Solitary Confinement And Inmates Withs SMI

Question 1

What are the four pathways leading to increased use of solitary confinement (Reena Kapoor)?

Answer 1

1) inadequate screening of mental health illness among prison populations -> punishment of behaviour not recognized as related to SMI
2) overwhelmed prison systems which lack the resources to treat SMI inmates
3) inaccurate characterization of self-harm or impulsive violence as behavioural problems rather than symptoms of SMI
4) a culture within prisons in which mental health professionals are marginalized and their opinions minimalized

Question 2

What is the US BOP’s three-pronged approach to to address concerns about the dangers of SMI inmates and the exacerbation of psychiatric symptoms in solitary?

Answer 2

1) the creation of specialized, secure housing units (less restrictive)
2) provision of enhanced mental health services for inmate in solitary
3) the provision of mental health care to all inmates in an effort to reduce and/or prevent disruptive behaviours that result in segregation

Question 3

What is the DOJ’s three-part framework for examining the effects of solitary confinement on individuals with mental illness and what was the conclusion?

Answer 3

1) The investigators considered the direct effects of solitary confinement on mental health (both SHU syndrome and exacerbation of other illnesses)
2) Examined lack of access to mental health care created by placement in segregation
3) Addressed the combination of isolation with other harsh conditions (such as excessive use of force and unclean condition)

Solitary confinement was not just a harm itself, but also the final common pathway in a grossly inadequate mental health system

Question 4

What is the cycle of solitary confinement and mental illness (five steps)?

Answer 4

Inadequate resources for evaluation and treatment of mental illness in general population -> acting out by untreated inmates unable to follow prison rules -> placement of inmates in solitary -> exacerbation of illness, more acting out -> greater number of inmates in solitary confinement requiring more resources to treat -> back to inadequate resources…

Question 6

What are the BOP care levels?

Answer 6

Care Level 1: no significant level of functional impairment associated with an illness and has no history of impairment or a demonstrated ability to seek help if necessary

Care Level 2: mental illness requiring routine mental health care ongoing and/or brief crisis-oriented mental health care (ie suicide watch, behavioural observation status)

Care Level 3: unstable, complex chronic care requiring enhanced outpatient mental health care or a residential mental health care program

Care Level 4: if the inmate is gravely disabled and unable to function in general population of a Care Level 3 environment

Inmates classified with SMI: Care level 2, 3, 4

Question 8

What were three of the revisions to the BOPs mental health policies in 2014?

Answer 8

1) providing mental health services for all inmates placed in restrictive housing regardless of mental health-care level
2) conducting mental health screening to ensure that inmates with SMI are diverted from solitary housing
3) incorporating an enhanced review of mental health issues as part of the disciplinary process