No Man Should be an Island: A Literature Review on the Effects of Prisoners in Long-term Solitary Confinement
Mary Blanchard
Argosy University

Abstract
This literature review examines the effects of short and long-term solitary confinement on individuals, especially those segregated in prisons and so-called "Supermax" facilities. The hypothesis is that while short-term confinement does not appear to cause serious harm, long-term confinement is detrimental to prisoners, particularly to those who are mentally ill. The evidence concludes there is a correlation between long-term isolation and psychological and physiological problems. The articles cover the history of solitary confinement, the wax, and wane of the practice, life in Special Housing Units, the constitutionality, and recidivism. Additionally, there are suggestions for improving confinement when it is necessary, as well as reducing the use as much as possible by limiting it to the "worst-of-the-worst" offenders.

keywords: solitary confinement, "Supermax", Special Housing Units, mentally ill, recidivism, "worst-of-the-worst"

No Man Should be an Island: A Literature Review on the Effects of Prisoners in Long-term Solitary Confinement
Inroduction

From the Iron Maiden and the Rack to Waterboarding and Sensory Deprivation, thoughts of these practices can make the most stoic person shudder. What many do not imagine is that the most harmful form of torture is also the simplest to apply. This "corrective measure" still in use today is solitary confinement (SC). Under the theory of “just deserts” (Sloan & Miller, 1990; Johnston, 2011), SC may well fall into the category of torture. Not all torture is swift or merely physical. Meriam Webster defines torture as "something that causes mental or physical suffering." (www.meriam-webster.com, 2015) There is evidence that long-term solitary confinement does cause severe psychological and physiological distress.
Life in Solitary
Life in segregated housing is worse than most people can imagine. Prisoners are confined twenty-three out of twenty-four hours a day in Special Housing Units (SHUs) or "Supermax" prisons. The cell is typically six feet by eight feet. (Lanes, 2011; Topley, 2010) The furnishings are concrete or stainless steel--a bunk, toilet, and sink combo are all that the cell contains. The door is solid steel with a small window for observation, (Lanes, 2011) and small slots for food, as well as for shackling prisoners before their removal. When prisoners are let out for exercise, it is often in a small, caged enclosure known as a "dog-run." (Haney, 2006; Topley, 2010) Even going to the showers involves shackles, and prisoners must kneel down with their back to the door for cuffing, causing further humiliation. Social interaction is limited to staff and the occasional visitor (separated by a barrier). There is inadequate mental health care unless the prisoner enters the behavioral health unit. (Haney, 2006; Shira, 2014) Ironically, the time in behavioral units is considerably shorter than the time spent in SC. Additionally, prisoners often do not have exposure to natural light; a single light is kept on around the clock. Inmates have no personal items or reading material other than a Bible. (Arrigo & Bullock, 2008) Television and radios are not permitted. There are no hobbies, no vocational training, no education, and no purpose. (Ross, 2007; Shira, 2014) Furthermore, the harmful controlling actions such as hog-tying, Tasers, stun guns, sting-shot rubber bullets, pepper spray and restraint chairs (Cohen, 2006) adds to the perfect storm that creates hostile, uncooperative, and even mentally ill prisoners. It is not unexpected that research shows SC has an undesirable impact on incarcerates. These effects are true for both mentally sound and mentally ill prisoners alike, but without a doubt, it is much worse for those suffering from severe mental illness. Isolation leads to rapid decompensation for individuals who present with psychiatric disorders like bipolar or borderline disorders, depression, and schizophrenia, or are brain-damaged or mentally deficient. (Shalev, 2008, Johnston, 2013) Even for mentally healthy inmates, the social isolation, lack of control, and inactivity result in psychiatric issues and despair. (Shale, 2008)
Effects of Isolation
The effects of isolation are numerous. Physical problems such as "insomnia, heart palpitations, back and joint pain, loss of appetite, weight loss and diarrhea, lethargy and shaking"(Shale, 2006) are some of the physical reactions to prolonged SC. Not only does the extreme isolation lead to mental breakdown, but physical deprivations can cause mental illnesses. An example of this is the link between insomnia and depression. When circadian rhythms are interrupted, it can lead to insomnia, which in turn can cause a depressive state. (www.aasmnet.org, 2008) Likewise, there is a large body of evidence showing that SC is responsible for a myriad of other psychological disturbances. Some evidence dates back to the 1800s with the advent of the segregated penal system. Confusion, paranoia, insomnia, poor concentration, memory issues, aggression, rage (Arrigo & Bullock, 2008), anxiety, hallucinations, feces smearing (Ceresnie, 2009), and self-injurious behaviors (Lane, 2011) are just some of the problems that are either observed or self-reported by those in segregation. (Grassian,1983) Extreme isolation can also lead to a type of psychosis known as SHU Syndrome. SHU Syndrome is characterized by "massive free-floating anxiety, hyper responsiveness to external stimuli, perceptual distortions, and hallucinations, a feeling of unreality, difficulty with concentration and memory, acute confusional states, the emergence of primitive aggressive fantasies, persecutory ideation, motor excitement, and violent destructive or self-mutilatory outbursts." (Grassian, 2006; Ceresnie, 2009) Not surprisingly, individuals in segregation are at risk for suicide attempts, with "over 40% of completed suicides" occurring in SC. (Ceresnie, 2009).
