Psychological Distress in Solitary Confinement: Symptoms, Severity, and Prevalence in the United States, 2017–2018

Abstract

Objectives. To specify symptoms and measure prevalence of psychological distress among incarcerated people in long-term solitary confinement. Methods. We gathered data via semistructured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for 106 randomly selected people in solitary confinement in the Washington State Department of Corrections in 2017. We performed 1-year follow-up interviews and BPRS assessments with 80 of these incarcerated people, and we present the results of our qualitative content analysis and descriptive statistics. Results. BPRS results showed clinically significant symptoms of depression, anxiety, or guilt among half of our research sample. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations. Interview content analysis revealed additional symptoms, including social isolation, loss of identity, and sensory hypersensitivity. Conclusions. Our coordinated study of rating scale, interview, and administrative data illustrates the public health crisis of solitary confinement. Because 95% or more of all incarcerated people, including those who experienced solitary confinement, are eventually released, understanding disproportionate psychopathology matters for developing prevention policies and addressing the unique needs of people who have experienced solitary confinement, an extreme element of mass incarceration.

Institutional Responses to the COVID-19 Pandemic in American Prisons

“…Reductions in institutional movement and lockdowns are likely to have resulted in decreased access to exercise, movement, and mobility, an especially important consideration for older incarcerated adults (Prost et al, 2020). Moreover, research indicates the physical and psychological harms of solitary confinement are severe and include sensory hypersensitivity and loss of identify (Reiter et al, 2020), post-traumatic stress disorder (Hagan et al, 2018), and chronic somatic diseases (Gamman, 1995;Haney, 2003). We encourage future scholars to explore how efforts to quarantine large numbers of incarcerated individuals during the pandemic may have increased exposure to solitary confinement-like living conditions for incarcerated persons, both in practice and in its effects.…”

Shedding Light on “the Hole”: A Systematic Review and Meta-Analysis on Adverse Psychological Effects and Mortality Following Solitary Confinement in Correctional Settings

“…The evidence of six of these studies was ranked as moderate and two as low quality. Regarding depression and dysthymia, three studies with moderate quality evidence found higher scores in inmates having been exposed to SC (52)(53)(54). However, low quality evidence from two other studies (30,55) and one study with moderate quality evidence (51) did not observe differing depression scores between groups.…”

The body in isolation: The physical health impacts of incarceration in solitary confinement

“…WADOC is a mid-sized state prison system, with the 12 th lowest rate of incarceration of the 50 United States [20]. The state and its prison system have a reputation for being progressive,…”

“…Some researchers, however, have argued that the psychological harms of solitary confinement are limited or unverified [18,19]. The analyses on which such opinions rely have, in turn, been criticized for neglecting existing literature and for other serious methodological concerns, including an inability to isolate exposure to solitary confinement, lack of specificity about variability and comparability in actual conditions of confinement, and the inapplicability of psychological assessment scales in the prison context [1,20].…”