Yet, although the use of solitary confinement on a large scale ceased, it remained an integral part of prison systems and, as previously noted, in the last decade its use has increased in many jurisdictions. Throughout the decades researchers have continued to report negative effects associated with solitary confinement, and their findings are strikingly similar to those made by their historic counterparts. Contemporary findings More recent studies have mostly reaffirmed that solitary confinement adversely affects those subjected to it, and have identified “confinement psychosis” as a medical condition typified by “psychotic reaction characterised frequently by hallucinations and delusions, produced by prolonged physical isolation and inactivity in completely segregated areas” (Scott & Gendreau, 1969:338). A 1975 inquiry into the use of isolation in Canadian prisons concluded that administrative isolation over long periods of time represented a “serious danger for prisoners”22. Two years later a Council of Europe (1977) study suggested that prolonged close-confinement of long-term prisoners led to what was termed ‘separation syndrome’ that included emotional, cognitive, social and physical problems23. Benjamin & Lux (1977:262) stated that “evidence overwhelmingly [indicates] that solitary confinement alone, even in the absence of physical brutality or unhygienic conditions, can produce emotional damage, decline in mental functioning and even the most extreme forms of psychopathology such as depersonalization, hallucinations and delusions”. Ruling in a case involving prisoners held in strict isolation in Germany, the European Human Rights Commission (1978:97) similarly noted that “isolation can be sufficient in itself to gravely impair physical and mental health”. Grassian’s (1983) psychiatric evaluation of 14 prisoners held in the solitary confinement block at the Massachusetts Correctional Institution at Walpole reported perceptual changes, affective disturbances, difficulty with thinking, concentration and memory, disturbances of thought content, and problems with impulse control. Korn’s study (1988) of the women’s High Security Unit at Lexington, Kentucky, found that women held there suffered claustrophobia, rage, severe depression, hallucinations, withdrawal, blunting of affect and apathy. He also reported appetite loss, weight loss, visual disturbances and heart palpitations. Brodsky & Scogin’s (1988) study of 45 prisoners held in protective custody similarly reported a high prevalence of negative physiological and psychological symptoms including nervousness, talking to oneself, hallucinations and delusions, confusion, irrational anger, headaches and problems sleeping. Hodgins & Cote (1991) found severe mental disorders amongst 29 per cent of a sample of 41 segregated prisoners held in Quebec’s Special Handling Unit (SHU), and in 31 per cent of a sample of 32 prisoners segregated in the Long-Term Segregation Unit (LTSU)24. Haney’s (1993) study of 100 randomly selected prisoners in one of California’s supermax prisons, Pelican Bay Security Housing Unit, reported a very high prevalence of symptoms of psychological trauma with 91% of the prisoners sampled suffering from anxiety and nervousness, more than 80% suffering from headaches, lethargy and trouble sleeping and 70% fearing impending breakdown. More than half of the prisoners suffered from nightmares, dizziness and heart palpitations and other mental-health problems caused by isolation, which included ruminations, irrational anger and confused thought processes (more than 80% of prisoners sampled), chronic depression (77%), hallucinations (41%) and overall deterioration. Sourcebook on solitary confinement: The health effects of solitary confinement 11