Hearing shows setting matters for addiction, mental health care

Boston Statehouse

BOSTON (SHNS) – Two sets of elected officials on Monday offered different visions on the role of correctional facilities in addiction treatment, an issue that has become part of the public debate over how to respond to the substance use and homelessness crises at Boston’s Massachusetts Avenue and Melnea Cass Boulevard.

Five years after a state law ended the practice of sending women to prison when they were civilly committed for addiction treatment, bills filed by Rep. Ruth Balser and Sen. Cindy Friedman aim to do the same for men subject to so-called Section 35 civil commitments.

Meanwhile, a Sen. Nick Collins bill lays out a procedure for handling Section 35 petitions when courts are closed, in which a justice could temporarily commit a person facing a “grave likelihood of serious harm,” with a hearing to be held on the next business day. His bill also would establish that “correctional facilities operated by the Suffolk County Sheriff shall be permitted to enter into agreements with approved section 35 facilities to provide public health services at the same level of care.”

The Mental Health, Substance Use and Recovery Committee heard testimony on both bills Monday.

Suffolk County Sheriff Steve Tompkins has proposed repurposing a vacant building at his house of correction campus into a treatment center, where people living in the nearby Mass. and Cass encampments could be committed for addiction services and temporary housing if they have active warrants or are deemed to be a danger.

Supporters of the Collins bill (S 1265) said that in a perfect world, they’d rather see people in need of treatment get services voluntarily in a health care facility, but cited a lack of available beds and pointed to an urgent need for action at Mass. and Cass.

“Is it perfect if we section someone because we think they are a danger to themselves?” said Sue Sullivan, executive director of the Newmarket Square Business Association. “No, it’s not perfect, but you know what? It’s better than what’s happening and at least it gives them a fighting chance to determine that they want to get better. Down here, down what I see every day, they don’t have that fighting chance.”

Public health experts and other advocates have pushed back against Tompkins’ suggestion, and speakers who testified in support of the Balser/Friedman bill (H 2066/S 1285) said that treatment in correctional settings can be stigmatizing and traumatizing for people who are sent there.

Dr. Sarah Bagley, an attending addiction specialist at Boston Medical Center, said she has worked with multiple patients civilly committed under Section 35 and has “significant concerns about the irreparable harms and trauma that are perpetrated in correctional environments.”

“There’s no other disease where we would propose individuals be sent to these settings and the fact that it continues demonstrates society’s continued stigma toward individuals with substance use disorders,” she said.

A 2016 law stopped women from being civilly committed to the state prison in Framingham, and Balser told the committee that the state then established new programs for women through the Department of Public Health and Department of Mental Health.

“The good news was that we did that for women,” the Newton Democrat said. “The bad news was that we introduced gender discrimination into our laws. It makes absolutely no sense for men who are suffering from a serious addiction to be treated in a correctional facility, while we recognize that women shouldn’t be.”

Balser said Massachusetts is the only state in the country whose statutes allow civilly committed individuals to be sent to a facility run by the criminal justice system.

Bonnie Tenneriello of Prisoners’ Legal Services said most Section 35 beds for men are run by the Department of Correction and the Hampden County Sheriff’s Office, and said that those facilities still feel like jails to the people who reside there.

“It reinforces the perception that they are second-class citizens who deserve no better than jail. This is profoundly countertherapeutic and directly undermines any chance for successful treatment and recovery,” she said.

Tompkins, who testified with Collins, former Sen. Linda Dorcena Forry of Dorchester, Boston City Councilor Frank Baker and Councilor-elect Erin Murphy, said that of the roughly 1,000 people in his custody, upwards of 60 percent suffer from some sort of substance use disorder. Correctional facilities, he said, “have had to spin out full-blown mental health and substance use” operations.

“Good or bad, I do run a correction facility, but I also have the resources and the wherewithal to help people until we can get them to a health care facility,” he said.

Murphy said that people need to “be creative” and work together to find solutions around Mass. and Cass.

“We don’t have beds to provide what we need for these people and though I would prefer a hospital setting, we’re not in a position at this time to be picky,” she said. “We can’t watch people die while we’re waiting for beds.”

Balser said her response to points people raised around the need for more beds was, “How do we make that happen?” She called on Gov. Charlie Baker and Health and Human Services Secretary Marylou Sudders to “work with the Legislature, make the appropriation” to support additional beds.

“Let’s build a system of care now, for these folks,” she said.

Friedman voiced a concern that allowing one sheriff to host a treatment center would “become the way that we’re going to start to do business.”

“If you can guarantee me that this is going to be something that’s incredibly short term, and we’re going to put people in these rooms and they are going to be treated only by health care professionals and they wouldn’t even know that they were part of the Suffolk House of Corrections, you know what, I’d say alright, but I am so deeply concerned that this is going to be the way that we’re going to start treating people with substance use disorder, many, many of which have mental health conditions, and we’re going to be back to criminalizing people who are sick,” she said.

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