Mental Illness Equals More Solitary Confinement

Mental Illness

An independent review of the practices at Rikers Island, a prison in New York City, finds them lacking in terms of how mental illness is handled.  The New York Board of Correction, who commissioned the study, found that having a mental illness at Rikers equals more time in solitary confinement, which is used to punish prisoners who either do not abide by the rules of the prison, need to be isolated due to unpredictable behavior, or injure themselves or others.  In some cases, mentally ill prisoners, who are more apt to break the rules or attempt to harm themselves due to the very nature of their illness, spent years inside of solitary.

Because of growing awareness of the abuse at some hospitals for the mentally ill, mental institutions across the country have been mostly shut down during the past 50 years, making individuals with mental illness who commit crimes often sent to prison instead of to hospitals or institutions, which in turn causes prisons in the United States to house a higher percentage of the mentally ill.  A 2010 survey by the nonprofit Treatment Advocacy Center and National Sheriff’s Association found that prisons and jails contain three times more mentally ill people than hospitals do.

At Rikers, inmates sentenced to solitary confinement reside alone in a suicide-resistant cell of cement block walls, with the only human interaction occurring through a slot in which means are delivered and handcuffs can be placed.  The capacity for solitary confinement at Rikers has increased 61.5 percent since 2007, going from 614 beds to 998.  Of the roughly 12,000 inmates inside, approximately 40 percent of them suffer from a mental health issue.  One third of these have more serious conditions such as bipolar disorder or schizophrenia.  At any time, a little more than half of the inmates populating solitary confinement are classified as being mentally ill.  Instead of confining prisoners to solitary to punish them for breaking prison rules, the NYC Board of Correction recommends instead forming a partnership with a hospital with a focus on teaching so that mental illness will not equal more solitary confinement, but will instead be a call for receiving intensive therapy.

The lead author of the study, Dr. James Gilligan of New York University, notes that “Since prolonged solitary confinement can cause symptoms of mental illness to appear even in previously healthy individuals, we strongly recommend against imposing it as a punishment for a predetermined duration even on those inmates not deemed to be mentally ill.”  Previously healthy prisoners confined to solitary can exhibit signs of mental illness, such as depression, anger, paranoia, obsessive thoughts, and even psychosis.  An even more disturbing find of the study is that the increased instances of solitary confinement are linked to an elevating level of violence overall.  Correction staff reports of having to use force have tripled while the number of suicide attempts and self-harm instances have increased by 75 percent.  Of the number of serious injury assaults on both staff and fellow inmates, 60 percent are committed by mentally ill inmates.

In an effort to curb these disturbing trends, New York City’s Correction Commissioner, Dora B. Schriro, reports that new sentencing guidelines and reforms are being instituted, including the use of time-outs and the opening in July of two units inside Rikers to be used for the mentally ill as part of a “Clinical Alternative to Punitive Segregation.”  .There, those with serious mental illnesses will receive medicine and treatment by psychiatrists.  Inmates suffering from less serious mental illnesses will attend counseling sessions to help them learn to change their behavior. No inmates will be released into the regular population until treatment has been completed. In addition, the Board of Correction has voted to examine the process of defining when solitary can be used in the case of mentally ill inmates.  As long as mental illness continues to suffer the stigma that it’s controllable and most likely imagined,  mental illness will be discounted in prisons and will equal more time in solitary confinement.  With continued research and study into this topic, mental illness may someday be treated in the prison system much the same as cancer or diabetes is – by trained medical personnel equipped at treating these diseases.

By Jennifer Pfalz

ABC News

Journal of the American Academy of Psychiatry and the Law Online

New York Times