by Chuck Sharman

The Massachusetts Department of Correction (DOC) announced new procedures on March 18, 2026, to “strengthen suicide prevention, clinical coordination, and safety operations across the correctional system.” The changes came in response to an audit ordered after a spate of six prisoner suicides in 2025; the results faulted the prison system for failing to stem the influx of dangerous illegal “K-2” cannabinoids and for failing to provide sufficient mental healthcare in “behavioral adjustment units” (BAUs), a form of isolation intended to comply with a 2018 prison reform law that banned solitary confinement in DOC lockups. The report also faulted the DOC for failing to sufficiently distinguish conditions inside the BAUs from those found in “the hole” that they were supposed to replace.

That failure is already the subject of a suit filed by six state prisoners in July 2024, accusing the DOC of violating the 2018 reform law when it implemented the new BAUs, as well as a Secure Adjustment Unit (SAU) at Souza-Baranowski Correctional Center; in these new forms of isolation, the prisoners alleged that only the name had changed, with conditions indistinguishable from solitary confinement, as PLN reported. [See: PLN, Sep. 2024, p.22.] That suit was certified on April 15, 2025, to proceed on behalf of a class consisting of some 200 prisoners. See: Evelyn v. Jenkins, Mass. Super. (Suffolk Cty.), Case No. 2484CV01746.

The recent suicides occurred while DOC mental health care was still under federal oversight established in a 2022 settlement agreement with the federal Department of Justice (DOJ). That agreement was prompted by a 2020 DOJ investigation which found 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 also reported. However, the monitor overseeing the agreement reported in March 2026 that the DOC was not likely to meet a year-end deadline for achieving substantial compliance, as reported elsewhere in this issue. [See: PLN, July 2021, p.26; and May 2026, p.43.]

The DOC reported that mental health staffing had improved since the contract was given to private contractor VitalCore Strategies, and the vacancy rate had since fallen from 32% in July 2024 to 19% in May 2025. In addition, there is now a new overnight mental health hotline available to prisoners, as well as new interdiction strategies targeting the flow of K-2.

Audit Identifies Failures

Following the recent suicides, the DOC hired nationally recognized correctional mental health expert Dr. Sharen Barboza to investigate. Her report, dated January 30, 2026, summarized her review of incident reports, electronic health records and substance use treatment documentation, as well as interviews that she conducted with staffers and “unsolicited” correspondence that she received from four prisoners.

Of the six who killed themselves, four had made earlier suicide attempts and were on the mental health caseload at the time they died. But Barboza had to go back 17 days to find a point prior to their deaths when all were last seen by a DOC mental health provider. In the BAUs, where half of the six were held, she found that the “excessively short length of clinical contacts” was especially problematic. “The vast majority of contacts documented with individuals in the BAU lasted for under five minutes,” Barboza wrote, “with some being documented as lasting less than one minute.”

Two of the six who killed themselves were intoxicated when they arrived in the BAU, and two more reported regular drug use. For that, Barboza noted, prisoners “could face disciplinary action and social isolation, such as placement in the BAU.” But while the DOC “has specifically defined the BAUs as ‘a housing unit that is not Restrictive Housing,’ the experience for individuals transferring into the BAU may be the same as being placed in restrictive housing,” she said, “resulting in increased risk for suicide that is often seen in these settings.”

An investigation by Advance Local Media found one reason for the proliferation of K-2 in state prisons: A one-inch square fragment of paper sprayed with the cannabinoids can fetch $250 and provide 100 hits of the drug, which is typically smoked. The DOC said that it seized $9 million worth of K-2 in 2025, but at such an inflated value that equates to just 225 sheets of 8-1/2 x 11-inch drug-sprayed paper.

Since the recent suicides, the DOC has started diverting prisoners found high on K-2 to a “detox” unit rather than a BAU or the SAU. In addition, the recently announced policy changes include “[a]dd[ing plain-language education about BAU to personal tablets for incarcerated individuals so individuals understand what the BAU is, what to expect, and how to request help”; “[p]rovid[ing] additional training for VitalCore staff to strengthen thorough risk assessment connected to BAU placement”; and “[i]ncreas[ing] collaboration among clinical teams to support consistent application of BAU placement criteria and clearer communication during transfers.”

Other Policy Changes Made

The DOC says that “the BAU is used for the assessment of incarcerated and civilly committed individuals who pose an unacceptable risk to the security, safety and orderly operations of the correctional institution,” as well as those who “have a possible personal safety need that needs to be investigated, or who pose a threat to others and require separation from the general population.” So another policy change was aimed at “[c]larify[ing] the definition of ‘unacceptable risk’ [which triggers BAU placement] to support consistent interpretation and application,” along with “training to ensure staff understanding” that has been expanded to include “administrators and shift commanders (in addition to BAU personnel).”

In addition, a new “comprehensive risk assessment” is required “for all individuals transitioned into the BAU, beyond point-in-time evaluations.” The DOC promised to “[r]einforce expectations for reviewing mental health history and continuity of care during housing transitions” and to “[w]ork with the contracted healthcare provider to ensure all clinical staff are aware of this requirement.” Also required now is “[c]ontinue[d] monitoring of individuals with open mental health cases, per their plan, regardless of housing placement.”

Importantly, the DOC agreed to “[s]et minimum expectations for clinical contact length and document when adequate contacts cannot be completed,” as well as “[r]einforc[ing] documentation expectations so clinical notes better support safety, continuity of treatment, and decision-making.” To those newly placed in a BAU, the DOC also promised to seek “a primary care clinician check-in within 24 hours” and “[e]valuate the addition of regular follow-up contacts for individuals housed in the BAU longer than the average 72-hour length of stay.”

As part of its exploration of “tablet-based information sharing so providers can review medical/mental health needs across clinical teams,” the DOC further vowed to “[w]ork with VitalCore to ensure each person’s healthcare record clearly lists their assigned care team, including their primary care clinician (PCC) and other key providers, when applicable.”  

Additional source: Advance Local Media

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