RISK FACTORS AND MEASURES TO REDUCE RISK f. Solitary confinement / disciplinary segregation It has been documented on numerous occasions that solitary confinement can have extremely harmful psychological, and sometimes physiological, ill effects.66 The Istanbul Statement recommends that ‘[t]he use of solitary confinement in prisons should therefore be kept to a minimum’67 and absolutely prohibited for mentally ill prisoners, among others.68 The Committee against Torture, the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT) and the Special Rapporteur on Torture, have all recognised the harmful physical and mental effects of prolonged solitary confinement and have expressed concern about its use.69 In light of increasing concern about solitary confinement, the revised Standard Minimum Rules have introduced, for the first time, explicit guidance and limitations on the use of this practice. They 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’ (Rule 37). The Rules define solitary confinement as ‘confinement of prisoners for 22 hours or more a day without meaningful human contact’ and prohibit its indefinite or prolonged use (in excess of 15 days) (Rules 43 and 44). Beyond this absolute prohibition, the Rules clarify that ‘solitary confinement shall be used only in exceptional cases as a last resort, for as short a time as possible, subject to independent review, and only pursuant to the authorization by a competent authority’ (Rule 45(1)). Furthermore, the Rules call on measures to alleviate the potential detrimental effects of separated confinement for the prisoners concerned (Rule 38(2)). Women are at particular risk of having existing mental healthcare needs on admission to prison or developing mental health disorders in prison. Therefore they constitute a high risk group in terms of their susceptibility to the harmful psychological effects of solitary confinement, as one example below, of a highly publicised case in Canada, demonstrates. In 2007 a 19-year-old woman prisoner with a mental disability committed suicide in Ontario, Canada while her guards stood outside her segregation cell door, watching and videotaping her. The guards had been instructed not to intervene after previous attempts at selfharm. She had spent her final year in solitary confinement, had been transferred 17 times among nine different prisons in five provinces with little treatment for her mental illness. A coroner’s inquest was on-going at the time of writing.70 In the case of women who are pregnant, breastfeeding mothers or women who have children with them in prison, solitary confinement harms not only the women’s mental wellbeing, but also that of their children, penalising the children as well, with possibly long-term harmful ill-effects. The health of pregnant women and women who have recently given birth can also be compromised. Taking into account these risk factors, monitoring groups should assess whether punishment by disciplinary segregation is used in the case of pregnant women, women with infants and breastfeeding mothers in prison, and develop recommendations to bring an end to such practices, with reference to the Bangkok Rules, Rule 22, which prohibits the use of solitary confinement as punishment for these categories of women. They should also bear in mind that a measure that is prohibited as punishment is all the more unacceptable when applied in situations where no disciplinary offence has occurred and formulate their recommendations on that basis. Going further, and with reference to the Istanbul Statement and other international jurisprudence referred to above, they should also determine whether solitary confinement is used in the case of women with mental healthcare needs and a history of self-harm and suicide attempts, and recommend the prohibition of this practice in the case of these categories of women. (See also Section 4 (c)). g. The inappropriate and unjustified use of restraints The use of mechanical restraints on prisoners is another highly sensitive issue. Being restrained is humiliating to all prisoners and if restraints are used unjustifiably and for prolonged periods the requirement to treat prisoners with dignity is violated.71 The revised Standard Minimum Rules place strict restrictions on the use of body restraints on prisoners.72 They prohibit the use of instruments of restraint which are inherently degrading or painful, and as a sanction 66. Istanbul Statement on the Use and Effects of Solitary Confinement, Adopted on 9 December 2007 at the International Psychological Trauma Symposium, Istanbul, Annexed to the Interim report of the Special Rapporteur on torture and other cruel, inhuman or degrading treatment or punishment, A/63/175, 28 July 2008, p23. 67. Ibid., p24. 68. Ibid., p25. 69. UN Doc. A/63/175, 28 July 2008, para. 80; UN Doc/A/66/2685, August 2011; 21st General Report of the CPT, European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment; UN Doc. A/66/268, 5 August 2011; see also Principle 7 of the Basic Principles for the Treatment of Prisoners. 70. See, ‘Our prison system was not designed for women’, by Dawn Moore, Associate Professor in the Carleton University Department of Law. The Ottawa Citizen, 20 October 2012, available at: https://manitmirror.wordpress.com/2012/10/20/ottawa-citizen-our-prison-system-was-not-designed-forwomen/ <accessed 24 November 2015> and http://www.cp24.com/news/key-recommendations-from-the-jury-at-the-ashley-smith-inquest-1.1600932 <accessed 24 November 2015>. 71. As required by the ICCPR, Article 10. 72. Revised Standard Minimum Rules, Rules 43 (2), 47-49 and 76(c). Penal Reform International | Women in Detention: a guide to gender-sensitive monitoring | 13