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Looking Deep Inside America’s Legalized Torture Chambers

by Mark Wilson

There are many ways to destroy a person, but one of the simplest and most devastating is through prolonged solitary confinement. Deprived of meaningful human interaction, otherwise healthy prisoners become unhinged. … Not only psychological or social identity but the most basic sense of identity is threatened by prolonged solitary confinement.

Lisa Guenther, Solitary Confinement, Social Death and Its Afterlives (University of Minnesota Press 2013)

Solitary confinement is as old as prisons themselves, from the Mamertine Prison’s cages that confined prisoners beneath the sewer system in ancient Rome in 64 B.C. to America’s first formal prison — Eastern State Penitentiary, commonly known as Cherry Hill — where the political descendants of Pennsylvania’s Quaker founders embraced this barbaric practice of “burying prisoners alive” when they designed it in 1829.

Harry Hawser, a poet imprisoned there in 1840, referred to his eight-by-twelve-foot solitary confinement cell as “a living tomb.” Current Supreme Court Justice Sonia Sotomayor recently agreed, noting that solitary confinement “comes perilously close to a penal tomb.”

The difference, those early-19th century Pennsylvanians incorrectly believed, was a matter of intent. Convinced that being locked alone in a small cage with no meaningful human contact 24 hours a day for months or years on end would reform criminals, they made solitary confinement a foundational element of Cherry Hill’s design and philosophy.

French historian Alexis de Tocqueville and British author Charles Dickens were horrified when they toured Cherry Hill in 1831 and 1842, respectively. Dickens described solitary confinement as “worse than any torment of the body,” as the prisoner “is a man, buried alive; to be dug out in the slow round of years.” Similarly, de Tocqueville noted that solitary “devours the victim incessantly and unmercifully; it does not reform, it kills.”

Nevertheless, Cherry Hill was celebrated wide and far for its “enlightened” approach to punishment. At least 300 prisons throughout America, Europe, and South America quickly replicated its philosophy and design.

But Pennsylvania discovered almost immediately what was obvious to de Tocqueville: Solitary confinement did not reform men, it drove them mad. The Supreme Court first recognized this undeniable truth as early as 1890.

“A considerable number of the prisoners fell, after even a short confinement, into a semi-fatuous condition, from which it was next to impossible to arouse them, and others became violently insane,” the Court acknowledged. “Others, still, committed suicide, while those who stood the ordeal better were not generally reformed, and in most cases did not recover sufficient mental activity to be of any subsequent service to the community.” See: In re Medley, 134 U.S. 160 (1890).

In the 132 years since acknowledging the devastating psychological impact of solitary confinement, members of the Court have repeatedly returned to it. “Years on end of near total isolation exact a terrible price,” wrote Justice Anthony M. Kennedy in a 2015 concurring opinion. “Common side effects of solitary confinement include anxiety, panic, withdrawal, hallucinations, self-mutilation, and suicidal thoughts and behavior.” See: Davis v. Ayala, 576 U.S. 257 (2015).

Other justices have made similar observations. “We ... know that solitary confinement imprints on those that it clutches a wide range of psychological scars,” Justice Sotomayor noted in 2018, adding with a nod back to Medley:“As far back as 1890, this Court expressed concern about the mental anguish caused by solitary confinement.” See: Apodaca v. Raemisch, 139 S. Ct. 5 (2018).

Apparently sharing this concern, Philadelphians abandoned solitary confinement as a rehabilitative tool at Cherry Hill by 1913. But officials in virtually every prison and jail have continued to embrace solitary confinement for other purposes.

Who Is in Solitary Confinement?

Solitary confinement developed not as a response to violent predators, “but rather as a means for officials to achieve control of political activists and ‘troublemakers’ amongst prisoners,” declared Professor Jules Lobel in an August 2020 Northwestern University Law Review article, explaining that it is justified by a “mythology of the violent predator, for whom prison officials have no alternative but to confine in Draconian isolation from other inmates, staff, and even families and friends.” [See: PLN, Mar. 2021, p.30.]

Citizens for Prison Reform, (CPR), a Michigan civil rights group, agrees. “Despite the perception that these prisoners are the ‘worst of the worst,’ most people in solitary confinement are there because of mental illness or because they are ‘nuisance’ prisoners, who repeatedly have low-level violations,” declared their February 2021 report, Solitary: The Family Experience.

In fact, a Washington Department of Corrections (DOC) review of its 2,500 solitary confinement placements in 2019 and 2020 revealed that over half were made for non-violent offenses. The Vera Institute of Justice made similar findings about the Oregon DOC’s use of solitary confinement in its 2015 report, The Safe Alternatives to Segregation Initiatives: Findings and Recommendations for the Oregon Department of Corrections.

“I served 18 consecutive years in isolation because each minor disciplinary infraction — like having a magazine that had another prisoner’s name on the mailing label — added an additional six months to my time in solitary confinement,” wrote former Florida prisoner Ian Manuel in the New York Times. “The punishments were wholly disproportionate to the infractions. Before I knew it, months in solitary bled into years, years into almost two decades.”

In McClary v. Kelly, 4 F.Supp.2d 195 (W.D.N.Y. 1998), a federal court found that such gross disproportionality between offending conduct and the harshness of the solitary confinement sanction weighs in favor of finding an “atypical and significant hardship” on a prisoner’s protected liberty interest, as laid out in Sandin v. Conner, 515 U.S. 472 (1995), giving rise to a due process violation of his Fourteenth Amendment rights or constituting cruel and unusual punishment in violation of the Eighth Amendment. [See: PLN, Mar. 1999, p.18.]

People of Color

As in most all other aspects of America’s criminal justice system, people of color are disproportionately over-represented in solitary confinement, and they receive longer solitary terms than white people for the same disciplinary infractions.

Reviewing records of nearly 192,000 Florida prisoners between July 1, 2007, and December 31, 2015, researchers at Florida State University and the University of Cincinnati found that Black people were almost twice as likely as white prisoners to be placed in long-term solitary confinement, while Hispanics were 1.7 times more likely to be confined in long-term solitary confinement than whites.

“At the most severe housing assignment, where solitary confinement conditions are the most Draconian,” in North Carolina, “anywhere from 75%–85% of incarcerated people are people of color,” agreed attorney Luke Woollard. [See: PLN, June 2021, p.38.] Texas prisons also place “a lot of Mexican-Americans ... right into solitary confinement as suspected gang members,” without due process protections, noted Marc Levin, vice-president of criminal justice at the Texas Public Policy Foundation. [See: PLN, Oct. 2018, p.26.]

