Could My Autistic or Intellectually Disabled Loved One Be Arrested in Massachusetts?

Terms used in this post: IDD means intellectual and developmental disabilities. HCBS refers to Home and Community-Based Services. ICF/IID refers to Intermediate Care Facilities for Individuals with Intellectual Disabilities.

The chart below illustrates the scale of the mismatch between service needs and where individuals receive housing and supports.

Figure 1. Illustrative comparison of the number of people with IDD who are incarcerated versus those served in ICF/IID settings

Why this matters in Massachusetts

Families in Massachusetts frequently report that their loved ones are placed in settings that are unsuitable. ICF/IID options are often not offered, and families recognize immediately that the community-based placement does not meet their loved one’s needs. The likelihood of justice-system involvement increases, especially for individuals with complex needs, such as limited communication, co-occurring medical or mental health issues, and behaviors that require intensive, specialized care.

This does not have to be the outcome. Massachusetts can offer a more complete continuum of care that includes true high-acuity options, along with crisis pathways that do not run through police cruisers and jail intake. Until those options exist at the scale families need, people will continue to be “held” in settings that are not treatment settings. That should concern all of us.

Many families assume severe or profound disability will prevent arrest or incarceration. Unfortunately, that is not always how crises unfold. A person can still be detained after an incident, or held while courts address competency and, critically, while agencies search for an appropriate placement. Access to the correct level of care is not just a policy debate; it affects safety, health, and community stability.

When the right care is missing, disability-related crises can become legal crises

When disability-related behavior is met with emergency response instead of appropriate clinical support, a person can enter a pipeline that is difficult to reverse. A 911 call can lead to arrest. A single incident can lead to extended detention while systems search for an appropriate placement. Families should not be placed in that position.

Publicly reported examples

Families ask whether this can really happen. Public reporting shows that it can. The following cases involve people described as having autism, intellectual disability, or other developmental disabilities who were arrested, charged, and then held in jail or moved through the court system, often with major questions about competency, appropriate placement, and what alternatives exist besides incarceration.

• Beverly/Middleton Jail (2020): GBH reported on Jonathan Jutras, a 20-year-old described as having developmental disabilities (including autism spectrum disorder) who was held without bail at Middleton Jail while charged with indecent assault and battery. The reporting highlighted that he had been found incompetent by doctors and that his case raised questions about scarce alternatives and placements for developmentally disabled people entangled in the criminal courts (GBH, Nov. 1, 2020; Salem News reporting referenced by GBH).
• Massachusetts (Attleboro/Bristol County, 2015): In a COFAR post about the case of Brett Reich, blogger Dave Kassel warned against using the criminal courts as a substitute for appropriate care. He wrote: “We shouldn’t criminalize intellectual disability. When people with intellectual disabilities commit assaults or other violent crimes, our response should not be to race to lock them up.” He added that this “appears to be the intent of the Bristol County District Attorney’s Office,” describing an “Attleboro young man with very low intellectual functioning” who was being prosecuted rather than served in an appropriate setting (COFAR blog, “We shouldn’t criminalize intellectual disability,” Dec. 1, 2015).
• Virginia (2010–2021): Reginald “Neli” Latson, described in national reporting as autistic and intellectually disabled, was arrested after an encounter outside a library and later spent years cycling between prison, solitary confinement, and mandated programs. Advocates argued that a disability-related crisis was treated as a criminal matter, with devastating consequences for his health. He ultimately received clemency and later a full pardon (see, for example, The Washington Post, Nov. 14, 2014; The Hill, July 28, 2020; ACLU of Virginia press release, Jan. 20, 2015; and The Arc, “Pardon of Neli Latson,” June 30, 2021).

