How Solitary Confinement Contributes to the Mental Health Crisis

The U.S. is a global outlier in its incarceration rates and widespread use of solitary confinement, a common practice in juvenile and adult facilities. The measure — which involves locking a person alone or with people without access to meaningful human engagement or programming — is a form of torture. Yet, it is used arbitrarily in the U.S. for indeterminate periods of time, frequently without recourse.

Currently, in U.S. prisons, jails, youth detention, immigration detention and other carceral settings, people can be locked in solitary for periods of time that range from hours to days, months, years and even decades. Those kept in solitary are often fed through a slot in their door, denied human touch, denied access to critical services or lifesaving medical care and ultimately trapped in a cell or “box” often without any knowledge of when their isolation will end.

Each day, tens of thousands of people across the U.S. are locked in solitary. Moreover people of color  are disproportionately locked in solitary, as are transgender and gender non-conforming people, young people and people with mental health conditions.

Solitary confinement often results in tragic outcomes, including physical and mental health crises, increased incidence of violence and high rates of recidivism.

Mental Illness and Solitary Confinement

Those with mental illness are overrepresented in solitary confinement, despite the vulnerability and threats to the mental health of those incarcerated. Research shows that the effects of solitary confinement on mental health are often fatal, both during and after incarceration. Half of all suicides in prisons and jails occur in solitary confinement. A recent study shows the long-lasting effects; that any amount of time spent in solitary increases the risk of death in the first year after release.

Individuals were overall 24% more likely to die in the first year after release, including from suicide (78% more likely) and homicide (54% more likely). They were also 127% more likely to die of an opioid overdose in the first two weeks after release.

Among many other mental health experts, Dr. Stuart Grassian, a psychiatrist, observed the devastating mental health consequences of the practice. Solitary confinement, he found, caused either (1) the exacerbation or recurrence of preexisting mental health issues, or (2) the onset of an acute mental illness. He is also credited for identifying a specific psychiatric syndrome associated with solitary confinement, termed the SHU Syndrome.

Addressing the Problem with Legislation

While this practice remains widespread across the U.S., there is a growing movement to end solitary confinement, while employing alternative interventions that improve safety and well-being. Fueling this surge in efforts to end solitary confinement is a recognition that it is a form of torture and injury (physical, psychological, emotional and social) on people subjected to it and has severe effects on their loved ones and on the wider community.

Deeply disturbed by this reality, an increasing number of campaigns led by people who have survived solitary confinement and those with loved ones in solitary have helped spur legislative and administrative policy changes to curb the use of solitary and to promote alternatives.

Between 2009 and the present, 920 bills across 46 states were introduced to restrict or end solitary confinement in some form; 40 states have passed at least one of these bills. Since 2021, 258 pieces of legislation were filed across 41 states to regulate some aspect of solitary confinement, the vast majority seeking to end at least some component of the practice in state prisons and jails, youth facilities and other carceral settings. 39 bills were passed during this period, namely, in Arkansas, New York, Kentucky, Illinois, Connecticut, Louisiana, Virginia, Hawaii, Colorado and Maryland.

These anti-solitary efforts have also contributed to the closure of entire prisons, buildings and units used to inflict the practice, most recently with the closure of supermax prisons in New York and Connecticut. As a result of the ever-growing list of states advancing these efforts, advocates in at least a dozen states have introduced or intend to introduce comprehensive legislation to end prolonged solitary confinement beyond 15 days, aligned with the Nelson Mandela standards for solitary confinement in their state legislatures in 2023.

Public Support for Ending Solitary

The collective work across the country to end solitary confinement is achieving broader support. New nationwide polling data released by Data for Progress shows widespread bipartisan support for various restrictions on solitary confinement, including banning solitary beyond four hours for purposes of emergency de-escalation.

Specifically, voters support this ban on solitary beyond four hours by a +32-point margin, with 78% of Democrats, 61% of Independents, and 51% of Republicans supporting it. Other restrictions on solitary also had widespread bipartisan support, including banning solitary entirely for people with mental health needs (78% support), implementing rehabilitative interventions focused on programs and counseling rather than punishment (65% support) and creating a new office to investigate corruption and mismanagement in U.S. prisons (86% support).

We simply cannot continue to ignore the facts and collateral damage of this unjustifiable practice. Let us remember that the use of solitary confinement, even in the smallest increments, is harmful and it fails to improve prison or public safety. Legislators and advocates must continue their efforts to end solitary confinement for the most vulnerable among us.

The public has spoken: the punishment of solitary confinement isn’t worth the devastation it creates.
Jessica Sandoval, MPA has dedicated almost three decades to community organizing and advocating for social justice causes. She has led successful campaigns to change policies affecting youth and adults concerning incarceration, gang-involved youth and harmful practices within the criminal legal systems. Through positions in leadership, organizing and legislative advocacy, she has developed and administered a variety of effective strategies and tools at both the state and national level. Jessica currently serves as the National Director for the Unlock the Box Campaign, a national campaign to end solitary confinement in U.S. jails, prisons and youth facilities.