People of color made up 65% of all suicides in New York solitary confinement units according to a May 2020 report by #HALTsolitary Campaign, which analyzed data obtained through public records requests from the state Department of Corrections and Community Supervision (DOCCS) [See: PLN, Dec. 2020, p.48.] Those who spent one to three years there accounted for 35% of the suicides, reflecting a rate 20% higher than those spending less than one year and 15% higher than those confined for three to five years. People serving five–to–ten-year solitary sanctions had the highest suicide rate, nearly twice as high as the general population.

While all incarcerated people of color are more likely than whites to die within one year of release from prison, being locked in solitary confinement only amplifies this risk, according to a 2020 study by researchers at the University of North Carolina, Emory University, and North Carolina’s Department of Public Safety and Department of Public Health.

Mentally Ill Prisoners

“Over the past 30 years, prisons and jails have become the nation’s largest inpatient psychiatric facilities,” notes Solitary Watch. A 2014 Treatment Advocacy Center report, The Treatment of Persons with Mental Illness in Prisons and Jails: A State Survey, found that over 350,000 individuals with severe mental illness were being held in U.S. prisons and jails in 2012, while just 35,000 were patients in state psychiatric hospitals. Thousands of those incarcerated mentally ill people end up in solitary confinement.

Researchers at Florida State University and the University of Cincinnati found that prisoners who spent time in a mental health unit were nearly 14 times more likely to end up in long-term solitary confinement. In a 2003 report, Ill-Equipped: U.S. Prisons and Offenders with Mental Illness, Human Rights Watch estimated based on then-available data from state prisons that one-third to one-half of those in solitary suffered from some form of mental illness.

Former Minnesota GOP state Rep. Nick Zerwas agreed, noting that the population of prisoners in solitary confinement is disproportionately skewed toward those with mental health problems. “We are using solitary confinement to isolate and push aside the mentally ill,” said Zerwas. [See: PLN, Oct. 2018, p.26.]

Alabama also continues “to see the mentally ill kept in extreme isolation, and this is driving a steep rise in suicides,” according to Maria Morris, senior supervising attorney for the Southern Poverty Law Center. The number of mentally ill Alabama prisoners in solitary confinement rose from 196 in 2014 to 274 in 2018, when Morris made her comment. Since then, she noted that the state’s prisoner suicide rate has climbed to “60 per 100,000,” a rate many times higher than the national average of 18.4 per 100,000. [See: PLN, Mar. 2022, p.38.]

Solitary “either creates mental illness where it didn’t exist before, or it can aggravate existing mental illness,” noted Angel D’Angelo, co-founder of Florida’s Restorative Justice Coalition. “It creates a sense of isolation, of course — that’s what it’s there for.” Solitary confinement creates “ubiquitously unhealthy” conditions and causes or worsens chronic mental health issues, especially dementia — common among older prisoners — leading them to violate rules that land them back in solitary, agreed Dr. Brie Williams, criminal justice and health program director and professor at the University of California at San Francisco Medical School.

The American Psychiatric Association, National Commission on Correctional Health Care (NCCHC), National Alliance on Mental Illness, and other professional organizations oppose locking people with serious mental illness in solitary confinement. Sadly, however, those recommendations have fallen on the deaf ears of prison officials and policymakers who routinely lock mentally ill prisoners in solitary confinement.

“They isolate people so they don’t have to deal with them,” said Minnesota prisoner Jayde Moon. “Why don’t they just chop off a body part? It is just as outdated. As a society, don’t we have a better way to deal with mental illness?”

“Now they say that seg is not ‘punishment,’” Moon continued. “But there is a girl I know there who bangs her head ‘til it bleeds just to get out of her cell.”

Prisoner Elizabeth Hawes echoed this sentiment. “People are led to believe that segregation is used to contain extremely dangerous, violent people. In a women’s prison at least, this is hardly the case,” said Hawes. “While women can be and are sent to solitary for fighting, the truth is women are more often there because of mental health issues and for a wide range of petty infractions that have nothing to do with violence.” Of the 51 fellow prisoners she interviewed who had gone to segregation between April and July 2019, “the common denominator was not a tendency for violence, but a history of trauma,” Hawes explained.

As previously reported by PLN, between January 2015 and April 2019, suicide attempts in New York solitary confinement cells accounted for 43% of all DOCCS prisoner suicide attempts, according to a May 2020 report by #HALTsolitary Campaign. The 20 suicides in New York’s Security Housing Units (SHU) is believed to be under-reported. Yet, even if not, the rate is five times higher than the overall New York prison suicide rate. In 2019, the New York solitary suicide rate was ten times the national average. [See: PLN, Dec. 2020, p. 48.] Of course, this will come as no surprise to regular readers of PLN, which has repeatedly reported throughout the years on the extraordinarily high rate of solitary confinement suicides in prisons across the nation.

Sexual Minority Prisoners

Amid the fear and hysteria surrounding the AIDS epidemic during the 1980s and early 1990s, prison officials routinely locked incarcerated prisoners sick with AIDS or infected with HIV in solitary confinement. Now, gay and transgender prisoners continue to be sent there as homophobic guards weaponize the Prison Rape Elimination Act (PREA) against them.

A transgender Oregon prisoner, who asked to be identified only as D.A., was handcuffed and placed in solitary confinement without explanation in April 2021, according to a federal suit she later filed. After a month in solitary, D.A. was finally told that another prisoner had accused her of fondling his penis, which D.A. denied. The charges were later deemed unsubstantiated, and D.A. was released from solitary after serving 11 weeks there.

But six months later, D.A. was again locked in solitary confinement on charges that she consensually kissed another prisoner. D.A. again denied the charge. This time, however, prison officials claimed that they had video evidence of the kiss.

However, when D.A.’s attorney, Katharine Edwards, received the security footage, it showed D.A. and the other prisoner merely talking, with D.A. wearing a face mask the entire time, according to Edwards.

“I watched it from every angle I could find. Zoomed in, slowed down,” said Edwards. “There is absolutely no way anyone could think they were kissing.” Nevertheless, D.A. was found guilty of the disciplinary rule violation. Prison officials later denied a public records request for a copy of the video footage, claiming that it “would allow (prisoners) to avoid surveillance.”

When former Massachusetts prisoner Michael Cox hugged another openly LGBTQ+ prisoner goodbye as they left the prison recreation yard in 2011, guards claimed the hug was a PREA violation, and a Lieutenant ordered: “Lock them up!”

“It was very apparent that it was just a hug,” Cox said. “And even if the suspicion was that we were in an intimate relationship, that shouldn’t be enough to put someone in solitary confinement. It is stigmatizing for LGBT people that we are treated differently than others while in the system. It happens all the time.”

