Mental health disparities in solitary confinement

Abstract

Harsh prison conditions have been widely examined for their effects on the mental health of incarcerated people. Few studies of punishment examine how mental health status could expose individuals to greater risk of harsh and punitive treatment in the criminal justice system. With prisoners confined to their cells for up to 23 hours each day, often deprived of visitors or phone calls, solitary confinement is an important case for studying both harsh treatment and cumulative disadvantage. Routinely used as punishment for prison misconduct, the quasi-legal process leading to solitary confinement may be subject to the same forces that criminalize the mentally ill in community settings, and drive disparities in treatment. Analyzing a large administrative dataset showing admissions to solitary confinement, we find very high rates of punitive isolation among those with serious mental illness that result from the cumulative effects of disciplinary tickets and disciplinary hearings, in which long periods of solitary confinement are disproportionately dispensed to the mentally ill. We estimate that prisoners with serious mental illness could expect to spend three to four times longer in solitary confinement than a similar person with no history of mental illness. These findings suggest the stigma of dangerousness follows individuals into prison, providing new evidence of how the criminalization of mental health conditions also accompany greater severity of incarceration.