Fyodor Dostoyevsky said: “The degree of civilization in a society is revealed by entering its prisons.”
I just came across this NY Times article on Colorado’s approach to solitary confinement, and it made me think about my own experiences providing mental health services to people in solitary confinement.
I worked in two different prisons for a total of about three years – a Level IV Super-Max prison and a Level II prison in California.
In the Super-Max prison, I saw mentally ill inmates in the “prison” within the prison the Psychiatric Services Unit (PSU). It is solitary confinement (“the hole”) for severely mentally ill inmates convicted of additional crimes within prison.
The Secure Housing Unit (SHU) has been in the media because of its high sensory deprivation. The SHU is the prison within the prison for inmates who aren’t mentally ill.
I also spent time seeing mentally ill inmates in the “jail” within the prison – Administrative Segregation or Ad Seg.
Ad Seg can also be a holding place for inmates whose safety is determined to be at risk and need to be administratively segregated from the general population.
The men in PSU represented some of the most dangerous offenders in the State. There is no denying the risk they represent – to themselves and other inmates, to officers and other staff, and to the safety and security of an institution.
I saw inmates assault Custody Officers (requiring their hospitalization and potential retirement) and was present during the process of two post-suicide reviews.
Fortunately, I didn’t have any inmates I worked with directly who completed suicide. The serious suicide attempts were hard enough.
Two different inmates, who had been convicted of murder, threatened to kill me. They offered up specific and grueling details when I followed policies and procedures that they expected or demanded I not follow.
Psychological threats and manipulation and physical violence are not unusual in these kinds of environments. In a constantly locked-down environment, the subtleties of psychological manipulation become high art.
In fact, one of my supervisors had a term for it: psychological rape. I learned that no one is immune from it.
If you don’t learn to see the often invisible but nonetheless dangerous tentacles of influence and persuasion, terrible things happen. And they did.
It’s a risk that anyone who lives or works in these kinds of corrections environments faces every day.
In PSU and Ad Seg, I worked with men in what were (and are) called “Therapeutic Behavioral Modules”. Basically, they’re old-school telephone booth sized cages with a metal desk and stool welded to the cage side and floor.
At one point, I was asked to cover for a few days in the unit next door.
They were the same mentally ill inmates I’d been seeing, but ones who had completed their Secure Housing Unit (SHU) terms in the PSU for violating prison rules or committing a crime in prison.
I literally saw an inmate I’d been working with for several months in a cage one day, and several days later, sat face-to-face with him in a group room playing dominoes.
There was nothing qualitatively different about this man from one day to the next.
He was just in a cage in therapy one day, and in a group therapy room face-to-face with me the next day. He joked with me in normal and healthy ways, and beat me handily in a game of dominoes.
It was one of many moments where I had to wonder about the systems in place and how they serve and don’t serve safety. Or rehabilitation.
Or the capacity to function after release back into the community.
I can’t even imagine what it would be like to go from having to be seen for therapy inside a cage to being seen face-to-face like the man with whom I’m worked.
That said, I’ve worked with enough post-release inmates to see the impact on “normal everyday” functioning (interacting with family, going shopping, etc) once they return to the community.
The mental and emotional costs to the person (and their family and community) can be severe.
The intense fear I felt with this inmate when that cage was no longer present is still palpable years later. It was a level of fear I didn’t experience when I worked in Reception and saw inmates of all risk levels face to face before they had been classified.
I respected the potential for danger in Reception, yes, but that’s something altogether different than the crazy, sweat-drenched fear I felt once the cage had been removed from the therapeutic relationship and I saw this man face-to-face.
How does this kind of fear drive the behavior of people who work in these environments?
I had to consciously and intentionally go against every fear signal in my body to keep playing dominoes, despite there not being any subtle or overt observable indication of danger.
And I had to do it while I did my job and tried to help people who needed helping.
How does that kind of fear shape the sometimes split-second judgments staff have to make in ways that risk safety or promote it?
It’s prison. You have to keep focused on every detail – constantly – because the potential for violence is always there. You can’t get caught sleeping.
In other words, vigilance is a necessity.
And, yet, with what we know about the power of environment to shape behavior, how much of this razor’s edge that anyone who lives or works in prison has to walk could be shaped differently if the environment were different?
Solitary confinement may have its role to play in prison, but at what point does it contribute to more dangerous behavior? And at what point does it become cruelty that does not belong in our society?