A/63/175 hallucinations and mental illness. The key adverse factor of solitary confinement is that socially and psychologically meaningful contact is reduced to the absolute minimum, to a point that is insufficient for most detainees to remain mentally well functioning. Moreover, the effects of solitary confinement on pre-trial detainees may be worse than for other detainees in isolation, given the perceived uncertainty of the length of detention and the potential for its use to extract information or confessions. Pre-trial detainees in solitary confinement have an increased rate of suicide and self-mutilation within the first two weeks of solitary confinement. 83. In the opinion of the Special Rapporteur, the use of solitary confinement should be kept to a minimum, used in very exceptional cases, for as short a time as possible, and only as a last resort. Regardless of the specific circumstances of its use, effort is required to raise the level of social contacts for prisoners: prisonerprison staff contact, allowing access to social activities with other prisoners, allowing more visits and providing access to mental health services. 84. On 7 and 8 December 2007, the Special Rapporteur participated in the Fifth International Psychological Trauma Symposium in Istanbul, Turkey, where he delivered a presentation entitled “Solitary confinement and isolation practices as a human rights problem”. He participated in a task group together with several prominent international experts in the field of solitary confinement, prisons and torture, and an outcome document was produced, the Istanbul Statement on the Use and Effects of Solitary Confinement. 48 The document aims to promote the use of existing human rights standards in the use of solitary confinement and creates new standards based on the latest research. 85. The Special Rapporteur draws the attention of the General Assembly to the Istanbul Statement (see annex) and strongly encourages States to reflect upon the Statement as a useful tool in efforts to promote the respect and protection of the rights of detainees. __________________ 48 08-44075 See P. Scharff Smith, “Solitary confinement: an introduction to the Istanbul Statement on the Use and Effects of Solitary Confinement, Journal on Rehabilitation of Torture Victims and Prevention of Torture, vol. 18, No. 1, pp. 56-62. 21