Psychological Distress in Solitary Confinement: Symptoms, Severity, and Prevalence in the United States, 2017–2018
Open accessAbstract
Objectives. To specify symptoms and measure prevalence of psychological distress among incarcerated people in long-term solitary confinement. Methods. We gathered data via semistructured, in-depth interviews; Brief Psychiatric Rating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary files for 106 randomly selected people in solitary confinement in the Washington State Department of Corrections in 2017. We performed 1-year follow-up interviews and BPRS assessments with 80 of these incarcerated people, and we present the results of our qualitative content analysis and descriptive statistics. Results. BPRS results showed clinically significant symptoms of depression, anxiety, or guilt among half of our research sample. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations. Interview content analysis revealed additional symptoms, including social isolation, loss of identity, and sensory hypersensitivity. Conclusions. Our coordinated study of rating scale, interview, and administrative data illustrates the public health crisis of solitary confinement. Because 95% or more of all incarcerated people, including those who experienced solitary confinement, are eventually released, understanding disproportionate psychopathology matters for developing prevention policies and addressing the unique needs of people who have experienced solitary confinement, an extreme element of mass incarceration.
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Many studies document psychological harms of segregation, including associations between solitary confinement and self-harm, anxiety, depression, paranoia, and aggression.
“There are many studies that document the psychological harms of segregation, including associations between solitary confinement and self-harm, anxiety, depression, paranoia, and aggression, among other symptoms [25].”
Cites
The Brief Psychiatric Rating Scale.
Overall, J. E., & Gorham, D. R. (1962) · Psychological Reports · doi:10.2466/pr0.1962.10.3.799 · Cited by 11,090 · see citing works
Constructing grounded theory. A practical guide through qualitative analysis
Brink, E., Dellve, L., Hallberg, U. E., Abrahamsson, K. H., Klingberg, G., & Wentz, K. (2006) · International Journal of Qualitative Studies on Health and Well-Being · doi:10.3402/qhw.v1i3.4932 · Cited by 6,909 · see citing works
Mental Health Problems of Prison and Jail Inmates
James, D. J., & Glaze, L. E. (2006) · PsycEXTRA Dataset · doi:10.1037/e557002006-001 · Cited by 1,546 · see citing works
Mental Health Issues in Long-Term Solitary and “Supermax” Confinement
Haney, C. (2003) · Crime & Delinquency · doi:10.1177/0011128702239239 · Cited by 537 · see citing works
Ventura, J., Nuechterlein, K. H., Subotnik, K. L., Gutkind, D., & Gilbert, E. A. (2000) · Psychiatry Research · doi:10.1016/s0165-1781(00)00228-6 · Cited by 357 · see citing works
Self-citationSolitary confinement and risk of self-harm among jail inmates
Kaba, F., Lewis, A., Glowa-Kollisch, S., Hadler, J., Lee, D., Alper, H., Selling, D., MacDonald, R., Solimo, A., Parsons, A., et al. (2014) · American Journal of Public Health · doi:10.2105/ajph.2013.301742 · Cited by 252 · see citing works
The Psychological Effects of Solitary Confinement: A Systematic Critique
Haney, C. W. (2018) · Crime and Justice · doi:10.1086/696041 · Cited by 146 · see citing works
23/7: Pelican Bay Prison and the Rise of Long-Term Solitary Confinement
Guenther, L. (2017) · Journal of American History · doi:10.1093/jahist/jax550 · Cited by 134 · see citing works
Public Health and Solitary Confinement in the United States
Cloud, D. H., Drucker, E., Browne, A., & Parsons, J. (2014) · American Journal of Public Health · doi:10.2105/ajph.2014.302205 · Cited by 128 · see citing works
Reiter, K., Sexton, L., & Sumner, J. (2017) · Punishment & Society · doi:10.1177/1462474517737273 · Cited by 121 · see citing works
Self-citationProspective cohort study of mental health during imprisonment
Hassan, L., Birmingham, L., Harty, M. A., Jarrett, M., Jones, P. B., King, C., Lathlean, J., Lowthian, C., Mills, A., Senior, J., et al. (2011) · The British Journal of Psychiatry · doi:10.1192/bjp.bp.110.080333 · Cited by 106 · see citing works
Senior, J., Birmingham, L., Harty, M. A., Hassan, L., Hayes, A. J., Kendall, K., King, C., Lathlean, J., Lowthian, C., Mills, A., et al. (2012) · Psychological Medicine · doi:10.1017/s0033291712002073 · Cited by 97 · see citing works
Quantitative syntheses of the effects of administrative segregation on inmates’ well-being.