Although PREA does not prohibit hugs, many prisons have imposed hug bans. Former prisoner Kelly Savage-Rodriguez, now a program coordinator with the California Coalition of Women Prisoners (CCWP), said a California prison memorandum prohibited hugs for eight years of her nearly two decades of confinement.

“It was really inappropriate when we would have somebody who the sergeant or captain notified of a loss, and [the individual] couldn’t even get a hug in a serious grief moment,” said Savage-Rodriguez.

Black & Pink, a national LGBTQ+ advocacy group, conducted a survey of 1,118 incarcerated LGBTQ+ individuals and found that 85% of respondents had been locked in solitary confinement, half of them for two years or longer. Transgender prisoners were especially likely to be placed in solitary confinement, often designated as “protective custody.”

Former Nebraska transgender prisoner Dominique Morgan was locked in solitary confinement for 90 days after another prisoner reported her consensual sexual activity with her partner, Doug. Afterwards, Dominique and Doug were transferred to solitary confinement units in different prisons.

“I remember thinking: ‘I’m not violent … I’m stuck in the hole. I’m scared. I’m alone,’” said Morgan, former executive director of Black & Pink. “It was sad to realize it was all because of my sexual orientation and gender identity.”

The ACLU of Nebraska intervened, and Morgan was finally released from solitary confinement after serving 18 months there. She notes that this happened 20 years ago but she continues to hear similar stories from other incarcerated LGBTQ+ people today.

Many are concerned that PREA is “being used as a sword instead of a shield,” admitted Amy Fettig, executive director of the Sentencing Project, who was trained as a PREA auditor and spent years helping finalize the nation’s PREA standards in her previous role as deputy director of the ACLU’s National Prison Project. “Anecdotally, we have heard from clients that affectionate behavior is being criminalized because there is animus towards the LGBT community in prisons,” Fettig said. “PREA doesn’t say no touching … I think when we have seen PREA abused, it is more about homophobia than anything else.”

Jailhouse Lawyers & Politically Active Prisoners

“It was retaliation for litigating,” said former jailhouse lawyer Derrick Hamilton of his ten years in New York’s solitary confinement. “They don’t like people that litigate against them.”

Jailhouse lawyers and other politically active or vocal prisoners frequently find themselves targeted by jail and prison staff who see litigation as a threat. This retaliation often manifests in fabricated disciplinary charges and months or years of solitary confinement. Former jailhouse lawyer Avon Twitty, for example, alleged in a federal suit that his transfer to a highly restrictive unit in the federal Bureau of Prisons (BOP) was in retaliation for his legal work. [See: PLN, Mar.1, 2016, online.] He is, of course, far from alone.

Oregon prison officials retaliated against me — for the second time — in 2021, alleging that in my capacity as an Inmate Legal Assistant (ILA), I had “Compromised an Employee” — which requires proof that the prisoner “knowingly engaged an employee … in a personal relationship” — and sanctioned me to 120 days in solitary confinement. The employee was my supervisor, Oregon State Correctional Institution Library Coordinator Pam McKinney, a 22-year DOC veteran.

Yet, as federal judge Michael H. Simon noted during a hearing on December 6, 2021, McKinney — who resigned under threat of losing half of her retirement, for which she is now suing DOC — submitted a sworn declaration stating, “Wilson never behaved inappropriately throughout my time working with him. Had he done so, I would have removed him from his position as an ILA.”

“I believe that DOC was pushing this narrative because … Wilson had won a lawsuit against them in the past, and they were worried that he would be successful again,” McKinney declared under oath. “I strongly believe that DOC disapproves of … Wilson’s lawsuits and legal actions, and that I am collateral damage.”

During the hearing, Judge Simon asked, “I’m trying to figure out, what did Mr. Wilson do?” Assistant Attorney General Kenneth C. Crowley, who represented state prison officials, offered a less than impressive answer, prompting Simon to find no evidence that I had “compromised” my supervisor.

“I don’t see that … so I think there’s probably even a substantial likelihood of success on the merits,” Simon found. “There is so much here that at a minimum raises serious questions and probably would be enough for a jury to find by circumstantial evidence … that what really was going on was retaliation against Mr. Wilson.” See: Wilson v. Plante, USDC (D. Or), Case No. 6:21-cv-01606.

Oregon Rep. Janelle Bynum (D-Clackamas), Chair of the state House Judiciary Committee, agreed: “There was some level of outrage in terms of the length of time Mr. Wilson was segregated, and whether there was a case of retaliation and unfair treatment.”

Bynum requested that DOC make me available to appear and testify before the Judiciary Committee on January 11, 2022. But after telling the Committee that DOC would comply with the request, then-DOC Director Colette S. Peters — who was appointed as head of the federal BOP effective August 1, 2022 — blocked that requested legislative appearance and testimony. She then personally appeared to offer her own self-serving testimony before declaring “We look forward to litigating this in court.” [See: PLN, Feb 2022, p.22.]

Sadly, Oregon prison officials are far from alone in engaging in this type of blatant retaliation. As also previously reported by PLN, a Florida federal court was forced to issue a protective order prohibiting prison officials from retaliating against prisoners for participating in litigation or discovery in a pending solitary confinement suit there. In doing so, DOC Secretary Mark Inch issued a memorandum on February 13, 2020, which the court found “tacitly admits that retaliation is an ongoing threat.” [See: PLN, Oct. 2021, p.18.]

The harm caused by sending jailhouse lawyers to solitary confinement is great when it ends their individual litigation and advocacy efforts. But the greatest harm it causes is the deep and long-lasting chill it sends throughout the prison population, as other prisoners receive the message that they will suffer the same fate if they dare to sue or grieve prison officials.

As noted by one Oregon jailhouse lawyer, who requested anonymity due to fear of retaliation, working on cases against DOC “puts too much heat on you.” That “heat” typically includes a stay in solitary confinement.

How Many Are in Solitary Confinement?

“The number of people held in solitaryconfinement in the United States has been notoriously difficult to determine,” notes Solitary Watch. “The lack of reliable information is due to state-by-state variances and shortcomings in data gathering and ideas of what constitutes solitary confinement.”

Many prison administrators disingenuously claim they do not use “solitary confinement,” disguising it behind a range of euphemistic terms, including: Administrative Segregation (Ad Seg); Close Management Unit (CMU); “Control Unit”; Disciplinary Segregation Unit (DSU); Intensive Management Units (IMU); “involuntary ad seg”; “involuntary protective custody”; “punitive segregation”; Restricted Housing Unit (RHU); Security Housing Unit (SHU); Special Management Unit (SMU); and “Supermax.”