Similarly, people in isolation for occupational or medical reasons can experience these same symptoms, so it is not surprising that long-term confinement produces the same results in prisoners. Even the Bible agrees that isolation is harmful--"It is not good for man to be alone." (Genesis 2:18) Also, according to Haney, prisoners who are segregated for extended periods often develop a pathological problem of "institutionalization", whereby an inmate is unable to act of their accord without direction from others. (Haney, 1983) The film "Shawshank Redemption" highlights this effect. While it is a fictional story, it completely captures the reality that released prisoners are at times unable to successfully assimilate into society once more. Indeed, institutionalism often leads to recidivism. (Shira, 2014; Gibbons & Katzenbach, 2006) These methods of isolating prisoners have effects that remained static throughout the observable history of solitary confinement.
History of Solitary Confinement In the 1800s, the Quakers began a movement to change the prison system of that period, which they viewed as cruel and dehumanizing. They believed that strict solitude would create repentance in the prisoner, leading to his or her rehabilitation and re-entry into society. The model was so popular that other states adopted it as well. Furthermore, it became popular in other countries such as Germany, Canada, and Great Britain. It was not long, however before the so-called humane treatment turned out to be anything but rehabilitative. (Grassian, 2006) During a visit in 1833 to examine the penal system in the United States, de Tocqueville and Beaumont commented on the dismal practice, saying, "It does not reform, it kills." (Shira, 2014) And Charles Dickinson wrote, after a visit to the Eastern State Penitentiary, that the "system... was immeasurably worse than any torture of the body." Large quantities of reports from the era document the disastrous results, such as psychoses, hallucinations, dementia, and more. Thirty-seven reports and articles from Germany were published between 1854 and 1909 agreeing with the findings. One report in 1854 by a prison doctor in Germany identified a condition he called, "Prison Psychosis," characterized by hallucinations and other effects on the mind. England too found similar experiences with prisoners, where they discovered that "32 out of 1,000" prisoners became insane from segregation. Finally, in the United States, the Boston Prison Discipline Society also reported severe mental health problems like dementia and hallucinations. (Shalev, 2008) By the twentieth century, it was finally decided that this model was not working. (Smith, 2007) It seemed the practice of extreme solitary confinement was over. However, future events would see this practice become more frequently employed once again.
Resurgence of Solitary Confinement
Despite the terrible lessons learned over those early decades of SC, the use of extreme isolation would make a comeback in the modern American prison system. After the demise of the practice, the SC was limited to the "worst-of-the-worst." (Tapley, 2010) Then in the 1970s and into the 1980s, the political climate, financial woes, and upheaval in the prison system itself, (Ross, 2007) brought a rise in segregation once more. While there were riots and murders in many facilities across the country, a tragic incident in Marion, Illinois was the primary catalyst for this rise. In 1982, two corrections staff were stabbed to death by inmates, necessitating a lockdown that became permanent and spurred other prisons in the federal penitentiary system to upgrade to or create maximum security housing units, called "Supermax" prisons. Since that time, there are forty-four states in the U.S. with Supermax facilities. (Carrington, edu., 2016) As many as 80,000 men, women, and children languish in solitary confinement in America, with 23,307, or 11.9% of inmates in high-security prisons. (www.bop.gov, 2015). Whether the reason is to protect the incarcerate from self-harm or from harming others, or waiting on remand, no matter what the reason for segregation, the practice causes harm to most prisoners. Even those that do not suffer mentally or physically still suffer by missing out on social and vocational skills that will assist them upon release. Along with these dilemmas, SC is more costly than being in the general population. On average it costs approximately $75,000 in taxpayer money, but only $25,000 for incarcerates to remain in general population.(Rodriguez, 2012) Solitary confinement, as currently practiced in the United States, represents a serious miscalculation of the appropriate balance among prison security, public safety, cost efficiency, and prisoner welfare." (Bennion, 2012) It appears the benefits do not justify the cost. It is not only costly but also counter-productive. SC creates people who are more angry and violent than they were before their sentence---"If you spit in my face, smack me in the mouth, throw me in solitary confinement for no reason....what do you think is gonna happen when I get out of here?" -- Charles Manson. While certainly some situations require short-term isolation, such as prisoners on remand, or for the protection of themselves or others, the abuse of lengthy sentences continues to be a problem in prisons today. It may be practical to "put-away" serial killers, mass murderers and terrorists for life, but it is costly; though most would agree that the financial cost is a better price to pay than the cost of potential victims if high-risk individuals were released. Even so, inmates in solitary confinement deserve to be treated humanely.
Reformation Starts with Changing Attitudes
The first step in improving the penal system may be the easiest, by developing respect for those in prison. Using words like "prisoner" and "criminal" in place of "people", aids those in authority to objectify and dehumanize, making it easier to be callous and cruel. How authorities treat those in their care is important. The famous Stanford Prison Study bears this out. The social experiment by Philip Zimbardo showed changes in the mindset of all the test subjects, those in either the role of "guard" or "prisoner". Those portraying guards quickly became sadistic and abusive, and those acting as prisoners became so depressed that Zimbardo aborted the experiment after only six days. (Zimbardo,1999) Understandably, all occupations use jargon, but this is not about being politically correct, but rather that human thinking produces humane treatment. One correction officer in a Maine prison tells inmates,

