by Susan Mortimer—Wednesday, April 30, 2008

On February 11, four steel cages were delivered to the state prison in Walpole. That was two months after publication of the Globe series on alleged suicides among Massachusetts prisoners. Just four square feet and eight feet high, they cost the Department of Corrections almost $60,000. The cages feature small metal benches and have openings for leg shackles. They have a sinister name, too: Custom Therapeutic Modules. (editors' note)

State prison plans: mental therapy or torture?

Walpole Prison

Four Custom Therapeutic Modules delivered to State prison at Walpole [anonymous photo]

The rate of “suicide” in Massachusetts prisons is three times the average rate for U.S. prisons. Deaths behind bars have escalated in the past two years; and much attention has been paid to this continuing trend.

Ignoring the root causes of such deaths, the Commonwealth and the press—the Boston Globe in particular—have pushed instead for ill-conceived reforms, which will increase the suffering of Massachusetts prisoners, but not their safety.

Massachusetts Correctional Legal Services (MCLS), some State legislators and the Disability Law Center (DLC) presume that these deaths were in fact suicide and not murder by the DOC; that the prisoners were "mentally ill" at the time of their conviction; and that only "mentally ill" people commit suicide.

While we do not have space here to enumerate all the reasons why such presumptions are fallacious, we must acknowledge that racism, poverty and the War on Drugs are the foundation of the prison industrial complex.
Charity paves a road to Hell
Powerlessness, constant stress, solitary confinement and sensory deprivation inflict great suffering. Lack of fresh air and exercise, medical neglect and abuse, inadequate nutrition, guard violence, daily deprivation and degradation combine to destroy physical and psychological health. From the extremes of sensory deprivation to seemingly mundane daily occurrences, prison policy and practice violate human rights. Thus, we believe that conditions of confinement, inflicted by the state, manufacture disability.

While we recognize that some behaviors may be viewed as mental illness, designating and placing the focus of an investigation into the deaths of “mentally ill” prisoners allows administrators, guards and medical staff to evade responsibility for the cruel, inhumane and degrading conditions that engender such desperate behavior. Further, labeling people as “mentally ill” masks disablement caused by child abuse, poverty, racism, sexism and finally, prison conditions.

Coping responses to inequality and unsafe conditions must be differentiated from “mental illness.” Counterproductive measures meted out for such coping mechanisms punish individuals for the harms the DOC inflicts upon them.

This institutional abuse brings some prisoners to a terrible choice: to live in unending despair or to end their suffering.

The role of paternalism in the development of Residential Treatment Units is clear. Liberal reformers want to do the charitable thing. But charity emanates from pity of the allegedly inferior individual; it does not seek to ally with prisoners to work for systemic change.
Paternalism originates in privilege and assumed superiority. It is loathe to challenge the power of the state. It wants to do what it believes is best for the victim without consulting her. Criminal justice policy born of charitable ideology has had devastating effects on the minds and bodies of incarcerated people.
In the nineteenth century, Quakers advocated penitentiaries as a charitable way to improve prisoners’ minds. Prosecutors and jailors use reforms such as parole to punish and to lengthen sentences.
Liberals respond
Enter Massachusetts Correctional Legal Services (MCLS), Representative (and psychologist) Ruth Balser, the Disability Law Center (DLC) and the Boston Globe.
The MCLS lawyers are suing for Residential Treatment Units (RTU) and Rep. Balser is sponsoring H.1313, a bill calling for $40 million for secure mental health units within prisons to be staffed with Department of Mental Health employees.

The Globe has editorialized in favor of RTUs. Last May during oversight hearings on Prison Suicide and Prison Mental Health at the State House, Boston Globe reporter Beth Healy declined to accept written testimony from the only invited group opposed to the treatment units—the Statewide Harm Reduction Coalition (SHaRC). Healy is a member of the Spotlight Team that spent several months working on a three-part investigative series on prison suicides.

The expose was biased toward RTUs. It appears to have been guided, particularly regarding the pro-RTU viewpoint, by MCLS’ Leslie Walker, a long-time proponent of RTUs.
The Globe published Walker's op-ed, touting the treatment units, on February 2, 2008. Walker has ignored prisoners and families who understand that the DOC co-opts reform measures to inflict punishment and to add to its bloated budget.
By insisting on labeling prisoners who may be suicidal as "mentally ill," liberal reformers are choosing not to address the root causes of prison deaths. Closer monitoring of suicidal prisoners in RTUs would not treat despair—a product of prison environs. Instead it formalizes policy, protects the DOC administration and consolidates more power in the prison industrial complex.

Balser's bill, H.1313, gives wide latitude to DOC superintendents and Corrections Commissioner Harold Clarke to administer RTUs under supervision of the Department of Mental Health (DMH).

At present, however, even low-level guards challenge medical orders, withhold pink slips (requests for medical attention), look through patient records and hamper prisoner efforts to get medications in a timely manner. H.1313 does not address guard interference in provision of therapeutic services or guard-on-prisoner violence except to mandate forty hours of mental health training annually for correctional staff assigned to the RTUs. All other guards would be required to undergo eight hours of training yearly.
Get text of H.1313 on Rep.Balser's web page
Reform through the looking glass
Prior studies commissioned by the DOC have recommended such training. The department has repeatedly failed to implement even such minimal requirements.
Many prisoners deride the concept of special mental health treatment units as "same guards, same treatment, different location."

Prisoners understand that the prison culture affects mental health clinicians as deeply as DOC employees. Indeed many "lifers" and older prisoners speak eloquently about being subjected to behavior modification programs, aversive conditioning, electro-shock "therapy", forced administration of powerful sedatives and four-point restraints.

(The writings of Joe Labriola, Albert Gagne, Stephen Metcalf, The Lifers Group and other prisoners are readily available online. Read Massachusetts prisoners writings. )

Nevertheless, against this reform backdrop the DOC has seized the liberal momentum. In February, four Custom Therapeutic Modules were delivered to MCI-Cedar Junction. The CTMs are steel cages, measuring approximately 4’ by 4’ by 8’ which contain a small opening for shackled legs and a metal stool. A sales slip shows that the DOC Central Office in Milford ordered the units at a cost of $15,000 each.

On April 23, 2008 Representative Ruth Balser’s office was presented a copy of the sales slip and photographs of “Custom Therapeutic Modules." The Representative was invited to comment. On April 28 Balser’s aide Jake Larson was again invited to provide a comment. To date there has been no response.

Can a person be "cured" in a cage? Can humanization occur in a dehumanizing atmosphere? If prisoners need treatment, it is in large part for injuries from the institutional violence to which they are subjected in prison and within a society that wages war against its young, the poor and people of color.

The push for RTUs inverts cause and effect of disablement in the prison system. Any legislation, lawsuit or advocacy work which requires that abused and disabled prisoners be "helped" to heal by the very entity which tortures them is no help at all. It is betrayal and collusion with state -sanctioned violence.

Susan Mortimer is an anti-prison activist whose disabled brother is a Massachusetts prisoner. She knew Anthony Garafolo, a paraplegic, whose June 2006 death in a prison hospital unit the Department of Correction has labeled a suicide.
Andrea Hornbein contributed to this article.