Florida prison officials, for example, claim that they don’t use solitary confinement while admitting in the next breath that nearly 10,000 prisoners are confined in “restrictive housing,” including what DOC spokesperson Paul Walker calls “Close Management.”

The pervasive linguistic gymnastics that prison officials engage in proves that they clearly understand that “solitary confinement” is bad and they should not be talking about it. Instead of eliminating it, however, they think everything will be okay if they simply rebrand it.

In a sworn declaration on January 11, 2022, Oregon DOC Inspector General (IG) Craig Prins declared that the prison agency’s DSUs “are very different than solitary confinement.” Yet nationally renowned solitary confinement and correctional mental health expert Dr. Terry Kupers noted in his sworn declaration ten days later that “Prins appears to have had little hands-on experience with solitary confinement” and that the IG’s description of DSUs “is a description of solitary confinement according to all standards and research literature in the field of corrections.”

“Currently available estimates suggest that at least 80,000 incarcerated men, women, and children are held in some form of isolated confinement on any given day,” Solitary Watch reports. Justice Sotomayor noted in 2018’s Apodaca ruling that “a recent study estimated that 80,000 to 100,000 people were then held in some form of solitary confinement.”

The U.S. Department of Justice’s Bureau of Justice Statistics also reported the solitary confinement of approximately 80,000 prisoners in both 2000 and 2005, up from 57,591 prisoners in 1995, according to Solitary Watch. [See: PLN, Dec. 2017, p.57.]

“Terms in solitary range from a few days to several decades,” Solitary Watch notes. A 2020 study from the Correctional Leaders Association and the Arthur Liman Center for Public Interest Law at Yale Law School found that about 7,000 prisoners have spent at least one year in solitary confinement and about 1,500 have been isolated for more than six years. “In California in 2011 … nearly all of the 1,100 men in the SHU at Pelican Bay State Prison had been in solitary for five years or more; about half for ten years or more, over 200 for 15 years or more; and 78 for 20 years or more,” Solitary Watch noted, adding: “The group of men incarcerated in Louisiana known as the Angola 3 spent what are likely the longest spans of time in solitary — 29, 42, and 44 years.”

About 10,000 Florida prisoners — one out of eight, or 12% of the prison population — are in solitary confinement, according to the Southern Poverty Law Center. A February 2021 report by Michigan’s CPR found that 47% of the state’s prisoners locked in solitary confinement had been there for more than two consecutive years and 11% for five–20 years. Texas is the leader in prolonged solitary confinement with more than 500 prisoners having served more than ten years there and 138 serving more than 20 years.

Solitary confinement is so pervasive because the Supreme Court Justices who have condemned it have found themselves in the minority, so the Court has effectively sanctioned its use in a half dozen recent cases, from Hutto v. Finney, 437 U.S. 678 (1978), to Hewitt v. Helms, 459 U.S. 460 (1983), to Sandin v. Conner, 515 U.S. 472 (1995), to Wilkinson v. Austin, 545 U.S. 209 (2005), to Davis v. Ayala, 576 U.S. 257 (2015), to Ruiz v. Texas, 580 U.S. 1191 (2017).

Research Establishes Solitary’s Profound Harm

Importantly, however, the Court has never considered the extensive research — which has only grown much stronger in recent years — establishing the devastating harm inflicted by solitary confinement.

“Solitary confinement is one of the most damaging things you can do to a human being,” said David Fathi, director of the ACLU National Prison Project. “People lose their ability to interact with humans, because they’ve been deprived” of social contact.

As Justice Kennedy recognized, the toxic combination of social isolation, sensory deprivation, and enforced idleness results in distinctive psychiatric symptoms, including anxiety, depression, anger, impaired impulse control, paranoia, visual and auditory hallucinations, cognitive disturbances, obsessive thoughts, hypersensitivity to stimuli, posttraumatic stress disorder (PTSD), psychosis, self-harm, and suicide. Given these grave risks, it should come as no surprise that solitary confinement exacerbates pre-existing mental illness.

Physical health also suffers from exposure to solitary confinement as prisoners frequently experience severe headaches, dizziness, lethargy, gastrointestinal and genitourinary problems, diaphoresis, insomnia, eyesight deterioration, profound fatigue, heart palpitations, migraines, back and joint pain, weight loss, diarrhea, and aggravation of pre-existing medical problems.

Just one week of solitary confinement results in decreased electroencephalogram (EEG) activity and increased theta wave activity, which are associated with stress, tension, and anxiety.

Because humans are naturally social beings, it is the “social pain” that isolation inflicts which can be most torturous and damaging, affecting the brain in the same regions and in the same way as physical pain.

Researchers define “social pain” as “the feelings of hurt and distress that come from negative social experiences such as social deprivation, exclusion, rejection, or loss.” This social pain can actually cause longer term suffering than physical pain due to the ability of humans “to relive social pain months or even years later.”

Neuroscience studies also suggest that solitary confinement can “fundamentally alter the structure of the human brain in profound and permanent ways.” The distinctive harm caused by solitary confinement can culminate in a “complete breakdown or disintegration of the identity of the isolated individual.”

Studies show that “after even a relatively brief period of time … an individual is likely to descend into a mental torpor or ‘fog,’ in which alertness, attention, and concentration all become impaired … [T]he individual becomes increasingly incapable of processing external stimuli. … Over time the very absence of stimulation causes whatever stimulation is available to become noxious and irritating.”

Dr. Craig Haney describes the reaction of “isolation panic,” which sets in quickly. “The longer they’re in it, and especially if they’re not sure when they’re going to get out, a range of negative psychological reactions begin to mount.”

“When they put you in solitary confinement, you’re no longer thinking clearly,” said Andrew Johnson, a U.S. Army Veteran who underwent Special Forces training before spending 16 months in solitary confinement in a California jail. “You’re thinking, ‘Oh my God, Oh my God, Oh my God. I’m trapped.’”

Solitary’s damaging effects “can persist long after release from segregation, making it difficult to transition back into life in the prison’s general population and the community.” Over 10,000 prisoners are released directly into the community from solitary confinement each year. Yet, spending any time in solitary confinement increases “the risk of being convicted of another crime within three years after release by about 15%,” according to a June 2020 report in the Cornell Chronicle, quoting a study by College of Human Ecology professor Christopher Wildeman.

A 2018 study of recently released prisoners also found that those with a history of solitary confinement were more than two and a half times more likely to report PTSD symptoms. Individuals who are confined in these environments also have higher rates of suicide and other forms of early death.

