A study of self-harm cases in New York City jails published in the March 2014 issue of the American Journal of Public Health found that prisoners placed in solitary confinement are almost seven times more likely to try to hurt or kill themselves than those not in isolation.
The three-year study, conducted by the New York City Department of Health and Mental Hygiene (DOHMH) between January 2010 and January 2013, examined medical records for nearly a quarter-million incarcerated individuals during that period. Among those incarcerations, researchers found 2,182 acts of self-harm. Seven of those cases were suicides.
According to DOHMH, 53% of all acts of self-harm in NYC Jails – and 45% of those acts that were potentially fatal – were committed by prisoners in solitary. Of those isolated prisoners who harmed themselves, a majority were 18 or younger with serious mental illness.
And while over half of all self-harm cases were committed by prisoners who had been isolated, only about 7% of those booked into city jails end up in solitary confinement.
“According to our analysis, length of stay in jail, SMI, solitary confinement and young age appear to be important and independent predictors of self-harm in jail,” the study said. “These data support the need to reconsider the use of solitary confinement as punishment in jails, especially for those with SMI and for adolescents.
The study’s authors wrote that, based on their clinical experience, adolescent prisoners commit “lower-lethality acts of self-harm” in attempts to avoid the stress and bleakness of solitary confinement, “though with not infrequent unintended consequences.” Older prisoners in isolation, meanwhile, are “more likely to commit potentially fatal self-harm,” according to the study.
Those who commit self-harm to escape solitary confinement – especially SMI prisoners – often end up with new infractions and even more time in isolation.
“In the most extreme type of example,” the study said, “a patient held in solitary confinement may break off a sprinkler head, use that metal to slash themselves, and then earn not only a new infraction and more solitary time, but also a new criminal charge for destruction of government property.”
Both DOHMH and the NYC Department of Corrections, the study said, recently announced plans “to eliminate the practice of solitary confinement for inmates with SMI.” Instead, SMI prisoners cited for jail infractions will be admitted into individual and group therapy “in a clinical environment.”
And mentally ill prisoners whose illnesses are not “serious” will be given incentives such as increased time out of their cells and reduced time in isolation for following jail rules.
“These reforms,” the study concluded, “provide an opportunity to evaluate the effect of increased clinical management and decreased reliance on solitary confinement as a means to reduce self-harm and other behaviors among inmates with mental illness.”
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