Mentally ill in prison: Isolation in solitary confinement exacerbates conditions

Mentally ill in prison: Isolation in solitary confinement exacerbates conditions

There are various reasons why mentally ill adults and juveniles in county jails, state or federal prisons aren’t advocated for. The main reason stems from an inability to care for themselves. The mentally ill population of county jails, as well as state and federal prisons – usually slips through the cracks, and as a result of any behavioral issues displayed, often due to lack of proper psychiatric treatment, are sent to solitary confinement. In most cases, those in solitary confinement have either displayed an inability to recognize and abide by prison rules, or they may be at a high risk of being physically harmed due to their mental illness.

Solitary confinement is a completely isolated placement of a prisoner in a federal or state prison, kept away from other prisoners and usually used as a form of internal penal discipline. The amount of time spent in solitary confinement can range from months to years, and is usually a 24/7 stay, with no time outside the cell. A solitary confinement unit usually consists of grey cement or steel walls, cement floor, no bars to see out or to communicate with other inmates, a toilet, shower, bed or hammock bed – and if the inmate is lucky a window or slot to see outside. In 2005, the United States had about 80,000 prisoners housed in solitary confinement units. (Calella, Ridgeway 2012)

The National Sheriff’s Association recently observed many U.S. jurisdictions have jails and prisons that hold more people with severe psychiatric illnesses than any psychiatric facility in the country. However, state and federal prisons hold the least amount of therapeutic resources for the severely mentally ill. According to A Directory of  Bureau of Prisons’ National Programs 2014, the three federal programs for inmates with mental illnesses are all residential programs; and the only nonresidential programs are for drug abusers and sex offenders. Despite the fact that some of the most heinous criminals are sent to maximum security prisons, there is still a need to address their mental health and psychiatric condition. (Bureau of Prisons 2014)

Although the American Psychological Association has developed and supported a set of standards for assessing and treating mental illnesses of the U.S. prison population, they still have yet to recognize the severe psychological consequences of solitary confinement, especially without psychological or psychiatric treatment. There is an extreme lack of oversight in regards to therapeutic treatment and medication management in the prison system, and especially with prisoners in solitary confinement, as they are rendered individuals that should be punished or kept away from other people. Any mental illness or psychiatric conditions requiring medication are often ignored, as many states prefer to allocate their funds towards programs that will benefit those who are cognizant enough to communicate with lawyers that will also represent them in court. Severely mentally ill people usually don’t have many legal advocates as a result of their inability to communicate effectively.

Isolation in solitary confinement exacerbates the mental health conditions the prisoners are admitted with as well as develop while in prison; and with lack of proper psychiatric treatment, or basic medication management, mentally ill populations in solitary confinement are prone to higher recidivism rates when released. Solitary confinement, lack of therapy, medication and the lack of support and guidance when released all create a vicious cycle of recidivisms. Recidivism and suicide rates among juvenile and adult offenders in solitary confinement are astonishingly high. Between 1995 and 1999, 110 juvenile suicides occurred in juvenile correctional and detention facilities; 62 percent of the victims had a history of room confinement. (Hayes 2009)

Psychological effects caused by solitary confinement include:   

  • Anxiety
  • Depression
  • Anger
  • Cognitive disturbances
  • Perceptual distortions
  • Hopelessness
  • Loss of time
  • Loss of purpose
  • Obsessive thoughts
  • Paranoia
  • Loss of identity
  • Loss of reality
  • Becoming delusional
  • Hypertension
  • Uncontrollable anger
  • Hallucinations
  • Emotional breakdowns
  • Chronic depression
  • Suicidal thoughts
  • Psychosis

Under the Eighth Amendment, prisoners have a right to be free from inhumane conditions that constitute “cruel and unusual punishment”. Medical care and attention to any long-term or short-term medical or mental health issues also must be given (H.R.401 — 113th Congress 2013-2014); however, the loophole clauses have allowed prisons to skirt around these issues.

Each State Attorney General has been authorized by the Justice and Mental Health Collaboration Act 2015 to award grants that will oblige officers and practitioners to care for the lives of all prisoners. It’s up to each state’s jurisdiction on whether they utilize the grant money for its particular programs. The Justice and Mental Health Collaboration Act allows for the following:

  • Support for mental health courts and crisis intervention teams;
  • Emphasizes evidence-based practices that have been proven to be effective through empirical evidence;
  • Authorize investments in veterans’ treatment courts, which serve many arrested veterans who suffer from PTSD, substance addiction and other mental health conditions;
  • Support the development of curricula for police academies and orientations;
  • Increase focus on corrections-based programs like transitional services that reduce recidivism and screening practices that identify inmate with mental health conditions;
  • Give local officials greater control over program participation eligibility.

Advocation for the mentally ill in all institutions will always be a great challenge.  Understanding the warning signs of mental illness in children and teens is more important now than ever before, so proper guidance and treatment can be initiated before any criminal activity begins. With prison populations growing exponentially, obtaining treatment for any mental health or substance use issues at any age can prevent an enormous amount of unnecessary suffering and abuse. When the actions of the weakest and most vulnerable of a society can cause major hurdles in the growth and safety of their communities, it’s tremendously important to pay attention to treating any mental health issues with psychotherapy and psychiatric treatment to prevent dire consequences of mental illness.

Getting proper treatment for mental illnesses such as bipolar, schizophrenia, borderline personality disorder, anxiety disorders or psychosis, as warning signs surface could prevent incarceration and solitary confinement. However, treating the mental illness during and after incarceration is just as important. We are here to help people get the mental health care they need and guide the mentally ill on their journey to recovery. Call us today for any questions you might have on mental illness or treatment for mental health disorders.