Psychological Distress in Solitary Confinement: Symptoms, Severity, and Prevalence in the United States, 2017–2018

By Keramet Reiter, Joseph Ventura, David Lovell, Dallas Augustine, Melissa Barragan

Objectives. To specify symptoms and measure prevalence of psychological distress among incarcerated people in long-term solitary confinement. Methods. We gathered data via semistructured, in-depth interviews; Brief PsychiatricRating Scale (BPRS) assessments; and systematic reviews of medical and disciplinary filesfor 106 randomly selected people in solitary confinement in the Washington StateDepartment of Corrections in 2017. We performed 1-year follow-up interviews and BPRS assessments with 80 of these incarcerated people, and we present the results of our qualitative content analysis and descriptive statistics.Results. BPRS results showed clinically significant symptoms of depression, anxiety, orguilt among half of our research sample. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations. Interview content analysis revealed additional symptoms, including social isolation, loss of identity, and sensory hypersensitivity.Conclusions. Our coordinated study of rating scale, interview, and administrative data illustrates the public health crisis of solitary confinement. Because 95% or more of all incarcerated people, including those who experienced solitary confinement, are even-tually released, understanding disproportionate psychopathology matters for developing prevention policies and addressing the unique needs of people who have experienced solitary confinement, an extreme element of mass incarceration.

Am J Public Health. 2020, 7 p.