One hundred and twenty-five years ago, this Court recognized that, even for prisoners sentenced to death, solitary confinement bears “a further terror and peculiar mark of infamy.” In re Medley, 134 U. 160, 170 (1890); see also id., at 168 (“A considerable number of the prisoners fell, after even a short [solitary] confinement, into a semi-fatuous condition. …[R]esearch still confirms what this Court suggested over a century ago: Years on end of near-total isolation exacts a terrible price. In a case that presented the issue, the judiciary may be required, within its proper jurisdiction and authority, to determine whether workable alternative systems for long-term confinement exist, and, if so, whether a correctional system should be required to adopt them.See, e.g., Grassian, “Psychiatric Effects of Solitary Confinement,” 22 Wash. Thus, the constitutional implications of long-term segregation remain to be determined.MHA has as its symbol a 350-pound bell cast from melted-down shackles and chains formerly used to restrain people with mental illnesses in psychiatric facilities.
It is noteworthy, however, that Pennsylvania has greatly and sustainably reduced the use of seclusion and restraints without increasing staffing or other resources, and that reduction in the use of seclusion and restraints has increased staff safety and has not increased violence.6 In the tradition of Clifford Beers, Mental Health America challenges the mental health professions to live up to the vision expressed by SAMHSA, NASMHPD (the National Association of State Mental Health Program Directors), and the Commonwealth of Pennsylvania, all of which have adopted the goal of ultimately eliminating the use of seclusion and restraints in behavioral health facilities..
This goal was adopted by SAMHSA in its 2005 “Roadmap to Seclusion and Restraint Free Mental Health Services”7 and by NASMHPD in a comprehensive 1999 position statement.8 State and federal agencies should take a greater role in assuring the safety and protection of children, young people, and adults in psychiatric settings.
Behavioral Health Treatment People are still being traumatized and dying from the use of seclusion and restraints.
Lack of adequate staffing cannot justify the use of seclusion and restraints, and staffing may need to be increased to further this goal.
Corrections The most isolated people in our society are those confined in the dungeons, the “holes,” of administrative and punitive segregation in jails and prisons, on death row, and in “supermax” prisons.
Many of these people are in seclusion for their own protection, rather than for disciplinary reasons.1 Seclusion exacerbates the suffering of people with mental health conditions, who make up approximately half of the prison population.2 And solitary confinement is a cruel and traumatizing threat to the mental health of anyone so deprived of human interaction.
MHA also cautions against any unnecessary use of restraints; handcuffs and leg irons are still used indiscriminately for prisoner transfers throughout the criminal justice system.
MHA is already on record opposing use of such restraints in juvenile justice interactions whenever possible.4 MHA has authored legislation advocating an imminent danger standard for use of seclusion and restraints in child residential care.5 And caution is appropriate for adult prisoners as well, especially those with mental health conditions.
In 2002 he stated: Seclusion and restraint – with their inherent physical force, chemical or physical bodily immobilization and isolation – do not alleviate human suffering. And they do not help people with serious mental illness better manage the thoughts and emotions that can trigger behaviors that can injure them or others.