Solitary confinement

== Effects ==

=== Psychological ===
[[File:Fort Christiansvaern Christiansted St Croix USVI 07.jpg|thumb|Solitary confinement cell at [[Fort Christiansværn]], [[United States Virgin Islands]]]]

Solitary confinement has been associated with significant negative effects on mental health.<ref name=walker2013>{{cite journal |last1=Walker|first1=J. |last2=Illingworth|first2=C. |last3=Canning|first3=A. |last4=Garner|first4=E. |last5=Woolley|first5=J. |last6=Taylor|first6=P. |last7=Amos|first7=T. |title=Changes in Mental State Associated with Prison Environments: A Systematic Review |date=18 November 2013 <!--Epub--> |journal=[[Acta Psychiatrica Scandinavica]] |volume=129 |issue=6 |pages=427–36 |doi=10.1111/acps.12221 |display-authors=1 |pmid=24237622|s2cid=9187097 }}</ref> Research indicates that the psychological effects of solitary confinement may encompass a range of adverse symptoms including "[[anxiety]], [[Depression (mood)|depression]], anger, [[Cognitive distortion|cognitive disturbances]], [[Sensory processing disorder|perceptual distortions]], obsessive thoughts, [[paranoia]], and [[psychosis]]."<ref name=metzner2010>{{cite journal |last1=Metzner |first1=Jeffrey L. |last2=Fellner |first2=Jamie |title=Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics |date=March 2010 |journal=[[Journal of the American Academy of Psychiatry and the Law|J Am Acad Psychiatry Law]] |volume=38 |issue=1 |pages=104–108 |pmid=20305083 |url=http://www.jaapl.org/content/38/1/104.full |access-date=18 March 2014 |archive-date=25 June 2014 |archive-url=https://web.archive.org/web/20140625065631/http://www.jaapl.org/content/38/1/104.full |url-status=live }}</ref> These symptoms are so widespread among individuals held in solitary that some psychiatrists have labeled them "SHU Syndrome," with SHU standing for Special Housing Unit or Security Housing Unit. In a 1983 journal article, Stuart Grassian described SHU Syndrome as a "major, clinically distinguishable psychiatric syndrome."<ref name="Grassian1983">{{cite journal |last=Grassian |first=Stuart |date=November 1983 |title=Psychopathological effects of solitary confinement |journal=[[American Journal of Psychiatry]] |volume=140 |issue=11 |pages=1450–1454 |doi=10.1176/ajp.140.11.1450 |pmid=6624990 |s2cid=6716834 }}</ref> Grassian notes solitary confinement can cause extremely vivid hallucinations in multiple sensory modalities including visual, auditory, tactile, olfactory. Some other effects include dissociative features including amnesia, motor excitement with aimless violence and delusions.<ref name="Grassian1983"/>
  
For those who enter the prison system already diagnosed with a mental illness, solitary confinement can significantly worsen their condition. Incarcerated individuals with mental health conditions often "[[Decompensation|decompensate]] in isolation, requiring crisis care or psychiatric hospitalization."<ref name=metzner2010/> The lack of human contact and [[sensory deprivation]] that characterize solitary confinement have been shown to cause permanent or semi-permanent changes to brain physiology. <ref name="Grassian2006">{{cite journal |last=Grassian |first=Stuart |url=http://openscholarship.wustl.edu/cgi/viewcontent.cgi?article=1362&context=law_journal_law_policy |title=Psychiatric effects of solitary confinement |date=January 2006 |journal=[[Washington University School of Law|Wash. U. J. L. & Pol'y]] |volume=22 |page=325 |format=PDF <!--redacted, non-institution and non-inmate specific version of a declaration submitted in September 1993 in ''Madrid v. Gomez'', 889F.Supp.1146--> |access-date=18 June 2008 |archive-date=21 February 2015 |archive-url=https://web.archive.org/web/20150221160459/http://openscholarship.wustl.edu/cgi/viewcontent.cgi?article=1362&context=law_journal_law_policy |url-status=live }}</ref> Alterations to brain physiology can lead individuals to commit [[suicide]] or [[self-harm]].<ref>{{cite journal |last=Haney |first=Craig |title=Mental Health Issues in Long-Term Solitary and "Supermax" Confinement |date=January 2003 |journal=[[Crime & Delinquency]] |volume=49 |issue=1 |pages=124–156 |doi=10.1177/0011128702239239 |s2cid=145380807 }}</ref> 

