The ‘Misery of Solitary Confinement’

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Last month, New York City Mayor Bill de Blasio announced that solitary confinement will no longer be applied to inmates aged 21 and under who are held in city jails.   That’s welcome evidence of the growing recognition of the grueling nature of this punishment.

A standard practice in jails and prisons nationwide, solitary confinement is used to punish jailhouse infractions, although it can also be used for other purposes, such as securing a high profile inmate, or separating suspected gang members from the general population.

Solitary goes by many names – Administrative Segregation, Special Housing, the SHU, the Box, the Hole, and on Rikers Island, by the slang name, the “Bing” – but it all amounts to the same thing:  23 hours inside a cell roughly the size of a parking spot, no meaningful human contact, with a food tray passed through a flap in the door.

The length of time in the cell can range from a few days, to a few months, to many years.

As a former assistant chief of mental health in the Rikers Island 500-cell solitary confinement unit, the misery of solitary is something that I knew all too well. Our team was routinely summoned to cell doors to assess those who were threatening suicide, showing signs of psychosis, or making suicidal gestures.

“If they had no mental health issues before they entered solitary, they do now,” was our mantra.

As I took in these grim cells—the cot, the tiny sink and toilet, the small footlocker, and the desperate person inside begging for a reprieve—I was continually struck by the cruelty of this punishment. But as I stood in those doorways, I was also struck by the role I played in this punishment as a mental health caregiver.

A mental health team in a correctional setting provides emotional and psychiatric support to the incarcerated, and especially in a solitary confinement unit. Under the rigors of solitary, mental deterioration is swift, and mountains of anti-depressants, anti-psychotics, and sleeping pills are routinely dispensed.

Yet nothing could have prepared me for blood-smeared cells, makeshift nooses, and agonized shell-shocked faces. My immediate reaction was that this punishment had all the signs of torture, but I brushed the word from my mind.

I was surrounded by all the earmarks of legitimacy: nurses and board-certified doctors in white lab coats, correction officers in navy uniforms, even the American flag flying above the jail.

How could any of this be wrong?

This was a legally sanctioned punishment carried out in jails and prisons across a nation that prides itself as progressive on human rights. Yet despite my rationalizations, whenever I approached a cell door, my knees wobbled, my throat clenched, and I could never seem to get the word torture out of my mind.

Although it has been more than a decade since I left Rikers, I have not forgotten the misery of this unit.  I am relieved to see that, with the national spotlight focused on mass incarceration and its related issues, solitary confinement is finally being exposed for the horror that it is.

Pope Francis, President Obama, and Supreme Court Justice Anthony Kennedy have denounced it, while Juan Mendez, the United Nations Special Rapporteur on Torture, has deemed that anything beyond 15 days in solitary constitutes torture.

With the tide starting to turn, we are seeing the beginnings of reform, primarily in dealing with justice-involved juveniles and the mentally ill.  But it is far from enough.

The practice of solitary confinement is deeply entrenched across the nation.  Some 80,000 to 100,000 people continue  to be held in isolation cells in prisons and jails across the country.

The growing consensus that solitary confinement is inhumane and torturous is apparently, and unfortunately, not shared by the National Association of Social Workers and the American Psychological Association.  Yet their members are on the front lines of this issue.

It is social workers and psychologists who enter these cells on a daily basis to assess the mental deterioration that solitary will induce, and to determine when the risk of suicide is high enough to warrant a “timeout.” They are a key component in this punishment; without their participation, solitary confinement as we know it, would come to a halt.

With the United Nations opposing this punishment, and world leaders condemning it, there can be no further ambiguity as to the human rights violations posed by solitary confinement, and no excuses for the “helping professions” to remain silent.

Mary Buser

Mary Buser

It is time for the National Association of Social Workers and the American Psychological Association to take a meaningful stand, and offer guidance to the thousands in their ranks who, in the course of their duties, are often called upon to be monitors of human suffering.

To do anything less represents a betrayal of the ethics that are at the core of these helping professions.

 Mary Buser was a clinical social worker in the Mental Health Department on Rikers Island between 1995 and 2000. She served as assistant chief of Mental Health in the island’s Mental Health Center, as well as the 500-cell Punitive Segregation Unit. Her book, “Lockdown on Rikers,” (St. Martin’s Press) was published in September, 2015, and  won the 2016 Brooklyn Eagles Literary Award for non-fiction. She is also a member of Social Workers Against Solitary Confinement. She welcomes comments from readers.

10 thoughts on “The ‘Misery of Solitary Confinement’

  1. Prisons are a microcosm of society. In our society we have jails and prisons to separate those who prey on peaceful citizens. What if those predators are already in prison or jail? What then?