Morgan, R. D., Gendreau, P., Smith, P., Gray, A. L., Labrecque, R. M., MacLean, N., Horn, S. A. V., Bolaños, A. D., Batastini, A. B., & Mills, J. F. (2016) · Psychology Public Policy and Law · doi:10.1037/law0000089 · Cited by 96 · see citing works
Study retention as bias reduction in a hard-to-reach population
Western, B., Braga, A. A., Hureau, D. M., & Sirois, C. (2016) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1604138113 · Cited by 82 · see citing works
Persistence Pays Off: Follow-Up Methods for Difficult-to-Track Longitudinal Samples
Kleschinsky, J. H., Bosworth, L. B., Nelson, S. E., Walsh, E. K., & Shaffer, H. J. (2009) · Journal of Studies on Alcohol and Drugs · doi:10.15288/jsad.2009.70.751 · Cited by 69 · see citing works
A longitudinal study of administrative segregation.
O'Keefe, M. L., Klebe, K. J., Metzner, J. L., Dvoskin, J. A., Fellner, J., & Stucker, A. M. (2013) · PubMed · Cited by 66 · see citing works
Patterns of Disturbed Behavior in a Supermax Population
Lovell, D. (2008) · Criminal Justice and Behavior · doi:10.1177/0093854808318584 · Cited by 63 · see citing works
Self-citationAssessment of psychosocial impairment in a supermaximum security unit sample
Cloyes, K. G., Lovell, D., Allen, D. G., & Rhodes, L. A. (2006) · Criminal Justice and Behavior · doi:10.1177/0093854806288143 · Cited by 61 · see citing works
Self-citationTotal Confinement: Madness and Reason in the Maximum Security Prison
Thomas, J. (2005) · Contemporary Sociology A Journal of Reviews · doi:10.1177/009430610503400447 · Cited by 38 · see citing works
Calavita, K., & Jenness, V. (2014) · University of California Press eBooks · doi:10.1525/california/9780520284173.001.0001 · Cited by 36 · see citing works
Pathological Effects of the Supermaximum Prison
Rhodes, L. A. (2005) · American Journal of Public Health · doi:10.2105/ajph.2005.070045 · Cited by 35 · see citing works
Reiter, K., & Koenig, A. (2015) · Palgrave Macmillan UK eBooks · doi:10.1057/9781137441157 · Cited by 29 · see citing works
Self-citationWalters, G. D. (2018) · Criminal Justice and Behavior · doi:10.1177/0093854818780177 · Cited by 18 · see citing works
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Sideropoulos, V., Kye, H., Dukes, D., Samson, A. C., Palikara, O., & Van Herwegen, J. (2023) · Journal of Autism and Developmental Disorders · doi:10.1007/s10803-022-05450-0 · Cited by 21 · see citing works
Pang, N. T. P., James, S., Giloi, N., Rahim, S. S. S. A., Omar, A., Jeffree, M. S., Hayati, F., Lim, M. C., Kassim, M. A. M., & Ng, J. R. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18189656 · Cited by 19 · see citing works
Bursky, M., Kosuri, M., Walsh Carson, K., Babad, S., Iskhakova, A., & Nikulina, V. (2023) · Psychological Reports · doi:10.1177/00332941211048734 · Cited by 13 · see citing works
- Authors
- Reiter, K., Ventura, J., Lovell, D., Augustine, D., Barragan, M., Blair, T., Chesnut, K., Dashtgard, P., Gonzalez, G., Pifer, N., & Strong, J.
- Affiliations
- University of California, Los Angeles (US)
- Keramet Reiter is with the Department of Criminology, Law, and Society and the School of Law, University of California, Irvine. Joseph Ventura is with the Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles. David Lovell is with the School of Nursing, University of Washington, Seattle. Dallas Augustine, Melissa Barragan, Kelsie Chesnut, and Gabriela Gonzalez are doctoral candidates in the Department of Criminology, Law, and Society, University of California, Irvine....
- ORCID
- Venue
- American Journal of Public Health
- Publisher
- American Public Health Association
- Published
- 2020-01
- Volume
- 110
- Issue
- S1
- Pages
- S56-S62
- ISSN
- 0090-0036 (ISSN-L)
- 1541-0048
- PMC
- PMC6987940
- OpenAlex
- W3001865546
- Cited by
- 133
- References
- 23
- Citations by year
- 2026: 10 · 2025: 22 · 2024: 20 · 2023: 20 · 2022: 23 · 2021: 29 · 2020: 9
- FWCI
- 27.07
- 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)
- Journal of Media Literacy Education (submittedVersion, cc-by)
- Topics
- Social Sciences › Sociology and Political Science › Criminal Justice and Corrections Analysis
- Social Sciences › Psychology › Clinical Psychology › Psychopathy, Forensic Psychiatry, Sexual Offending
- Social Sciences › Law › Criminal Justice and Penology
- Keywords
- solitary confinement, psychological distress, prisoners, depression, anxiety, guilt, severe mental illness, self-harm, social isolation, sensory hypersensitivity, identity loss, mass incarceration
- MeSH terms
- Psychological Distress, Adult, Aged, Cross-Sectional Studies, Humans, Male, Middle Aged, Prisoners, Prisons, Social Isolation, Stress, Psychological, United States, Prevalence, Young Adult
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