Solitary Confinement and Mental Health

Background

Solitary confinement by any other name, whether it is ‘restrictive housing’, ‘lock-down’, or ‘segregation’, is essentially the same in any prison. Putting a prisoner in solitary confinement involves placing them in a tiny, single-occupancy cell with no natural light, removed from other prisoners, for anywhere from 22 to a full 24 hours a day. Trays of food are placed through a small slot in the door. If prisoners are not kept the full 24 hours, they may be allowed to walk around for a short amount of time, but this occurs at a different time than for the other prisoners, so there is no social contact involved.

There are numerous reasons prison staff choose to place inmates in solitary confinement. It may be a punitive course of action, whether for minor or serious transgressions. Prisoners can be punished with solitary confinement if staff find that they have contraband materials, witness them fighting with other prisoners, or if they are insolent toward guards. It is also not uncommon for staff to use solitary confinement as a preventative course of action, if they believe certain prisoners could pose a future behavioral problem or will form gang-like alliances with other inmates.

The main types of solitary confinement and how common they are for what duration of time are shown in the figure above. Administrative solitary is the type used when a certain inmate poses a risk to themselves or their fellow inmates, so guards use it as a preventative method, hoping to avoid fights being caused or the security of the institution being breached. Disciplinary solitary is used if an inmate has actually committed a punishable (how this is defined depends completely on the strictness of the guard in question) offense while in prison. Protective solitary is used to ‘protect’ an inmate who is vulnerable for some reason, if it is believed by the guards that the other inmates could pose a risk to this inmate’s safety. 

Prevalence of Use

The first figure below, from the Association of State Correctional Administrators Report, shows the percentage of the general prison population by state that has been kept in solitary confinement for 22 hours or more a day for 15 or more days. Louisiana has the highest, at nearly 15 percent, while Hawaii is the lowest, around 1 percent.

The second figure shows how many people spent how much time in solitary confinement, with each line representing a different state. 

Claimed Benefits

Proponents of the use of solitary confinement cite a wide variety of benefits that can be derived from the practice. It can be used as a tool to restrict certain inmates from being a threat to others, or even to ‘protect’ certain inmates from others to whom they may be vulnerable. Being in solitary confinement can allegedly reform the character of an inmate for the better, preventing future offenses once they are eventually released from prison. Prison guards can use it to maintain a sense of order within the prison, as well as controlling negative behavior of other inmates who may fear being placed in solitary confinement and thus be motivated to behave well.

Rebuttal Data

It has been proven that recidivism rates are just as high, if not higher, for those prisoners who have spent time in solitary confinement. According to data from the ACLU, in 2006, 49% of all inmates released from Texas prisons were rearrested in three years or fewer, while the rate of rearrest over the same time period for inmates released directly from solitary confinement was 61%. In 2001, over the same three-year time period in Connecticut, 66% of inmates not kept in solitary were rearrested, while 92% of those who had been were. According to a 2007 study of 200 prisoners who committed felonies after release, funded by the University of Washington and conducted by David Lovell, the prisoners who had never spent time in solitary confinement had a median time of 27 months between their release and committing the act. For the prisoners who had, the median time was 12 months.

Mental Health Over Time

Why does solitary confinement negatively affect the mental health of prisoners? The answer involves a combination of factors. The first and most significant is that human beings are social animals. Our brains literally depend on social contact and connection to stay healthy and to keep our neural connections alive and functioning. Another factor is the lack of stimuli. In some cases, prisoners are allowed to read books while in solitary, but in general, no entertainment of any kind is permitted. Prisoners thought to be at risk of self-harm or suicide cannot even keep things like blankets in their cell for fear they will smother themselves with it. Since their brains have nothing to process and nothing new to sense, their synapses begin to atrophy. This can lead to an imbalance of neurotransmitters in the brain.

There are five main categories of adverse mental health effects that result from prolonged time spent in solitary confinement. The first three categories are symptoms of depression, aggression, and anxiety/stress; the fourth is schizophrenic symptoms like delusions, hallucinations, and paranoia, and the last is a general desire to self-harm and/or commit suicide.

Depression

In a long-term 1993 study by Bauer and colleagues, it was shown that prisoners who had undergone long-term solitary confinement had increased symptoms of depression, such as hopelessness, lack of pleasure in formerly enjoyed activities, and feelings of isolation even among others.

