local Media that “[t]he Department remains committed to building on [the progress that Kapoor reported] and will continue working closely with Dr. Kapoor to strengthen care and compliance across the system.”
Sources: Advance Local Media, New York Times
As a digital subscriber to Prison Legal News, you can access full text and downloads for this and other premium content.
Already a subscriber? Login