Massachusetts' Bridgewater State Hospital, which treats mentally ill prison inmates, has reduced the use of seclusion and restraint to control inmates after the country's top hospital accrediting organization criticized it for frequent use of those measures.

The hospital has now instituted programs to reduce isolation and restraints, hospital Superintendent Kenneth Nelson told The Boston Globe. Hospital data showed that for the first three weeks of September, patients were restrained or secluded 152 times, compared to 260 times in the same period last year.

The hospital is run by the Department of Correction and houses 348 inmates. Judges often send mentally ill convicts and people facing criminal charges to Bridgewater for mental health evaluations.

The state Department of Correction stopped seeking accreditation from the Joint Commission on Accreditation of Health Care Organizations in 1994 because it felt it would cost too much to meet the group's standards for care and physical facilities. But many physicians and legislators, including state representative and psychiatric nurse Kay Khan, D-Newton, urged Bridgewater to seek national accreditation.

In 1997, the hospital decided to do so and has been working since that time to improve care.

On its first review, the joint commission granted Bridgewater accreditation earlier this year, as long as the hospital improved in several areas. Nelson said the hospital had to meet 700 joint commission standards, and had troubles with just 10 of them, mostly about the use of restraints and seclusion.

Joint commission reviewers, who visited the hospital last year, said prisoners were sometimes placed in tiny, locked rooms or strapped to their beds when they "refuse their medications" or because they have a "history of self-abuse," according to a Feb. 12 report obtained by the Globe.

The joint commission also found that during one month, prisoners were secluded for an average of 29 hours each, even if they were quiet and calm.

Reviewers recommended that mentally ill inmates should be secluded or restrained only if they were in danger of hurting themselves or another prisoner or employee.

In a follow-up report last month, reviewers said the hospital has improved, but needed to show more progress in four months or risk losing its accreditation.

Nelson said the new policies ensure that only licensed health care workers can restrain or seclude a patient. Restrained and secluded patients are also checked every 10 minutes, rather than every three hours, to determine whether they are calm enough to be freed, Nelson said.

"If a patient assaults another patient, a guard can put him in handcuffs, bring him to the intensive treatment unit, and have a clinical person assess him," he said. "Upper management is doing the training, so employees get the message from us about how important this is."