An article about solitary confinement appears in the current issue of Psychiatric News, a publication of the American Psychiatric Association,  “Psychiatrists Decry Punishment That Isolates Prisoners.” It’s encouraging to see this issue at least being discussed in a forum for the leading professional organization of American psychiatrists–which has never undertaken an official review of mental health professionals’ possible role in torture in U.S. prisons, as it has on interrogations at Guantanamo.

As politically popular “supermax” prisons and extended solitary confinement have become widespread in the United States in recent decades, mental health advocates, including psychiatrists, have begun to push back because of concerns about the mental health sequelae of this type of incarceration. However, divisions remain among psychiatrists over whether extended solitary confinement causes mental illness and how best to reform such prison practices…

The extensive use of solitary confinement has drawn growing criticism from mental health advocates. That’s because prisoners with mental illness are often relegated to this type of detainment when they fail to follow rules, which they may be unable to do because of their illness.

Although there has been no comprehensive examination of all supermax or other solitary-confinement populations, some research indicates that the prevalence of psychiatric illness among supermax inmates can reach over 50 percent, said forensic psychiatrist Paul Appelbaum, M.D., a member and former chair of APA’s Council on Psychiatry and Law and a past APA president.

“The data are not very good,” he commented. “However, it doesn’t take a lot of evidence to see it’s not good for people with serious mental illness.”

The article is especially valuable for presenting a summary of different kinds of challenges to solitary confinement, through both lawsuits and legislative efforts. It is scrupulously “balanced,” presenting opinions from some who think that prolonged solitary confinement may exacerbate pre-existing mental illnesses, but does not drive sane people crazy. (They might wish to conduct the experiment suggested by one prisoners in Illinois’ Tamms supermax: “Lock yourself in your bathroom for the next 10 years and tell me how it will affect your mind.”)

However, the piece also includes statements from some of solitary confinement’s sharpest critics in the psychiatric community. Henry Weinstein, chair of the APA Caucus on Correctional Psychiatry and a clinical professor of psychiatry at New York University, “believes that solitary confinement can have mental health impacts on both healthy people and those with psychiatric illness,” according to the article. “Its effects are likely similar to the mental health consequences of torture, which leave some permanently mentally impaired and others relatively unscathed.”

Terry Kupers, who teaches at Berkeley’s Wright Institute and has written extensively on the effects of supermax confinement, told Psychiatric News that “people with no previous history of mental illness can become ill in extended solitary confinement, which he defines as longer than three months.” He said this is especially true of “people with earlier traumatic episodes, who are also more likely to self-medicate by abusing drugs, be arrested, and be attacked while in prison, which lands them in solitary confinement [as punishment].” (Look for a guest post from Terry Kupers next week on Solitary Watch.)