Solitary confinement remains one of the most controversial practices in correctional facilities worldwide. This form of incarceration involves isolating inmates in small cells for extended periods—typically 22 to 24 hours per day—with minimal human contact, limited environmental stimulation, and restricted access to rehabilitative programming. While correctional officials often defend its use as necessary for maintaining institutional safety and managing dangerous or disruptive behavior, research has documented profound psychological consequences for those subjected to it. Understanding these psychological effects is essential for developing humane correctional policies that balance security needs with fundamental human rights and mental health protection.

What Is Solitary Confinement?

Solitary confinement goes by many names within the correctional system, including administrative segregation, restrictive housing, special housing units, intensive management, and supermax confinement. Despite the varying terminology, the core practice remains consistent: an individual is placed in a small cell for 22 to 24 hours per day with minimal human interaction or meaningful activities. The conditions typically include single-cell confinement with severely limited opportunities for social contact, recreation, educational programs, or work activities.

The reasons for placing inmates in solitary confinement vary widely across jurisdictions. 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. Some inmates are placed in solitary for disciplinary reasons following rule violations, while others are housed in protective custody due to safety concerns. 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 prevalence of solitary confinement in the United States is substantial. According to the Bureau of Justice Statistics (BJS), almost 20% of incarcerated people in the U.S. experienced solitary confinement from 2011–2012. More recent estimates suggest that an estimated 55,000 to 62,500 people had spent the previous 15 days in solitary confinement in state and federal prisons on any given day. The duration of solitary confinement can range from days to decades, with some inmates spending years in isolation. In 2011, about 45% of people in the Pelican Bay Security Housing Unit had been in solitary for longer than a decade.

The Psychological Foundation: Why Isolation Harms the Human Mind

At its core, the controversy surrounding solitary confinement is not solely about discipline or institutional management, but about the psychological limits of human isolation. Psychological science has long emphasized that social interaction, environmental stimulation, and routine engagement are fundamental to mental health and cognitive functioning. The human brain has evolved to function within social contexts, relying on interpersonal connections and environmental variation to maintain psychological equilibrium.

These effects are not dependent on legal status, background, or individual behavior; rather, they reflect well-established principles of human psychology. Examining solitary confinement through this lens allows for a broader discussion of how isolation affects the mind and what that means for standards of humane treatment in correctional environments. When individuals are deprived of these essential psychological stimuli, the consequences can be severe and wide-ranging.

Early research on sensory deprivation established the foundation for understanding solitary confinement's psychological impact. Sensory deprivation studies with incarcerated samples supported these earlier findings, with difficulties in thinking, problems with impulse control, and massive anxiety as some of the self-reported psychopathological effects of solitary confinement. These foundational studies demonstrated that solitary confinement—that is the confinement of a prisoner alone in a cell for all, or nearly all, of the day with minimal environmental stimulation and minimal opportunity for social interaction—can cause severe psychiatric harm.

Comprehensive Psychological Effects of Solitary Confinement

Research findings on the psychological effects of solitary confinement have been strikingly consistent since the early nineteenth century. Studies have identified a wide range of frequently occurring adverse psychological reactions that commonly affect prisoners in isolation units. The prevalence of psychological distress is extremely high. The psychological consequences of solitary confinement manifest across multiple dimensions of mental health and cognitive functioning.

Emotional and Mood-Related Effects

The emotional toll of solitary confinement is among its most immediate and pervasive effects. Individuals in solitary confinement frequently experience increased anxiety, depression, difficulties with memory and concentration, hallucinations, panic, paranoia, and symptoms consistent with post-traumatic stress disorder. Research using standardized psychiatric assessment tools has confirmed these observations. BPRS results showed clinically significant symptoms of depression, anxiety, or guilt among half of our research sample in a study of Washington State inmates in solitary confinement.

The majority of those held in solitary confinement experience adverse emotional effects that can range from acute to chronic, depending on the individual and the length of stay in isolation. Confined prisoners also report feelings of panic and rage, including irritability, hostility, and poor impulse control. These emotional disturbances can emerge rapidly, with confined inmates often describing feelings of extreme mental duress after only a couple of days in solitary confinement.

