50 Special Report to the Storting Document 4:3 (2018–2019) The prison should seek to reintegrate inmates who are held in isolation for preventive purposes (including on their own request) as soon as possible.166 If it becomes clear that there is a need for long-term protection and no other response is possible, special effort should be put into regime enhancement measures. Examples of such measures would be to identify other inmates with whom the inmate concerned could safely associate and situations where it would be possible to bring the inmate out of cell to get other sensory inputs, meaningful human contact and physical exercise. 7.1 Lack of meaningful human contact The most effective way of reducing the harmful effects of isolation is to facilitate meaningful human contact. For such contact to be meaningful, it should be ­empathetic and face to face. The communication should not be fleeting or incidental to the performance of other tasks, such as delivering food trays or ­medication.167 The statutory requirement is that inmates who are excluded from company must be seen to several times a day, and the guidelines specify that, as a point of departure, supervision shall take place once an hour. The guidelines also state that inmates may be granted extended access to the open air, the company of staff, visits from friends and family, physical activity or other measures that could prevent the detrimental effects of being excluded from the company of other inmates. 168 During our visits, we have found that such measures are made limited use of, however. Many inmates have no human contact other than staff supervision. We have also found that the requirement for hourly checks is ­seldom adhered to in practice, and that such checks often consist of brief messages or questions. The ­unequal balance of power can also make it difficult for prison officers to establish good relations with inmates in solitary confinement. This also applies to inmates who have been confined on their own request. Many inmates we meet in restrictive units sit with the curtains closed and lights off in the middle of the day in cells with a poor state of ­cleanliness and hygiene. Such conditions raise concerns about the adverse effects of isolation, which some prisons show little awareness of. ‘An officer comes in the morning and says “good morning”, then at breakfast, then for exercise in the yard and then at dinner, and then one who says “goodnight”. Other than that, nothing’. Inmate interviewed by the NPM 51 Inmates in solitary confinement eat in their cells and do not partake in meals with other inmates. In many cases, the food is placed on a trolley in the corridor for the inmates to pick up. In some cases, and in the case of remand inmates who are held in isolation to prevent destruction of evidence, the food is brought into the cell. We have observed that, in some sections, food is routinely delivered through the hatch in the cell door. In one prison, we were informed that this was common practice and applied to all inmates regardless of why they had been placed in that section. This procedure ­entailed a further reduction in human contact for inmates in solitary confinement, and could be perceived as dehumanising and enhance the feeling of isolation. The procedure also meant that staff missed an ­important opportunity to observe and engage in conversation with inmates. In sections with little or no communal facilities and where the cells have a ­refrigerator, there is even less contact with staff. In such cases, several days’ rations of food for meals other than dinner are distributed in one go. ‘The TV is my best buddy. They say that all inmates shall have an offer of activities, but that doesn’t happen’. 7.2 Limited offer of activities for inmates in solitary confinement Prolonged periods without activity and external input lead to passivity, fatigue and apathy, people’s capacity for attention, concentration, planning and motivation is reduced, and they tend to move and talk less. In step with this, their brain activity is significantly reduced. Inmates who spend a long time in their own cell with limed human contact can therefore easily develop passivity. It is therefore very important to ensure that inmates engage in both physical and mental activity. The CPT recommends that inmates who are excluded from the company of other inmates should be provided with a programme of measures to ensure human contact as well as the maximum possible level of activity.169 This was also stressed in the CPT’s report after its visit to Norway in 2018.170 The vast majority of prisons we have visited offer few activities to inmates in solitary confinement. As a rule, the offer is limited to use of the exercise yard and gym, and activities that the inmates can pursue in their own cell. All inmates who are excluded from the company of other inmates shall have the possibility of spending at least one hour outdoors every day. This follows from international standards and, in Norwegian law, from Section 22 of the Execution of Sentences Act. Inmate interviewed by the NPM In most prisons we have visited, inmates in solitary confinement feel that the officers seldom take the time to engage in a longer conversation. We find few systematic efforts to reintegrate inmates into the general prison population. Chess board used by inmates. 166 Council of Europe: Committee for the Prevention of Torture (CPT), 21st General Report, 10 November 2011, CPT/Inf (2011) 28, paragraph 61 (d). 167 See Essex Paper 3, Initial Guidance on the interpretation and implementation of the UN Nelson Mandela Rules, written by an expert group organised under Penal Reform International and Essex Human Rights Centre 7–8 April 2016, pp. 88–89. 168 Directorate of the Norwegian Correctional Service (2002). Guidelines to the Execution of Sentences Act and its Regulations, section 37.14. Revised version of 2 April 2019. Even if staff in many prisons are only able to ensure that they have meaningful human contact with inmates in solitary confinement to a very limited degree, we have seen examples of the opposite. During one visit, we observed a high degree of awareness among both prison officers and in the healthcare department of the importance of following up inmates in solitary ­confinement, and the inmates told us they were being looked after in a good way. Follow-up by officers included long conversations, extra hours in the gym and time in the library when it was closed to the general prison population. The healthcare department followed up and spoke with inmates in solitary confinement on a daily basis. ‘Sitting here is like sitting on a desert island, it’s extremely demanding. I don’t think people understand this. I don’t think it’s right, whether you have ­committed a crime or not. Those who put us here should try it themselves’. Inmate interviewed by the NPM 169 Council of Europe: Committee for the Prevention of Torture (CPT), The CPT standards, 8 March 2011, CPT/Inf /E (2002) 1 – Rev. 2010. See also the Nelson Mandela Rules, Rule 38.2 170 Council of Europe: Committee for the Prevention of Torture (CPT), Report to the Norwegian Government on the visit to Norway 2018, CPT/Inf (2019) 1, paragraph 82.