Prison is not a pleasant place. Every single occupant has committed a crime or series of crimes, each defying the laws and morals of society. That reluctance to conform doesn’t end at the prison gate. Within the prison walls, many inmates continue to ignore the concepts of order and justice.

For those inmates there is a prison within the prison. Correction officials will say that restrictive housing — solitary confinement — is for the worst of the worst. There would be chaos inside the prison walls if there was no way to punish unruly, violent or dangerous prisoners.

Unfortunately, the prison within the prison is not just for the violent or dangerous — “the hole,” as many inmates refer to it, is a dumping ground for the most vulnerable prisoners.

A 2006 study by the U.S. Department of Justice’s Bureau of Justice Statistics found that more than 64 percent of local jail inmates, 56 percent of state prisoners and 45 percent of federal prisoners have symptoms of serious mental illnesses.

Inmates with serious mental illness often struggle to conform to prison rules and increasingly end up in isolation as a result.

Granted, isolation and solitary confinement are not just for the mentally ill. Prisoners can be placed in such units for many reasons — as punishment for breaking prison rules; while under investigation; when suspected of gang involvement; protection of the inmate; protection of staff and other inmates.

Although conditions vary from state to state, and even institution to institution, isolation and solitary confinement, and the accompanying restrictions, take many different forms. The American Friends Service Committee, an organization that once won the Nobel Peace Prize, lists on its website some of the restrictions as — confinement for 23 hours a day; infrequent phone calls and rare non-contact family visits; limited access to rehabilitative or educational programming; and restricted reading material and personal property.

According to The Washington Post, more than 4 percent of Texas’s prisoners — more than 6,000 people — are in solitary, spending an average of nearly four years in near-total isolation, locked in 60-square-foot cells for at least 22 hours a day.

How does solitary confinement effect prisoners? Stuart Grassian, a board-certified psychiatrist and a former faculty member at Harvard Medical School, told NPR interviewed hundreds of prisoners in solitary confinement.

In one study, he found that roughly a third of solitary inmates were “actively psychotic and/or acutely suicidal.” Grassian concluded that solitary can cause a specific psychiatric syndrome, characterized by hallucinations; panic attacks; overt paranoia; diminished impulse control; hypersensitivity to external stimuli; and difficulties with thinking, concentration and memory.

Progress is being made in some parts of the country. A new rule approved by the New York City Board of Correction will prohibit the use of solitary confinement to punish inmates aged 21 and younger on Rikers Island, the city’s primary jail complex. Slate reported that the new rule comes about a year after city officials announced that Rikers would no longer subject inmates classified as “seriously mentally ill” to solitary confinement.

In Pennsylvania, the state Department of Corrections recently settled a lawsuit with the Disability Rights Network that will result in new rules regarding the use of solitary confinement for mentally ill inmates. Under the agreement, reported the Pittsburgh Post-Gazette, when any of the state’s 8,000 inmates with serious mental illness break prison rules, they may go to diversionary treatment units, not solitary confinement.

In the new units, they will get treatment and a minimum of 20 hours per week outside of the cell, including 10 “structured” and 10 “unstructured” hours. By mid-2016, Pennsylvania will stop punishing seriously mentally ill inmates with assignments to solitary confinement.

Corrections Secretary John Wetzel told The Post-Gazette, the state was “stepping up to do the right thing” in an era in which prisons “have become the de facto system responsible for treating the mentally ill.”
Matthew T. Mangino is of counsel with Luxenberg, Garbett, Kelly & George. His book, “The Executioner’s Toll, 2010,” was released by McFarland Publishing. You can reach him at mattmangino.com and follow him on Twitter at @MatthewTMangino.