Shrink Rap News

Voice of experience missing at Senate hearing on solitary confinement


 

Recently, the Senate Judiciary Committee heard testimony regarding the use of solitary confinement in the Federal Bureau of Prisons. This was the second hearing on this issue, which featured testimony from the director of the federal system, from several human rights organizations, from state prison officials, and from former inmates themselves. Although one of the main concerns of the hearing was the psychological effects of solitary confinement, only one of the 11 speakers was a mental health professional. Psychology professor Craig Haney, Ph.D., has spent 30 years studying the effects of solitary confinement; however, by his own testimony, he did this primarily as an expert witness retained in the context of correctional litigation. None of those offering testimony was a mental health professional actively involved in the treatment of segregated prisoners. In fact, according to the curriculum vitae that Dr. Haney filed in his capacity as an expert in the California prison overcrowding case, Dr. Haney has never worked in a jail or a prison.

During the hearing, Sen. Al Franken (D-Minn.) made a reference to the risks some inmates posed to prison "guards." For those readers who have never worked in corrections, this is a tremendous faux pas. A "guard" is a generic term for a civilian hired by a private company or business who is given minimal training, slapped into a uniform, and told to stand watch over something. A correctional officer is a law enforcement professional who is trained, regulated, and monitored by the state. A correctional officer is a professional with a code of ethics and who is granted police powers, including the right to use deadly force. Confusing a correctional officer with a "guard" is like mistaking a Navy Seal for a Boy Scout.

So we have a hearing about the psychological effects of confinement in which a psychologist with no correctional experience is testifying before a senator who is not familiar with even basic correctional training standards. What could possibly go wrong?

This topic is close to my heart lately, because there is a bill currently before the Maryland General Assembly to study the use of solitary confinement in our prison system. I’ve read the bill, I’ve listened to the testimony, and I have a few opinions on the issue myself.

First, a few stipulations and clarifications. People involved in this issue tend to confuse terminology related to restricted housing within a correctional facility. The term "solitary confinement" traditionally means a housing situation in which the inmate is placed alone in a cell. The term "administrative segregation" or "ad seg" is sometimes used interchangeably with "disciplinary segregation," although this is not accurate. Disciplinary segregation means that the inmate is removed from the general population because of a rule violation. Inmates on disciplinary segregation are often barred from owning certain property like a television or radio. Visiting privileges and phone calls may also be restricted as a punishment.

In contrast, an inmate could be placed on administrative segregation for nondisciplinary reasons if the prisoner requires medical isolation temporarily, if the inmate voluntarily requests special housing, or if there is a need for protective custody. In this case, the inmate is still allowed to own property, and he retains basic visiting and telephone privileges. In all cases, there is time allowed out of the cell for exercise and recreation. There is also still access to medical and mental health services.

Regarding the stipulations, I don’t question that the prevalence of mental illness among prisoners will be high in a facility that is designated as maximum security or in a control unit prison. I also agree that solitary confinement, or housing without a cellmate, is a bad idea for a prisoner who is deemed a high suicide risk. I agree that boredom and lack of activity are generally a very bad thing for anyone, prisoner or not, and that we shouldn’t keep prisoners on segregation status longer than is necessary to accomplish the intended purpose of the housing.

Here’s where the agreement ends: I don’t think restricted housing is automatically and consistently bad for everyone, and I certainly don’t agree that the segregated housing itself causes whatever mental disturbance may be present. Association does not prove cause and effect, and the number of well-designed, controlled studies of this issue are too few and far between to allow a causal link to be drawn. I realize that this goes against the grain of most court findings on this issue, but that’s the state of the science. I was not surprised to see that the proponents of the solitary confinement bill didn’t mention contradictory evidence. Few journalists in the traditional media have, either.

Pages

Recommended Reading

CBT: Making the most of a brief session
MDedge Family Medicine
Stroke risk jumps after head, neck trauma
MDedge Family Medicine
Alzheimer’s treatment requires ‘multiple shots on goal’ approach
MDedge Family Medicine
Managing patients on antipsychotics: Your domain, too
MDedge Family Medicine
VIDEO: Traumatic injury ups stroke risk in people under 50
MDedge Family Medicine
High-yield techniques in brief CBT sessions can promote adherence
MDedge Family Medicine
Consider four factors in refractory MDD
MDedge Family Medicine
Vision test has additive effect on concussion detection in athletes
MDedge Family Medicine
Report highlights state of child abuse and neglect research
MDedge Family Medicine
The future of psychiatry may depend on integrated care
MDedge Family Medicine