Solitary confinement and risk of self-harm among jail inmates
Open accessAbstract
OBJECTIVES: We sought to better understand acts of self-harm among inmates in correctional institutions. METHODS: We analyzed data from medical records on 244 699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013. RESULTS: In 1303 (0.05%) of these incarcerations, 2182 acts of self-harm were committed, (103 potentially fatal and 7 fatal). Although only 7.3% of admissions included any solitary confinement, 53.3% of acts of self-harm and 45.0% of acts of potentially fatal self-harm occurred within this group. After we controlled for gender, age, race/ethnicity, serious mental illness, and length of stay, we found self-harm to be associated significantly with being in solitary confinement at least once, serious mental illness, being aged 18 years or younger, and being Latino or White, regardless of gender. CONCLUSIONS: These self-harm predictors are consistent with our clinical impressions as jail health service managers. Because of this concern, the New York City jail system has modified its practices to direct inmates with mental illness who violate jail rules to more clinical settings and eliminate solitary confinement for those with serious mental illness.
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In adolescent prisoners, being younger than 19 and assignment to solitary confinement were the two strongest predictors of self-harm.
“These detrimental effects are amplified in adolescent prisoners: one study showed that being younger than 19 years of age and assignment to solitary confinement were the two strongest predictors of self harm in prisoners.58”
From The effects of social deprivation on adolescent development and mental health (2020) · cites this paper as [58]
Results Table 2 identifies age 18 or younger and solitary confinement as strong predictors of self-harm, but serious mental illness has a higher odds ratio than either (7.97 versus 7.50 and 6.89). The analysis covers the New York City jail population, not adolescent prisoners alone. It therefore does not show that age and solitary confinement were the two strongest predictors among adolescents. (LLM, conf=0.88)
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Experimental — accuracy not yet measuredSelf-harming is highly prevalent among incarcerated individuals.
“Kaba et al. (2014) even noted that self-harming is highly prevalent among incarcerated individuals.”
From A Scoping Review of the Relationships Between Cash Bail, Failure to Appear, Re-Arrest, Health and Well-Being, Race, and Gender (2026) · cites this paper as Kaba et al. (2014)
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“These detrimental effects are amplified in adolescent prisoners: one study showed that being younger than 19 and assignment to solitary confinement were the two strongest predictors of self-harm in prisoners( 59 ).”
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“In addition, being institutionalized has also been connected to adverse mental and physical health outcomes (Crane & Pascoe, 2021; Johnson et al., 2021; Kaba et al., 2014).”
- Authors
- Kaba, F., Lewis, A., Glowa-Kollisch, S., Hadler, J., Lee, D., Alper, H., Selling, D., MacDonald, R., Solimo, A., Parsons, A., & Venters, H.
- Affiliations
- New York City Department of Health and Mental Hygiene (US)
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2014-03
- Volume
- 104
- Issue
- 3
- Pages
- 442-447
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC3953781
- OpenAlex
- W2073384691
- Cited by
- 252
- References
- 9
- Citations by year
- 2026: 4 · 2025: 21 · 2024: 12 · 2023: 21 · 2022: 39 · 2021: 27 · 2020: 26 · 2019: 19 · 2018: 31 · 2017: 20 · 2016: 16 · 2015: 11 · 2014: 5
- FWCI
- 56.29
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Public Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- Topics
- Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
- Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
- Social Sciences › Law › Criminal Justice and Penology
- Keywords
- solitary confinement, self-harm, jail inmates, severe mental illness, juvenile offenders, risk factors
- MeSH terms
- Adolescent, Adult, Mental Disorders, Female, Humans, Male, Medical Audit, Middle Aged, New York City, Prisoners, Social Isolation, Multivariate Analysis, Self-Injurious Behavior, Age Distribution, Sex Distribution, Risk Assessment, Young Adult
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