Mental Health Issues in Long-Term Solitary and “Supermax” Confinement (original) (raw)
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Placement of prisoners in 'strip' cells has been criticized as inappropriate for those with psychotic symptoms and at risk of suicide and self-harm. A national survey confirmed that prisoners who reported having been placed in special cells had extensive histories of previous psychiatric treatment, parasuicide and diagnoses of depression and schizophrenia. They were more likely to have cluster A and C Axis II personality disorders and criminal histories of arson and sexual offending. Current policy for mentally disordered prisoners who pose risks to themselves and others reflects the lack of more appropriate facilities for disturbed mentally disordered individuals in prison and psychiatric hospitals, and the failure of 'diversion' to NHS psychiatric inpatient facilities. In future, all prisoners placed in 'strip' cell conditions should receive specialist psychiatric assessment.
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The journal of the American Academy of Psychiatry and the Law, 2010
In recent years, prison officials have increasingly turned to solitary confinement as a way to manage difficult or dangerous prisoners. Many of the prisoners subjected to isolation, which can extend for years, have serious mental illness, and the conditions of solitary confinement can exacerbate their symptoms or provoke recurrence. Prison rules for isolated prisoners, however, greatly restrict the nature and quantity of mental health services that they can receive. In this article, we describe the use of isolation (called segregation by prison officials) to confine prisoners with serious mental illness, the psychological consequences of such confinement, and the response of U.S. courts and human rights experts. We then address the challenges and human rights responsibilities of physicians confronting this prison practice. We conclude by urging professional organizations to adopt formal positions against the prolonged isolation of prisoners with serious mental illness.
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As a growing number of individuals suffering from serious mental illness are consigned to prison and selectively relegated to long-term isolated confinement, there is a newly expanded subpopulation of prisoners approaching their release from prison while exhibiting signs of mental illness and repeatedly violating rules. An attribution error and various forms of obfuscation divert attention from a cycle of longer stints in isolation and more rule-breaking behavior, until the time arrives to release the “disturbed/disruptive” prisoner. Since this subpopulation of prisoners is deemed dangerous, there is a crisis in the criminal justice system. There are attempts to solve the crisis by convicting the prisoner of additional crimes to extend prison tenure or by activating postincarceration civil commitment to a psychiatric hospital. These trends are examined, and the question is raised whether they address the core problems in the criminal justice system that result in more prisoners near...
Psychological Distress in Solitary Confinement: Symptoms, Severity, and Prevalence in the
American Journal of Public Health, 2020
Objectives. To specify symptoms and measure prevalence of psychological distress among incarcerated people in long-term solitary confinement. Methods. We gathered data via semistructured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for 106 randomly selected people in solitary confinement in the Washington State Department of Corrections in 2017. We performed 1-year follow-up interviews and BPRS assessments with 80 of these incarcerated people, and we present the results of our qualitative content analysis and descriptive statistics. Results. BPRS results showed clinically significant symptoms of depression, anxiety, or guilt among half of our research sample. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations. Interview content analysis revealed additional symptoms, including social isolation, loss of identity, and sensory hypersensitivity. Conclusions. Our coordinated study of rating scale, interview, and administrative data illustrates the public health crisis of solitary confinement. Because 95% or more of all incarcerated people, including those who experienced solitary confinement, are eventually released, understanding disproportionate psychopathology matters for developing prevention policies and addressing the unique needs of people who have experienced solitary confinement, an extreme element of mass incarceration. (Am J
International Journal of Mental Health Nursing, 2020
The aim of this meta-analysis was to examine the association between any mental health problem and the risk of being placed into solitary confinement in correctional settings. PubMed, PsycINFO, Web of Science and Google Scholar were searched from each database's inception date to November 2019. All publications assessing both mental health problems and placement into solitary confinement in a sample of adult inmates in correctional settings were included. The meta-analysis was performed using random-effects models. Heterogeneity among study point estimates was assessed with Q statistics and quantified with I 2 index. Publication bias was assessed with funnel plots. Guidelines from Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) were followed throughout. After screening 2777 potential studies, 11 studies were included amounting to a total of 163 414 inmates. Included studies comprised of a mix of mental disorders rather than a specific diagnosis per se. The odds ratio (OR) from the pooled studies was 1.62 (confidence interval (CI) = 1.21-2.15). The observed relationship remained unchanged regardless of the removal of outliers (OR = 1.63, CI = 1.47-1.80) and regardless of the adjustment of confounders (OR = 1.58, CI = 1.32-1.88). The present study shows a moderate association between any mental health problem and placement into solitary confinement within a considerable sample of inmates. As more individuals suffering from mental illness enter the correctional system, it is essential that correction officials create new safe interventions to manage these inmates and offer them proper mental health care to limit the use of solitary confinement, which may have deleterious effects.
American Journal of Public Health, 2020
Objectives. To specify symptoms and measure prevalence of psychological distress among incarcerated people in long-term solitary confinement. Methods. We gathered data via semistructured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for 106 randomly selected people in solitary confinement in the Washington State Department of Corrections in 2017. We performed 1-year follow-up interviews and BPRS assessments with 80 of these incarcerated people, and we present the results of our qualitative content analysis and descriptive statistics. Results. BPRS results showed clinically significant symptoms of depression, anxiety, or guilt among half of our research sample. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations. Interview content analysis revealed additional symptoms, including social isolation, loss of ...
Supermax institutions and solitary confinement: History, term definition and rationale for spreading
Crimen - Journal for Criminal Jutice, 2019
After short reminding on more than one-century abandoned Philadelphian model of solitary confinement, definition of supermax prison has been given: this is penitentiary institution in which persons deprived of freedom are held in the long cell confinement by a decision of authorities in the conditions of strict control and supervision. By opinion of the author, this definition includes all institutions if they satisfied stated condition, regardless of organizational model, judicial status of persons situated in those institutions, as well as decision and reasons of detention. The birthplace of this institutions are USA, and time of its introduction (the last quarter of 20th century) is characterized by sharpening of criminal reaction in the wave of penal populism and strengthening of retributive models of sentencing which broth to brutal rebellions in the prisons, which has been violently suppressed, and resulted in more serious rebellions. Way out form this circle of violence was traced in institutions in which prisoners are whole day isolated without any human communication. This new solution has been popularized not only by penitential authorities, but also by: workers in the prison industry complex; local communities in which those prisons are situated; and by citizens, to whom has been suggested that is the only way to protect themselves from the most dangerous criminals. At first sight, we can recognize that those arguments are without serious weight. Although those institutions still survive and represent one of the bases of the penitential system in America. This trend, with few exceptions, has spread in the other parts of the world, including Serbia, in which the heaviest crime perpetrators can be sanded to isolation by the court decision.