====Self-harm====

A major issue within the prison system in general, and solitary confinement in particular, is the high number of incarcerated individuals who turn to [[self-harm]]. Self-harm in carceral settings can include, but is not limited to, cutting, head-banging, and swallowing foreign objects.<ref name=kaba2014>{{cite journal |last1=Kaba|first1=Fatos |last2=Lewis|first2=Andrea |last3=Sarah|first3=Glowa-Kollisch |last4=Hadler|first4=James |last5=Lee|first5=David |last6=Alper|first6=Howard |last7=Selling|first7=Daniel |last8=MacDonald|first8=Ross |last9=Solimo|first9=Angela <!--and Amanda Parsons, Homer Venters--> |title=Solitary Confinement and Risk of Self-Harm Among Jail Inmates |journal=[[American Journal of Public Health]] |volume=104 |issue=3 |date=March 2014 |pages=442–447 |display-authors=1 |doi=10.2105/ajph.2013.301742 |pmid=24521238 |pmc=3953781}}</ref> 

A 2014 study of New York City jail admissions published in the ''[[American Journal of Public Health]]'' found that, after controlling for length of jail stay, age, race/ethnicity, and mental illness status, individuals placed in solitary confinement were 6.9 times more likely to commit self-harm and 6.3 times more likely to commit potentially fatal self-harm than the general jail population. While 7.3 percent of jail stays included any time in solitary, 53.3 percent of acts of self-harm and 45 percent of acts of potentially fatal self harm took place among people who had spent time in solitary during their stay.<ref name=kaba2014/>

Incarcerated individuals who attempt self-harm or suicide are often placed on [[suicide watch]], an intensive form of [[Social isolation|isolation]] and monitoring that takes place in a "bare cell" with few if any furnishings. While on suicide watch, individuals are typically denied clothing and bedding (to prevent them from hanging themselves using bedsheets), as well as programming and contact visits. Though these conditions are intended to prevent individuals from committing suicide, they often exacerbate [[psychological trauma|trauma]] and other pre-existing mental health conditions.<ref>{{cite web |last1=Quandt |first1=Katie Rose |title=When 'Suicide Watch' Becomes a Death Sentence |url=https://www.thenation.com/article/society/suicide-watch-death-sentence/ |website=The Nation |access-date=28 June 2023 |date=22 May 2023}}</ref> Despite controls in place, individuals in suicide watch cells have still found ways to harm themselves.<ref name="Bottos2007"/>

===Physical===

Solitary confinement has been reported to cause [[hypertension]], [[headaches]], profuse sweating, [[dizziness]], and [[heart palpitations]].<ref>{{cite book |last1=Shalev |first1=Sharon |title=Prisons in health |date=2014 |publisher=World Health Organization, Regional Office for Europe |location=Copenhagen |isbn=978-92-890-5059-3 |pages=27–35}}</ref> Many individuals in solitary experience extreme weight loss due to digestion complications and abdominal pain. They can also develop neck and back pain and muscle stiffness due to long periods of little to no physical activity. These symptoms have been linked to the intense anxiety and [[sensory deprivation]] caused by isolation, and often worsen with repeated visits to solitary.<ref>{{cite web |last1=Corcoran |first1=Mary|title=Effects of Solitary Confinement on the Wellbeing of Prison Inmates|url=https://wp.nyu.edu/steinhardt-appsych_opus/effects-of-solitary-confinement-on-the-well-being-of-prison-inmates/|access-date=27 May 2021|website=Applied Psychology Opus|publisher=NYU Steinhardt|archive-date=29 August 2021 |archive-url=https://web.archive.org/web/20210829162343/https://wp.nyu.edu/steinhardt-appsych_opus/effects-of-solitary-confinement-on-the-well-being-of-prison-inmates/|url-status=live}}</ref>

Studies have shown that solitary confinement also has a marked effect on the [[human brain]]. [[Functional magnetic resonance imaging|fMRI scans]] have found that social isolation causes brain activity nearly identical to hunger cravings, and that it activates the same regions of the brain as physical pain.<ref name = factsheet>{{cite web |last1=Riccobene |first1=Veronica |title=Solitary Confinement and the Brain: The Neurological Effects |url=https://solitarywatch.org/wp-content/uploads/2023/06/SW-Fact-Sheet-5-Neurological-Effects-v230613.pdf |publisher=Solitary Watch |date=June 2023}}</ref> Furthermore, the sensory deprivation of solitary has been found to cause reduced [[electroencephalography]] (EEG) frequency on brain scans.<ref name = factsheet /> The part of the brain that plays a major role in memory has been shown to physically shrink after long periods without human interaction.<ref>{{Cite web |last=Herring |first=Tiana |date=December 8, 2020 |title=The research is clear: Solitary confinement causes long-lasting harm |url=https://www.prisonpolicy.org/blog/2020/12/08/solitary_symposium/ |access-date=2023-12-08 |website=Prison Policy Initiative |language=en}}</ref> One study that placed adult rats in solitary-like conditions found that, after a month in isolation, the rats' [[neurons]] had shrunk by 20 percent.<ref>{{cite conference |vauthors=Heng V, Zigmond MJ, Smeyne RJ |date=5 November 2018 |title=Neurological effects of moving from an enriched environment to social isolation in adult mice |url=https://www.abstractsonline.com/pp8/#!/4649/presentation/20940 |conference=Society for Neuroscience Annual Meeting}}</ref> 