Cognitive Impairment and Disrupted Thinking

Beyond emotional distress, solitary confinement produces measurable cognitive impairments. Another confinement related psychological symptom that inmates may experience is disrupted thinking, defined as an inability to maintain a coherent flow of thoughts. This disrupted thinking can result in symptoms of psychosis. The lack of environmental stimulation and social interaction appears to interfere with normal cognitive processing, leading to difficulties with concentration, memory, and logical reasoning.

The conditions associated with confinement in solitary are strikingly toxic to mental functioning, producing a stuporous condition associated with perceptual and cognitive impairment and affective disturbances. In more severe cases, inmates so confined have developed florid delirium—a confusional psychosis with intense agitation, fearfulness, and disorganization. These severe cognitive disruptions represent the extreme end of a spectrum of impairment that affects most individuals in prolonged isolation to varying degrees.

Psychotic Symptoms and Perceptual Disturbances

Among the most disturbing psychological effects of solitary confinement are psychotic symptoms and perceptual disturbances. Inmates who exhibit these symptoms of psychosis often report experiencing hallucinations, illusions, and intense paranoia, such as a persistent belief that they are being persecuted. In extreme cases, inmates have become paranoid to the point that they exhibit full-blown psychosis that requires hospitalization.

These psychotic symptoms are not limited to individuals with pre-existing mental illness. Even those inmates who are more psychologically resilient inevitably suffer severe psychological pain as a result of such confinement, especially when the confinement is prolonged, and especially when the individual experiences this confinement as being the product of an arbitrary exercise of power and intimidation. The development of hallucinations and paranoid thinking in previously healthy individuals underscores the profound impact of extreme isolation on mental functioning.

Social Isolation and Identity Loss

Research has identified additional psychological consequences that extend beyond traditional psychiatric symptoms. Interview content analysis revealed additional symptoms, including social isolation, loss of identity, and sensory hypersensitivity. These effects reflect the fundamental disruption of normal psychological processes that depend on social interaction and environmental engagement.

One aspect that is often overlooked in discussions of solitary confinement is the extent to which isolation disrupts fundamental psychological processes tied to time perception, identity formation, and emotional regulation. Psychological research suggests that humans rely heavily on routine social cues, environmental variation, and interpersonal feedback to maintain a coherent sense of self and temporal continuity. In solitary confinement, the absence of these stimuli can distort an individual's perception of time, leading hours, days, or weeks to blur together in ways that are deeply disorienting. This distortion can intensify feelings of helplessness and despair, as individuals lack external markers to anchor their experiences or anticipate meaningful change. Over time, these disruptions may hinder emotional regulation capacities, making it more difficult for individuals to manage frustration, fear, or anger once they return to social environments.

Self-Harm and Suicide Risk

Perhaps the most tragic consequence of solitary confinement is its association with self-harm and suicide. The effects of solitary confinement on mental health can be lethal. Even though people in solitary confinement comprise only 6% to 8% of the total prison population, they account for approximately half of those who die by suicide. This dramatically elevated suicide rate demonstrates the severe psychological distress experienced by individuals in isolation.

Research has consistently documented elevated rates of self-harming behavior among inmates in solitary confinement. Luigi et al. (2020) found evidence contending that inmates in solitary confinement were more at risk for self-harm, regardless of previous mental health history. The New York City jail system also discovered that its prisoners who have experienced solitary confinement were seven times more likely to self-harm than others. These findings indicate that the risk of self-harm is not limited to those with pre-existing mental health conditions but extends to all individuals subjected to prolonged isolation.

Long-Term and Lasting Psychological Consequences

The psychological damage caused by solitary confinement does not necessarily end when an individual is released from isolation. Research has also shown that even after release from solitary confinement, individuals may continue to experience adverse psychological outcomes. For example, studies involving formerly incarcerated people who were held in long-term isolation report lasting symptoms, including emotional dysregulation, relationship difficulties, and diminished social functioning.

Long-term studies of veterans of prisoner of war camps, and of kidnapping and hostage situations have demonstrated that while many of the acute symptoms I outlined above tend to subside after release from confinement, there are also long-term effects which may persist for decades. These enduring consequences include persistent symptoms of post-traumatic stress, chronic hypervigilance, and lasting personality changes that can severely impair an individual's ability to function in social environments.

