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Prisoner Admissions Soar at Massachusetts Psychiatric Lockup Plagued by Overcrowding and Violence

As of March 11, 2024, almost half those held at Massachusetts’ Tewksbury Hospital were forensic patients, admitted to the state-­run mental health lockup from the criminal justice system. At the same time, the state Department of Mental Health (DMH) said the aging facility was overcrowded, with 176 people but only 165 beds, and also understaffed, with fewer staffers in 2023 than 2019, when there were 8% fewer beds.

Feeding the increase in admissions is a doubling of transfers since 2018 from the state Department of Correction (DOC), as well as a rise in court-­ordered psychiatric evaluations. Coupled with challenges in maintaining both staffing and the crumbling facility, the environment for patients and staff has grown increasingly dangerous. Over just 36 months there were more than 3,000 calls to 911 from the hospital.

The problems are not unique to Tewksbury, representing challenges faced by an overwhelmed state mental health system that includes four other lockups. DMH said that waits for inpatient care at its facilities rose from 35 days in 2015 to 293 days in 2021, leaving those in need of care deteriorating in jails or on the streets. An additional mental health unit came online in 2022, but its 21 beds came at the expense of treatment spaces and activity areas. As a result, treatment sessions have been held in inadequate spaces, including broom closets. “These patients have nowhere to go,” a former nurse at the hospital reported.

The opportunity for outdoor time, limited by the lack of staff and recreational space, leaves patients sharing a fenced courtyard only a bit larger than a basketball court, and staffers report that up to 10 of each patient’s 30 minutes of outdoor time is taken up by traveling to the secured outdoor area. The constant threat of violence that accompanies such conditions exposes patients to aggressive and destructive behaviors which hinder recovery. State law requires mental health facility administrators to notify the county district attorney about any behavior that they believe to be criminal, and the number of such reports filed from Tewksbury topped 70 in 2022 and 2023, according to a spokesperson for the Middlesex District Attorney’s office.

“You’re waiting for violence,” said a former Tewksbury mental health worker. “You better hope there’s enough staff there to help you.”

Despite the difficult working conditions, Tewksbury staffers know that those in their care have it worse. “They’re really unwell,” said one. “They’re all under-­slept, overwhelmed, overstimulated, angry to be there … all of that comes out behaviorally.”  

Source: Boston Globe

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