To Torture or to Treat?

The Realities of Solitary Confinement

In early August, ACLU-DE, Community Legal Aid Society, Inc. (CLASI), and Pepper Hamilton LLP filed a suit claiming that Delaware Department of Corrections’ treatment of over 100 inmates with mental illness held in solitary confinement violates both the U.S. and Delaware constitutions. CLASI executive director Dan Atkins recently chatted with us about the realities of solitary confinement in Delaware.

connection: You talked to a lot of prisoners about their experience in solitary confinement. Can you walk us through a typical inmate’s week?

Atkins: What makes solitary so brutally dangerous is the sameness, the extreme isolation, the complete deprivation of human contact. Four days a week, the prisoner in solitary is kept in his cell 24 hours per day. Meals are delivered to his cell through a slot in the door. The toilet is in the cell. He will not leave at all. Three days a week, he will be offered a chance to leave the cell for one hour, at which time he can shower and recreate—which means he is put in a larger cage without any equipment other than a pull-up bar, and no room to run. Still without any other meaningful contact with others. No chance to talk with anyone.

connection: How does an inmate end up in solitary?

Atkins: Typically one of two reasons—he breaks rules and so as punishment is sent to solitary, or he is put there because he may be vulnerable to abuse if in general population. We are concerned that the system does not do a good job of distinguishing truly volitional bad behavior from behavior that is symptomatic of serious mental illness, so essentially the prison is often punishing people for being seriously mentally ill.

connection: This suit specifically addresses inmates diagnosed with severe mental illnesses. What level of mental health treatment do they receive in solitary?

Atkins: Of the dozens of people in solitary we interviewed, most were receiving no mental health treatment other than medication and a check-in at their cell door during which a mental health worker asks, “How are you doing,” and they reply, “Fine,” because they have no expectation that saying they need help will lead to treatment, and because they don’t want to disclose private information when other inmates or officers can hear. Most are not receiving individual therapy and none are receiving group therapy. Everyone receives a packet of worksheets, regardless of their literacy level, instead of real treatment.

connection: So what should “meaningful mental health treatment” look like?

Atkins: People with mental illness have a right to treatment, even when they are in prison, just like someone with diabetes has a right to receive insulin. We’re working with an expert psychiatrist who has helped reform solitary confinement throughout the country. The accepted treatments include individual and group therapies and daily opportunity to be out of the cell in order to interact with other human beings.

connection: We only put the worst of the worst in solitary confinement, right? These guys are never getting out?

Atkins: The overwhelming majority of prisoners in solitary will be getting out of prison. Which raises an important public policy question—what is better for our society: Should we torture or treat?

connection: Complete isolation and sensory deprivation for prolonged periods must really wreak havoc on a person’s mental state.

Atkins: The scientific evidence is mounting that solitary confinement is very damaging, sometimes irreversibly. If you’re not mentally ill before you are put in solitary, you may be by the time you are out. And if you go in with a mental illness, it can make you much worse. It can even kill people; it has led to prisoners having suicidal thoughts and attempting suicide.

connection: What’s the solution here? Obviously solitary confinement is a pretty barbaric and tortuous form of correction, regardless of an inmate’s mental state before they are isolated. But what are the alternatives?

Atkins: Solitary confinement can be provided in a more humane way than we are doing in Delaware right now. By providing more time out of the cell, by providing real mental health treatment, by more rigorously limiting time in solitary, by making sure that people are not in solitary because of their illness, they would better off than we are now. And we would be much safer when they eventually get out of prison.


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