Studies linking solitary confinement histories with increased risk of PTSD symptoms show how isolation can have enduring consequences that extend far beyond the period of confinement itself. Such psychological impacts are not just individual experiences; they carry broader implications for public health, community reentry, and the overall well-being of people who have been incarcerated. The long-term nature of these effects raises serious questions about the practice's impact on successful reintegration into society and the prevention of recidivism.

Recent studies show that time spent in solitary confinement shortens lives, even after release, with research documenting elevated mortality rates among formerly incarcerated individuals who experienced prolonged isolation. Some studies outside the U.S. have also found associations between solitary confinement experiences and increased mortality risks after release, including higher rates of suicide and other causes of death among people who have been isolated.

Vulnerable Populations and Disproportionate Impact

Individuals with Pre-Existing Mental Illness

The impact of solitary confinement is particularly severe for individuals with pre-existing mental health conditions. In recent years, physicians have increasingly confronted a new challenge: the prolonged solitary confinement of prisoners with serious mental illness, a corrections practice that has become prevalent despite the psychological harm it can cause. Despite the recognized dangers, many of the prisoners subjected to isolation, which can extend for years, have serious mental illness, and the conditions of solitary confinement can exacerbate their symptoms or provoke recurrence.

Research has documented that those with serious mental illness spend three times longer in solitary confinement than similar incarcerated people with no mental health problems. This extended exposure to isolation compounds the psychological harm experienced by this already vulnerable population. Administrative data showed disproportionately high rates of serious mental illness and self-harming behavior compared with general prison populations among individuals in solitary confinement.

The use of segregation to confine the mentally ill has grown as the number and proportion of prisoners with mental illness have grown. Although designed and operated as places of punishment, prisons have nonetheless become de facto psychiatric facilities despite often lacking the needed mental health services. This transformation has created a situation where individuals with serious mental health needs are subjected to conditions that worsen their symptoms while simultaneously lacking access to adequate treatment.

Racial and Demographic Disparities

Studies show that Black and Brown individuals are disproportionately placed in solitary confinement compared to their white counterparts. This racial disparity compounds the harm of solitary confinement by disproportionately affecting communities of color, raising serious concerns about systemic bias within correctional systems.

Certain inmate demographics are more likely to be sent into isolation in an effort to protect themselves or others, including members of the LGBTQIA+ community, the developmentally impaired, and the mentally ill. However, this practice often has the opposite of its intended effect. Rather than providing protection, the isolation exacerbates psychological distress and increases vulnerability to self-harm and other adverse outcomes.

The Scientific Debate: Conflicting Research Findings

While the majority of research documents significant psychological harm from solitary confinement, some studies have produced different findings. These recent studies produce mixed evidence for whether placement in solitary confinement is associated with psychological distress. We advance our understanding of these relationships in two critical ways. Understanding this scientific debate is important for developing evidence-based policies.

An alternative line of research indicates that placement in solitary confinement has little effect on the mental well-being of people in prison. A longitudinal study of people in segregation in Colorado is one of the more well-known and well-discussed of these studies. This research and similar studies have found that some inmates do not show significant deterioration in mental health during their time in solitary confinement.

However, these contradictory findings have been subject to substantial criticism. Advocates defend its use, often citing two recent studies to support claims that isolation has no significant adverse psychological effects, including even on mentally ill people. Those studies, however, are fundamentally flawed, their results are not credible, and they should be disregarded. Critics have identified numerous methodological problems with studies that fail to find harm, including inadequate measurement tools, failure to account for pre-existing conditions, and reliance on self-report measures in coercive environments.

The weight of evidence continues to support the conclusion that solitary confinement causes significant psychological harm. More recent works, again, find that people in isolation in prison experience significant rates of psychopathological symptoms, even when compared to people in less restrictive settings. The idea that solitary confinement in prison is a harmful practice is bolstered by several decades of research that finds that people in isolation experience damage to their mental well-being.

International Standards and Human Rights Perspectives

The international community has increasingly recognized solitary confinement as a human rights concern. The United Nations has established specific guidelines regarding the use of isolation in correctional settings, known as the Mandela Rules. These standards recommend that solitary confinement should not exceed 15 days, as prolonged isolation beyond this threshold is considered to constitute cruel, inhuman, or degrading treatment.

Solitary confinement is recognized as difficult to withstand; indeed, psychological stressors such as isolation can be as clinically distressing as physical torture. This recognition has led international human rights bodies to call for strict limitations on the practice and the complete prohibition of solitary confinement for certain vulnerable populations, including juveniles, pregnant women, and individuals with mental illness.

