Bridgewater State Hospital

MAMH joins a broad coalition of advocates urging reforms at Bridgewater State Hospital to ensure that people served there receive effective services in a therapeutic, non-prison environment.

Bridgewater State Hospital serves men with serious psychiatric needs who also have pending criminal charges or convictions or who have been found not guilty by reason of insanity. Despite reforms that have removed correctional officers from the housing units, Bridgewater remains a prison with the rules and disciplinary culture that carceral life entails.

People with mental health needs who are held at Bridgewater by the Commonwealth deserve a therapeutic setting which maximizes the possibility of recovery. Most prisoners will return to the community. We should strive to return people in good mental health, with the personal resources to succeed.

As has been the case repeatedly in the history of Bridgewater State Hospital, patients are living there in inexcusable conditions. Learn more in our white paper on the history of Bridgewater State Hospital and our recommendations for next steps, including:

The Department of Mental Health (DMH), not the Department of Correction (DOC), is the appropriate agency to care for persons confined at Bridgewater State Hospital

DMH can provide Bridgewater patients with access to a range of traditional and alternative mental health services, and other resources, in a therapeutic setting that maximizes the possibility of recovery.

Design a secure forensic mental health hospital with care

Incorporating emerging ideas to create a dignified healing environment for those who require strict security, a new, therapeutic facility administered by DMH would provide patients the mental health services they need, without the use of unnecessary force and control.

Choose providers that are right for Massachusetts patients

Administrative and clinical responsibilities for patients at Bridgewater should derive from in-state talent and rest with local professionals, rather than continuing to rely on for-profit and out-of-state corporations who do not provide consistent quality care.

Take direction from patients, families, and other advocates

We should establish an empowered and sufficiently resourced oversight body that includes patients, family members, and advocated to review all aspects of care at Bridgewater State Hospital, and to address the root causes of racial and ethical disparities affecting the patient population.

Advocates are pursing a variety of approaches to address the deficiencies at Bridgewater State Hosptial. The Disability Law Center (DLC), Massachusetts' Protection & Advocacy agency, conducts on-site monitoring of conditions at Bridgewater, and has produced a series of carefully investigated reports, highlighting legal wrongdoing. Representative Ruth Balser and Senator Cynthia Creem have sponsored legislation to transfer authority for the administration of Bridgewater from DOC to DMH, one of MAMH's key recommendations for reform.

A Timeline of Bridgewater State Hospital

1850s - 1920s: The predecessors to Bridgewater State Hospital absorb a rolling cast of populations unwanted by our larger society

The Bridgewater Almshouse accept a wide range of categories of disfavored people, including those labeled "insane."

The influence of Dorothea Dix reinforces an ongoing dichotomy between the care provided in State Mental Asylums and in the Bridgwater Almshouse and its successor institutions.

Bridgewater Almshouse expanded to include a workhouse and hospital, leading simultaneously to the gradual admission of more persons labelled insane and a more prison-like operation.

The establishment of the State Farm at Bridgewater and the Asylum for Insane Criminals, while seemingly an attempt to eliminate the stigma of placement at a workhouse, leads to growing segregation of large numbers of men labeled insane, included those with criminal histories.

The manufacturing of a new category of persons for confinement - the "defective delinquent."

Learn more on pages 3-6, here.

1930s: The State Farm at Bridgewater houses a mix of populations who receive little care and deteriorating conditions

Learn more on page 7, here.

1940s: The State Farm at Bridgewater sees the brutal consequences of poor conditions

Learn more on page 7, here.

1950s: The State Farm at Bridgewater becomes Massachusetts Correctional Institution (MCI) - Bridgewater

The population of persons housed at MCI shifts exclusively to persons with behavioral health issues.

A proposal to transfer the hospital to the Department of Mental Health (DMH) fails.

Learn more on page 7, here.

1960s: Observers reveal rights violations and mistreatment at Bridgewater State Hospital

Observers question the bases for civil commitments and their indefinite duration.

Fredrick Wiseman documents the horror and absurdity of life within Bridgewater State Hospital in Titicut Follies.

Nason v. Superintendent of Bridgewater State Hospital spurs reforms, including transfers from the facility, but the Supreme Judicial Court rejects the contention that Bridgewater patients should be housed by DMH facilities.

Learn more on pages 8-10, here.

