Press Release  DOC Reaches Agreement with DOJ Regarding Mental Health Care for Prisoners in Mental Health Crisis

Boston — Today, the Massachusetts Department of Correction (DOC) entered into an agreement with the Department of Justice (DOJ) that will further advance the significant improvements implemented by the DOC with respect to mental health care policies and practices in DOC facilities.  While the DOC has already made many changes over the past 3 years, the agreement will help the DOC achieve its goal of providing greater supervision and the highest standards of care for those experiencing a mental health crisis in a correctional facility.

In October 2018, the DOJ initiated an investigation into the adequacy of DOC’s care for prisoners with serious mental illness or who are otherwise at risk of serious harm from restrictive housing conditions, and for geriatric and palliative care prisoners. The DOJ found no evidence that the DOC provided substandard geriatric and palliative care to prisoners, or that prisoners were at risk of serious harm from restrictive housing. The DOJ did, however, develop concerns related to the supervision and care of prisoners in mental health crisis and continued its investigation for that reason.

In November 2020, the DOJ issued its report and called upon the DOC to make significant changes to its policies and practices regarding supervision, mental health care, and restrictive conditions during prolonged mental health watches. The DOJ did not file suit against the DOC, and acknowledged in its report that the DOC had already begun to change its practices. The DOC’s efforts have continued to this day.

“We are pleased the DOC has reached an agreement with the DOJ. The Executive Office of Public Safety and Security is committed to supporting the DOC’s efforts to provide the highest standards of mental health treatment to prisoners suffering from mental health crises and to ensure the ongoing implementation of meaningful reforms to protect vulnerable individuals and promote public safety,” said Public Safety and Security Secretary Terrence Reidy.

“The Department has been diligent, transparent, and cooperative with the DOJ to advance our shared goal of improving mental health care for those experiencing a mental health crisis. We remain deeply committed to the health and well-being of all entrusted to our care while ensuring the protection of their physical safety and civil rights,” said DOC Commissioner Carol Mici.

Implementation of the following actions are either complete or underway by DOC:

• Appointment of an independent qualified expert agreed upon by DOJ and DOC to review the care of individuals in crisis and ensure ongoing compliance with the agreement.
• Increase in data collection requirements regarding therapeutic supervision (formerly known as mental health watch) to ensure a consistent reporting structure to improve data analysis and evaluation of intervention efficacy.
• Enhancement of clinical interventions, out of cell therapeutic contacts and adjusted property allowances for individuals on therapeutic supervision.
• Expansion of existing Crisis Intervention Training for DOC personnel with evidence-based curricula on mental health care, suicide prevention, and de-escalation techniques.
• Development of an Intensive Stabilization Unit at the Department’s designated mental health facility (currently Old Colony Correctional Center) to provide individualized treatment for those on extended therapeutic supervision who do not meet the statutory requirements for in-patient hospitalization.
• Retention of Support Persons, provided by a contracted healthcare provider and under the supervision of qualified mental health professionals, to engage in non-clinical interactions with individuals on therapeutic supervision.   

In consultation with the DOJ, the DOC retained Reena Kapoor, MD, to serve as the independent expert and person responsible for ensuring compliance with the agreement.

Dr. Kapoor’s professional experience reflects her indisputable commitment to the care and treatment of individuals suffering from mental illness in correctional facilities. Dr. Kapoor, who is a professor at Yale School of Medicine, has worked as a psychiatrist in correctional facilities, served as a consultant to litigants and as an independent monitor in other jurisdictions with the goal of facilitating improvements in policies and practices as they relate to prisoners with mental illness. 

At the federal level, Dr. Kapoor serves as a consultant to the Department of Justice on concerns related to correctional mental healthcare, and she previously served as a consultant to plaintiff-prisoners in their claims against the Federal Bureau of Prisons. At the state level, her experience includes overseeing settlement agreements involving prisoners with mental illness in Illinois, Louisiana, and Connecticut. 

In fulfilling her mandate at the DOC, Dr. Kapoor will work with a team of committed and experienced professionals with expertise in the field of correctional facility management, direct care, and investigations. 

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