“Compared with individuals who were incarcerated and not placed in restrictive housing, individuals who spent time in restrictive housing were 24% more likely to die in the first year after release, especially from suicide (78% more likely) and homicide (54% more likely); they were also 127% more likely to die of opioid overdose in the first two weeks after release,” according to a 2019 study of 229,274 people released from North Carolina prisons from 2000 to 2015. [See: PLN, Dec. 2020, p.49.]

United Nations Condemns Solitary Confinement as Torture

This massive body of research documenting the devastating physical and psychological suffering caused by solitary confinement compelled the United Nations (UN) Special Rapporteur on Torture to declare in 2011 that solitary confinement “can violate the international prohibition against torture and cruel, inhuman and degrading treatment.” In 2014, the Committee Against Torture — the governing body of the Convention Against Torture, to which the U.S. is a party — expressed concern about America’s use of solitary confinement and recommended that the U.S., in its capacity as a party to the Convention Against Torture, limit the use of solitary confinement to a measure of last resort for as short a time as possible.

The UN’s General Assembly unanimously adopted a 2015 resolution titled “Standard Minimum Rules for the Treatment of Prisoners,” commonly known as the “Nelson Mandela Rules.” Those rules declare that under “no circumstance may restrictions or disciplinary sanctions amount to torture or other cruel, inhuman, or degrading treatment or punishment.”  They expressly prohibit “prolonged solitary confinement,” which the UN defines as “solitary confinement … in excess of 15 consecutive days.” Even for periods of less than 15 days, “Solitary confinement shall be used only in exceptional cases as a last resort, for as short a time as possible,” the rules declare.

A large and growing number of national and international organizations have followed the UN’s lead, adopting positions consistent with the Mandela Rules. The World Health Organization (WHO), for example, has taken a position against solitary confinement because of the inherent damage it causes. Likewise, the Association of State Correctional Administrators (ASCA) issued a 2015 report critical of long-term segregation. [See: PLN, Nov. 2015, p. 28.] Standards issued by NCCHC in April 2016 found that solitary confinement exceeding 15 days “is cruel, inhumane, and degrading treatment, and harmful to an individual’s health.” [See: PLN, May 2017, p.20.]

Similarly, the American Bar Association (ABA) has issued Standards for the Treatment of Prisoners for many years, supplemented with a 2018 resolution declaring: “Solitary confinement should be used only in exceptional cases as a measure of last resort, where less restrictive settings are insufficient, and for no longer than is necessary to address the specific reason for placement, typically not to exceed 15 consecutive days.”

“We’re talking about putting someone in a room the size of a parking space,” noted Robert T. Gonzalez, chair of the ABA’s Commission on Disability Rights. “This is inhumane.”

This national and international condemnation of solitary confinement has compelled policymakers and prison officials in many states to significantly reduce or end the use of solitary confinement, in order to comply with the Mandela Rules. There has been a “seismic shift” in the willingness of federal and state authorities to reform or eliminate its use, said the ACLU’s Fathi, who noted that at least 78 laws have been passed by state legislatures to limit solitary confinement over the last five years.

California: 15 CCR§ 3315(a)limits disciplinary segregation to ten days, with limited extensions available with approval of the statewide director or deputy director of institutions of the state Department of Corrections and Rehabilitation, per 15 CCR §§ 3315(c) and 3330.

Colorado: “[L]ong-term solitary confinement used to be a tool that was regularly used in corrections,” former state DOC Executive Director Rick Raemisch admitted in a 2018 essay, after voluntarily spending just 20 grueling hours in solitary confinement at the Colorado State Penitentiary in January 2014. “The problem is that it was not corrective at all. It was indiscriminate punishment that too often amounted to torture and did not make anyone safer.” Announcing that state prisons were ending the use of “longer-term solitary confinement” and limiting each stay to 15 days, Raemisch said the change was needed not only because “research has shown that housing someone in a cell the size of a parking space for 22 or more hours per day for extended periods of time damages them both mentally and physically” but also “because we are committed to public safety.” As he went on to explain, “Since most people who go to prison — 97 percent — return to their community, that means we were releasing people back into their communities in worse shape than when they arrived. That’s why long-term restrictive housing needs to end, not only for the health and wellbeing of incarcerated people — but for the communities to which they will return.” Unfortunately for Colorado prisoners, the COVID-19 pandemic came on the heels of Raemisch’s announcement, sparking lockdowns and isolation that tested the limits of solitary confinement reforms. [See: PLN, July 2021, p. 22.]

Connecticut: The state legislature introduced The Protect Act (Senate Bill 1059) in 2021, proposing to end prolonged solitary confinement. As Judith Resnick and Anna VanCleave of the Yale Law School’s Liman Center for Public Interest Law explained, “Decades ago, prison officials expanded the use of solitary confinement because they believed it could ‘solve’ the problem of dealing with people whom they perceived to be ‘threats’ to institutional security. In contrast, leaders of correctional systems today are part of a nationwide effort to end profound isolation, which they now understand to be a problem itself in need of a solution.” As they point out, “Solitary is not only bad for the people in it; it is also bad for correctional employees who oversee it.” Guards who work in solitary confinement have a 25% higher risk of suffering major depressive disorder, 50% higher risk of [generalized] anxiety, 41% higher risk of PTSD, 25% higher risk of alcohol abuse, and 9% higher risk of suicidal tendencies. [See: PLN, May 2021, p.50.] “Dozens of state legislatures are considering statutes, and some have put restrictions into place,” noted Resnick and VanCleave. “Now it is Connecticut’s turn to move forward.”

Idaho: The state DOC limits disciplinary segregation to 15 days, though a second consecutive sanction is possible with approval by the division chief or designee. Announcing the policy in 2016, former Director Kevin Kempf said his goal was to completely stop using solitary confinement for disciplinary reasons, and the only time a prisoner would be temporarily isolated was when he posed a threat to staff or other prisoners.“But even then, we’re going to follow the Mandela rules,” Kempf promised, “which say that if you put an inmate in a segregation cell, in solitary confinement, for more than 15 days, that’s considered torture.”

