7.3 The Problem of Solitary Confinement

Anne Nichol

7.3 The Problem of Solitary Confinement

As described by Pulitzer-Prize-winning journalist Ron Powers in his book No One Cares About Crazy People:

Among the most gruesome and least forgivable forms of sanctioned torture by prison [staff] is “punitive segregation,” as the delicate euphemism has it. The more familiar term is “solitary confinement.” Solitary confinement, even for brief periods—several days, say, with an hour’s respite each day—is known to trigger hallucinations and paranoia among sane and insane prisoners alike. For people already mad, it is a quick route to deep and lasting psychosis. The human psyche is essentially social and abhors isolation; enforced separation from others thus amounts to an act of sanctioned depravity.

Solitary confinement has been used as a short-duration measure in the past. In recent decades, overwhelmed wardens increasingly have turned to it in a hair-trigger way, popping prisoners into tiny, badly ventilated cells, often restricting food, water, and medications as part of the bargain. (Powers, 2017, pp. 147-48)

Solitary confinement, also called isolation or segregation, involves the placement of an incarcerated person in a cell alone, with their interactions strictly limited. Solitary confinement is generally used as a form of discipline for prison rule violations or as a method of keeping the isolated person or others safe (Cornell Law School, Legal Information Institute, 2021). The reality of confinement to a very small cell for days, hours, weeks, and even years is unthinkable for most people and hard to imagine for anyone who has not had this experience. Watch the short video linked in figure 7.8 to see and hear about the experience of solitary confinement as shared by inmates at a maximum security federal prison in California.

https://www.youtube.com/watch?v=Q7ajzsh-i54

Figure 7.8. This video provides a brief glimpse into the lives and thoughts of inmates living in segregation, or solitary confinement, in a federal prison in California. Transcript.

Solitary confinement is overused for people with mental disorders, and its ill effects are especially harmful for people with preexisting mental disorders. In addition, solitary is used disproportionately among people in other marginalized groups in criminal justice: transgender or gender non-conforming people, young people, and people of color, particularly Black and Hispanic men (Sandoval, 2023; Lantigua-Williams, 2016).

Overuse of Solitary Confinement

The use of solitary confinement has, deservedly, come under heightened scrutiny as its devastating harms are increasingly understood. For years, concerns have been raised from as high as the presidency that America’s prisons are overusing solitary confinement, in part as a by-product of prisons’—and society’s—failure to adequately treat and otherwise safely manage people with mental disorders. Despite pressure from the top and efforts in state and federal systems to limit its use, solitary confinement in various forms is still a frequent practice in jail and prison environments (U.S. Government Accountability Office [GAO], 2024).

The presence of a mental disorder, especially one that is not adequately treated, increases the likelihood of behavioral issues that correctional staff are ill-equipped to manage—and that may prompt the use of solitary confinement. The AVID Jail and Prison Projects both have a particular focus on the problem of segregating and isolating incarcerated people with mental disorders because this is a common and exceptionally harmful occurrence (Guy, 2016). The AVID Projects share stories that give specific names and faces to the reality that solitary confinement is routinely used to manage behaviors directly related to mental disorders. Watch the short videos from the AVID Jail Project (figure 7.9) and the AVID Prison Project (figure 7.10) to hear two men share their experiences enduring solitary confinement amidst mental illness. As you watch the videos, consider: Why should prisons try to maintain people with mental disorders in less restrictive environments, and how might that be accomplished?

https://www.youtube.com/watch?v=a0Q_4y6YCSQ

Figure 7.9. Ricardo Rodriguez speaks from a jail in King County Washington, where he has spent 6 months. Rodriguez has multiple serious mental illnesses and engages in self-harm driven by hallucinations. Transcript.

https://www.youtube.com/watch?v=DJZQAd5dkOs

Figure 7.10. Five Mualimm-ak, a formerly incarcerated, prison reform advocate, shares what it was like to be in prison with a mental disorder. Mualimm-ak served a substantial amount of time in solitary confinement due to rule violations. Transcript.

