Challenging Solitary Confinement for People with Serious Mental Illness

Treatment Advocacy Center – Research Weekly Publication

by Morré Taylor; Photo by Khashayar Kouchpeydeh
By Morré Taylor (August 10, 2022) People with serious mental illness have a long history of being highly engaged in the criminal justice system, as at least 40% of individuals with serious mental illness have been in jail or prison during their lifetime, according to a Treatment Advocacy Center report. When people with serious mental illness are incarcerated, they are subjected to segregation, also known as restrictive housing or solitary confinement, more frequently than their peers without serious mental illness, according to a new study from The Prison Journal. 

Defined as spending 22 or more hours in a single cell for extended periods with little to no simulation or social contact, segregation is often used to punish inmates for infractions or separate those who are presumed to be dangerous to themselves or the rest of the prison population. This isolation, however, has been known to have short and long-term mental health consequences, such as worsening suicidality and depression. Some researchers and psychiatrists have even claimed that solitary confinement can induce hallucinations, panic attacks and paranoia, which are preexisting symptoms in many with serious mental illness. 

Study details For this study, the Vera Institute of Justice provided technical assistance to state corrections departments in five states between 2017 and 2019 with the goal of reducing segregated housing and providing effective alternatives. Looking at one state example, researchers investigated how many people with serious mental illness were in solitary confinement, the relationship between self-harm and isolation and whether correctional mental health policy was being followed. Administrative data containing demographic information, as well as movement data containing information on changes in housing status, segregation status and pending stays in disciplinary segregation were used in the researchers’ investigation. Data was collected from the state’s prison population as of June 30, 2016, totaling 20,824 inmates. 

Results Of the inmates observed in this study, 9.5% (n = 1,970) were identified as having serious mental illness and of those in maximum custody (15.7% or n = 3,272), 16.8% (n = 549) were identified as having serious mental illness. The researchers found that people with serious mental illness spent an average of 56.7 days longer in social isolation compared to those without serious mental illness. 

In the prison’s mental health treatment unit, 31 individuals were held in segregation-like conditions— 22 of whom had records of self-harm, which is a behavioral infraction for which someone can be put in isolation. Of those 22 individuals, 20 were identified as having serious mental illness. While the authors cannot suggest that segregation caused the self-harm, they were able to state that more people began self-harming while in segregation than before entering segregation.

With regard to whether correctional mental health policy was followed, the authors of this study found that 2.2% of the observed population did not receive a mental health assessment prior to entering segregation, which is a violation of standards set by the American Correctional Association. Additionally, no individual who was assigned to the most critical mental health indicator level was placed in a treatment unit, which is a deviation from Department of Corrections policy. 

Discussion and implications These findings highlight the problematic trends in which mental health symptoms, such as self-harm, are treated by placing individuals in solitary confinement, putting people with serious mental illness at high risk for segregation. To challenge these trends, the authors of this study encouraged the observed state prison to update their policies to reflect best practices regarding the diagnosis and treatment of serious mental illness, no longer classify suicide attempts and self-harm as a disciplinary offense and provide monthly mental health assessments for people in solitary confinement. The goal of these recommendations is to reduce time spent in segregation among people with serious mental illness whose disproportionate isolation currently prevents them from receiving the proper mental health treatment they require. 

References  Maszak-Prato, S., & Graham, L. (May 2022). Reducing the use of segregation for people with serious mental illness. The Prison Journal. 
Morré Taylor is a research intern at the Treatment Advocacy Center.

1 thought on “Challenging Solitary Confinement for People with Serious Mental Illness

  1. I am so touched by the poem “from the inside.” This poem is authentic, insightful and reflective. It speaks of our need as struggling human beings for self-compassion and healing. This poem inspires us to be kind not only to others but to remember to be kind to ourselves as well. To the poet, I thank you for the message.


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