Patricia Reams, MD, MPH, CCHP-P, joins Lorry to discuss the health consequences of solitary confinement and key concepts from a new NCCHC position statement that provides guidance for correctional health professionals about the practice. The full position statement can be found HERE.

Dr. Reams is a pediatrician from Richmond, VA, and immediate past chair of the National Commission on Correctional Health Care’s Board of Directors. She is also a member of the NCCHC Taskforce that recently created this position statement.

According to NCCHC, this position statement was developed to guide correctional health professionals in addressing issues about solitary confinement and provides foundational information about the harms of this practice. The statement also reviews the history of solitary confinement practices in the US criminal justice system and notes that there has been a marked increase over the last few decades with an estimated 80,000 inmates in some form of isolation on any given day.

Solitary confinement reduces social interaction and environmental stimulation; both are detrimental to mental and physical health but particularly hazardous to several vulnerable patient groups. NCCHC recommends that juveniles, mentally ill, and pregnant women be excluded entirely from solitary confinement. Others should be confined for only limited periods and definitely less than 15 days. This is based on findings that extended isolation can lead to the following detrimental health effects:

• Back and joint pain
• Diaphoresis
• Eyesight deterioration
• Gastrointestinal problems
• Genitourinary problems
• Heart palpitations
• Insomnia
• Migraines
• Weight loss

The position statement includes 17 guiding principles for correctional health professionals related to solitary confinement. Of particular interest are the following points discussed in this podcast:

• Prolonged (greater than 15 consecutive days) solitary confinement is cruel, inhumane, and degrading treatment that is harmful to an individual’s health.
• Health staff must not be involved in determining whether an inmate is physically or psychologically able to be placed in isolation.
• Health staff must advocate for individuals to be removed from solitary confinement if their medical or mental health deteriorates.

Patient advocacy is a primary role for correctional nurses, so advocating for the reduction of the use of solitary confinement is an appropriate action in those facilities where it is used excessively.

 

 

What are your thoughts about limiting the use of solitary confinement? Share your ideas in the comments section of this post.