PERVASIVE MOLD AND the potential for exposure to asbestos are endangering the health of individuals confined at Bridgewater State Hospital, according to a new report, leading to renewed calls to close the institution.
The Disability Law Center, an independent organization with legal authority to monitor the hospital, wrote that every report it has issued since 2018 “has made clear that the state of the physical plant and infrastructure at BSH warrant the facility’s closure.”
Bridgewater State Hospital is the state’s secure institution for people with severe mental illness who are incarcerated, civilly committed, or being held pre-trial. After a 2014 lawsuit and years of complaints by advocates for people with mental illness, Gov. Charlie Baker in 2017 announced an overhaul of the hospital. He separated people convicted of crimes from those who have not been convicted and hired a private company to provide clinical services, rather than using correction officers. The administration touted significant drops in the use of restraints and seclusion on patients, both of which had been the subject of complaints before the reforms. But the latest report, which is being released publicly on Wednesday, finds that there are still problems at the hospital – primarily environmental issues but also operational concerns, related to the continued use of restraints.
“It’s just a broken facility in terms of the physical plant but also in terms of the services it provides and does not provide,” said Tatum Pritchard, litigation director and acting executive director of the Disability Law Center.
The Disability Law Center is an agency tasked under federal law with monitoring state care for people with disabilities, and it also has authority over Bridgewater State Hospital as part of a legal settlement.
Rep. Michael Day, a Stoneham Democrat and the House chairman of the Judiciary Committee, said he is “deeply disturbed” by report, which he said highlights chronic problems at the facility. “The Legislature specifically provided the Disability Law Center with the authority and funds needed to investigate the Administration’s management of Bridgewater and, in the wake of these findings, we are now evaluating what measures are needed to fix this,” Day said in a statement. “All options are on the table at this point in time.”
The Department of Correction, which received a copy of the report on January 31, declined to comment.
The report says that people living or working at the hospital have for years complained of symptoms consistent with exposure to poor quality air. A 2019 report by the Disability Law Center reported on a “mold explosion” damaging medical records. According to Rick Glassman, director of advocacy at the Disability Law Center, staff working for the Department of Correction and its health care contractor Wellpath have complained about respiratory issues, and some left their jobs because of it.
But the center said the Department of Correction refused to conduct comprehensive testing for mold.
In 2019, the Disability Law Center obtained new legislative authority and arranged for the testing itself. It found the presence of mold “in almost every single area” swabbed by a hired expert from Gordon Mycology Laboratory, including in HVAC systems and vents. The Department of Correction said it remediated the problem, but follow-up testing in December 2021 found many of the same conditions. In fact, an inspection of the facility found that many of the conditions had worsened. There was visible mold growth in many of the inspected areas, and dampness and a mold odor in the basements. There was mold growing within the HVAC systems, which were in “horrible condition,” the report found.
Pritchard said the department appeared to have made some efforts to correct the problems identified in 2019 – removing moldy furniture from a basement and painting walls and ceilings. But the expert said mold needs to be removed, not painted over, and mold can actually feed on paint.
Photographs of the mold growth were redacted from the public version of the report. But descriptions in the report make clear that mold and filth, particularly in the HVAC systems that process the air people breathe throughout the facility, were pervasive.
The basement of an administration building had visible mold growth on the walls, black dust inside HVAC diffusers, and a wastewater pit with raw sewage left uncovered. The medical building basement had HVAC vents that were almost blocked with black dust and debris and a ceiling covered with mold. HVAC systems in a residential common room were moldy, filthy, and rusted. An air handling system in a residential building had filthy air handlers, mold growth, and open compartments, allowing air in from a room with widespread mold growth. A computer room and a room used for services for people with developmental disabilities both had mold growth on the ceiling, in one case because an air conditioner was running continuously in December. A shower room had moldy walls and floors.