Massachusetts: In June 2021, following a comprehensive review that included input from consultants, the public, and DOC administrators, former state Secretary of Public Safety and Security Thomas Turco announced that state prisons were “on a path to eliminating restrictive housing across the system.” [See: PLN, Dec. 2021, p.49.] One of those consultants, Falcon, a Chicago-based firm specializing in prison mental health treatment, issued a 41-page report recommending the outright elimination of the Department Disciplinary Unit (DDU), which is the most severe form of solitary known as “punitive long-term supermaximum confinement.” The report also recommended other changes that could result in the elimination of other forms of solitary confinement. DOC Commissioner Carol Mici claimed her agency “has worked hard to develop creative solutions to the challenge of restrictive housing.” But critics remained skeptical. “We don’t have enough details right now to know what this really means and what those things will be replaced by,” noted Elizabeth Matos of Prisoners’ Legal Services, though she said she was “cautiously optimistic.” Democratic state representatives Brandy Fluker Oakley and Liz Miranda issued a joint statement calling on DOC to immediately implement the changes, saying “DOC has failed to commit to a clear timeline to implement the recommendations of the Falcon report of metrics to measure success, and we must demand better.”

Michigan: On October 19, 2021, the state DOC announced it would limit the use of solitary confinement of pregnant prisoners, effective November 21, 2021. [See: PLN, Nov. 2021, p.50.] The change came following the February 2021 release of a report entitled Solitary: The Family Experience, by CPR, the state civil rights group, which notes that DOC keeps over 3,200 prisoners in solitary confinement at any given time. [See: PLN, May 2021, p.50.]“The damage that is done in solitary cannot be undone,” the report concludes. “It cannot bereversed. We need to take action now so that no other mother needs to watch her child suffer.”

Nebraska: The state Department of Correctional Services ended its use of disciplinary segregation in July 2016. See: 2020 Nebraska DOC Policy, Discipline Rules, 6.

Nevada: The state DOC does not follow the Mandela Rules but only two offenses allow solitary confinement sanctions of more than 60 days: Assault and Battery on Staff (180 days) and Murder (one year). All other violations are ranked from Class A to Class E. The maximum sanction for a Class A violation is 60 days. Only one sanction can be imposed per incident and consecutive sanctions are prohibited.

New Jersey: Legislative reforms enacted in 2019 limit solitary confinement of all incarcerated persons to no more than 20 consecutive days, and no more than 30 days in a 60-day period.

New Mexico: A bill passed by the state legislature in 2019 prohibits use of solitary confinement for children, pregnant women, and the mentally ill. It also requires jails and prisons to report on their use of solitary confinement. [See: PLN, Mar. 2021, p. 34.]

New York: After legislation passed on March 18, 2021, which became effective on March 21, 2022, “No person may be placed in segregated confinement for longer than necessaryand no more than fifteen consecutive dates.” [See: PLN, Aug. 2021, p.26.] The law also requires an intervening period of detention in a residential rehabilitation unit of at least 15 days between each placement in segregation.“It is no secret that the use of solitary confinement is inhumane, unethical, and constitutestorture under international law if it extends more than fifteen days,” said the bill’s sponsor, state Sen. Julia Salazar (D-Brooklyn), who added: “It must be discontinued immediately.” State Senate Majority Leader Andrea Stewart-Cousins (D-Yonkers) said the reforms are “morally right, fiscally responsible, and will improve outcomes at jails and prisons.” Her Deputy Majority Leader, Sen. Michael Gianaris (D-Astoria), also declared that “there should be no place in civilized society for the legalized torture of solitary confinement, which serves no useful purpose.”

North Carolina: The state Department of Public Safety (DPS) was one of five state prison systems selected by the Vera Institute of Justice for a pilot program to reduce the use of solitary confinement. As part of that pilot, DPS adopted new disciplinary rules, generally limiting segregation to no more than 30 days. [See: PLN, Oct. 2018, p. 26.] The rules were part of a larger effort to use “evidence-based practices for managing inmate behavior, thereby creating a safer prison environment,” according to DPS Spokesman Keith Acree.

Oregon: The Oregon Youth Authority (OYA) adopted rules in 2015 limiting the use of solitary confinement to no more than five days and ending the use of disciplinary solitaryconfinement — which it calls “isolation” — except as a last resort to stop or prevent violence, stating: “Isolation must not be used as punishment, as a convenience or substitute for staff supervision, or a substitute for individualized treatment.” OYA then sponsored legislation to incorporate the rule into statute in 2017. Assistant Director of Development Services Erin Fuimaono said this would allow the reforms to continue beyond the terms of current OYA leadership. Sen. James Manning (D-Lane Cty.) — a former prison guard — carried the bill on the floor of the state senate, stating: “We know that locking any person up in isolation as punishment is harmful to them mentally and emotionally.” In a June 2021 policy statement, OYA declared that “[i]solation must be used sparingly and as a final course of action,” and it noted that “Lengthy use of isolation has been linked to adverse psychological reaction, which may exacerbate histories of trauma, cultural trauma (whether personal, historical, or generational), mental health concerns, developmental disability or other cognitive delays.” As a result, “Once it is determined that a youth is emotionally regulated and ready to engage in reintegration planning, the youth must spend as much time out of the isolation room as possible during waking hours.”

Yet, state DOC officials resist similar reforms for adult prisoners. “For the last several years, DOC has been aware of information regarding the effects of long-term isolation on [prisoners], and has been interested in reducing the use of disciplinary segregation and other types of restricted housing,” admitted the IG, Craig Prins, in a January 11, 2022 sworn declaration. Yet, he then offered his baseless opinion that “the imposition of a sanction of no more than 15 days in DSU would be insufficient to deter serious physical assaults on other [prisoners] and staff, and violence would increase as a result.” The actual expert, Dr. Kupers, dismissed these “concerns” outright: “These are misperceptions commonly expressed by some people working in corrections before reforms to long-term disciplinary solitary confinement are implemented,” but the “opinions [expressed] by Mr. Prins fly in the face of a significant amount of research reflecting that when utilization of solitary confinement is robustly reduced, the rates of violence and rule-violation fall.” Kupers added that Prins’ “focus exclusively on violence against other [prisoners] or staff” ignores “the alarmingly high rate of suicide among [prisoners] in solitary confinement.”

Pennsylvania: After reports of abuse by guards at the Allegheny County Jail in Pittsburgh [See: PLN, Sept. 2016, p.27.], nearly 70% of county voters passed a law prohibiting use of solitary confinement at the jail. [See: PLN, Oct. 2021, p.45.] The only exceptions to the ban are during lockdowns, medical or safety emergencies and protective separation requests. “It’s inhumane,” said Brandi Fisher, of Pittsburgh’s Alliance for Police Accountability. “There was an overwhelming response from people who wanted these to be passed.”

Texas: Effective September 1, 2017, the state Department of Criminal Justice (TDCJ) eliminated the use of solitary confinement for disciplinary purposes. However, the change affected only a small percentage of state prisoners: Just 76 prisoners were held in punitive segregation in July 2017. Yet about 3,940 other prisoners were confined in administrative isolation, according to TDCJ spokesman Jason Clark, who claimed they were there for their own protection, to separate them from prison gangs or to minimize danger to staff or other prisoners. [See: PLN, July 2018, p.53.]“You still need security detention because the Hannibal Lecters of the world are still outthere,” claimed Lance Lowry, former head of the Texas guard union. “There are still some badactors in prison that will hurt people.”