These cases differ in facts and outcomes, but they share a reality families recognize: when a disability-related crisis is treated as a criminal incident, the person with autism/IDD can be arrested, charged, and held in jail while courts and agencies struggle to identify a safe alternative. In Massachusetts, that is why access to appropriate high-acuity services matters, including timely access to the Wrentham and Hogan Emergency Stabilization Units (ESUs) and an actual, usable choice between HCBS and ICF/IID-level care for people who cannot be safely served elsewhere.

Incarceration risk for people with autism/IDD

National data help show that this is not a rare edge case, and why Massachusetts families should take the risk seriously.

A Bureau of Justice Statistics analysis (Survey of Prison Inmates, 2016) estimates that hundreds of thousands of incarcerated people report some type of cognitive disability, and other analyses suggest substantial overrepresentation of people with IDD in jails and prisons..[i] People with IDD face unique risks behind bars, including higher rates of victimization and exploitation.[ii] An estimated 550,000 individuals with IDD are currently incarcerated. For context, roughly 100,000 people are served in ICF/IID facilities specifically designed for individuals with IDD[iii], approximately 150,000–200,000 adults with IDD live in nursing homes nationwide — roughly twice the number in ICF/IID settings,.[iv] and about 861,038 people received IDD-targeted HCBS services (U.S., 2021).[v] Taken together, these figures raise an urgent question: why does incarceration function as a de facto “placement” option when appropriate high-acuity disability services are unavailable?

Relationship between incarceration and deinstitutionalization

This broader context matters because today’s gaps in high-acuity capacity did not happen overnight. There is evidence indicating a relationship between deinstitutionalization and the increased incarceration rates of individuals with IDD. Deinstitutionalization, which began in the mid-20th century, aimed to close large state-run institutions that housed people with mental illnesses and developmental disabilities, with the goal of integrating these individuals into community settings to promote autonomy and improve quality of life. Despite good intentions, this shift often lacked adequate planning and investment in community-based services for individuals with high-acuity needs.

How the pipeline happens (in plain language)

• Placement that cannot support high-acuity needs: Staffing, training, clinical coverage, or the physical environment is not sufficient.
• Escalation and 911 calls: Predictable disability-related behaviors (often triggered by fear, change, pain, communication barriers, or trauma) can escalate into a safety incident.
• Law enforcement becomes the responder: Officers may lack disability-specific training and may interpret behavior as defiance or criminal intent.
• Arrest/detention “because there is nowhere else”: Even when everyone recognizes the person needs treatment (not punishment), jail becomes the holding location.
• Competency evaluations and long waits: The person may be found incompetent, yet remain incarcerated while courts and agencies search for an appropriate placement.
• Harm accumulates: The jail environment can intensify behaviors, increase vulnerability to victimization, and cause regression. This can make community placement even harder.

Misinterpretation of Behavior

Behaviors resulting from a person’s disability may be misinterpreted as intentional misconduct. Additionally, without proper training, law enforcement officers may not recognize signs of IDD or autism and could respond inappropriately.

Advocates claim society must accommodate behaviors that stem from disability, but there are limits to what a community setting can absorb. Behaviors such as assault, property destruction, indecent exposure, or theft will never be tolerated in a civilized society. The solution is not to expect communities to “tolerate” dangerous incidents. It is to ensure access to intensive, high-acuity services: structured teaching that replaces unsafe behavior with safer alternatives, appropriate medical and behavioral treatment, and protected environments and safety protocols.

What families can do now: focus on the right to the right level of care

Families are often told to “work with the provider,” adjust a behavior plan, or find a better fit in the community. For many high-acuity individuals, families have already tried those routes repeatedly, and the reality is that the current system does not reliably accommodate them. The most practical step is to name the core issue: Massachusetts must offer a real, usable continuum of care, including the federally recognized choice between ICF/IID and HCBS, so people are not forced into settings that cannot keep them or the community safe.

