Revisiting and Unpacking the Mental Illness and Solitary Confinement Relationship

Abstract

There is mixed evidence on whether incarcerated persons with mental illnesses have increased odds of being placed in solitary confinement. This study answered this question using a large system-wide sample and a propensity score matching design that accounted for a wide range of individual and facility confounds. Having a mental illness was associated with an increase of up to 170% in the odds of extended solitary confinement, depending on the diagnosis. A wide range of mental illnesses predicted extended solitary confinement. The association between having a mental illness and being sent to extended solitary confinement was only partially explained by misconduct. The findings suggest that incarcerated persons with mental illness may garner differential responses from the prison system, similar to those seen in studies of arrest and incarceration. Studies are needed that examine how incarcerated persons with mental illnesses are perceived by, interact with, and are sanctioned by prison staff.

Keywords:

• Corrections
• mental illness
• solitary confinement

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 The phrase “solitary confinement” captures the key elements of what we examine here: single-cell isolation for all but a few hours of the day combined with restrictions on programming, leisure activities, and other privileges. Inmates in solitary confinement have some contact, however, with people such as correctional officers, healthcare workers, and other such staff. Our focus is on extended solitary confinement that, in this study, typically lasted months, as distinguished from short-term segregation for punishment or administrative reasons that lasts weeks.

2 In this state, men and women are housed in separate facilities, so we attempted to run all analyses separately by gender. However, we were unable to achieve covariate balance in our analyses of women. Because these group differences undermined our quasi-experimental analyses, we do not present results for women. However, the main results for women were substantively similar to those for men.

3 This indicator captures days in which the inmate was assigned to an extended solitary confinement placement. It occasionally included isolated days in which the inmate was not yet or was not currently physically in a solitary confinement unit, such as when he was awaiting a bed, on a mental health unit, or out to court.

4 Newly admitted inmates typically spend the first month in a reception facility where they are assessed on a range of factors by reception staff. They are then transferred to a permanent institution where they may receive additional assessments. Our measures thus capture the main time period when assessments would be conducted.

5 In supplemental analyses, we also considered a measure of victimization with injury, which was a dichotomous indicator of whether the inmate was involved in an inmate-perpetrated offense that involved an injury; unfortunately, in this measure we do not know which inmate was injured. The substantive findings were unchanged.

6 The criminal justice history variables capture arrests, convictions, and incarcerations within the study state.

7 Nearly all inmates experienced a move within the first 60 days of their incarceration. Because inmates were not nested within specific facilities, we could not use multilevel modeling or other adjustments for clustering.

Additional information

Funding

This work was supported by the National Institute of Justice under grant 2016-IJ-CX-0014. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Justice or the Department of Corrections of the state in which the research was conducted.

Notes on contributors

Sonja E. Siennick

Sonja E. Siennick, PhD, is a professor at Florida State University’s College of Criminology and Criminal Justice. She studies crime and criminal justice system contacts as they relate to other aspects of the life course, especially social relationships and mental health.

Mayra Picon

Mayra Picon is a doctoral candidate at Florida State University’s College of Criminology and Criminal Justice. Her research interests include social control and punishment, racial and ethnic disparities in criminal justice processing, and juvenile justice.

Jennifer M. Brown

Jennifer M. Brown, PhD, is a Postdoctoral Scholar at Florida State University’s College of Criminology and Criminal Justice. Her research interests include correctional programming, prisoner reentry, and juvenile justice. She has completed research projects for the National Institute of Justice and the Florida Department of Corrections.

Daniel P. Mears

Daniel P. Mears, PhD, is the Mark C. Stafford Professor of Criminology at Florida State University’s College of Criminology and Criminal Justice. His work examines crime and policy. He is the author of American Criminal Justice Policy (Cambridge University Press), Prisoner Reentry in the Era of Mass Incarceration (Sage), and, most recently, Out-of-Control Criminal Justice (Cambridge University Press).