===Social===

Some [[Sociology|sociologists]] argue that prisons create a unique social environment that do not allow individuals to create strong social ties inside or outside of the facility. The [[social isolation]] that incarcerated individuals experience is especially acute in solitary confinement, where they may be denied access to phone calls, mail, and visits from loved ones.<ref name=pss/>

The psychological effects of isolation continue long after individuals are released from solitary, affecting society as a whole. Upon their reentry into society, many individuals who have spent long periods of time in solitary report having difficulty adjusting back to life outside the prison walls.<ref name="kupers">{{cite journal |last=Kupers |first=Terry A. |title=What To Do With the Survivors? Coping With the Long-Term Effects of Isolated Confinement |journal=[[Criminal Justice and Behavior]] |volume=35 |number=8 |date=August 2008 |pages=1005–1016 |doi=10.1177/0093854808318591 |s2cid=146474911 }}</ref>  They are often startled easily, and avoid crowds and public spaces. They seek out small, confined spaces because public areas overwhelm their sensory stimulation.<ref name="Goode">{{Cite news|url=https://www.nytimes.com/2015/08/04/health/solitary-confinement-mental-illness.html|title=Solitary Confinement: Punished for Life|last=Goode|first=Erica|date=3 August 2015|newspaper=The New York Times|issn=0362-4331|access-date=4 December 2016|archive-date=6 December 2016|archive-url=https://web.archive.org/web/20161206172251/http://www.nytimes.com/2015/08/04/health/solitary-confinement-mental-illness.html|url-status=live}}</ref>

[[Anthony Charles Graves | Anthony Graves]], who spent more than 18 years in solitary confinement on the Texas [[death row]] before being [[exoneration|exonerated]] in 2010, described the lasting effects of solitary in his testimony for the [[United States Senate Judiciary Subcommittee on the Constitution|US Senate Judiciary Subcommittee on the Constitution, Civil Rights, and Human Rights]]: 
<blockquote>
Solitary confinement does one thing, it breaks a man's will to live and he ends up deteriorating. He's never the same person again… I have been free for almost two years and I still cry at night, because no one out here can relate to what I have gone through. I battle with feelings of loneliness. I've tried therapy but it didn't work. The therapist was crying more than me. She couldn't believe that our system was putting men through this sort of inhumane treatment.<ref>{{cite web |last1=Graves |first1=Anthony |title=Testimony Presented to the Senate Judiciary Committee Subcommittee on The Constitution, Civil Rights & Human Rights 'Reassessing Solitary Confinement: The Human Rights, Fiscal and Public Safety Consequences' |url=https://solitarywatch.org/wp-content/uploads/2012/06/anthony-graves-texas-death-row-exoneree.pdf |website=Anthony Believes |access-date=28 June 2023 |date=19 June 2012}}</ref>
</blockquote>

According to numerous studies, any amount of time in solitary confinement can increase the risk of [[recidivism]] after release.<ref>{{cite thesis |last1=Nguyen |first1=Anh |title=The Determinants and Consequences of Solitary Confinement: Risk Factor, Future Criminal Justice Involvement, and Mortality |url=https://deepblue.lib.umich.edu/handle/2027.42/145805 |publisher=PhD Thesis |access-date=28 June 2023 |date=2018|hdl=2027.42/145805 |type=Thesis }}</ref><ref>{{cite journal |last1=Mears |first1=Daniel |last2=Bales |first2=William D. |title=Supermax incarceration and recidivism |journal=Criminology |date=December 2009 |volume=47 |issue=4 |pages=1131–1166 |doi=10.1111/j.1745-9125.2009.00171.x}}</ref> A 2007 [[Case-control study|matched control study]] of Washington State prisons found that people in the study cohort who spent time in supermax prisons had a 3-year felony recidivism rate of 53 percent, which was 15 percent higher than that of their counterparts in the general prison population. The recidivism rate was even higher among people who were released directly from supermax into the community, at 69 percent.<ref>{{cite journal |last1=Lovell |first1=David |last2=Johnson |first2=Clark |last3=Cain |first3=Kevin |title=Recidivism of Supermax Prisoners in Washington State |journal=Crime & Delinquency |date=October 2007 |volume=53 |issue=4 |pages=633–656 |doi=10.1177/0011128706296466|s2cid=53064653 }}</ref>