A new study found that a program to provide more social contact and activities for prisoners in solitary confinement led to improved mental health and behavior.
The program was based on a “Resource Team” model developed in Norway.
Key Facts:
- Solitary confinement involves isolating prisoners in cells for 22+ hours per day with limited social interaction or activities.
- It is used frequently in US prisons, especially for prisoners with mental illness. Up to 4.5% of prisoners experience it.
- Solitary confinement has been linked to anxiety, depression, psychosis, self-harm, suicidality and health problems.
- Prison staff are also negatively affected by working in solitary units.
- Reform efforts seek to limit solitary confinement, but implementing changes can be challenging.
Source: PLOS One July 2023
Harmful Effects of Solitary Confinement
Solitary confinement, also known as restrictive housing or isolation, is the practice of confining prisoners to their cells for 22-24 hours per day with limited social interaction or access to programs.
Prisoners are kept in small cells, sometimes no larger than a bathroom, where they eat, sleep and use the toilet.
Time out of cell is restricted to only 1 hour per day in a caged recreation area.
Prisoners are placed in restraints when moved out of their cell.
Solitary confinement also involves other restrictions like limited property, reading materials, and access to education.
This highly restrictive practice has been used frequently in US prisons since the 1980s.
An estimated 55,000 to 62,000 prisoners—4 to 4.5% of the prison population—are in solitary confinement.
Extensive research shows that solitary confinement has severe psychological effects including:
- Anxiety, depression, anger, paranoia, psychosis
- Cognitive disturbances like memory loss, concentration problems
- Hypersensitivity to stimuli
- Compulsive behaviors
- Suicidal thoughts and self-harm
- Physical health problems
These psychological harms are especially common for prisoners with pre-existing mental illness (“SMI”), who are disproportionately held in solitary confinement.
Prison staff are also negatively impacted by working in solitary units.
Officers have higher rates of depression, substance abuse, and suicide compared to the general population.
Staff report that the tense, stressful environment of solitary confinement units leads to burnout, vicarious trauma, and “moral injuries” from witnessing human suffering they contributed to.
Calls for Reform But Challenges in Implementation
Human rights and public health advocates have called for reforms to solitary confinement because of these harms.
Some key reforms aim to restrict its use, especially for prisoners with mental illness.
Legislation in many states now limits solitary confinement for vulnerable groups like juveniles and pregnant women.
Federal courts have also mandated restrictions, especially for prisoners with mental illness.
However, major challenges remain in implementing reforms successfully to translate policies into practice:
- Correctional cultures accustomed to control via isolation
- Limited correctional staff training in mental health, de-escalation, crisis intervention
- Labor relations and contracts inhibiting flexibility needed for reforms
- Lack of adequate mental health treatment alternatives
With increasing public scrutiny, some prison systems have started their own reform initiatives to limit solitary confinement.
But very few of these have been rigorously assessed.
Oregon’s Resource Team Model for Change
The new study assessed a reform initiative launched in 2019 by the Oregon Department of Corrections to reduce solitary confinement, especially for prisoners with mental illness.
The initiative adapted a “Resource Team” model created in Norway focused on:
- Maximizing out-of-cell time in social activities
- Supporting the least restrictive confinement needed
- Building relationships between staff and prisoners
In the Oregon prison’s Behavioral Health Unit (BHU), prisoners with mental illness were previously kept in isolation for up to 23 hours per day with few programs or treatment.
From 2019-2021, a Resource Team of 5 trained officers worked to increase time out of cell for these prisoners through daily social, recreational and skill-building activities.
A mental health practitioner was part of the team.
The Resource Team took a relationship-based approach, avoiding use of force in responding to problematic behaviors.
Their goal was to motivate prisoners to engage more, improve functioning, and transition to less isolated housing.
Assessing the Impact of Oregon’s Resource Team Model
The researchers evaluated the Resource Team’s impact using several sources:
- Prison system data on disciplinary incidents, self-harm, uses of force
- Interviews with 16 prisoners and 14 staff in the program
- Weekly activity logs detailing time out of cell and types of activities
The results showed numerous benefits:
- 85% decrease in staff’s use of force responses
- 56% drop in overall disciplinary incidents
- Over 55% decrease in prisoner assaults and self-harm
- Prisoners reported improved mental health, outlook, social skills
- Staff experienced higher job satisfaction and less stress
Prisoners said participating in social activities like sports, games and classes helped reduce anxiety, depression, and other symptoms they experienced in isolation.
They appreciated developing relationships with Resource Team officers, gaining their trust and emotional support.
The activities also helped prisoners become more comfortable with social interaction.
Staff reported better understanding of how isolation harms mental health, and felt empowered to make positive differences through engagement and avoiding force.
With much less violence and use of force, the unit became safer and less stressful for both prisoners and staff.
Broader Impacts
The early success of Oregon’s Resource Team approach spurred expansion to other prisons in the state and inspired similar programs in Washington and California.
The model shows that focusing on rehabilitation and mental health support rather than control and isolation can improve outcomes even for prisoners considered the highest risk.
It suggests officer training and flexible procedures are key to enabling reforms.
However, fully implementing this resource-intensive model requires commitment of adequate funding and staff.
For broader impact, additional policy changes are likely needed to restrict solitary confinement and divert prisoners with mental illness to dedicated treatment units instead.
Nonetheless, the study indicates that a relationship-based, multi-disciplinary team approach could significantly advance solitary confinement reform.
It demonstrates the potential for culture change centered on human dignity rather than control.
Such models may offer a path to ending solitary confinement and improving correctional environments for both prisoners and staff.
References
- Study: The resource team: A case study of a solitary confinement reform in Oregon
- Authors: David H. Cloud et al. (2023)