"This is a terrible place for you to live. We don’t want you here. We are going to work with you to get out of here. No one has ever said this to them. I never thought about it before; it never mattered to me. I never personalized what it would be like in that little cell. Now I do take it personally. It’s wrong. It’s wrong for human beings to lock them in these little cells.” (Rhodes, 2004)

Society should not justify the callous and cruel treatment of criminals; to do so makes society no better than the perpetrators. Torture has no place in a just system. Cruelty and correction should not be synonymous. Once the perception changes, it opens avenues that may rehabilitate those who are willing and able, to redirect the course of their sentence. Suggestions for improving life in confinement include reducing overcrowding, better rehabilitation, and reclassifying offenses to limit overuse of SC, and only using force or restraints as a last resort. (Gibbons, 2006) Vocational training, spiritual counseling, literacy and other educational programs, mental health care, building social skills and better transitions all would make a difference in preparing them for successful re-entry into their communities. Other needs like more family visits and mail, clocks and calendars (to stay oriented), reading materials, and control over their environment would be enormous improvements (Arrigo & Bullock, 2008) for those who suffer from losing all freedom, regardless of how long it is lost.
Short-term versus Long-term SC
There continues to be a debate over whether or not short-term solitary confinement is detrimental. In one study, research with prisoners after ten days of confinement did not show added levels of stress, based on plasma cortisol measurements. (Ecclestone, et al., 1974) And in another study where inmates were tested using standardized tests, inmates performed better. (Bulman, Garcia, & Hermon, 2012) But these were small studies on a limited number of subjects. Despite the findings, there is overwhelming evidence that being sentenced to SC for longer than ten days is harmful.
The Need for More Research It would be beneficial if more empirical evidence were available since those in official positions rely on statistical proof rather than anecdotal information. It is unfortunate that this is so, but the reality is that it is difficult to study prisoners, due to safety and other restrictions. The "lack of reliable and comprehensive data on jail isolation" (Haney, et al., 2015) makes it that much harder for the improvement of a broken system. Researchers and authorities would do well to work together on finding real solutions that could lessen the need for this practice, helping individuals and society alike.
Conclusion
Regardless of the amount of empirical evidence gathered on the effects of solitary confinement on people in segregation, there is no denying the sufficient observations by those who care for them. These observations further validate the traumas, both mental as well as physical, reported by those who are in confinement. Emmeline Pankhurst described it well when she said "Solitary confinement is too terrible a punishment to inflict on any human being, no matter what his crime. Hardened criminals in the men's prisons, it is said, often beg for the lash instead."

References

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