Miller’s (1994:48) study of 30 prisoners in a Kentucky prison similarly found that “inmates housed in the most restrictive environment [punitive segregation] reported significantly higher levels of psychological distress symptoms such as anxiety and hostility, than inmates in the general population”. A follow-up study (Miller & Young, 1997:92) reported withdrawal, hostility, aggression, rage and irresistible impulses among those held in disciplinary segregation and concluded that these findings indicate that “there may be a level of restriction that, instead of solving administrative problems, becomes both a mental health issue and a further problem for the prison administration”. Sestoft et al. (1998:105) concluded their study of the impact of solitary confinement on subsequent hospitalisation among Danish detainees by stating that “individuals in solitary confinement are forced into an environment that increases their risk of hospitalisation ... for psychiatric reasons”. In his extensive study on the effects of imprisonment on more than 900 prisoners, including those held in segregation units, Hans Toch coined the term “‘Isolation Panic”’ to describe the experiences of isolated prisoners. Symptoms of this syndrome included A feeling of abandonment … dead-end desperation… helplessness, tension. It is a physical reaction, a demand for release or a need to escape at all costs… [Isolated prisoners] feel caged rather than confined, abandoned rather than alone, suffocated rather than isolated. They react to solitary confinement with surges of panic or rage. They lose control, break down, regress... (Toch 1992:49). Harvard psychiatrist Stuart Grassian, who has been studying the effects of solitary confinement for over two decades, similarly suggested that the symptoms experienced by isolated prisoners form a distinct syndrome, closely akin to ‘delirium’, That is, a constellation of symptoms occurring together and with a characteristic course over time, thus suggestive of a discrete illness… while this syndrome is strikingly atypical for the functional psychiatric illnesses, it is quite characteristic of an acute organic brain syndrome: delirium, characterised by a decreased level of alertness, EEG abnormalities ... perceptual and cognitive disturbances, fearfulness, paranoia, and agitation; and random, impulsive and self-destructive behavior … (Grassian, 2006:338). Finally, the growing body of research into the health effects of confinement in ‘supermax’ prisons in the United States (for example: Cloyes et al. (2006); Haney (2003); Kupers (1999); Miller (1994); Miller & Young (1997); Rhodes (2004); Grassian, (2006).) largely confirms findings reported in earlier studies, namely, that “this experience is psychologically painful, can be traumatic and harmful, and puts many of those who have been subjected to it at risk of long-term emotional and even physical damage” (Haney& Lynch, 1997:500). The accounts of prisoners Researchers have found that prisoners in solitary confinement often have little insight into their own mental state and tend to minimise their reaction to solitary confinement and play down any mental health problems (Grassian, 1983; Haney, 2003). Segregated prisoners also appear to have a more negative view of psychiatric treatment in prison and tend to avoid seeking such help (Coid et al. 2003-1:315). Mental health problems are particularly stigmatised amongst Muslim prisoners who are reluctant to seek help (Robbins et al. 2005). A report of the inspection of a small unit for Muslim prisoners detained under immigration law on the grounds of national security in the UK, for 12 Sourcebook on solitary confinement: The health effects of solitary confinement