Special Report to the Storting Document 4:3 (2018–2019) 24 4 Solitary confinement is an intrusive measure and ­detrimental to health Restricting an individual’s access to social contact with other people is an extensive infringement upon that person’s integrity and autonomy. It limits the possibility of making one’s own ­decisions about fundamental matters such as meals, hygiene, ­social contact, movement and medical care. The ­inmates become more dependent on staff and lose the possibility of looking out for themselves. Solitary ­confinement also reduces inmates’ possibility of ­protecting themselves against abuse, since their fate is put in the hands of people who can both make ­decisions and commit acts against their person. The risk of integrity violations, degrading treatment and abuse, whether intentionally or not, increases. Sometimes the conduct of inmates who are placed in isolation is already challenging for the staff’s ability to perform their duties in an ethical manner. Solitary confinement can also trigger aggression and violent ­behaviour, however, which in turn trigger further ­isolation and less human contact. Combined with the limited possibility of being observed by others, such situations entail a risk of staff violations.57 4.1 Harmful elements of solitary ­confinement Contact with other human beings is one of the most fundamental of human needs and a precondition for good mental health.58, 59 Loneliness and social isolation have been described as major health challenges of our times. Research has demonstrated that it can increase the risk of premature death more than, for example, obesity.60 Both the scope and quality of human contact are ­important. In a prison context, the extent of social contact is very much reduced at the outset. At the same time, the quality of social contact will be ­affected by the balance of power between inmates and staff. The ­human contact is often monotonous and ­superficial, and thus lacks elements of importance to human health. In addition to constituting an extensive infringement on the individual’s autonomy, restrictions on human ­contact can harm a person’s physical and mental health. 57 58 59 60 The Istanbul Statement (2007). Retrieved from: http://solitaryconfinement.org/istanbul, p. 2. The World Health Organization (WHO) defines health as follows: ‘Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’. WHO (1948), Official Records of WHO, no 2, p. 100. For example: Maslow, A H (1943). A theory of Human Motivation. Psychological Review, 50, 370-396. Holt-Lundstad, J et al. (2015). Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-analytic Review. Perspectives on Psychological Science, 10, 227-237. 25 ‹ 4