Despite these international standards and recommendations, many correctional systems continue to use prolonged solitary confinement. Solitary confinement in the U.S. is not limited to one or two facilities; it is woven into the fabric of how many prison systems manage behavior and security. Typically, a person in solitary is locked in a small cell alone for most of the day with limited contact with others and little access to programming or rehabilitative resources. In recent years, the use of solitary has been scrutinized not only by advocacy groups and researchers but also by courts and oversight bodies.

Court decisions and legal mandates, such as the injunction in New York requiring mental health programming for confined individuals, reflect ongoing recognition within the U.S. legal system that solitary confinement raises constitutional and human rights concerns, particularly when applied to vulnerable populations. These legal developments represent important steps toward reform, though implementation remains inconsistent across jurisdictions.

Effectiveness and Penological Justifications

Correctional officials typically justify the use of solitary confinement on several grounds: maintaining institutional safety, preventing violence, managing gang activity, protecting vulnerable inmates, and punishing serious rule violations. However, research increasingly questions whether solitary confinement effectively achieves these stated goals.

Beyond psychological effects, research indicates that solitary confinement may produce counterproductive outcomes when measured against goals such as reducing future misconduct or promoting public safety. Some research points out that solitary confinement does not significantly improve safety or lower recidivism and may, in fact, undermine rehabilitation by increasing psychological harm without commensurate benefits to institutional security.

The psychological damage caused by solitary confinement can actually increase the likelihood of problematic behavior both during incarceration and after release. Individuals who experience severe psychological distress, cognitive impairment, and emotional dysregulation are less equipped to manage their behavior constructively. The practice may therefore be counterproductive to the stated goals of corrections, including rehabilitation and successful community reintegration.

Furthermore, this reliance on solitary ignores the abundance of studies demonstrating the harmful and often long-lasting effects it wreaks on the human mind and body. At the International Symposium on Solitary Confinement, sponsored by Thomas Jefferson University in November, researchers and formerly incarcerated people made it clear that any "positive" benefits correctional institutions gain by using solitary confinement are outweighed by the severe and often permanent damages caused by prolonged isolation.

Alternatives to Solitary Confinement

Recognition of the psychological harms of solitary confinement has spurred the development of alternative approaches to managing challenging behavior and maintaining institutional safety. These alternatives seek to address security concerns while minimizing psychological harm and promoting rehabilitation.

Therapeutic and Mental Health-Based Interventions

Alternatives to solitary confinement, such as therapeutic interventions and restorative justice practices, not only reduce harm but also foster rehabilitation and social reintegration. These approaches acknowledge the humanity of incarcerated individuals and prioritize their mental health and well-being. Therapeutic interventions may include enhanced mental health services, cognitive-behavioral programs, and structured therapeutic communities that address underlying issues contributing to problematic behavior.

Mental health-based approaches recognize that many individuals who end up in solitary confinement have underlying mental health conditions or trauma histories that contribute to their behavior. Providing appropriate treatment and support can address the root causes of problematic behavior more effectively than isolation, which typically exacerbates mental health problems.

Step-Down Programs and Graduated Privileges

Some correctional systems have implemented step-down programs that provide structured pathways for individuals to earn increased privileges and social contact through positive behavior. These programs maintain security while avoiding the complete isolation characteristic of traditional solitary confinement. Inmates progress through levels with gradually increasing opportunities for social interaction, programming, and out-of-cell time.

Step-down programs have shown promise in reducing both the use of solitary confinement and institutional violence. By providing clear behavioral expectations and meaningful incentives for positive behavior, these programs can achieve security goals while minimizing psychological harm.

Enhanced Supervision and Small Group Settings

Rather than complete isolation, some facilities have developed enhanced supervision units where individuals are housed in small groups with increased staff oversight. This approach maintains security through intensive monitoring while preserving essential social contact and environmental stimulation. Small group settings can reduce the risk of violence while avoiding the severe psychological consequences of complete isolation.

Restorative Justice Approaches

Restorative justice practices focus on repairing harm, addressing underlying conflicts, and promoting accountability through dialogue and community involvement rather than punishment through isolation. These approaches can be adapted to correctional settings to address rule violations and interpersonal conflicts in ways that promote healing and behavioral change rather than psychological deterioration.

