4 WHAT ARE THE RISKS WITH ISOLATION? 4 What are the risks with isolation? The above-mentioned Istanbul Statement says that it is well-documented that solitary confinement of an inmate risks causing serious psychological damage, and even physical injury. This includes, for example, insomnia, confusion, hallucinations and psychosis. Negative health effects can already Even a short period in occur after a couple of days isolation can cause a of isolation and the risks person both psycho- increase with each day of further solitary confinelogical damage and ment. The most damaging physical injury element of solitary confinement is the reduction of social contact, in terms of social and psychological stimuli, to such a low level that many will experience as insufficient to sustain a sense of health and well-being.1 There are studies showing that the psychological stress that solitary confinement can cause can, in turn, cause physical discomfort. The lack of fresh air and sunlight as well as long periods of inactivity can also cause physiological problems. These include, for example, gastrointestinal problems, migraines and severe fatigue. Other physiological ailments observed during isolation are deterioration of eyesight, back and joint pain and lethargy. The most common problem, however, is that solitary confinement gives rise to psychological effects. These vary from person to person and are dependent on, for 1 See The Istanbul statement on the use and effects of solitary confinement (adopted on 9 December 2007), p. 2. example, how long the isolation lasts. In addition to the above, inmates who are held in solitary confinement can also suffer from panic attacks and depression. Solitary confinement can also affect cognitive ability and give rise to difficulties concentrating, as well as memory problems and disorientation.2 A review of studies investigating the effects of isolation on inmates indicates that inmates who are isolated have significantly more mental health problems than inmates who are not. However, the picture is somewhat ambiguous as there are studies which show some inmates’ moods improved when placed in isolation. Factors such as whether isolation is voluntary or not and an individual’s particular circumstances as well as the ability to adapt to difficult situations can be important in terms of the effect isolation has on an inmate. As such, it is important whether an inmate feels that he or she has some degree of control over the situation. With regard to acts of selfharm, the author of the study states that: “People punished with solitary confinement were around seven times more likely to self-harm (and around six times more likely to potentially fatal selfharm).”3 In connection with a study of isolation of inmates in prisons in England and Wales, interviews were conduc2 See Sharon Shalev, A Sourcebook on Solitary Confinement, 2008, pp. 15–17. 3 See Flora Fitzalan Howard, The Effect of Segregation, Prison Service Journal, No. 236, pp. 5 and 6. – 26 –