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Handling violent behavior within correctional settings is an unforgiving task. Correctional officers, prison administrators, and behavioral health staff alike will attest to this fact. From time to time, news stories highlight the potential tragic endpoints of attempts to remedy violent behavior of incarcerated persons.
Solitary confinement, also referred to as segregation, seclusion, or isolation, has been one practice designed to remedy disciplinary problems. As it sounds, solitary confinement comprises a singular cell for a prisoner imposed for a number of reasons, most commonly violent behavior. It is also sometimes employed as a preventive measure for incarcerated persons expressing suicidal and self-harming intent.
In Western nations, solitary confinement has drawn widespread criticism as a practice for any purpose. Federal standards require the notion of using the least restrictive environment to guide decisions for solitary confinement of incarcerated persons. However, solitary confinement has been the subject of criticism and lawsuits by civil rights organizations among other entities. In large part due to concerns about humane treatment of incarcerated persons, the National Commission on Correctional Health Care, among other professional organizations, released a 2016 position statement condemning the use of solitary confinement. The National Commission provides further guidance on best practices for violence prevention in correctional settings.
Research and practice literature in fields like psychology and criminal justice have debated the effectiveness, impacts, and future of solitary confinement. Recently, Ellie Brown of the Institute of Criminology at the University of Cambridge, published an article entitled, "A systematic review of the effects of prison segregation" in the journal Aggression and Violent Behavior. Her review of almost 40 years of solitary confinement literature provides an up-to-date take on the appropriateness of the practice. Specifically, Ms. Brown synthesized a dense behavioral science literature to assess impacts and provide research-informed guidance moving forward. Here are three takeaways from the review.
The relationship between solitary confinement and psychological health is complicated.
Many lay and scientific entities have made the argument that solitary confinement is inhumane in part due to its negative effects on mental health. Ms. Brown’s review certainly leaves little doubt of the high likelihood that solitary confinement can pose risk to a person’s mental health. A number of studies demonstrate such impacts, particularly for risk of self-harm. However, a number of studies yield no such patterns. It is important to note that virtually no evidence was found to support positive mental health outcomes associated with solitary confinement.
What makes the relationship complicated? For one, Ms. Brown’s review raises the possibility that pre-existing mental illness (e.g., thinking disorders, prior suicide attempt, and self-harm behavior) and interpersonal deficits (e.g., poor social skills) concerns exist among those who tend to be placed in solitary confinement. Further, pre-existing deficits may worsen solitary confinement-based mental health outcomes. A legitimate question to ask seems to be whether, at a minimum, solitary confinement should be ruled out for persons with documentable pre-existing mental health or related conditions.
Solitary confinement doesn’t work.
Recall that a primary goal of solitary confinement is violence prevention. Ms. Brown’s review dug into whether solitary confinement affected a range of outcomes germane to violence, such as violent misconduct while incarcerated and later re-arrest and re-incarceration. The body of evidence shows absolutely no support that solitary confinement reduces violence or improves any of these outcomes. At best, solitary confinement does not make violence risk worse; however, some data exist suggesting solitary confinement may actually make violence more likely during and after institutionalization.
Two important caveats exist to the interpretation of mental health and violence prevention outcomes. First, much of the scientific evidence is based on what Ms. Brown labels as institutional data, meaning analyses are based on records kept by correctional institutions. Such administrative data is potentially fraught with inaccurate or biased reporting on the part of corrections employees. Additionally, mental health information is commonly drawn from self-report measures more appropriate for clinical, as opposed to correctional, settings. Thus, we may draw the wrong conclusions about the nature of conditions like depression based on inappropriate use of standard clinical assessment tools with persons who may not respond to them as intended. More objective ways of assessing incarcerated persons’ mental health and violent behavior are very clearly needed.
A second caveat is seen in the quality of the existing scientific evidence on solitary confinement. A standard part of systematic reviews (i.e., comprehensive reviews of an area of scientific research) is to assess the rigor and strength of the methods used in a body of research. Ms. Brown concluded the overall strength of the solitary confinement as weak, meaning significant limitations exist such as lack of comparison groups and the possibility of alternate explanations of findings.
The way forward for understanding solitary confinement is through narrative exploration.
The drawbacks of solitary confinement scientific study to date have been documented by Ms. Brown. She rightly points out that the use of traditional quantitative clinical measures may fail in their intended scientific purpose. An alternative take on solitary confinement is that the experience is unique to the individual. As such, the best path to capturing the variation and depth of the experience may be through qualitative interview methods. More simply, we need to use interview methods to fully capture the potential trauma or negative impacts of solitary confinement.
Solitary confinement will remain a controversy in the correctional and mental health fields. Ending its use does not seem likely in the near future. Should we desire to fully understand this restrictive approach to violence prevention, more forethought is required regarding evaluation design and data collection strategies.
