The total number of people spending time alone in a U.S. prison or jail cell for an average of 22 hours or more per day for 15 continuous days is decreasing. So is the number of those with serious mental illness (SMI).
That’s according to the most comprehensive study of national data on the number of prisoners in restrictive housing — or what is more commonly known as solitary confinement.
“Reforming Restrictive Housing,” released in October from the Association of State Correctional Administrators (ASCA) and the Arthur Liman Center for Public Interest Law at Yale Law School, estimated that 61,000 people were in isolation in prisons in the fall of 2017. Of that number, more than 4,000 were people with SMI.
That’s compared to the 68,000 people counted in isolation in the fall of 2015, of whom 5,443 were people with SMI, according to the Liman Center and ASCA’s December 2016 report titled “Aiming to Reduce Time-In-Cell.”
“These reports provide evidence that some jurisdictions are able to maintain safety and security with far less use of solitary confinement than they had in the past,” said Yale Law School Professor Judith Resnik.
Numerous studies have documented the physiological and psychological harms attributed to solitary confinement, from chronic headaches, extreme dizziness, heart palpitations, irregular digestion and drastic weight loss to increased risk of suicide, hallucinations, insomnia, paranoia, post-traumatic stress disorder and hypersensitivity to noise and touch.
The Liman Center sent surveys to the 50 states, the Federal Bureau of Prisons (FBOP), the District of Columbia, and four jail systems in large metropolitan areas.
The 43 prison systems that provided data on prisoners in restrictive housing held 80.6 percent of the nation’s prison population. They reported that 49,197 individuals — 4.5 percent of those in their custody — were in restrictive housing.
The median percentage of the population held in restrictive housing was 4.2 percent; the average was 4.6 percent. The percentage of prisoners in restrictive housing ranged from 0.1 percent in Colorado to 19 percent in Louisiana.
Only three New England states — Connecticut, Massachusetts and Rhode Island — were among the 33 states plus the FBOP that broke down the number and percentages of those in restrictive housing by sex.
The median for the percentage of males with SMI in restricted housing in the Liman report was 7.9 percent. For women the rate was 0.8 percent.
Sketching a national picture of how well correctional institutions are doing in managing the subpopulation of people with SMI is complicated. Resnik noted there was wide variation in definitions of mental health conditions classified as serious and in policies governing holding individuals in restrictive housing.
Rhode Island reported 16 men with SMI in restrictive housing out of a total of 140 men with SMI in the custodial population — or 11.4 percent in the recent Liman report. That’s even though only 2.7 percent of the total population of 2,852 were held in restrictive housing.
“We have a very robust definition for SMI,” said psychologist Louis Cerbo, Ed.D., clinical director of behavioral health for the Rhode Island Department of Corrections (RIDOC). “Our numbers for SMIs are going to be a little bit elevated.”
RIDOC’s SMI definition includes post-traumatic stress disorder and three personality disorders — borderline, schizotypal and schizoid. The state also considers an individual’s history of psychiatric hospitalizations, suicide attempts, and self-injurious behaviors, Cerbo added.
Another factor, Connecticut and Rhode Island have unified systems that combine their jail and prison populations. As a result, their percentages of individuals in restrictive housing are much higher than in Massachusetts which reported only its prison population.
“If you did not include the jail, and I’ll be ultra conservative, I would say that number would be half,” Cerbo said of the SMI restrictive housing data.
Connecticut had 2.3 percent of its overall custodial population in restrictive housing in the fall of 2017 but 10.7 percent of its men with SMI were placed in it. Zero percent of women with SMI were in restrictive housing.
In contrast, Massachusetts reported overall rates of 5 percent of men and 3.9 percent of women in restrictive housing. Among the subpopulation with SMI, the rates were 1.6 percent men and zero percent women.
RIDOC did not provide data on people with SMI in the fall of 2015 for the Liman Center’s 2016 report because officials were manually tracking this subpopulation and working on significant IT programming changes to be able to aggregate data.
Cerbo said he would expect to see Rhode Island’s restrictive housing numbers go down for the next Liman Center report in two years.
That’s because a new residential treatment unit that opened in February 2018 for inmates with SMI has already shown a decrease in recidivism of behavioral problems.
Inmates placed in the unit have disciplinary time suspended and meet with clinicians for one-on-one and group therapy and are provided a balanced schedule of structured and unstructured hours out of their cell.
Additionally, as part of a revision to the inmate code of discipline completed last February, RIDOC reclassified more than 40 infractions that used to warrant punitive segregation for one to 10 days — including cutting in line, noise disturbances, and displaying pornography — and instead made them punishable by loss of privileges.
Loss of privileges could mean temporarily being unable to have visitors, participate in recreation activities or use electronic devices or watch television. Other levels of infractions were also moved down to lower levels of punishment that resulted in more loss of privileges and less confinement.
Only the most serious infractions, considered predatory and violent in nature — escape, sexual assault, arson, hostage taking, rioting and drug trafficking inside a facility — remain punishable by 31 to 365 days of confinement under RIDOC policy.