Isolation: many have long-term health problems

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By Katja Ridderbusch

Sometimes Pamela Winn isn’t quite sure how to connect with people, even the ones she loves, like her 9 month old granddaughter. When the baby is in her arms, “I’m just sitting there, and I don’t know what to say. What to do, she said, her eyes filled with tears. “My socialization skills are just not there anymore.”

On days like these, Winn, who lives south of Atlanta, is haunted by the memory of her 6ft by 9ft jail cell, where she spent eight months in solitary confinement over 10 years ago. years. She said she now felt “safer when I’m alone”.

It is a common paradox of solitary confinement, said Craig haney, professor of social psychology at the University of California-Santa Cruz. Instead of wanting the company of others after being released from social isolation, many former inmates want the exact opposite.

“Isolation forces prisoners to live in a world without people,” he said. “And they adapt to it.”

Research has long shown that solitary confinement – isolating prisoners for weeks, months, years, and sometimes decades – has devastating effects on their physical and mental health. Once released, whether in the general prison population or in the outside world, they may face a series of problems, such as heart damage and depression. They are often hypersensitive to light, sound, smell or touch. Like Winn, they may have a hard time reading social cues. People, Haney said, “become a source of anxiety rather than support.”

And the coronavirus pandemic may have made matters worse.

Before the pandemic, the estimated number of people in solitary confinement in the United States ranged from 50,000 to 80,000 every day, although many advocacy organizations believe the numbers are underestimated. The Centers for Disease Control and Prevention says medical isolation – the separation of people with contagious disease from the rest of the population – should not depend on solitary confinement. Yet at the height of the pandemic last year, as many as 300,000 incarcerated people were in isolation, according to estimates by The Lonely Eve and the Marshall Project, nonprofit organizations focused on criminal justice.

“Prisons and prisons, like many organizations, have acted in fear,” said Tammie gregg, Deputy Director of the National Prison Project of the American Civil Liberties Union. “They thought the way to keep people from getting infected was to simply put them in isolation.”

Solitary confinement can serve many purposes, from punishment to protection. And it’s called a lot of things – protective custody, restrictive or secure housing, administrative or disciplinary isolation, or just “the hole.”

“The conditions are essentially the same: it’s the extreme deprivation of any meaningful social contact,” Haney said.

In the so-called Mandela Rules, named after South African leader Nelson Mandela, who was jailed for 27 years, the The United Nations associates solitary confinement for more than 15 consecutive days with a form of torture. More than half of all US states have introduced or passed some type of legislation restricting or regulating the use of solitary confinement, such as limiting the practice for minors, for example. But it is still widely used in American prisons and prisons.

Inmates in segregation typically live in a small cell for up to 23 hours a day. They have little sensory stimulation, like sunlight. Access to reading materials, educational programs and personal belongings is limited or non-existent. Prisoners can spend an hour in a playground, an equally secluded area usually enclosed or surrounded by concrete walls, with a tall, secure window that opens to let in fresh air.

Analysis by researchers at the University of Colorado and Human Rights Watch suggests that more than half of all suicides in prison occur in solitary confinement. A New York City Department of Health and Mental Hygiene study found that the rate of self-harm among people in segregation is 10 times that of the general prison population.

Isolation can be particularly unsettling for people with pre-existing mental health issues, often exacerbating the underlying issues that cause people to end up behind bars in the first place. “It’s a downward spiral,” Haney said.

A Florida State University A study published earlier this year found that inmates with mental illness, particularly bipolar disorder, severe depression and schizophrenia, were up to 170% more likely to be placed in segregation for long periods of time. In many prisons, experts worry, mental health care is non-existent, making matters worse.

But even among people with no history of mental health problems, it may be impossible to predict who is susceptible to the harmful effects of solitary confinement, including suicide.

Pamela Winn, a registered nurse by training, was incarcerated in 2008 and later sentenced to 6.5 years in federal prison for healthcare fraud. As the now 53-year-old African American woman with red-colored curls sits in her ranch house, her mind returns to what she said was the darkest time of her life.

Pamela Winn was put in solitary confinement for what she was told to be a medical observation. Those eight months of isolation marked her for life, she says. (Katja Ridderbusch for KHN)

When she entered a federal detention center south of Atlanta, she said, she was a healthy woman. She was also six weeks pregnant. One day, she fell while trying to get into a van while in chains. Three months later, she miscarried and was put in solitary confinement for what she was told was a medical observation.

After a few months, she was transferred to a municipal prison, where she was again placed in solitary confinement, this time for protection. For a total of eight months, at two facilities, she lived in tiny cells, with iron beds, thin foam mattresses, and metal sinks with attached toilets.

“No window. No mirror. No clock. No notion of time, ”she said. She was allowed out of her cell for one hour a day. She could shower three times a week if staff were available.

At first, she replayed the traumatic memory of the night she lost her baby. Finally, she joined the group when other inmates screamed in their cells.

” I acted. I threw things against the wall. I was angry, “she said. Before falling asleep she prayed that God would take her.” But I kept waking up.

In Haney’s experience, prisoners who develop a strategy to resist the excruciating loop of idleness have a better chance of surviving. Some individuals force themselves to maintain a routine, to act as if there is consistency in their life, “even if there isn’t,” he says.

Winn said she had developed a strategy: she would start the day by praying. She would imagine what her two teenage sons were doing. She did sit-ups and mental exercises, like remembering street names. After solitary confinement, she served most of her sentence in a Florida federal prison and was released in 2013.

Her time in isolation marked her for life, she said. To this day, she suffers from high blood pressure. Paranoia is a constant companion; her house is surrounded by a strong wooden fence with a security gate and she has two Rottweilers. Small spaces make her anxious and she cannot tolerate strangers approaching too close, like in a line of cafes.

As she struggles to connect with her granddaughter, Winn keeps a diary, hoping that one day, when her granddaughter is old enough, she will understand.

“She can read it and learn whatever is in my heart and in my head… if I’m still here, if I’m not there, wherever I am.”

Haney and Gregg both said jails and jails have alternatives to extreme long-term isolation. Mentally disturbed prisoners who commit disciplinary offenses should be placed in a treatment-oriented unit, Haney said.

For someone acting violently, solitary confinement should only be a short-term solution to acutely defuse the blast, Gregg said. Then these people should go to units that provide programming to address the root cause of their behavior. This can mean separation from the general prison population, but less time in total isolation.

A similar model could also apply to inmates placed in segregation for their own safety, such as former Minneapolis cop Derek Chauvin, who is serving a 22-and-a-half-year sentence for the murder of George Floyd. They could be placed in smaller units with people who have undergone a thorough risk assessment and have access to education and training, Haney said.

Prisoner advocates hope that solitary confinement in the United States will ultimately be a concept of the past. In April, New York became the first state to codify the UN Mandela rules that prohibit isolation after 15 consecutive days, when the End of Solitary Confinement Act has been promulgated. The legislation will come into force next April.

After Winn’s release from prison, she founded RestoreHER, a non-profit organization that campaigns to end the mass incarceration of women of color, and pregnant people in particular. She also helped enact laws in Georgia and North Carolina banning chaining of pregnant women.

“What I’m doing now gives me a bit of redemption,” she said.

Katja Ridderbusch is an Atlanta-based journalist who works for news organizations in the United States and her native Germany. His stories have been published in Kaiser Health News, US News & World Report, USA Today, and several NPR affiliates.


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