Restorative practices may include mediation, conflict resolution programs, and structured dialogue between individuals involved in incidents. By addressing the underlying issues and promoting understanding, these approaches can reduce future problematic behavior more effectively than punitive isolation.

Reform Efforts and Policy Developments

Growing awareness of the psychological harms of solitary confinement has led to reform efforts at various levels of government and within correctional systems. Some jurisdictions have implemented restrictions on the use of solitary confinement, particularly for vulnerable populations.

Advocates for criminal justice reform are calling for policies that limit or eliminate the use of solitary confinement, particularly for vulnerable populations such as juveniles, individuals with mental health conditions, and those subjected to racial bias. These reform efforts have achieved varying degrees of success across different jurisdictions.

Several states have enacted legislation limiting the duration of solitary confinement, prohibiting its use for certain populations, or requiring enhanced oversight and reporting. Some correctional systems have voluntarily reduced their reliance on solitary confinement and implemented alternative approaches. These reforms demonstrate that change is possible and that correctional facilities can maintain safety while reducing the use of harmful isolation practices.

However, implementation of reforms remains inconsistent, and many facilities continue to use prolonged solitary confinement despite evidence of its harmful effects. Sustained advocacy, continued research, and policy development are necessary to promote widespread adoption of more humane and effective practices.

The Role of Healthcare Professionals in Correctional Settings

Physicians who work in U.S. prison facilities face ethically difficult challenges arising from substandard working conditions, dual loyalties to patients and employers, and the tension between reasonable medical practices and the prison rules and culture. In recent years, physicians have increasingly confronted a new challenge: the prolonged solitary confinement of prisoners with serious mental illness, a corrections practice that has become prevalent despite the psychological harm it can cause. There has been scant professional or academic attention to the unique ethics-related quandary of physicians and other healthcare professionals when prisons isolate inmates with mental illness.

Healthcare professionals working in correctional settings face difficult ethical dilemmas when inmates with mental illness are placed in solitary confinement. Prison rules for isolated prisoners, however, greatly restrict the nature and quantity of mental health services that they can receive. This creates a situation where healthcare providers may be unable to provide adequate care to patients who are experiencing severe psychological distress due to their conditions of confinement.

Professional medical and mental health organizations have increasingly taken positions against the prolonged solitary confinement of individuals with mental illness. We conclude by urging professional organizations to adopt formal positions against the prolonged isolation of prisoners with serious mental illness. These professional standards provide important guidance for healthcare providers and can support advocacy for policy changes.

Implications for Recidivism and Community Reintegration

The psychological damage caused by solitary confinement has significant implications for successful community reintegration and recidivism prevention. Individuals who have experienced prolonged isolation often struggle with the transition back to social environments, both within correctional facilities and upon release to the community.

The lasting psychological effects of solitary confinement—including emotional dysregulation, social anxiety, difficulty with interpersonal relationships, and cognitive impairments—create substantial barriers to successful reentry. These individuals may struggle to maintain employment, establish healthy relationships, and navigate the complex demands of community life. The resulting difficulties can increase the risk of recidivism, undermining public safety goals.

Furthermore, the trauma of solitary confinement can compound other challenges faced by formerly incarcerated individuals, including stigma, limited economic opportunities, and disrupted social networks. Addressing the psychological consequences of solitary confinement requires comprehensive reentry support, including mental health services, social support, and assistance with practical needs.

Current State of Solitary Confinement Practice

The use of extended solitary confinement (ESC) has received domestic and international condemnation for its potential effects on the mental health of incarcerated persons. Despite the criticism, prison systems continue to rely on the practice. Understanding why correctional systems continue to use solitary confinement despite evidence of harm requires examining institutional culture, staff perspectives, and systemic factors.

The study examines survey responses from prison personnel who have worked in ESC and finds that personnel hold mixed views about ESC's harms. Structural equation modeling indicates that perceptions about agency and empathy influence views about ESC and whether it harms the mental health of incarcerated persons in the housing. Staff perspectives and institutional culture play important roles in perpetuating or reforming the use of solitary confinement.

