America’s prison population is the largest in the world, with 2.2 million people incarcerated across federal, state and local levels — representing a four-fold increase since 1973. A 2014 U.S. National Research Council report notes that in 2012 roughly one quarter of the world’s entire prison population was housed in the United States; about 1 in every 100 American adults are in prison.
One correctional facility practice that has come under scrutiny in recent years is the separation of prisoners into special quarters for the purposes of safety or additional punishment. Known variously as “solitary confinement,” “isolation,” “segregation,” “special management” or “restricted housing,” the practice frequently involves putting prisoners in small, confined spaces for months, even years. Curbing this practice has become a central focus of prison reform and has spurred the “Stop Solitary” movement, which argues that it constitutes inhumane treatment and makes things considerably worse for the sizable mentally ill population now in U.S. prisons. Meanwhile, journalists continue to investigate and make more visible issues relating to the psychology of isolation, the day-to-day realities of extreme confinement and activism by prisoners. In January 2016, President Obama announced that he was adopting a list of recommendations made by the U.S. Department of Justice aimed at limiting the use of restrictive housing in federal prisons. The changes called for, among other things, ending solitary confinement for juveniles and increasing the number of hours that inmates who have been placed in solitary confinement spend outside their cells.
At the time of the 2013 GAO report, the federal system confined about 7.1 percent of its 217,000 prisoners in solitary units for roughly 23 hours a day. Within the federal system, there are different types and levels of confinement, referred to as Special Housing Units (SHU), Special Management Units (SMU) and Administrative Maximum (ADX). Increasing use of solitary confinement had taken place across the federal system, the report notes: “From fiscal year 2008 through February 2013, the total inmate population in segregated housing units increased approximately 17 percent — from 10,659 to 12,460 inmates. By comparison, the total inmate population in BOP facilities increased by about 6 percent during this period.” Housing prisoners this way is more expensive because it is more staff-intensive. While costs per inmate at federal facilities are around $57 a day for a medium-security and $69 for a high-security prison, those costs rise to $78 and $93 a day, respectively, for prisoners in segregated housing units. For administrative maximum units, costs can rise to $216 a day per inmate.
A 2012 report from the Colorado Department of Corrections found that prisoners spent a mean of 19.5 months in isolation. Some were sent there because of infractions such as assaults on staff or other prisoners, while many others were sent because of gang or drug-related activity.
A 2014 study published in the American Journal of Public Health, “Solitary Confinement and Risk of Self-Harm Among Jail Inmates,” analyzes the medical records of more than 134,000 prisoners, with a combined 245,000 incarcerations, over the period 2010-2013. The researchers are doctors and mental health experts affiliated with the New York City Department of Health and Mental Hygiene. Among the population of prisoners studied, about 56.1 percent were non-Hispanic Black, 31.6 percent were Hispanic and 8.4 percent were non-Hispanic white. This study provides unique insight into city and municipal jails, where inmates frequently receive shorter stays in solitary confinement than they sometimes see in state and federal systems.
Of all the incarcerations analyzed, 4 percent involved inmates who were diagnosed with serious mental illness. Overall, 7.3 percent of incarcerations involved solitary confinement.
In many ways, the use of long-term segregation needs to be reviewed. It can create or exacerbate serious psychological change in some inmates and make it difficult for them to return to the general population of a prison or to the community outside prison. Although certain highly disruptive inmates may at times need to be segregated from others, use of this practice is best minimized, and accompanied by specific criteria for placement and regular meaningful reviews for those that are thus confined. Long-term segregation is not an appropriate setting for seriously mentally ill inmates. In all cases, it is important to ensure that those prisoners who are confined in segregation are monitored closely and effectively for any sign of psychological deterioration.
The 2008 paper “The Psychological Effects of Solitary Confinement on Prisoners in Supermax Units: Reviewing what We Know and Recommending What Should Change” and the 2010 paper “Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics” also provide vital background. Further, the American Civil Liberties Union, which advocates against the use of solitary confinement, has issued a 2014 report about the experiences of women inmates.
Citation: Venters, Homer; et al. “Solitary Confinement and Risk of Self-Harm Among Jail Inmates,” American Journal of Public Health, March 2014, Vol 104, No. 3. doi: 10.2105/AJPH.2013.301742.