DLC Issues Recommendations for Bridgewater State Hospital

Pursuant to its legislative charge to monitor the efficacy of service delivery reforms at Bridgewater State Hospital (“BSH”), the Disability Law Center (“DLC”) issued its six-month report summarizing its findings from its monitoring efforts there January 1, 2019 through June 30, 2019. The five-year anniversaries of both DLC’s investigation into the use of restraint and seclusion at BSH and the issuance of our first, of many, public reports occurred during this reporting period. Great strides have been made in the treatment and care of individuals at BSH over the past five years. More importantly, the past six months seem to have solidified the culture shift that began during the course of our investigation and monitoring. No doubt that there is still significant work to be done in the delivery of services, reporting of data, and physical plant infrastructure, but the right path seems to have been paved and is finally being consistently followed. To ensure the continued improvement of safety and treatment of persons served at BSH, DLC calls on the Commonwealth to follow the recommendations discussed in this report.

Key recommendations:

    • Deteriorating Physical Plant: Consistent with DLC’s recommendations in our public investigation findings on July 11, 2014, constantly reiterated since then, and stated in our February 25, 2019 report, “[i]nstead of the resource drain of patchwork fixes, the Commonwealth needs to construct a modern facility that can effectively provide humane and appropriate treatment.”
    • Administration of Medication: DLC renews its concerns raised in our May 2018 report that medication should be administered with informed consent first, if that is not possible, then a court order should be sought. Further, all individuals in need of “strict security” psychiatric evaluation and/or treatment should be under the auspices of the Department of Mental Health.
    • Programming: Wellpath must continue its efforts to collect data around programming to make the most use of how that information relates to an individual’s progress and treatment. The data can then inform person-centered treatment plans and programming recommendations.
    • Treatment of Individuals with Intellectual and/or Developmental Disabilities: Wellpath needs to continue to focus on development of individualized treatment plans and programming for individuals with intellectual and/or developmental disabilities. These efforts should range from de-institutionalization of individuals who have resided at BSH for decades to active discharge planning for individuals who would be better served by the Department of Developmental Services.
    • Persons Served at Old Colony Correctional Center (“OCCC”): Given the differing staffing constructs of the BSH and OCCC units, differing regulations and protocols, and differing union constraints, the disparity between BSH and OCCC may only be fully addressed if all individuals needing “strict security” in the Commonwealth are housed together and served under the auspices of Department of Mental Health. We believe the current distinctions used to differentiate between these populations do not necessarily reflect different security risks. In the meantime, DLC strongly encourages DOC to continue its efforts collaborating with Wellpath on this issue.
    • Staffing: DLC continues to raise concerns about data collection and reporting when there are vacancies in some of the positions tasked with such oversight and management. Wellpath should continue recruitment efforts for all vacant positions and review job responsibilities with staff to ensure that each person is efficiently and effectively performing his/her job.
    • Nutrition: DOC and Wellpath should continue this partnership in food service and delivery, and continue to expand programming around food initiatives. These programs boost community involvement in nutrition and have many ripple effect benefits from improved health to employment opportunities.
    • Stakeholder Involvement in Treatment: Wellpath should maintain its level of accessibility to the community and continue to engage stakeholders in professional development opportunities both on and off site. This sharing of knowledge and expertise improves the treatment and care of individuals at BSH and raises awareness about the significant progress that DOC and Wellpath have made over the past two years.

Marlene Sallo, the Executive Director of DLC, stated, “Over the past five
years, the culture at BSH has shifted from a punitive to a therapeutic
environment. We applaud this positive change and urge the Commonwealth to
follow our recommendations in order to ensure that improvements continue.”

As it has done in every one of its reports, DLC continues to implore the
Commonwealth to put DMH in charge of the facility. Historically, DMH has
resisted doing so as long as BSH remains at this antiquated facility. The
Commonwealth needs to construct a modern facility that can effectively
provide humane and appropriate treatment to this extremely needy population.
DLC urges state government to proceed with attending to this long overdue
unaddressed need under the auspices of the Department of Mental Health.

DLC, as the designated Protection and Advocacy System for Massachusetts, is
authorized under federal law to investigate incidents of abuse, neglect, and
death of individuals with disabilities throughout the Commonwealth.

Read the Report

Contact: Marlene Sallo, Executive Director
617-723-8455 x145