Moving Forward: Recommendations for Policy and Practice

Based on the substantial body of research documenting the psychological harms of solitary confinement, several key recommendations emerge for policy makers, correctional administrators, and advocates:

Strict Time Limitations

Solitary confinement should be limited to the absolute minimum duration necessary, with a maximum of 15 days in accordance with international standards. Prolonged isolation beyond this threshold should be prohibited given the severe psychological consequences documented in research.

Categorical Exclusions for Vulnerable Populations

Certain populations should be categorically excluded from solitary confinement, including individuals with serious mental illness, juveniles, pregnant women, elderly inmates, and individuals with developmental disabilities. These populations are particularly vulnerable to the psychological harms of isolation and lack the capacity to withstand such conditions without severe deterioration.

Enhanced Oversight and Accountability

The use of solitary confinement should be subject to rigorous oversight, including regular review of placements, clear criteria for use, procedural protections for inmates, and external monitoring. Data on the use of solitary confinement should be collected and publicly reported to ensure transparency and accountability.

Investment in Alternatives

Correctional systems should invest in developing and implementing evidence-based alternatives to solitary confinement, including therapeutic programs, step-down units, enhanced supervision models, and restorative justice approaches. These alternatives can address security concerns while minimizing psychological harm and promoting rehabilitation.

Improved Mental Health Services

Correctional facilities must provide adequate mental health services to all inmates, with enhanced services for those who have experienced solitary confinement. This includes screening for psychological distress, providing appropriate treatment, and ensuring continuity of care during transitions between housing units and upon release.

Staff Training and Culture Change

Correctional staff should receive comprehensive training on the psychological effects of solitary confinement, trauma-informed practices, de-escalation techniques, and alternative approaches to managing challenging behavior. Changing institutional culture to prioritize rehabilitation and mental health alongside security is essential for sustainable reform.

Support for Reentry

Individuals who have experienced solitary confinement require specialized reentry support to address the lasting psychological consequences of isolation. This should include mental health services, social support, vocational assistance, and other resources to promote successful community reintegration.

Conclusion

The psychological effects of solitary confinement are profound, well-documented, and often long-lasting. Decades of research into solitary confinement document a range of psychological harms that align with what psychologists understand about human social needs and mental functioning. The effects are not limited to a general sense of discomfort; they point to measurable and often severe consequences. Scientific studies have found that individuals in solitary confinement frequently experience increased anxiety, depression, difficulties with memory and concentration, hallucinations, panic, paranoia, and symptoms consistent with post-traumatic stress disorder. These effects arise from prolonged sensory deprivation, lack of social interaction, and forced idleness, conditions that most psychological theories identify as critically harmful to mental well-being.

The evidence demonstrates that solitary confinement causes significant psychological harm across multiple dimensions, including emotional distress, cognitive impairment, psychotic symptoms, identity disruption, and elevated risk of self-harm and suicide. These effects are particularly severe for vulnerable populations, including individuals with pre-existing mental illness, and can persist long after release from isolation, creating barriers to successful reintegration and increasing recidivism risk.

While some research has produced conflicting findings, the weight of scientific evidence clearly supports the conclusion that solitary confinement causes substantial psychological harm. International human rights standards recognize prolonged isolation as cruel, inhuman, or degrading treatment, and professional medical organizations have called for strict limitations on its use.

The continued widespread use of solitary confinement despite this evidence raises serious ethical and policy questions. Correctional systems must balance legitimate security concerns with fundamental human rights and the imperative to protect mental health. Evidence-based alternatives exist that can address security needs while minimizing psychological harm and promoting rehabilitation.

The psychological effects of solitary confinement demand urgent attention, especially as they intersect with issues of mental health and racial disparities. As research sheds light on the harm caused by isolation, the push for reform becomes ever more critical. Moving forward requires sustained commitment to reform from policymakers, correctional administrators, healthcare professionals, advocates, and the public.

Understanding the psychological effects of solitary confinement is not merely an academic exercise—it is essential for developing humane correctional policies that respect human dignity, protect mental health, promote rehabilitation, and enhance public safety. The evidence is clear: solitary confinement causes severe and often lasting psychological harm. The challenge now is to translate this knowledge into meaningful policy change that reduces reliance on this harmful practice and implements evidence-based alternatives that better serve the goals of corrections and society.

For more information on criminal justice reform and mental health in correctional settings, visit the Prison Policy Initiative and the American Psychological Association. Additional resources on international human rights standards can be found through the United Nations Office of the High Commissioner for Human Rights.