In 2018 the Justice Department sued the Massachusetts Department of Corrections (MDOC) and alleged that the MDOC violated the constitutional rights of mentally ill prisoners by placing them in solitary confinement for prolonged periods of time. The Justice Department alleged that the violations were pursuant to a pattern or practice that denied prisoners their Eighth Amendment right to be free from cruel and unusual punishment. The Justice Department and the State of Massachusetts reached an agreement on December 22, 2022 in which the MDOC agreed to implement numerous changes in the way it treats its prisoners.

The MDOC agreed to provide a sufficient number of security staff and mental health staff to provide meaningful supervision and / or therapeutic interventions to prisoners in mental health crisis. Each staffing plan will be subject to review and approval by the Justice Department.

The MDOC agreed to provide annual in-service training to security and mental health staff on new policies, mental health care, suicide prevention, and de-escalation techniques. Any potentially suicidal prisoner will be held under Constant Observation Watch by security staff until initially assessed / evaluated by mental health staff. Mental Health Watch will not be used as a punishment or for the convenience of staff, but will be used only when less restrictive means are not effective or clinically appropriate. If a prisoner has been on Mental Health Watch for longer than 72 hours and has not been approved for a shower approximately every two days, a Qualified Mental Health Professional will document individual reasons why a shower is contraindicated to their mental health. Lighting will be reduced during prisoner sleeping times as long as the prisoner’s hands, restraints (if any), and movements can still be clearly observed by MDOC staff. In most prisons the lights stay on both day and night. Prisoners have to sleep with the lights on. Prisoners usually resort to covering their eyes with a sock.

After 72 hours on Mental Health Watch, all prisoners will have access to outdoor recreation / exercise. If a prisoner is not clinically approved such access, the assessing Qualified Mental Health Professional will document on the Mental Health Watch form individual reasons why outdoor exercise is contraindicated to the prisoner’s mental health. In many prisons the guards have complete control on whether or not a prisoner has access to the outdoor yard.

MDOC, through its contracted healthcare vendor, will provide intensive stabilization services for prisoners unable to effectively progress with placement on Mental Health Watch or general population due to serious mental illness. Intensive Stabilization Unit treatment will be for prisoners who do not meet the statutory criteria required for inpatient hospitalization but who have been on Mental Health Watch and are clinically appropriate for a higher level of care. The primary goals for ISU treatment include the following: stabilizing of primary symptoms necessitating referral, providing a supportive, intensive therapeutic milieu for inmates with mental health needs, and preparing each prisoner for reintegration into the general prison population or Residential Treatment Unit offering a reasonable expectation of success given current mental health needs.

The agreement reached between the MDOC and the DOJ clearly shows that the MDOC had no meaningful policies or procedures to deal with prisons suffering from mental illness, other than placing them in solitary confinement. You can view the entire agreement by clicking this link. Some prisoners may have the right to file a civil rights lawsuit for monetary damages against the MDOC based on the allegations made by the DOJ.