1970s: Allegations of horrid conditions lead to a new campus and a new mental health services provider

A citizen's committee finds horrible conditions at Bridgewater State Hospital.

Repealing the statute regarding "defective delinquents," the Massachusetts Legislature limits who may be confined at Bridgewater.

Poor living conditions and a lack of adequate treatment persist, despite a new facility.

A contract between the Department of Corrections (DOC) and McLean Hospital brings a period of improved mental health care, but overall conditions at Bridgewater State Hospital limit any benefit from the contract.

Learn more on pages 11 and 12, here.

1980s: awsuits target the admission of civilly-committed patients who lack criminal involvement and the use of restraint, but responses to litigation are limited

Challenge to civil commitment of patients without criminal involvement fails to accomplish needed change.

DOC contract with Goldberg Medical Associates (GMA) precedes a decline in the quality of mental health care.

Bridgewater State Hosptial Working Group releases its findings and a challenge to the use of restraint on civilly committed patients precipitate reforms is filed.

Proposals to transfer control or even licensing responsibility from DOC to DMH fail.

Learn more on pages 13-17, here.

1990s: A contract with an out-of-state, for-profit medical provider has a rough start, although care improves when the provider subcontracts with University of Massachusetts Medical School

DOC contract with a for-profit medical provider, Emergency Medical Services Associates (EMSA), as well as other cost-saving measures, threaten quality of care.

The pattern of poor mental health care at Bridgewater State Hospital continues with DOC contract with another for-profit medical provider, Correctional Medical Services, Inc. (CMS).

Correctional Medical Services subcontracts mental health care to University of Massachusetts Medical School, resulting in improvements in the quality of mental health services.

Learn more on pages 18 and 19, here.

2000s: The Department of Correction cannot extricate Bridgewater State Hospital from its ongoing problems as changes in the mental health vendor alternate with patient deaths

DOC contracts with the University of Massachusetts Medical School and looks at overuse of restraint and seclusion at Bridgewater State Hospital.

William Mosher's death at the hands of another Bridgewater patient reveals a lack of appropriate mental health care.

DOC contracts with MHM Correctional Services, an out-of-state for-profit vendor.

Joshua Messier's death at Bridgewater State Hospital.

Bradley Burns' death at Bridgewater found to be due to a combination and restraints.

DOC awards contracts to the lowest bidder, the for-profit Massachusetts Partnership for Correctional Health.

Paul Correia's death after three days in a restraint bed at Bridgewater State Hosptial.

Learn more on pages 20-23, here.

2010s: With al eyes on Bridgewater State Hospital, the Patrick Administration must act, but it is not enough to avoid tragedy

Michael Rezendes' reports on restraint use and patient deaths at Bridgewater bring renewed exposure of risks facing patients.

The Patrick Administration finds failures in Messier's death.

Minich v. Spencer class action challenges the use of seclusion and restraint at Bridgewater State Hospital.

The Patrick Administration releases a plan for reform of Bridgewater State Hospital.

Disability Law Center (DLC) files the first of many critical reports exposing health care and environmental deficiencies at Bridgewater.

State negotiations with advocates:

- Disability Law Center

- Minich lawsuits trigger reforms and expose failures of contracted health care provider

Policy papers recommend changes at Bridgewater and specifically question the holding of civilly committed patients there.

The Baker Administration announces a plan for reform at Bridgewater State Hospital.

DOC contracts with for-profit Correct Care Recovery Solutions to implement reforms demanded by advocates at Bridgewater.

DOC renews contract with Correct Care Solutions, which is then acquired and combined with another company to create Wellpath, Bridgewater State Hospital's present-day health care provider.

Disability Law Center reports on Bridgewater State Hospital continue, with initial praise of reforms giving way to pressing concerns.

Learn more on pages 23-32, here.

2020s: Conditions at Bridgewater State Hospital remain troubling with new issues emerging; calls for more sweeping reforms gain traction

Bridgewater State Hospital presently operates in two buildings, but neither is a true hospital.

Bridgewater State Hospital population data raises concerns about disproportionate representation of people of color.

Wellpath refuses to discontinue its extensive use of Emergency Treatment Orders.

Disability Law Center reports continue to raise serious issues regarding care being provided at Bridgewater.

Advocacy efforts reinforce the need for radical change at Bridgewater State Hospital.

Learn more on pages 33-38, here.