Report: Segregation can lead to increased symptoms of mental illness in inmates

A new report from an inmates-rights advocacy group is calling for fewer prison inmates to be placed in segregation based on research that shows that segregation can lead to a higher risk for mental illness.

In “Locked Up and Locked Down: Segregation of Inmates with Mental Illness” — which was compiled by the Amplifying Voices of Inmates with Disabilities Prison Project, the National Disability Rights Network and protection and advocacy agencies in 20 states — Anna Guy, AVID attorney, writes that roughly 80,000 to 100,000 inmates are placed in single-person cells for 22 to 24 hours a day for days, months or even years. Most segregation cells are six-by-eight feet and contain a bed, sink and toilet.

While most prisons have claimed that segregating some inmates is necessary to reduce institutional violence, Guy writes that there is no research to suggest that segregation increases safety. Instead, Guy said many of the inmates who are in segregation are there because of behaviors related to mental illness, or later develop symptoms of mental illness because of their isolation.

“Segregation is harmful for all inmates, but it’s particularly harmful for inmates with mental illness who have unique therapeutic needs that are generally unavailable in prisons,” Guy said in a statement.  “In drafting this report, we found that inmates with mental illness from all over the country are routinely placed in the most restrictive form of segregated housing where they receive even less mental health care and are treated even more harshly than other inmates in segregation for serious rules violation, resulting in increased punishment based solely on their disability.”

Guy’s report references a recent case in Indiana, Indiana Protection and Advocacy Services Commission v. Commissioner, Indiana Department of Correction, in which a court found that the Indiana Department of Correction’s policies for segregation of inmates with mental illnesses violated the Eighth Amendment prohibitions against cruel and unusual punishment. The Department of Correction and the plaintiffs in the case – the Indiana Protection and Advocacy Services Commission (now Indiana Disability Rights) and the ACLU of Indiana – came to an agreement that makes improvements to the conditions for inmates with mental illnesses, including the prohibition of segregation of inmates with serious mental illnesses, with some exceptions.

“This case underscores the importance of access to care for people with mental illness and highlights the need for reform in our mental health system,” Indiana Disability Rights Executive Director Dawn Adams said in a statement.

The report, which can be read here, features examples of both litigation and non-litigation advocacy cases that show sensory deprivation, psychiatric decompensation and self-harm or suicidal behaviors exhibited by inmates with mental illness and segregation. Further, the report says that prison employees who work in these units are often untrained to deal with the symptoms of mental illness, which has resulted in chemical agents such as pepper spray or physical restraints being used to control the behaviors of segregated inmates who suffer from mental illness.
Additionally, inmates in segregation are often required to be escorted throughout the prison in restraints and accompanied by at least two officers, which reduces socialization opportunities, the report says.

“This and other security restrictions often result in limited access to programs such as skill building, education, vocational training, group therapy, socialization or other activities,” Guy writes in the report. “These activities are important tools for helping inmates learn skills for daily living and medication compliance, including how to take care of their most basic personal hygiene and everyday needs.”

To address the research and concerns included in the report on a national level, Guy offered five recommendations:

• Increased federal funding to the protection and advocacy networks for corrections-based monitoring and advocacy;
• Creation of independent corrections ombuds offices at the state level in order to address inmate concerns before they rise to the level of litigation;
• Increased data collection by the U.S. Department of Justice’s Bureau of Justice Statistics regarding the prevalence of people with mental illness in U.S. prisons and jails;
• Increased monitoring and outreach in prisons by protection and advocacy networks across the country; and
• Fostering of collaborative relationships between state prison systems and protection and advocacy networks.