Washington: The state DOC abolished the use of disciplinary segregation on September 16, 2021. “We must continue to examine our process and make meaningful changes that are both safe and humane,” DOC declared. “The data shows that the use of disciplinary segregation has many shortcomings, including failing to improve negative behavior.”So all facilities must “promptly transition to more effective sanctions.” DOC Secretary Cheryl Strange said, “The science is clear on this and the science says stop doing it.” Echoed Assistant Secretary Mike Obenland, “[W]e know a lot more now than we did years ago when our practices were designed.” Even Gov. Jay Inslee (D) agreed that “disciplinary segregation has been proven ineffective in our state correctional facilities and ending the practice as a form of discipline is the right thing to do.”

Yet, as PLN has reported, Washington’s move appears more semantic than substantive. Strange quickly issued a follow-up press release on September 30, 2021, declaring that DOC ended only the use of “disciplinary segregation” and will continue to use “administrative segregation” and “maximum custody.” As of March 2022, DOC still held an estimated 600 prisoners in solitary confinement [See: PLN, July 2022, p. 36.] House Bill 1756 would have limited all use of isolation, but it died during the 2022 legislative session. A companion bill, Senate Bill 5639, also failed to make it out of committee.

This growing national movement away from solitary confinement is certainly encouraging. “We are at a tipping point in this country” regarding the use of solitary confinement, declared Jessica Sandoval, the chief strategist with the ACLU National Prison Project’s Stop Solitary Confinement Campaign. We hope she’s right.

Litigation Remains Important Reform Tool

Still litigation — rather than the benevolence of prison officials — has been the primary motivation for recent American solitary confinement reforms. New Mexico’s legislation, for example, is largely the product of one lawyer’s tenacious efforts.

Attorney Matthew Coyte first filed a federal civil rights action for Stephen Slevin, who suffered almost two years of isolation in the Doña Ana County Jail. Slevin rejected the jail’s $25,000 settlement offer and ultimately won a $22 million jury verdict. Since then, Coyte and his small team have won dozens of solitary confinement cases against jails, netting multi-million-dollar settlements in many.

“If we won these cases and didn’t hit them hard in the pocketbook, no one would care,” said Coyte. New Mexico ACLU’s Barron Jones agrees. “I don’t know how successful we would have been in passing our solitary confinement bill here in New Mexico if it wasn’t for the [Slevin] verdict,” he said, noting that sometimes “the only thing that gets people to take action is money.” [See: PLN, Mar. 2021, p. 34.]

Similarly, California made its reforms under pressure from lawsuits, and New York advocates began a large and intense campaign for legislative reforms more than eight years before they were ultimately enacted. State leaders repeatedly killed those efforts until a lawsuit compelled New York officials to agree to change disciplinary segregation policies. [See: PLN, Nov. 2016, p.40; Jul. 2017, p.40; and Aug. 2021, p.26.]

Pressure mounted when teenager Kalief Browder committed suicide following his release from Riker’s Island, where he spent two years in solitary confinement while awaiting trial on low-level theft charges that were ultimately dismissed. The city paid $3.3 million to settle a lawsuit over Browder’s death [See: PLN, Apr. 2019, p.54.]

The final straw appears to have broken the camel’s back in 2019, when a transgender woman suffered an epileptic seizure and died in solitary confinement at Rikers Island. New York’s LBGTQ+ community organized demonstrations in the name of “Justice for Layleen Polanco,” who had been a member of the city’s extravagant ballroom scene. In 2020, the city paid $5.9 million to settle a suit over Polanco’s death [See: PLN, Dec. 2020, p.34.] Solitary confinement reform was introduced and enacted soon thereafter.

Admittedly, solitary confinement litigation is not easy, given the Supreme Court’s repeated endorsement of the practice. However, the standards of decency embodied within the Eighth Amendment have clearly evolved since the Court last considered challenges to solitary confinement, as evidenced by the growing body of research documenting the devastating psychological harm inflicted by solitary confinement and the widely-embraced Mandela Rules.

“A punishment need not leave physical scars to be cruel and unusual,” Justice Sotomayor recognized in 2018’s Apodaca ruling. “We do know that solitary confinement imprints on those that it clutches a wide range of psychological scars.”

As Oregon federal Magistrate Judge Stacie F. Beckerman acknowledged in 2020, “our jurisprudence has not kept pace with the evolving science and social science demonstrating that the solitary aspect of solitary confinement is cruel and unusual.” Though bound by precedent to dismiss the prisoner’s challenge to his solitary confinement, the judge declared that she was joining a “growing number of federal judges” in acknowledging the “research suggesting that the conditions to which inmates in solitary confinement are subjected often lead to profound psychological peril for the [prisoner], and as such, the use of solitary confinement itself may implicate an Eighth Amendment violation.” See: Mora-Contreras v. Peters, 2020 U.S. Dist. LEXIS 76678 (D. Or.).

More Lawsuits Driving Change

Other federal courts are also coming around. As PLN has reported, the U.S. Court of Appeals for the Fourth Circuit held that a Virginia prisoner’s indefinite placement in solitary confinement may constitute “an ‘atypical and significant hardship’” giving rise to a due process claim. [See: PLN, Feb. 2021, p.30.]  

Soon thereafter, on November 12, 2020, Virginia paid 28-year-old mentally ill prisoner Tyquine Rahmer Lee $150,000 and transferred him to New Jersey so he could be closer to his mother, settling claims stemming from his 600 days in solitary confinement that allegedly led to a “complete mental and physical collapse,” in which the prisoner lost the capacity for language and “when he spoke at all, he used an unintelligible string of numbers and nonsense words.” Lee also claimed he “lost the ability to handle the most basic self-care” until his “teeth were badly decayed, he was filthy, had terrible body odor, and he had lost nearly 30 pounds.” He was also unable to recognize his mother during a visit. See: Lee v. Va. Dep’t of Corr., USDC (W.D. Va.), Case No. 2:20-cv-00006.

Then, on January 15, 2021, Virginia paid prisoner Nicolas Reyes $115,000 to settle claims that the state locked him in solitary confinement for 12 years. “Mr. Reyes was in solitary for more than a decade for no legitimate reason — even after [the department] determined he posed no significant threat to security — and his mental illness was evident,” noted ACLU attorney Vishal Agraharkar who represented Reyes. See: Reyes v. Clarke, USDC (E.D. Va.), Case No. 3:18-cv-00611.

