RISK FACTORS DERIVING FROM AN OVEREMPHASIS ON SECURITY Inspired by these developments, the revised Standard Minimum Rules have incorporated explicit restrictions on the use of solitary confinement, regardless of whether it is imposed as a disciplinary sanction or for the maintenance of order and security.91 Furthermore, the revised Standard Minimum Rules emphasise that solitary confinement shall not be applied by virtue of a prisoner’s sentence, as is the case in some countries, for example for prisoners on death row or lifers.100 Regardless of its duration, the revised Standard Minimum Rules require authorisation by law or regulation of ‘any form of involuntary separation from the general prison population,(…) including policies and procedures governing the use and review of, admission to and release from any form of involuntary separation’.92 Where no absolute prohibition applies, solitary confinement should still be imposed only ‘in exceptional cases as a last resort, for as short a time as possible and subject to independent review, and only pursuant to the authorization by a competent authority’.101 Beyond this general requirement of a legal basis, concrete restrictions and procedural safeguards have been put in place for solitary confinement, which the Rules define as ‘confinement of prisoners for 22 hours or more a day without meaningful human contact’.93 Absolute prohibitions apply for the indefinite and prolonged use of solitary confinement, with ‘prolonged’ defined as ‘a time period in excess of 15 consecutive days’.94 The prohibitions included in other UN standards regarding children, pregnant women, women with infants and breastfeeding mothers are reiterated in the revised Standard Minimum Rules.95 A prohibition has also been incorporated for ‘prisoners with mental or physical disabilities when their conditions would be exacerbated by such measures’. It is worth noting in this context that an absolute prohibition of solitary confinement for persons with mental illness has been recommended by the Istanbul Statement on the Use and Effects of Solitary Confinement,96 which was reiterated by the Special Rapporteur on Torture97 and the Subcommittee on Prevention of Torture.98 Report of the UN Special Rapporteur on Torture99 Research has shown that solitary confinement often results in severe exacerbation of a previously existing mental condition. Prisoners with mental health issues deteriorate dramatically in isolation. The adverse effects of solitary confinement are especially significant for persons with serious mental health problems which are usually characterized by psychotic symptoms and/or significant functional impairments. Some engage in extreme acts of self-mutilation and even suicide. Regardless of the circumstances of isolation, efforts should be made to raise the level of meaningful social contacts for prisoners.102 This is acknowledged by the revised Standard Minimum Rules, which require prison administrations to take the necessary measures to alleviate the potential detrimental effects where prisoners are or have been separated from the general prison population.103 This means that prisoners must have meaningful social contact with others, for example by raising the level of staff-prisoner contact, allowing access to social activities with other prisoners and more visits, arranging in-depth talks with psychologists, psychiatrists, volunteers of NGOs, from the local community, or religious prison personnel, if so wished by the detainee. Regular contact with family members through visits, letters, phone calls or emails are crucial for detainees. The provision of meaningful in cell and out of cell activities, such as educational, recreational and/or vocational programmes, are equally important to prevent infringements of the right to dignity and health, and will have a positive effect on levels of violence. The role of health-care personnel has also been clarified in the revised Standard Minimum Rules. While required to pay ‘particular attention to the health of prisoners held under any form of involuntary separation, including by visiting such prisoners on a daily basis’ they ‘shall not have any role in the imposition of disciplinary sanctions or other restrictive measures’. Health-care personnel should report adverse effects of such measures to the director of the facility, without delay, and have the authority to review and recommend changes ‘to ensure that such separation does not exacerbate the medical condition or mental or physical disability of the prisoner’.104 91. Revised Standard Minimum Rules, Rule 37(d) and Rules 43-46. 92. Revised Standard Minimum Rules, Rule 37 93. Revised Standard Minimum Rules, Rule 44. 94. In Rule 43(a) and (b), the revised Standard Minimum Rules classify such practices as ‘restrictions or disciplinary sanctions’ amounting ‘to torture or other cruel, inhuman or degrading treatment or punishment’; Rule 44 includes a definition of prolonged solitary confinement. 95. Revised Standard Minimum Rules, Rule 45 (2), with reference to Rule 67 of the United Nations Rules for the Protection of Juveniles Deprived of their Liberty (resolution 45/113, annex); and Rule 22 of the United Nations Rules for the Treatment of Women Prisoners and Non-custodial Measures for Women Offenders (the Bangkok Rules) (resolution 65/229, annex). 96. The Istanbul Protocol on the use and effects of solitary confinement, adopted on 9 December 2007 at the International Psychological Trauma Symposium, Istanbul. 97. Report of the Special Rapporteur on torture and other cruel, inhuman and degrading treatment, 5 August 2011, A/66/268, para. 86. 98. For example, Report on the visit of the Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment to the Republic of Paraguay, 7 June 2010, CAT/OP/PRY/1, para. 185. 99. Report of the Special Rapporteur on torture and other cruel, inhuman and degrading treatment, 5 August 2011, A/66/268, para. 86, para. 68. 100. Revised Standard Minimum Rules, Rule 45 101. Revised Standard Minimum Rules, Rule 45 102. Istanbul Statement on the use and effects of solitary confinement adopted on 9 December 2007 at the International Psychological Trauma Symposium, p4. 103. Revised Standard Minimum Rules, Rule 38 (2) 104. Revised Standard Minimum Rules, Rule 46. Penal Reform International | Balancing security and dignity in prisons: a framework for preventive monitoring | 15