Harms of Solitary Confinement

Isolation in solitary confinement is known to be harmful to incarcerated people generally. For example, there is a clear connection between time in solitary confinement and physical harm or even death. A 2022 report indicated that while less than 10% of federal prisoners are in solitary confinement at any given time, those prisoners are at far greater risk of grave harm. Almost 40% of homicides and nearly half of suicides in custody occur among that group (Lartey & Thompson, 2024). For people with mental disorders, the risks of isolation and segregation are intensified, as solitary is likely to worsen pre-existing symptoms (Sandoval, 2023).

Consider the video linked in Figure 7.11, where a man in custody shares the lasting effects of his extended time in solitary confinement.

https://www.youtube.com/watch?v=zmzSjbKu6UI

Figure 7.11. Daniel Perez, a Washington State inmate with several mental health diagnoses, describes his time in prison. Perez explains that after spending many years in solitary confinement, he struggles to function—or even believe that he can function—in the typical prison environment. Transcript.

If you are interested in learning more about solitary confinement among people with mental disorders in prison and about collaborative advocacy efforts on their behalf, please consider exploring the AVID Prison Project webpage.

SPOTLIGHT: Solitary Confinement in Federal Prisons

Two different solitary confinement cells. They each have a narrow bed, a shower, and a place to sit. — **Figure 7.12.** Examples of two unoccupied restrictive housing cells in federal facilities.

As of 2023, the federal prison system, officially called the Federal Bureau of Prisons (BOP), routinely employed what it calls restrictive housing and what is commonly known as solitary confinement: isolating incarcerated people in cells for up to 23 hours per day (figure 7.12). People in restrictive housing are not permitted to leave their cells to attend programming or recreation or to intermingle with others in their unit. Numerous reports, admonitions, and proposals later, BOP continues to house about 8% of its population (about 12,000 inmates) in these settings, including a significant number of people with serious mental disorders.

The most common form of restrictive housing in federal prisons is the Special Housing Unit (SHU). These units are located at most federal facilities. People can be placed in a SHU for administrative or disciplinary reasons. Administrative segregation is intended to be “non-punitive,” so it might involve a person whose behavior is not controlled or who needs protection from others. SHU cells can be double- or single-bunked. Although isolation is not as severe as in a single cell, the dangers posed by a cellmate in these facilities can be substantial.

The federal system also has an entire facility, known as an Administrative Maximum Facility (ADX) that is located in Florence, Colorado. The ADX has only single cells, and it houses people who require the tightest controls and supervision. The unit has four programs, the most restrictive of which is the Control Unit, meant to house the most dangerous, violent, and disruptive incarcerated individuals (e.g., people who have assaulted or killed staff or other incarcerated people or who have escaped from another facility).

Additional restrictive housing intended to ensure safety was previously located in a “Special Management Unit (SMU)” located at Thomson Penitentiary in Illinois. However, the SMU was closed in 2023 after outside reporting revealed it to be incredibly unsafe—numerous homicides and suicides occurred there over a short period. All of the incarcerated people at the Thomson unit were relocated to a SHU in another facility. It is unclear whether the BOP will reopen this or another similar unit in the future (Khalid & Shapiro, 2023). If you are interested in learning more about the grim conditions at Thomson, consider reading this article about the people who were killed there [Website].

The BOP officially allows the housing of people with mental disorders in any of its restrictive options, with some loose limitations. Every new federal prisoner is required to receive a screening, intended to identify those who may need mental health or substance abuse treatment, and if necessary, evaluation of the identified concern. People with identified needs related to a mental disorder are assigned a care “level” from one to four that indicates the significance of their impairment and the degree of intervention required. People who are at the higher levels (levels 3 or 4) require more significant interventions, and BOP policy discourages “prolonged” placement of these people in the SHU or ADX. However, they continue to be placed there at higher rates than desired by BOP or observers. For example, more than 65,000 people at mental health levels 1 through 4 spent time in a SHU in 2022—a number that represents an increase of a few thousand from 2018. Around 450 people with mental health levels of 3 or 4 were held in either a SHU, SMU, or ADX in 2022, a slight increase over 2018 numbers.

Attempts to divert people with serious mental illness from restrictive housing in the federal prison system are ongoing. The BOP currently has only a few secure mental health treatment programs that could serve as alternatives to the standard solitary confinement options, but it plans to expand that capacity.