Following the payouts to Lee and Reyes, state Sen. Joe Morrissey (D-Henrico) introduced legislation to eliminate solitary confinement during the 2021 legislative session. Solitary “has an extreme mental and physical debilitating effect on individuals and mental health that carries over once they get out,” Morrissey explained. But the bill never made it out of committee. [See: PLN, Apr. 2021, p.30.]

On June 14, 2021, an Illinois federal court granted class certification to a suit brought by six prisoners challenging their solitary confinement. The court rejected Defendants’ argument thatclass certification should be denied because the issues were “subsumed” by another class action. The court also rejected Defendants’ attempt to moot the action by introducing new policies that they claimed “contributed to a sharp decrease in the numbers of segregated prisoners.” The court noted that Defendants did not provide any linkage between the updated policies and a reduced number of prisoners in solitary confinement. See: Davis v. Baldwin, USDC (S.D. Ill.), Case No. 3:16-cv-00600.

“Illinois’ prison system locks up too many people, for too long, in horrific conditions. And as solitary confinement is prison within prison, it, too, is overused,” said Alan Mills, co-lead counsel for the prisoners. “The UN states that over 15 days of solitary is torture, yet sometimes people in Illinois spend decades there. And everyone who spends more than a couple weeks ends up traumatized.” [See: PLN, Oct. 2021, p. 24.]

On February 4, 2021, Disability Rights Connecticut (DRC), the ACLU and Yale Law School’s Lowenstein International Human Rights Law Clinic filed a federal suit seeking to prevent the solitary confinement of mentally ill prisoners in that state. See: Disability Rts. Conn. v. Dep’t of Corr., USDC (D. Conn.), Case No. 3:21-cv-00146.

Five days later, Gov. Ned Lamont (D) announced that by July 1, 2021, the state DOC would permanently close its supermax unit, which had been open since 1995. “Nobody should be subjected to degrading and inhumane confinement,” said Deborah Dorfman, DRC executive director, “especially those whose behavior can only be addressed by treatment and rehabilitation, not humiliation and infliction of mental and physical pain, and disability discrimination.” [See: PLN, June 2021, p. 30.]

Beyond the Eighth Amendment, solitary confinement suits may also be brought under more favorable state constitutional provisions, like Oregon’s Article I, § 13, which prohibits subjecting prisoners to “unnecessary rigor.” The Oregon Supreme Court has recognized that this is a prohibition upon “needlessly harsh, degrading, or dehumanizing treatment of prisoners.” See: Sterling v. Cupp, 290 Ore. 611 (1981).

It appears that several states have comparable prohibitions, as the Oregon Supreme Court noted that the state’s “unnecessary rigor” clause has “antecedents as early as New Hampshire’s 1783 constitution, whose provisions came to Oregon by way of Ohio and Indiana.” The Court also noted similar “unnecessary rigor” prohibitions in Georgia, Tennessee, Utah and Wyoming.

Whether challenges are brought under the Eighth Amendment or state “unnecessary rigor” prohibitions, any challenge must not lose sight of the fact that “it is widely recognized … that even convicted prisoners retain claims to personal dignity,” embodied in the Universal Declaration of Human Rights, which proclaims: “All persons deprived of their liberty shall be treated with humanity and with respect for the inherent dignity of the human person.”

The Supreme Court has repeatedly acknowledged that “prisoners retain the essence of human dignity inherent in all persons. Respect for that dignity animates the Eighth Amendment prohibition against cruel and unusual punishment.” See: Brown v. Plata, 563 U.S. 493 (2011).

Yet author Guenther, like so many others, recognizes that “human dignity” is exactly what prisoners are stripped of within solitary confinement. “Under conditions like these, prisoners are not only dehumanized, they are de-animalized,” she argues. “Not only their human dignity but also their dignity as living beings is violated and exploited.”

Zach Norris put it best in his hope-inspiring book, We Keep Us Safe: “Real safety results from reinstating full humanity and agency for everyone who has been dehumanized and traumatized, so they can participate fully in society.” So the only remaining question is what more is it going to take for us, as a society, to finally stop torturing, dehumanizing, and destroying people in solitary confinement?  

Additional sources:, Black & Pink News;,,,,,,,,; Karen D. Davis, Herta Flor, and Henry T. Greely, at al., Brain Imaging Tests for Chronic Pain: Medical, Legal and Ethical Issues and Recommendations, Nature Reviews Neurology 13 (2017); Paul Gendreau, N.L., Freedman, G.J.S. Wilde & G.D. Scott, Changes in EEG Alpha Frequency and Evoked Response Latency During Solitary Confinement, 79 J. Abnormal Psychol. (1972); Stuart Grassian, Psychiatric Effects of Solitary Confinement, Wash. U. J. Law & Pol’y, Vol 22 (2006); Brian O. Hagan, et al., History of Solitary Confinement Is Associated with Post-Traumatic Stress Disorder Symptoms Among Individuals Recently Released from Prison, J. Urban Health volume 95 (2018); Hallinan, Joseph. Going Up The River, Travels in a Prison Nation, (New York, NY: Random House 2003); Craig Haney, Mental Health Issues in Long-Term Solitary and ‘Supermax’ Confinement (Jan. l, 2003); Health in Prisons: A WHO Guide to the Essentials in Prison Health (Copenhagen: World Health Organization, 2007); Tiana Herring, Prison Pol’y Init., The research is clear: Solitary confinement causes long-lasting harm (Dec. 8, 2020); Johnson, Robert. Hard Time, Understanding and Reforming the Prison, (2d ed.)(Belmont, CA: Wadsworth Publishing Co 1996); Juleyka Lantigua-Williams. The Link Between Race and Solitary Confinement, The Atlantic (2016); A.C. Pustilnik, Imaging Brains, Changing Minds: How Pain Neuroimaging Can Inform the Law, Alabama Law Review 66 (5)(2015); Rick Raemisch, Why I Ended the Horror of Long-Term Solitary in Colorado’s Prisons (ACLU)(2018); Alexander J. Shackman, Tim V. Salomons, and Heleen A. Slagter, et al., The Integration of Negative Affect, Pain and Cognitive Control in the Cingulate Cortex, Nature Reviews Neuroscience 12(2011); Peter Scharff Smith, The Effects of Solitary Confinement on Prison Inmates: A Brief History and Review of the Literature 441,475 Crime & Justice Vol. 34, No. l (2006); Southern Poverty Law Center, Solitary Confinement: Inhumane, Ineffective, and Wasteful, (2019).

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