For those predisposed to mental illness, isolation can induce anxiety, depression, distortions, paranoia, even psychosis.
When President Obama announced the end of solitary confinement in federal prisons for juveniles and as a response to low-level infractions last week, he cited "devastating, lasting psychological consequences." Among them, research has shown that spending time in the hole makes people depressed, anxious, socially withdrawn, paranoid, and ultimately more likely to lash out. Being alone can drive someone crazy, but being alone inside a concrete box can ruin a person.
Prisons have been slowly reconsidering the use of solitary confinement, particularly within the past year: In September, California agreed to drastically scale back its use, including an end to indefinite isolation; three months later, New York promised to rehouse about 1,000 solitary confinement prisoners into less isolated units. Supreme Court Justice Anthony Kennedy told Congress last year the practice literally "drives men mad," and in July, President Obama ordered a Justice Department review of the practice, which he determined was "not smart."
But the president's recent actions only go so far as to address the 26 juveniles in federal prisons, leaving many more vulnerable. The practice is perhaps most damning to those who suffer from mental illness (or who are predisposed to mental illness), a population growing within prisons. Clinical studies have estimated that as many as 20 percent of inmates in correctional facilities are in need of psychiatric care, often due to a serious mental illness.
Without treatment, mental illness can manifest as bizarre behavior or rule breaking. As a result, by the US Bureau of Justice's own figures, 29 percent of prison inmates with symptoms of "psychological distress" have spent time in restrictive housing in the past year (in both state and federal prisons). Research has shown that isolation can exacerbate symptoms of mental illness, as well as induce anxiety, depression, distortions, paranoia, and even psychosis.
Laura Rovner, an associate law professor at the University of Denver, told me about an inmate she represented, who had no history of violence but a habit of self-harming. Each time he self-harmed, she said, prison officials extended his stay in solitary—"not for any other reason, I think, than that he was annoying them."
Cases like this explain the high rate of suicides and self-harm within solitary confinement: A study of inmates in California between 2006 and 2010 found that while 2 percent of the prison population were held in solitary, they accounted for 42 percent of all prison suicides. A similar study conducted in New York state prisons found that 53 percent of incidents of self-harm and 45 percent of suicide attempts took place in solitary.
The Bureau of Prisons' regulations prohibit isolating prisoners who "show evidence of significant mental disorder." But in 2012, the Bureau of Prisons was sued for sending mentally ill prisoners to the US Penitentiary Administrative Maximum Facility in Florence, Colorado—the country's highest security prison, known as the ADX—where they were effectively isolated. ADX houses all its inmates in single-bed cells where they are kept for 23 hours a day in a condition which Robert Hood, the warden of the ADX from 2002 until 2005, once described as a "clean version of hell."
The lawsuit, filed on behalf of 11 prisoners held at the facility, claimed that by putting them in the ADX the Bureau of Prisons had violated its own rules. One of the prisoners in the lawsuit was Jack Powers, a convicted bank robber from New York, who was sent to the ADX in 2001 after breaking out of prison in Atlanta. In the next decade, as his mind started to unravel, Powers engaged in a litany of increasingly shocking acts of self-harm: He cut off both ear lobes, chewed off a finger, swallowed a toothbrush and then cut open his abdomen to retrieve it. He also slit his wrists, writing "American Gulag" in blood on his bed sheets.
The suit alleges that, despite this, prison doctors consistently denied he was mentally ill, refusing him psychotropic medication which may have alleviated his suffering but would also have been an admission that he didn't belong at the ADX.
"The mental anguish of 28 years of solitary confinement is worse than any physical pain I have ever suffered or imagined." — Tommy Silverstein
Rovner has represented a number of prisoners housed at the ADX, including Tommy Silverstein, a former Aryan Brotherhood member who killed a prison guard in 1983 at the Marion penitentiary in Illinois. The murder led to the jail's conversion to an all-lockdown facility, a move that arguably helped usher in the rise of supermax facilities like ADX.
Following the murder, the Bureau of Prisons went to extreme lengths to isolate Silverstein. He was made the subject of a "no human contact" order and housed in a purpose-built unit that became known as the "Silverstein suite" and was equipped with its own exercise yard to prevent contact with other prisoners. Aside from prison staff, he barely saw anyone for the next 15 years. In 2005, he was moved to the ADX, where his solitary confinement continued.
In 2011, in a legal challenge to end his isolation, Rovner had Silverstein examined by Dr. Craig Haney, a psychology professor at the University of California and one of the country's leading experts on the psychological impact of solitary confinement. Haney's assessment noted "extreme anxiety, sleeplessness, despair and hopelessness, depression," among other mental ailments.
"His was the most isolated form of long-term confinement I have ever encountered," Haney said in his report. "As a result, Mr. Silverstein has not had a remotely normal social interaction or touched another human being with affection for more than a quarter century."
As part of the same case, Silverstein also wrote a lengthy declaration in which he describes both his remorse for his past crimes (he has been a practicing Buddhist for many years now) and the devastating effect of his isolation on his mental faculties. The declaration describes hallucinations of human shadows outside of his cell window, constant anxiety, a mind permanently fogged, a body shaking uncontrollably at the physical contact of having his hair cut.
"The mental anguish of 28 years of solitary confinement is worse than any physical pain I have ever suffered or imagined," he wrote. "The indefiniteness of my confinement makes my mental suffering never-ending."
Silverstein, who is 63, lost his case and remains in solitary to this day.
President Obama's statement last week acknowledged the substantial population of mentally ill prisoners who are sent to solitary confinement, and pledged to start "expanding treatment for the mentally ill and increasing the amount of time inmates in solitary can spend outside of their cells." But it remains to be seen whether his actions will end the practice altogether and prevent the exacerbation of mental health issues for those who so desperately need help.
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