In the process of restraining Messier — a mental health patient who suffered from paranoid schizophrenia and who was in the midst of a violent episode — a group of guards placed him in a dangerous “suitcase’’ hold, with his knees pressed against his chest. Messier’s autopsy concluded that the hold, which was captured on video, contributed to heart failure. Half a dozen laws and policies were violated during the episode.

Joshua Messier won a small measure of justice last week. Unfortunately, it came six years after he died in the custody of prison guards at the misnamed Bridgewater State Hospital, our state’s dangerous and inappropriate prison for the mentally ill.


Now the three guards, who were fired last year, will face charges of involuntary manslaughter and civil rights violations in Messier’s death, a reversal of a 2009 decision not to seek criminal charges. But this decision, while long overdue and absolutely correct, does not go far enough.

Bridgewater State Hospital is an institution almost without parallel. It is a medium-security prison masquerading as a mental health hospital. Though the overwhelming majority of its nearly 300 inmates are not prisoners, they are effectively incarcerated. They are overseen by guards who have woefully inadequate training in caring for the mentally ill. That has to change — now.

The prosecution of the guards almost didn’t happen. Plymouth District Attorney Timothy Cruz refused to charge the guards, and stands by that decision. After Messier’s case was revealed in a series of stories by the Globe’s Michael Rezendes, then-Attorney General Martha Coakley appointed Martin F. Murphy, a stellar former prosecutor now at Foley Hoag, to investigate. Murphy called for an inquest, and presented the case to a statewide grand jury, which indicted the former guards last week. Thankfully, Timothy Cruz has finally been overruled in this case. But that isn’t enough to fix Bridgewater.


This tragedy is an opportunity for Governor Charlie Baker. Bridgewater must be immediately transferred from the state’s Department of Correction to the Department of Mental Health. In response to the Messier case, guards are getting more training. But to prevent further tragedies, this penal facility must become an actual hospital, and its inmates must become patients.

Murphy nailed the problem in a statement Thursday. “A system that places correctional officers in charge of mentally ill patients never convicted of a crime is a recipe for disaster,” he said. “Patients like Josh Messier who, through no fault of their own, suffer from debilitating psychiatric illnesses, should not be cared for by men and women trained to be prison guards. It’s not fair to the patients, and it’s not fair to the guards.”

Precisely.

Unfortunately, the Baker administration’s response hasn’t been reassuring. Baker’s people have spoken in bureaucratese about improving “protocols.” They say they get the problem, but they aren’t ready to say what they plan to do about it. Meanwhile, another tragedy could occur any day.

An obvious immediate first step is to place mental health patients in the proper care. That will be more expensive than the system in place. But as the Messier case graphically illustrates, this is a matter of life and death. At least two patients besides Messier died there in a four-year period.

The case raises troubling law enforcement issues, too. Cruz conducted two investigations into the case, and saw no reason to pursue charges. But other investigations have found evidence of major wrongdoing. A lawsuit Messier’s parents brought against the state and a private health care provider was settled for $3 million.


So far, only Cruz himself supports Cruz’s findings. But neither the indictments nor the civil settlement will protect the patients of Bridgewater. Only the state can do that, by completely overhauling the hospital. Regardless of the outcome of the criminal prosecution, the verdict is in on Bridgewater State Hospital, and it’s ugly.

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Adrian Walker is a Globe columnist. He can be reached at walker@globe.com. Follow him on Twitter @Adrian_Walker.