An independent federal expert has concluded that Massachusetts’ prison system cannot realistically achieve full compliance with a major 2022 agreement designed to overhaul how it cares for incarcerated people experiencing mental health crises, setting the stage for continued U.S. Department of Justice involvement beyond the current deadline.
Dr. Reena Kapoor, a Yale School of Medicine psychiatrist serving as the court-appointed monitor, delivered this assessment in her March 24, 2026 progress report. She determined that the Massachusetts Department of Correction (DOC) has reached substantial compliance on just 51 of the agreement’s 125 provisions—roughly 41 percent—and remains out of compliance on two others.
She stated that meeting the December 20, 2026 target is not possible and expects the parties to begin discussions soon about whether to extend, modify, or end the agreement after that date.
The settlement was signed on December 20, 2022, following a DOJ investigation launched in 2018. Federal findings released in 2020 documented systemic failures in supervising and treating prisoners in mental health emergencies, including disturbing cases of self-harm occurring under observation. The DOC denied violating constitutional rights but agreed to the reforms to avoid litigation. The pact required full implementation of new policies, staffing plans, training, and practices within three years, with the possibility of termination after four years if substantial compliance was maintained for a full year.
According to the Commonwealth, progress has been steady but uneven. While there have been incremental gains at most facilities, including a 65 percent increase in full-time mental health staffing (from 89 positions in early 2023 to 148 by late 2025), shorter average stays under therapeutic supervision, and an overall drop in self-harm incidents.
The department has also rolled out enhanced data collection, more frequent out-of-cell therapeutic contacts, updated suicide-prevention training, and a new Intensive Stabilization Unit at Old Colony Correctional Center to provide structured support for those in acute distress.
Yet significant hurdles remain, especially at Souza-Baranowski Correctional Center, the state’s maximum-security facility, where mental health staffing still lags and consistent therapeutic care is harder to deliver amid the security-focused environment. Policy revisions in some areas are behind schedule, and certain documentation and individualized decision-making practices need further refinement.
The report arrives against the backdrop of a difficult 2025, when six suicides occurred across DOC facilities—including Souza-Baranowski, MCI-Norfolk, and MCI-Shirley—a notable increase from prior years when the annual total was one or zero. Four of those individuals had been on the mental health caseload and seen by a professional within the prior 17 days; several had prior suicide attempts.
In response, the DOC hired correctional mental health expert Dr. Sharen Barboza to conduct an independent analysis. Her recommendations prompted the department to announce a package of enhancements on March 18, 2026.
Those steps include launching an overnight mental health wellness helpline, clarifying policies and training for transitions into Behavioral Adjustment Units, requiring more comprehensive risk assessments that review full mental health histories, improving continuity of care documentation, setting minimum standards for clinical contact length, and bolstering advanced training on suicide risk assessment and safety planning. The DOC has also intensified efforts to intercept contraband such as K2 that can destabilize vulnerable individuals.
While the reforms have produced measurable advances—such as the new stabilization unit serving as an “off-ramp” from prolonged crises and better multidisciplinary approaches to treatment—the monitor emphasized that high-security settings still struggle to provide consistent, therapeutic environments.
With roughly nine months until the current agreement’s milestone, stakeholders now face decisions about the future of federal oversight and how best to sustain momentum in protecting the rights and well-being of those in custody.