Solitary confinement involves physical isolation. This means a person has minimal interaction with other people. It can cause severe psychological distress and other adverse mental effects.

Solitary confinement is a common practice in prisons and jails. According to the Bureau of Justice Statistics (BJS), almost 20% of incarcerated people in the U.S. experienced solitary confinement from 2011–2012.

In this article, we explore the effects of solitary confinement on health and well-being and discuss some of the criticisms of the practice.

A photo of solitary confinement cells, which can have mental health effects.Share on Pinterest
Solitary confinement may lead to significant adverse mental health effects.

Solitary confinement is the physical isolation of individuals who are confined to their cells for 22.5 hours or more per day. Other names for solitary confinement include:

  • isolation
  • lockdown
  • segregation

People in solitary confinement have limited or no opportunity to interact with others. They eat, sleep, and use the toilet in the same area and have limited access to stimuli, such as educational materials. Solitary confinement cells do not always have windows.

The length of time that a person spends in solitary confinement varies greatly. Some people can spend hours or days in confinement, while others can spend weeks, months, or even years.

In extreme cases, people can spend decades in solitary confinement. In 2016, Albert Woodfox reentered society after spending more than 40 years in isolation.

Health equity resources

Visit our dedicated hub for an in-depth look at social disparities in health and what we can do to correct them.

Was this helpful?

A large body of research shows that solitary confinement causes adverse psychological effects and increases the risk of serious harm to individuals who experience it. According to an article in the Journal of the American Academy of Psychiatry and the Law, isolation can be as distressing as physical torture.

The BJS report that approximately 25% of people in prison and 35% of those in jail who had spent 30 days or longer in solitary confinement during the previous year had symptoms of serious psychological distress. The rates were similar for those who only spent 1 day in isolation.

Humans require social contact. Over time, the stress of being isolated can cause a range of mental health problems. According to Dr. Sharon Shalev, who authored A Sourcebook on Solitary Confinement in 2008, these problems may include:

  • anxiety and stress
  • depression and hopelessness
  • anger, irritability, and hostility
  • panic attacks
  • worsened preexisting mental health issues
  • hypersensitivity to sounds and smells
  • problems with attention, concentration, and memory
  • hallucinations that affect all of the senses
  • paranoia
  • poor impulse control
  • social withdrawal
  • outbursts of violence
  • psychosis
  • fear of death
  • self-harm or suicide

Research indicates that both living alone and feelings of loneliness are strongly associated with suicide attempts and suicidal ideation. Additionally, many individuals who experience confinement become incapable of living around other people.

Most studies focus on the psychological effects of solitary confinement. However, psychological trauma and loneliness can also lead to physical health problems. Studies indicate that social isolation increases the likelihood of death by 26–32%.

According to Dr. Shalev’s A Sourcebook on Solitary Confinement, the recorded physical health effects of solitary confinement include::

A lack of physical activity may also make it difficult to manage or prevent certain health conditions, such as diabetes, high blood pressure, and heart disease.

A prolonged lack of sunlight can cause a vitamin D deficiency, which can put older adults at risk of fractures and falls. These injuries are among the leading causes of hospitalization and death for older adults.

A paper from the criminal justice journal Federal Probation describes the three types of solitary confinement that U.S. prisons use:

  • Disciplinary segregation: The use of solitary confinement to punish a person for breaking prison rules.
  • Temporary segregation: The immediate isolation of a person from the general prison population due to a crisis, such as a physical altercation.
  • Administrative segregation: The isolation of a person who presents a continuous threat to the safety and security of other incarcerated people, staff, or visitors.

A 2016 report from the United Nations (UN) found that most countries that use solitary confinement do so as a form of punishment. However, the actions that prisons and jails punish with isolation vary significantly from place to place.

While countries such as Germany only use isolation for serious acts of violence, numerous countries and some U.S. states use isolation as a punishment for minor offenses.

Sometimes, prisons and jails also use solitary confinement to house people in protective custody who are not safe in other areas of the institution.

Some researchers suggest that people in protective custody prefer solitary confinement to being in the general prison population housing because it is safer. However, they still experience the negative effects of isolation.

The practice of placing prisoners in solitary confinement has come under strong criticism from many organizations and individuals.

The UN’s “Mandela Rules” provide guidance on the treatment of incarcerated people worldwide. These rules prohibit the use of indefinite or prolonged solitary confinement of more than 15 days and advise that prisons and jails only use it as a last resort. They also prohibit isolation for people with disabilities.

However, not every state in the U.S. follows these rules. A 2015 report found that in Illinois, 85% of the incarcerated people who had lived in isolation in the past year had done so because of minor offenses, such as using abusive language.

In general, the criminal justice system in the U.S. uses solitary confinement more widely and for longer periods than other countries. On a given day, up to 80,000 people are in isolation in state or federal prisons. This figure does not include those in isolation in jails and juvenile detention facilities.

The National Commission on Correctional Health Care, to which those working in the prison healthcare profession belong, have endorsed the Mandela rules. The American Public Health Association also recommend limiting the use of solitary confinement.

The following sections go into more detail on the criticisms of solitary confinement.

Effectiveness and cost

Some research indicates that solitary confinement:

  • is not cost effective
  • does not achieve its intended outcomes
  • may exacerbate the issues that it intends to solve

Solitary confinement units cost significantly more than other types of prison housing, both in terms of construction and operation. Due to the effect that isolation has on people, it can also lead to them becoming more violent and unpredictable.

Such behavioral changes may increase the number or intensity of assaults on staff and other incarcerated people. They may also make it more likely that the person will engage in illegal behavior or experience isolation-related adjustment problems when they reenter society.

Systemic racism

According to a 2018 analysis from the Association of State Correctional Administrators and Yale Law School, people of color are overrepresented in solitary confinement.

The authors report that Black people account for a higher percentage of those in isolation than of those in the general prison population. The same is also true for Hispanic males.

By contrast, white people, both male and female, are underrepresented in comparison with the general prison population.

Mental ill health

In a growing number of states, it is illegal to keep people with mental illness in solitary confinement. However, the American Psychological Association report that people with impaired mental health are still disproportionately represented in solitary confinement.

As isolation often worsens mental health conditions, this also makes people more difficult to care for and less likely to adjust when they reenter society.

People who experience solitary confinement are more likely to develop anxiety, depression, suicidal thoughts, and psychosis. The practice also affects physical health, increasing a person’s risk for a range of conditions, including fractures, vision loss, and chronic pain.

The U.S. uses solitary confinement more than some countries, with the practice disproportionately affecting Black and Hispanic people and those with mental health conditions. Solitary confinement faces strong criticism from organizations worldwide because of the harm that it causes.