SUFFOLK COUNTY SHERIFF Steven Tompkins could get permission to treat people civilly committed for substance use disorders in the Suffolk County jail, under a bill pending before the Legislature that is adding to the controversy already swirling around Tompkins’s role in cleaning up “Mass. and Cass” — the area around Massachusetts Avenue and Melnea Cass Boulevard in Boston that has become the center of the region’s opioid crisis.
“What I would like is for there to be health care facilities established outside of a correctional facility that would tend to these needs,” Tompkins said. “That said, in the absence of enough of those beds, in the absence of enough of that type of care, I’m willing to be part of the solution to help people suffering from mental health or substance use issues.”
Some health care experts and advocates for individual with substance use disorders say giving Tompkins that authority is a step in the wrong direction at a time when lawmakers are also considering whether to move civilly committed men out of correctional facilities entirely.
Bonnie Tenneriello, an attorney at Prisoners’ Legal Services, which filed a lawsuit challenging the practice of keeping civilly committed men in correctional facilities, said she understands the temptation to give Tompkins new authority, since the crisis is occurring outside his door. But she said Massachusetts should be going in the opposite direction. Expanding the reach of corrections “is a tremendous step in the wrong direction,” Tenneriello said. “It’s a strong temptation to make use of these empty jail beds, but it’s a very dangerous path.”
As Boston and state policymakers try to address the crisis in the area of Mass. and Cass, where people who are homeless and using drugs have been camping out, Tompkins has offered use of his jail as a treatment facility. Under his proposal, people in the encampments who have outstanding warrants for their arrest would appear before a judge, and the judge could send them to a unit at the South Bay House of Correction set up specifically to provide treatment for substance use disorders. A special court has already been set up at the jail to hear cases of people arrested at Mass. and Cass, though it has faced criticism for steering more people to jail than to treatment.For now, in order to be sent to the jail, someone has to have a pending criminal charge.
Under the new legislation that has been filed, however, Tompkins could be given custody of individuals through a separate court process, referred to as Section 35, in which a person can be involuntarily committed to treatment if they pose a danger to themselves or others due to an alcohol or substance use disorder.
Tompkins said he initially told city officials that he would take people who are already engaged with the criminal justice system because “I didn’t want to get into the whole debate over Section 35 right now.”
The Section 35 legislation, introduced by Sen. Nick Collins, would explicitly authorize the Suffolk County sheriff to enter into agreements to provide services for Section 35 commitments. Tompkins said the bill was Collins’s initiative, not his, but “if this were to become law… I’m open to whatever help we can offer.”
Collins, a Boston Democrat whose bill recently had a hearing before the Joint Committee on Mental Health, Substance Use, and Recovery, said he thinks there is a need for a facility that can provide for civil commitments in Suffolk County. The state’s website on Section 35 treatment lists three facilities for men: MASAC, which is a state facility run by the Department of Correction in Plymouth; a facility run by the Hampden County sheriff’s department at two locations, one of which is a jail; and a treatment center in Brockton. Collins said there were a few beds at Lemuel Shattuck Hospital in Boston, but they are slated to close.
“It’s a public health crisis, and a part of the solution, I believe, needs to be civil interventions,” Collins said. “Until we have beds, we can’t really accommodate that.”
Today, women who are civilly committed must be sent to a treatment facility overseen by the Department of Public Health. Under a state law spurred by litigation, civilly committed women cannot be housed in a correctional facility. Some men are sent to a DPH facility, but others are sent to MASAC or the Hampden County sheriff’s department – both run by correctional officials.
There has been a longstanding debate over whether a correctional facility is the appropriate place to provide treatment, and a lawsuit is pending that could eliminate the practice for men. Advocates are also seeking legislation that would ban the practice of keeping civilly committed men in correctional facilities.Tenneriello said giving Tompkins authority to treat civilly committed people “would be really shortsighted.” In other cases when men are held at correctional facilities, she said, “people are traumatized and heavily stigmatized.”
If Tompkins were to hold people in the House of Correction, even if the unit is set up as a treatment facility, “It would be nothing but a setback to recovery,” Tenneriello said. “He’d be cycling people through. They would come out without any benefit and may be more vulnerable to overdosing if he forces them to detox.”
Collins said his bill would set up an arrangement that would be different from the facilities at MASAC and in Hampden County, because it would have Tompkins contract with a public health facility, and the treatment would be run by health care staff using the jail solely for space.
The proposal is also igniting debate over the role of Section 35 in addressing a crisis like Mass. and Cass.
Miriam Komaromy, medical director of the Grayken Center for Addiction at Boston Medical Center, said she has problems with the concept of using involuntary treatment to address addiction. “Locking people up involuntarily, whether criminally or under a Section 35 approach, will get people off the street temporarily and may make certain segments of the neighborhood happy, but it’s not likely to do anything in the long term to really address the problem,” Komaromy said.
Komaromy said Section 35 should be used in very limited cases when a health care clinician judges it necessary, “but that shouldn’t be used as a way of addressing a public health crisis.”
“The reason most people are on the street in that area is a combination of addiction and lack of appropriate housing,” Komaromy said. “And without the housing piece, we’re not going to be able to deal with those problems.”
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