Solitary confinement

=== 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"/>