SPLC: Solitary confinement can cause mental illness

Healthy people who are forced into solitary confinement in prison may develop mental illnesses due to their isolation, but the Alabama Department of Corrections (ADOC) deliberately ignores the problem, according to a brief filed in federal court last week by the SPLC.

“Subjecting prisoners with mental illness to solitary confinement only makes their conditions worse, and it can even cause mental illness in previously healthy prisoners,” said Maria Morris, senior supervising attorney with the SPLC. “Alabama prisons should not be warehouses to hide away and abandon people who are struggling with mental illness. People in these situations go unnoticed and untreated, and too many take their own lives. Even after ADOC’s suicide rate shot up to one of the highest in the country, and ADOC recognized that solitary confinement was primarily what these suicides had in common, the state still did nothing to address the risks.”

The filing is the latest development in the SPLC’s ongoing litigation against ADOC for failing to provide adequate medical and mental health care for people in its custody. U.S. District Court Judge Myron Thompson issued a sweeping, 302-page ruling in June declaring the mental health care system in Alabama prisons “horrendously inadequate.”

Among other findings, the court condemned ADOC’s policies and practices with regard to its use of solitary confinement units, noting that “long-term isolation resulting from segregation, or solitary confinement, has crippling consequences for mental health,” and acknowledging the risk that in solitary, “even mentally healthy prisoners can develop mental illness such as depression, psychosis and anxiety.”

According to the judge, “ADOC’s segregation practices perpetuate a vicious cycle of isolation, inadequate treatment and decompensation.”

Decompensation is a term used by psychiatrists and psychologists to describe the inability of a person with mental illness to maintain normal or appropriate psychological defenses when faced with stress. This sometimes results in depression, anxiety or delusions.

“Mentally ill prisoners in segregation are hit with a double-whammy: they are exposed to a heightened risk of worsening symptoms, while having less access to treatment they need,” the judge wrote.

Many of the people who have taken their own lives or attempted suicide in ADOC solitary confinement cells were never determined by ADOC to be in need of mental health services, according to the SPLC filing.

In one of many examples cited in the brief, a prisoner in solitary confinement committed suicide on Feb. 18, 2016. During a prior stay in solitary confinement, he complained of “feeling anxious and feeling closed in, as well as of hearing voices.” However, he was not on the mental health caseload, and his suicide was described by ADOC as “not anticipated.”

At another ADOC facility, a woman self-mutilated and tried to hang herself while she was in solitary confinement. After surviving numerous suicide attempts, she testified that being in segregation made her depressed. However, an ADOC psychological associate, who evaluated the inmate only after her suicide attempts, wrote, “inmate appropriate for placement” in solitary confinement. The associate also circled the statement, “segregation placement not impacting inmate’s mental health,” yet failed to mention her repeated self-mutilations while in solitary confinement.

Since Thompson filed his ruling identifying many areas where ADOC has failed to maintain a constitutionally adequate mental health care system, the SPLC, Alabama Disabilities Advocacy Program and others who filed the lawsuit three years ago have been working with ADOC to reach an agreement on how to reform the system.

The judge visited solitary confinement units in five ADOC facilities, and said “[t]he court witnessed an overpowering sense of abandonment and despair, with a prolonged stay crushing all hope.”

Solitary confinement has increasingly been recognized as torture in the U.S. and around the world, and numerous state prison systems have adopted policies limiting or eliminating it. Two years ago, the U.N. adopted the U.S.-sponsored changes to the United Nations Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules). The rules prohibit “the confinement of prisoners for 22 hours or more a day without meaningful human contact … for a time period in excess of 15 consecutive days.”

In Thompson’s ruling, he cited Sen. John McCain’s observation about isolation during his prisoner-of-war experience in Vietnam:

“[Solitary confinement] crushes your spirit and weakens your resistance more effectively than any other form of mistreatment. Having no one else to rely on, to share confidences with, to seek counsel from, you begin to doubt your judgment and your courage.”