BOSTON – For decades, Bridgewater State Hospital was a dead end for the men with mental illness who were confined there with little meaningful treatment and sometimes under brutal conditions.
But in the past nine months, the drumbeat of criticism from disability rights activists has morphed into accolades for Gov. Charlie Baker, who instituted sweeping reforms at the Department of Corrections-run forensic hospital, and Correct Care Solutions, the Tennessee company brought in to oversee care of patients there.
“I think the headline of the last nine months is that there’s been incredible change in both practice and culture,” Stan Eichner, director of litigation for the Massachusetts Disability Law Center, said during a panel discussion hosted by Community Resources for Justice on Dec. 12. “We see this as a really critical time period to make sure the progress which has been achieved continues and improves more.”
Eichner, whose organization monitors conditions at the facility as part of a settlement of a lawsuit, joined Massachusetts Secretary of Public Safety and Security Daniel Bennett, Correct Care founder and Executive Chairman Jerry Boyle, and Crime and Justice Institute Director of Justice Initiatives Barbara Pierce on the panel at the Citizens Bank headquarters in downtown Boston. Crime and Justice Institute Executive Director Christine Cole moderated the discussion.
For decades, the facility ran more like a prison than a hospital with patients routinely strapped down or left in isolation. A series by the Boston Globe Spotlight Team in 2014 detailed the death of a 23-year-old patient at the hospital who suffered a heart attack while guards were forcibly restraining him and other examples of harsh treatment. The series renewed calls for reform at the facility.
In April, the Baker administration hired Correct Care Solutions, which brought in psychiatrists and clinicians to care for patients, and limited the role of guards to overseeing the outside perimeter of the facility.
“The first thing the governor said to me was that it was important to change how Bridgewater works; it needs to work like a hospital, not a prison,” Bennett said. “It was clear to me that we needed to get a care provider in there to treat patients like patients.”
Boyle said his organization’s staff is trained in de-escalation and other techniques to calm upset or disruptive patients down rather than putting them in restraints or isolation. The facility now averages 28 hours of having patients in seclusion per month compared to 4,500 hours before Correct Care came in, he said. Restraints are also down dramatically.
Along with staff changes, the company also implemented electronic record keeping, real-time patient updates, individual treatment plans, and other changes.
“Part of our role was to provide treatment without judgement for this population,” said Boyle, who was the superintendent of Bridgewater State Hospital from 1987 to ’91. “It’s been a great partnership.”
Boston Globe reporter Mike Rezendes, who contributed to the paper’s extensive reporting on abuses at Bridgewater State Hospital, congratulated the panelists for progress at the hospital beyond the past cycles of public attention prompting limited reform only to have it backslide when the spotlight faded.
“I think it is a real culture change,” Rezendes said from the audience. “We’ve had this cycle of scandal and reform and I think that’s been broken because the tension between punishment and treatment has been resolved.”
Massachusetts is not alone in its ongoing effort to untangle the often complicated intersection between corrections and mental health treatment. Pierce, whose work includes training corrections staff on the use of isolation, said it’s a struggle she frequently hears about from corrections and state officials who often lack resources to provide proper treatment or training on mental illness.
“Around the country you see this constant tension between mental health and corrections,” she said. “I think [Bridgewater] is a story of finally having adequate resources and the tools to do the job.”
But several panelists also cautioned that those applauding reforms at Bridgewater State Hospital still have to make sure progress doesn’t fall victim to budget pressure or lack of public attention.
“When people take their eye off the ball, that’s when things go back,” Eichner said.
In his closing remarks, Community Resources for Justice Board Chairman Scott Harshbarger called on attendees to be a part of the effort to keep attention focused on the facility.
“We need to be the support system for this,” he said.