The ACLU recently published a briefing paper on the dangers of solitary confinement in US prisons. This has been a topic of interest for some time in corrections news as more and more evidence of the effects of long term confinement emerge. This paper reports that more than 80,000 prisoners are likely held in some form of solitary confinement, be it administrative segregation, disciplinary segregation or protective custody. Panelists discuss the variable nature of what constitutes solitary confinement and the effects as reported in the paper. Sadly, many in solitary confinement are juveniles or have severe mental illness or cognitive disabilities that led to not understanding or following prison rules. The effects of confinement can’t be helping them. What can correctional nurses do about solitary confinement practices is also discussed.
Excited delirium is the topic discussed in a recent issue of the FBI Law Enforcement Bulletin. This poorly understood medical emergency is seen fairly frequently in the criminal justice system, particularly involving young males who have drug intoxication or mental illness. If not recognized and treated, respiratory arrest can result in death; often during a take-down situation. I’ve been involved in reviewing several correctional legal cases that involved possible excited delirium and know it can be hard to diagnose, even after the fact. It must be very difficult to recognize and manage in the midst of trying to manage a young, strong, agitated and hallucinating male. Panelists describe their experiences with this condition.
Philadelphia has opened a city health clinic geared toward ex-offenders and people leaving jail or prison. It is a response to the need for health care for our patient population once released. Most of us know that incarceration is often the first health care experience for many of our patients and chronic diseases end up being identified and treated. Then, once released to the community, follow-up is difficult. Panelists agree that this is a good idea that will hopefully be replicated elsewhere.
Oregon Live is reporting on the use of nature imagery as a therapy to reduce the mental health effects of solitary confinement at the Snake River Correctional Institute in Oregon. A forest ecologist from the University of Utah, Nalina Nadkarni, suggested the use of images of nature such as beaches, rain forests, and waterfalls could help reorient prisoners in isolation and decrease the mental illness, self-harm, and escalating agitation that emerges with continued isolation.
The therapy was picked up by administration at Snake River in early 2013. They used one of their recreation rooms to play nature videos and were able to convert the room for about $1500. They are seeing some positive results including some reductions in disciplinary infractions. The University of Utah hopes to research the effects of the intervention later this fall.