The Psychological Effects of Solitary Confinement

A cycle of isolation, trauma, and unseen consequences.

By James Hale

Imagine living in a space the size of a bathroom.

In reality, the space in solitary confinement isn’t too much larger: six by nine feet. Inside, there’s a toilet with a sink attached, a bunk bed, one steel stool, and a steel desk. You are in this space 23 hours a day with limited human contact. Your food and mail come through a dusty hole in the door.

The summers are brutally hot, and the winters bitterly cold. The only light comes through a cloudy perforated window and a steel door with three bars and a perforated screen. You are allowed out of your cell for an hour a day, handcuffed and shackled. To shower, you must be locked in a cage.

This environment does not support mental health. Inmates set their cells on fire, self-harm, and throw blood and feces. Assault is rampant.

This is where I spent six months, housed in the abnormal behavior observation unit (A.B.O.) at the Cook County Jail. I was confined there because, during a random shakedown, knives were found in a wall in my cell. The knives were never proven to be mine (and weren’t mine).

Solitary confinement is also used for “investigation status,” which is nothing more than a revenge tactic the administration uses against inmates they deem a threat. While under this status, an inmate can be segregated for up to 30 days without a ticket for alleged gang activity or inappropriate relationships with staff or volunteers. Most of the time, the reasons behind solitary confinement are proven to be baseless—forcing inmates to spend 30 days in segregation for nothing. Once you’re done serving time, though, the baseless accusations may not leave you: these actions could be used to justify long-term solitary confinement in the future.

We still don’t know the effects of solitary confinement on those who experience it. Jeff Tietz, an investigative journalist, notes the paradox of tracking its effects. “Effects of solitary confinement may not become fully apparent until inmates reenter society,” Tietz writes. “[H]owever, prison personnel do not monitor the long-term mental health of former inmates; in a 1999 study, the Justice Department cautioned that virtually no information exists on the effects of long-term solitary confinement.”

In some instances, solitary confinement may be necessary for a certain time—for example for inmates who are an escape risk or re-offend for offenses such as staff or inmate assault. However, no one should be segregated for years of their incarceration and then be released from isolation straight to society.

“Solitary confinement exacts its toll even on prisoners who start off healthy,” Tietz writes. He cites the work of one researcher who studied the effects of solitary confinement, noting that even individuals with more stable personalities and stronger cognitive functioning will still “experience some degree of stupor, difficulties thinking and concentrating, obsessional thinking, agitation, irritability and difficulty tolerating external stimuli.”

My ordeal doesn’t compare to that of Brian Nelson, who was sent to Tamms Correctional Center for unclear reasons. (Tamms, Illinois’s last supermaximum security prison, closed in 2013.)

Nelson spent 12 years in solitary confinement and was the first person ever released from Tamms. Two years after his release, Nelson became a paralegal at a prison rights firm, Uptown People’s Law Center.

However, after reentering society, Nelson continued to re-enact his confinement by locking himself in his basement, in the dark and away from others. Some days, he couldn’t go to work, or he worked at night when things were quieter.

After seeing 11 psychiatrists, Nelson was diagnosed with post-traumatic stress disorder (PTSD).

Solitary confinement followed him home, and in 2021, Nelson died in his Uptown People’s Law Center office while reading letters from incarcerated individuals.

“No one escapes solitary confinement unscathed,” writes researcher and psychiatrist Terry Kupers. “Everyone who is in a supermax has some kind of psychological damage as a result.”

The abolishment of long-term solitary confinement is the only way to fix and end this trauma. Why not instead provide access to programs, such as anger management or mental health treatment? Why can’t we teach current and former inmates their triggers along with coping skills? Why can’t we provide access to mental health personnel with regular psych evaluations to monitor inmates in prison and after inmates reenter society? Why can’t we, as a society, do better?