According to Gordon Mycology, several types of mold were identified that can cause myriad health problems, including respiratory diseases like pneumonia, chronic lung and sinus infections, skin infections, coughing, lethargy, and itchy eyes.
While the report did not confirm the presence of asbestos, it found that pipe wrappings, which had been put in place years before to contain asbestos, were deteriorating.
“Evaluation by [Disability Law Center’s] retained expert shows that the aged physical plant has deteriorated to the point that spending time inside [Bridgewater State Hospital] is not safe for anyone,” the report says.
The report also found that patients do not have an adequate process in place for reporting medical issues to staff.
The Disability Law Center recommends that the Department of Correction immediately remediate the mold and provide health screenings for all patients and staff. Going forward, it recommends the state remove Bridgewater State Hospital from the auspices of the Department of Correction and put it under the Department of Mental Health, while developing a plan to close the hospital and build a modern psychiatric treatment facility.
Rep. Ruth Balser, a Newton Democrat, has been filing legislation for several sessions, unsuccessfully, that would transfer Bridgewater State Hospital from the Department of Correction to the Department of Mental Health. “These folks are mentally ill, and DMH is the mental health authority of the state,” Balser said. “The DOC, they’re not trained in mental health.”
Pritchard said one reason to close the facility entirely is because remediating the mold would be expensive, and the building is prone to moisture build-up, so mold could easily return. “The facility is old in every way,” Pritchard said.
The Disability Law Center has also long been advocating for people with mental illness to be moved out of what they describe as a prison setting into a therapeutic one run by health officials. “It’s a prison that we’re sending people to who are in very, very difficult situations, experiencing all manner of behavioral health crisis,” Pritchard said. “There’s no therapeutic milieu for them to get better in or stabilize in.”
State Sen. Jamie Eldridge, an Acton Democrat and Senate chairman of the Judiciary Committee, said he recently heard concerns about mold at Bridgewater from a new ombudsman overseeing the state correction system. He has heard similar complaints about environmental conditions at other prisons, including MCI-Norfolk and MCI-Framingham.
“Clearly, whether it’s the Judiciary Committee or another committee, we should be looking into the health conditions at state prisons, including Bridgewater,” Eldridge said. “I do think [the Department of Correction] needs to do better job at making our state prisons more healthier places and safer places from a public health and cleanliness perspective.”
Attempts by state officials to build a replacement for MCI-Framingham, the outdated women’s prison, have been opposed by prison reform advocates who say the state does not need to build new prisons because they contribute to mass incarceration. Eldridge suggested that a similar debate could occur should the state consider replacing Bridgewater State Hospital. He said he would certainly support the institution being taken over by state health officials rather than correction officials. If the building is demolished, he would only support rebuilding it as a mental health treatment facility, not a prison.
“I think that one of the big question marks of the Baker-Polito administration is why didn’t we build more mental health facilities, whether for those people at Bridgewater or other people suffering mental health crises?” Eldridge said.
In addition to environmental factors, the Disability Law Center report examined other areas that have historically been problematic.
The report found that Wellpath is using restraints, seclusion, and the forced use of medication in unsanctioned circumstances. In many cases, it says, Wellpath issued emergency treatment orders, which allow for forced medication in cases of imminent harm, in circumstances that did not warrant it: like a person banging on a door demanding food; a person yelling on the phone and ignoring staff; or a person throwing food. Sometimes medication was administered after circumstances were brought under control. Physical restraints and seclusion were also used where there was no recorded threat of imminent harm. The Disability Law Center found around 80 instances where the health care company did not properly report the use of restraints or seclusion.
Pritchard said since Baker’s reforms, there has been a lessening of the amount of time people spend in restraints or seclusion, and there are improvements in how force is used. But she worries that with less use of physical restraints, Wellpath employees are using more unnecessary chemical sedation. When someone is being disruptive, Pritchard said, “It seems like the knee-jerk reaction is to put them away, shoot them up with medication to sedate them, and resolve the issue.”