    Inmates will privately say they’re grateful that there’s a place for other inmates who are disruptive to the good order of the institution, that rob and assault others, and who disregard the rules that make for a safer environment.

    • Actually, there are a great many problems with your argument, Ed. First, solitary confinement is used for a variety of purposes, not just to house inmates who are disruptive. This is a mistake a lot of people make. Second, there is no evidence past anecdotal evidence that suggests solitary confinement makes institutions safer. The fact is, it does not. Take a look at Colorado. 85% reduction in the use of solitary confinement and they saw an ENORMOUS reduction in disruptive and violent behaviors across the state. Third, even when solitary confinement is used, there should be limits to that confinement and a clear path out for inmates. Inmates will get worse, not better without these elements present. Fourth, this article was actually about calling on professional organizations designed to support mental health providers on these units. It is excruciating to witness suffering day after day with limited avenues to affect positive change. Professionals who work in this environment need support to address the problems they see on these units and protection from having to serve as part of the problem. I would suggest that you read Dr. Buser’s book, “Lockdown on Rikers” to get a full understanding of the issues she as well as many others like her have faced as mental health providers on these units. It is eye-opening!

  2. Incredible article– thank you for your detail and including a national call to action! It is far past time for NASW and APA to participate in this issue in a meaningful way. Thank you for your work, Dr. Buser.

    • Author note: Ed, thank you for weighing in — I think Ali, the second commenter, did a good of laying out the issue more broadly. I agree with you that jails & prisons must be kept safe, but I disagree that the only way to achieve this is by locking someone up for 23 hours a day — sometimes for years! When you see the extreme suffering that solitary causes, it becomes clear that SC is barbaric and inhumane. There are other ways!!

  3. As a chief clinical psychologist who worked for many years in a major role both supervising other psychologists and social workers and providing direct services in both male and female prisons, I feel I have some credibility in giving an opinion about this issue. This matter is not a case of all good or all bad; of wiping out all current procedures or of keeping everything in place as is. First, Barajas is correct. Depending on the conditions in particular states, there are any numbers of inmates begging for a single cell and a number who will do all kinds of things to obtain one. The reason? Prison overcrowding, being housed with an aggressive roommate or a paranoid roommate not quite meeting criteria for MI. This experience can be terrifying. Some solitary blocks are gruesome as described. This writer has worked in only one state and in only one system, as have I. But there is a wide range of prison milieus. Some states have multiple rules and regulations about having meaningful interactions with inmates and providing stimulating reading materials as well as providing out of cell time as needed. Solitary confinement however, is only one issue that needs to be addressed in reform.

    I, for one, do not think that solitary confinement always constitutes torture and I certainly wouldn’t condemn NASW or the APA for not claiming it is. There are situations which I cannot think can ever be called anything but torture. In the system in which I worked, women in labor had their ankles shackled together before being taken to the hospital to have their babies. Why? Because a regulation said all inmates leaving the facility should have their ankles while being transferred to prevent escape! The US (except perhaps for NY) removes babies from inmate mothers at birth and sometimes they lose their parental rights then. No other country in the world does this except one third world country. Other countries allow inmate and baby to stay together in special units and in one country a special helpful psychoanalytic psychotherapy is administered to mother with babe in arms to help her mother and attach to baby. Keep writing about these matters! But please do not run away nor write so as to discourage other mental health pros from working in these environments. The only way for us to speak truth to power (as I have done many times) is as a trusted insider.

  4. Please excuse the errors in my last post. I think it important to add that prison reform, in my opinion, does not just involve opening the doors and pardoning drug offenders. There are many aspects of incarceration that need to be addressed. Taken together, it is a multi-billion dollar project. One thing for sure in my view; our treatment of inmates, children, the mentally ill . . . all tend to signify who we are as a nation. Those of us who care will continue to fight for the cause of a caring, containing environment within which to help others find their way.

  5. Take a look at Pelican Bay in California. Since the hunger strike and the agreed ‘end of hostilities’ the SHU has pretty much been emptied and prisoners of all creeds and colours keep violence at bay in order to avoid the use of the SHU.

    Pelican Bay was built specifically with a SHU; a series of pods with no windows and no natural light. Why would you deliberately do that to another human being?

    What makes somebody the worst of the worst? My husband served seven years in those conditions simply for being named by another prisoner as a gang member.

    The USA has more prisoners than any other nation; 25% of the prison population worldwide. Maybe now is the time to accept that something is wrong.

    • Thank you for sharing that story. All too often people think that solitary is only for “the worst of the worst”, which isn’t true. But even if it were, those kinds of conditions don’t make people better, they make people worse. So, you stick the worst of the worst in solitary and they get WORSE! And then they move in next door to us when released! The logic of this escapes me! Again, thank you for your courage in telling your story. The more we talk about this, the more aware others are. Take care.

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