RISK FACTORS DERIVING FROM AN OVEREMPHASIS ON SECURITY confinement.77 Political detainees deemed to be a threat to national security are also sometimes held in this way.78 In the absence of sufficient numbers of staff, solitary confinement can seem an easier way of managing challenging prisoners rather than providing the supervision and control required. In the past decade, there has been an increase in largescale solitary confinement in the form of ‘super-max prisons’ (see Section 6). Other prisons have introduced ‘small group isolation’ where prisoners classified as dangerous or high risk are held in small high security units, and are only allowed limited association with one to five others at designated times, typically during the one-hour long outdoor exercise period. Special Disciplinary Regime in Brazil In Brazil, a form of solitary confinement called the Special Disciplinary Regime (RDD – Regime disciplinar diferenciado) is used as a disciplinary measure in response to infractions committed by detainees considered as dangerous. RDD can be applied for up to one sixth of the sentence. The worst conditions are observed in RDD within federal prisons: detainees are held in their cell 24 hours a day under constant camera surveillance, with no access to TV, radio or newspapers. They can receive two visitors per week but without any physical contact.79 Isolation and solitary confinement constitute a highrisk situation for human rights abuse. Because of the absence of witnesses, it increases the risk of torture or other ill-treatment going unnoticed and undetected. Prolonged solitary confinement can in itself amount to torture or other cruel, inhuman or degrading treatment,80 and has been found to have significant adverse health effects. The UN Special Rapporteur on Torture has called for a ban on prolonged or indefinite solitary confinement as incompatible with the prohibition of torture and other ill-treatment81 and as a ‘harsh’ measure, which is contrary to rehabilitation, the aim of the penitentiary system.82 Medical research confirms that the denial of meaningful human contact can cause ‘isolation syndrome’ the symptoms of which include anxiety, depression, anger, cognitive disturbances, perceptual distortions, paranoia, psychosis, self-harm and suicide, and can destroy a person’s personality.83 Istanbul statement on the use and effects of solitary confinement ‘Solitary confinement may cause serious psychological and sometimes physiological ill effects. A long list of symptoms ranging from insomnia and confusion to hallucinations and psychosis has been documented. Negative health effects can occur after only a few days in solitary confinement, and the health risks rise with each additional day spent in such conditions. (…) The central harmful feature of solitary confinement is that it reduces meaningful social contact to a level of social and psychological stimulus that many will experience as insufficient to sustain health and well-being.’84 For these reasons, a significant body of international law has developed that requires restriction of the use of solitary confinement,85 and an absolute prohibition on the use of solitary confinement has been enshrined for juveniles,86 and for pregnant women, women with infants and breastfeeding mothers in prison.87 The Basic Principles for the Treatment of Prisoners commit to ‘efforts towards the abolition of solitary confinement or the reduction of its use’.88 The Istanbul Statement on the use and effects of solitary confinement, the European Prison Rules89 and the Principles and Best Practices on the Protection of Persons Deprived of Liberty in the Americas reiterate that solitary confinement should be used only in very exceptional cases, as a last resort and for as short a time as possible, ‘when it is evident that it is necessary to ensure legitimate interests relating to the institution’s internal security, and to protect fundamental rights, such as the right to life and integrity of persons deprived of liberty or the personnel’.90 77. See PRI/APT, LGBTI persons deprived of their liberty: a framework for preventive monitoring, 2nd edition, 2015. 78. Sharon Shalev, A sourcebook on solitary confinement, Mannheim Centre for Criminology, London School of Economics, 2008. 79. Pastoral carceraria do Brasil/Association for the Prevention of Torture. Situaçao das Pessoas Privadas de Liberdade no Brasil – Informaçao Preliminar para Audiencia da Comissao Interamericana de Direitos Humanos, 20 October 2012. 80. Special Rapporteur on Torture, Report to the UN General Assembly, 5 August 2011, A/66/268. 81. Interim report of the Special Rapporteur on torture and other cruel, inhuman and degrading treatment, 5 August 2011, A/66/268. The European Committee for the Prevention of Torture (CPT) has made comparable recommendations: CPT 21st General report, 1 August 2010 – July 2011, November 2011. 82. First interim report to the General Assembly on 18 October 2011, A/RES/65/205 at para.79 (noting that: ‘that solitary confinement is a harsh measure which may cause serious psychological and physiological adverse effects on individuals regardless of their specific conditions’). 83. Grassian S, ‘Psychiatric effects of solitary confinement’, Journal of Law and Policy 22, 2007, pp325-383; Haney C, ‘Mental health issues in long-term solitary and ‘supermax’ confinement’, Crime & Delinquency 49(1) pp124-156, 2003; Shalev S, A sourcebook on solitary confinement, Mannheim Centre for Criminology, London School of Economics, 2008. 84. The Istanbul Protocol on the use and effects of solitary confinement, adopted on 9 December 2007 at the International Psychological Trauma Symposium, Istanbul. 85. See, for example, Principle 7 of the Basic Principles; the Human Rights Committee, General Comment No. 20. 86. Rule 67, UN Rules for the Protection of Juveniles Deprived of their Liberty. 87. Rule 22, UN Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules). 88. Principle 7, UN Basic Principles for the Treatment of Prisoners, 1990. 89. European Prison Rules, Rule 60(5): ‘Solitary confinement shall be imposed as a punishment only in exceptional cases and for a specified period of time, which shall be as short as possible’. 90. Principle XXII (3) of the Principles and Best Practices on the Protection of Persons Deprived of Liberty in the Americas. 14 | Penal Reform International | Balancing security and dignity in prisons: a framework for preventive monitoring