DOC accepts sweeping settlement on mental health care for prisoners
Rollins says agreement will make Mass. the ‘gold standard’
By 
THE MASSACHUSETTS Department of Correction will have to completely transform the mental health care it provides to inmates, under a settlement the department reached with the US Department of Justice on Tuesday.
More than two years ago, the Justice Department issued a scathing report finding that the Department of Correction violated its constitutional obligations by failing to provide adequate mental health services to prisoners. This settlement resolves that investigation in the final days of Gov. Charlie Baker’s administration. It will be up to Gov.-elect Maura Healey to implement the recommendations.
“As prosecutors, we have a duty to enforce criminal laws which can result in sending people to carceral facilities. We also have a duty to ensure that once someone is incarcerated and in the custody and control of a state, local or federal government, that they receive constitutional treatment and adequate mental and physical health care,” said US Attorney Rachael Rollins in a statement. “Our investigation found unconstitutional conditions and circumstances where incarcerated people in mental health crisis harmed themselves up to and including suicide.”
Rollins said the settlement agreement includes what she called innovative solutions. “With these innovations, we intend for Massachusetts to become the gold standard in mental health supervision and treatment for incarcerated individuals,” Rollins said.
The 2020 investigation identified numerous instances of prisoners harming themselves while on mental health watch – a status that was supposed to provide additional supervision – in some cases with correction officers egging them on. The federal investigators said the state failed to adequately supervise prisoners in mental health crisis, failed to provide them with adequate mental health care, and violated their rights by placing them under prolonged mental health watches in overly restrictive housing conditions.
Assistant Attorney General Kristen Clarke of the US Justice Department’s civil rights division said in a statement, “This agreement ensures heightened supervision, increased out-of-cell contact with mental health staff, and intensive mental health care in a new treatment-focused housing unit when needed. These reforms will help ensure people receive the services they need when they are in crisis.”
Under the terms of the settlement, any prisoner on mental health watch will have three contacts daily with a mental health clinician. The Department of Correction will be required to increase staffing so there is enough staff to escort people on mental health watch to out-of-cell activities like recreational and group activities. The department will be required to hire more mental health professionals to ensure that people receive “meaningful therapeutic interventions.” There will be on-call mental health clinicians available to quickly evaluate prisoners in crisis and write an assessment and treatment plan. All security staff will be trained annually in mental health interventions, including suicide prevention.
The settlement sets out standards for patients on mental health watch, ensuring they have proper clothing, shower access, lighting, and access to their property and to reading material. A qualified mental health professional, not a correction officer, will make decisions about whether they are allowed to participate in recreational activities, including visitation.
Unless there are documented reasons why these things cannot be provided, prisoners on mental health watch will have access to outdoor exercise and out-of-cell meals. The DOC will be required to provide a range of therapeutic interventions, including therapy dogs, peer support programs, de-escalation rooms, and out-of-cell activities.
There are consultations that will need to occur when a prisoner has spent 72 hours, seven days, and 14 days on mental health watch. There will also be planning for discharge to ensure the person gets follow-up care.
There are new rules and requirements imposed on staff observing people on mental health watch, establishing procedures for things like reporting self-harm. The settlement also establishes a new role of “support person,” an individual hired by a health care provider to do non-clinical activities with the prisoner and ensure the person has regular interaction with someone trained to provide them with support.
The department will have to report regularly on the status of prisoners on mental health watch in order to make sure the department is complying with all the proper procedures. There will be oversight by an internal committee; by outside expert Dr. Reena Kapoor, who is an associate professor of psychiatry at the Yale School of Medicine; and by the Department of Justice.