Self-harm/suicidal ideation

Closely linked to depression, self-injury and suicidal thoughts/impulses are also strongly correlated. According to the diathesis-stress model of psychology, inmates who are already diagnosed with mental illness and who are placed into solitary have a much higher risk of committing serious self-injury than normal. A data set from 2010-2013 compiled by Kaba, et al. in 2014, shows that among 240,000 inmate medical records, 53% of the recorded acts of self-harm had been from prisoners in solitary confinement, though there were only 1,303 inmates in this group who had been in solitary.

Anxiety

In a four-day-long 1963 study conducted by Walters, Callagan, and Newman, a group of 20 prisoners in solitary confinement was compared to a control group of 20 prisoners in normal prison housing. Symptoms of anxiety showed a documented increase over this period for the first group, but no change for the second.

Aggression

Signs of aggression create a vicious cycle for certain inmates, because these signs are seen by guards as inappropriate behavior. Thus inmates exhibiting such behaviors will often be punished with solitary confinement, exacerbating their feelings of aggression and risk of violent behavior. As shown by a 2007 study by Arriago et al., the most significant risk factors of solitary confinement that lead to increased aggression are the lack of social contact and the lack of sunlight, since these cause harm both physically and mentally, creating a perfect biopsychosocial storm.

Schizophrenia

Schizophrenia, which is a separation from reality marked by delusions, hallucinations, and severe paranoia, is slightly different from the first four adverse mental health effects of solitary confinement because its use does not necessarily cause schizophrenia but may bring on episodes of those for whom it has been inherited but lies dormant, or worsen the symptoms in those prisoners who already have it. Psychologists and psychiatrists describe this phenomenon as ‘decompensation’: people with mental illness, when placed into stressful situations like solitary confinement, find it impossible to maintain appropriate psychological defenses and coping mechanisms, causing the stress of the situation to magnify the symptoms of their mental illness.

The prevalence of all these effects is prominently correlated with the length of time a prisoner spends in solitary confinement. However, in vulnerable populations of prisoners, such as minors and those who already had instances of severe mental illness prior to incarceration, any length of time spent in solitary confinement causes these effects to show up more.

Other Issues with Solitary Confinement

Putting a prisoner in solitary confinement costs a great deal more than putting a prisoner in a normal cell. Exactly how much more expensive it is varies by prison and state, but it is evidently quite costly. Each day a prisoner spends in solitary increases this cost as well.

Another significant issue with the use of solitary confinement is that the behaviors disciplinary segregation attempts to control can often be amplified rather than curbed. Psychologically speaking, in terms of operant conditioning, positive punishment adds something adverse in hopes of lessening the frequency of a behavior. However, whether conditioning is punishment or reinforcement is defined by its effect on behavior, so if a behavior happens more frequently as a result of conditioning, the conditioning is actually reinforcement rather than punishment. The psychological ill-effects of time spent in solitary can create harmful conditioning associations that benefit nobody involved in the situation.

The Future of Solitary Confinement

Great strides have been made in the effort to reduce and eventually phase out the use of solitary confinement in prisons. In 1987, the United Nations signed into effect the Convention Against Torture, an international human rights treaty specifically targeting torturous practices. Torture as defined by the convention is an intentional, state-sanctioned act causing severe physical or mental pain, used for punishment or an assortment of other reasons. 

The United Nations has condemned the United States’ choice to use solitary confinement in prisons on many occasions since the signing of the Convention Against Torture. Representatives of the UN have stated that the practice can constitute torture if it is used as a punishment, if it is used before a prisoner’s trial occurs, if it is extended or even indefinite, or if it used is used on individuals without a fully developed capacity to reason, namely minors and those with mental disabilities.

The Fight Continues

An important and effective tool in the fight to reduce and eventually phase out the use of solitary confinement in prisons is litigation. Various inmates and powerful groups such as the New York Civil Liberties Union, the Center for Constitutional Rights, and Human Rights Watch have all brought about lawsuits and/or encouraged the review of isolation policies. Additionally, in 2012, the U.S. Senate held hearings, from which they declared that solitary confinement is not only wasteful and ineffective, but also a violation of human rights.

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