Center on Sentencing and Corrections

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

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

Reiter, Keramet, Joseph Ventura, David Lovell, Dallas Augustine, Melissa Barragan, Thomas Blair, Kelsie Chesnut et al. “Psychological Distress in Solitary Confinement: Symptoms, Severity, and Prevalence in the United States, 2017–2018.” American Journal of Public Health 110, no. S1 (2020), S56-S62.

This study, published in the American Journal of Public Health, aims to specify the symptoms and measure the prevalence of psychological distress among incarcerated people in long-term solitary confinement. Researchers analyzed data from semi-structured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; administrative data provided by the department; and systematic reviews of medical and disciplinary files for 106 randomly sampled people in long-term segregation in Washington State prisons in 2017. After one year, researchers conducted follow-up interviews and assessments with 80 participants—more than half of whom had returned to the general population. In year one of the study, they found that half of the study participants showed clinically significant symptoms of depression, anxiety, or guilt. People in these segregation units also had disproportionately high rates of serious mental illness and self-harming behavior compared to the general population. Interviewees’ responses also revealed symptoms of social isolation, loss of identity, and sensory hypersensitivity. In year two, researchers found that many participants, both those who remained in segregation and those back in the general population, sustained these symptoms in the following year. The findings add to the growing body of research characterizing solitary confinement as a public health crisis. Since 95% of all incarcerated people, including those who experience segregation, are eventually released, understanding disproportionate psychological distress is critical for developing preventative policies and re-entry services that meet the unique needs of people who have experienced solitary confinement. Further, findings from this study support advocates’ calls for reform and current efforts underway by corrections leaders—including the Washington State Department of Corrections, which the article notes has been implementing reforms in the treatment of mental illness and the use of long-term segregation in recent years.

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Keywords: solitary confinement, segregation, restrictive housing, University of California, Irvine, UCI, Washington DOC, IMU, supermax, psychological distress, BPRS, mentally ill, mental health effects, mental health impacts, suicide, self-harm, restrictive housing, qualitative, research.