What Massachusetts must build to prevent incarceration as “placement”

• Fund and open true high-acuity capacity: Create and sustain settings designed for people with profound disability plus complex medical and behavioral needs. This includes opening admissions at the Wrentham Developmental Center and the Hogan Regional Center.
• Guarantee access to Emergency Stabilization Units (ESUs) at Wrentham and Hogan: Families should be able to access these units when a high-acuity crisis occurs, without impossible barriers or delays. Stabilization should be based on clinical need, not an arbitrary time limit. Wrentham’s stabilization stay should last as long as it takes for the person to safely step down to the next appropriate level of care.
• Require training and diversion pathways: Disability identification, de-escalation, communication supports, and clear diversion options for police, courts, and corrections.
• Stop preventable placement breakdowns: When a placement is failing, escalate supports immediately (staffing, behavioral consultation, medical review) before crisis and arrest occur.
• Make the system accountable: Track jail bookings, competency waits, injuries, restraints, and placement disruptions for people with autism/IDD, and tie funding and oversight to measurable reductions.

For Massachusetts families, “crisis services” must mean real access to specialized stabilization, not a referral list, a wait, or a short stay that ends before stabilization is achieved.

Massachusetts leaders often express support for people with disabilities. That support needs to show up as real capacity: high-acuity services, crisis alternatives to jail, and pathways that keep people safe when placements fail. Without those options, families are left navigating crises in systems that were never designed to provide care.

When a person with autism and/or IDD is incarcerated, the environment itself can cause harm. Jails and prisons are built around compliance, verbal instruction, and rapid responses to authority. These are exactly the areas where many people with high-acuity needs struggle most. They may not understand rules, routines, or expectations, and staff may not recognize disability-related needs. This can lead to repeated disciplinary actions, isolation, escalation, and missed medical care. The result is often regression and trauma, outcomes that no family intends but that systems produce when the correct level of care is unavailable.

Ethical concerns of the state

It is also important for families to understand that when a state insists on community placement for someone who cannot understand rules, laws, or social expectations, it is not simply a clinical mismatch. It raises serious ethical concerns. Ethical practice in disability services requires matching supports to a person’s actual abilities and ensuring their safety, dignity, and stability. When a state agency knowingly places an individual with profound impairments into an environment where they cannot succeed, the risks are not theoretical. They are predictable: police involvement, behavioral crises, exploitation, and ultimately incarceration. Community living is not ethical if it is unsafe or unsupported, and forcing someone into a setting that cannot meet their needs exposes them to harm that could have been prevented with the right level of care. In this way, incarceration becomes not just a system failure but an ethical failure as well.

Call to action: Join and support the Saving Wrentham and Hogan Alliance and tell your story. Families’ lived experience is essential to showing Massachusetts what is happening and what must change.

Sources:

i. Maruschak, Linda, Bronson, PhD, Jennifer, Alper, PhD, Mariel, Survey of Prison Inmates, 2016, Disabilities Reported by Prisoners, https://bjs.ojp.gov/content/pub/pdf/drpspi16st.pdf

ii. Petersilia, J. (2021). US prisons hold more than 550,000 people with intellectual disabilities – they face exploitation, harsh treatment. The Conversation.

iii. https://www.cms.gov/medicare/health-safety-standards/certification-compliance/intermediate-care-facilities-individuals-intellectual-disabilities-icfs/iid?form=MG0AV3

iv Nursing home estimates (≈150,000–200,000 adults with IDD) derived from CMS Minimum Data Set (MDS) resident characteristics, which show 10–15% of long‑stay nursing home residents have an intellectual or developmental disability. See: Centers for Medicare & Medicaid Services, “Intermediate Care Facilities for Individuals with Intellectual Disabilities (ICFs/IID),” https://www.cms.gov/medicare/health-safety-standards/certification-compliance/intermediate-care-facilities-individuals-intellectual-disabilities-icfs/iid.

v. Friedman PhD, Carli, Medicaid Home and Community-Based Services Waiver for People with Intellectual and Developmental Disabilities, CQL, The Council on Quality and Leadership, American Association on Intellectual and Developmental Disabilities (AAIDD)