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Solitary confinement takes lasting toll on mental health

President Obama's decision to ban the use of solitary confinement for juveniles and low-level offenders in federal prisons shines a spotlight on the deep mental scars such punishment can inflict.

In an op-ed published in the Washington Post, the president wrote that solitary confinement has the potential for "devastating, lasting psychological consequences." Mental health experts agree, saying it's traumatic and life stunting, especially for young offenders.

The president cited Kalief Browder's story. Browder was 16 years old in 2010, when he was accused of stealing a backpack. Unable to make bail, the Bronx, New York, teen was sent to Rikers Island jail where he spent two years in solitary confinement. In the end, charges were dropped and he was released without ever standing trial.

But Browder had been irreparably scarred by the experience and committed suicide at age 22.

Obama bans solitary confinement for juveniles in fed prisons

"Life was a constant struggle to recover from the trauma of being locked up alone for 23 hours a day," Mr. Obama wrote.

Solitary confinement -- being placed in a locked room or cell with minimal or no contact with other people with the exception of staff -- is supposed to only be used as a protective mechanism, when a temporary emergency separation is required for medical reasons, or there's a need to separate prisoners who pose a threat.

But instead, solitary confinement is too often used as a form of discipline or punishment, Dr. Louis Kraus, chief of child psychiatry at Rush University Medical Center in Chicago, told CBS News.

Kraus previously worked for nine years at a maximum-security youth center in Joliet, Illinois. He has also served as a consultant to the Department of Justice on civil rights violations of youth in correctional facilities.

"What has become more and more evident in recent years is that it's progressively being used for punitive methods for kids," Kraus said. "There are still many states that use it for punitive purposes, for punishing kids, and that simply can not be allowed. There are examples of kids spending weeks on solitary confinement and that borders on cruel and unusual punishment."

Dr. Victor Fornari, director of the division of child and adolescent psychiatry at Zucker Hillside Hospital, in Glen Oaks, New York, and Cohen Children's Medical Center, in New Hyde Park, said, "Solitary confinement is a pretty traumatic experience and often the individuals who are incarcerated, whose behavior warrants increased disciplinary action, have been very traumatized in their early lives."

He said solitary confinement can exacerbate traumatic memories of previous traumas, including physical, emotional and sexual abuse. "Or their startle response can increase, where they become hyper vigilant and have intrusive negative thoughts. It's very toxic for any age," said Fornari.

Kraus said the American Medical Association came out with a formal policy against solitary confinement for juveniles in November 2014, but even before that, in 1990, the United Nations prohibited solitary confinement of juveniles.

He said while the president's move is an important one, "It's amazing to think it took 26 years for there to be a policy on a federal level." He said more states -- where far more juveniles are incarcerated than in the federal prison system -- need to follow suit.

In the meantime, young people especially are continuing to be damaged by the practice, Kraus said.

"There's a tremendous negative impact on youth placed in solitary confinement. It can worsen anxiety symptoms and worsen post-traumatic symptoms. Many of these kids have already been subjected to prior neglect and abuse and this would only worsen that symptomatology -- depression symptoms and issues of acting out behaviors, and issues of hopelessness," said Kraus.

He said the majority of suicides that occur in juvenile corrections happen when kids are isolated from everyone else.

Kraus was the primary author of a 2012 statement by the American Academy of Child and Adolescent Psychiatry that said solitary confinement of juvenile offenders has the potential for a myriad of psychiatric consequences due to their still-developing and therefore vulnerable brains, including chronic depression and anxiety, and psychosis and long-standing changes in personality and development.

If an inmate has an existing mental health condition -- many have pre-existing anxiety, ADHD and PTSD -- when they entered, Kraus said solitary confinement can lead to an intensity of the disorders, which can then become more severe and chronic.

President Obama's op-ed detailed much the same argument. "[Solitary confinement] has been linked to depression, alienation, withdrawal, a reduced ability to interact with others and the potential for violent behavior," he wrote. "Some studies indicate that it can worsen existing mental illnesses and even trigger new ones. Prisoners in solitary are more likely to commit suicide, especially juveniles and people with mental illnesses."

"The adolescent brain is developing up until the early to mid 20s. Functional magnetic resonance imaging [brain scans] has shown this consistently. As long as you have a developing brain, you need to focus on a rehabilitative model. If you focus on a punitive model, you'll do far more damage in the long run," said Kraus.

"People are shocked when these kids get out of these scenarios and they start developing a stronger sense of suspiciousness and a lack of trust in people and a fear of authority figures," he said.

A study cited by the president estimates that 80,000 to 100,000 people were held in solitary confinement in U.S. prisons in 2014 -- including juveniles and people with mental illnesses. As many as 25,000 inmates are serving months, even years of their sentences alone in a tiny cell, with almost no human contact.

Kraus said research shows if juvenile offenders receive appropriate education and mental health and health care services, and are not further traumatized in a facility by means of solitary confinement, the majority can re-enter society successfully.

Funneling more funds into rehabilitation -- education and health services including specialized health personnel -- would help facilities for adults and children beef up services and reduce solitary confinement abuses, said Kraus.

Fornari said a lot can be learned from other societies that don't have solitary confinement and have much lower rates of incarceration.

"Many of the Scandinavian countries have found therapeutic methods where you're not harming, but rehabilitating. Ultimately, as we re-traumatize individuals with experiences like solitary confinement, we're really going to just increase the period of time they're incarcerated, and we're just going to guarantee their behavior will remain problematic," Fornari said.

He said there are humane and creative ways to help offenders become productive members of society.

"We're coming to appreciate that neural pathways are vulnerable and we know certain kinds of treatments can change brains in a positive way," he added.

He said therapies that include mindfulness, relaxation and deep breathing to help with coping skills, a lot of physical activity, marital arts, music lessons, writing, and art workshops can be rehabilitative.

Kraus said, "When a juvenile facility takes a child into custody, they have a responsibility to take care of the child -- meet their educational, medical and mental health needs consistent with societal norms. They're falling way short."

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