A/66/268 juvenile and adult prison populations. 50 Regrettably, solitary confinement as a form of punishment of juvenile detainees has been prevalent in States such as Jamaica (A/HRC/16/52/Add.3, para. 211), Paraguay (A/HRC/7/3/Add.3, appendix I, para. 46) and Papua New Guinea (A/HRC/16/52/Add.5, appendix). In regard to disciplinary measures, a report has indicated that solitary confinement does not reduce violence among juvenile offenders detained in the youth prison. 51 2. Persons with disabilities 67. Persons with disabilities are held in solitary confinement in some jurisdictions as a substitute for proper medical or psychiatric care or owing to the lack of other institutional housing options. These individuals may not necessarily pose danger to others or to themselves, but they are vulnerable to abuse and often regarded as a disturbance to other prisoners and prison staff. 52 68. Research has shown that with respect to mental disabilities, solitary confinement often results in severe exacerbation of a previously existing mental condition. 53 Prisoners with mental health issues deteriorate dramatically in isolation. 54 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. 55 Some engage in extreme acts of self-mutilation and even suicide.54 3. Lesbian, gay, bisexual and transgender 69. Lesbian, gay, bisexual and transgender individuals are often subjected to solitary confinement as a form of “protective custody”. 56 Although segregation of such individuals may be necessary for their safety, lesbian, gay, bisexual and transgender status does not justify limitations on their social regime, e.g., access to recreation, reading materials, legal counsel or medical doctors. K. When solitary confinement amounts to torture and other cruel, inhuman or degrading treatment or punishment 70. Because of the absence of witnesses, solitary confinement increases the risk of acts of torture and other cruel, inhuman or degrading treatment or punishment. Given its severe adverse health effects, the use of solitary confinement itself can amount to acts prohibited by article 7 of the International Covenant on Civil and __________________ 50 51 52 53 54 55 56 11-44570 Article 37(c), Convention on the Rights of the Child; article 8(d), United Nations Standard Minimum Rules for the Treatment of Prisoners. Robert Wildeboer, “The Impact of Solitary Confinement in a Youth Prison”, Inside and Out (Chicago, 2010). Shalev, op. cit., p. 26. Stuart Grassian, “Psychiatric Effects of Solitary Confinement”; Shalev, op. cit., p. 10. American Civil Liberties Union, “Abuse of the Human Rights of Prisoners in the United States: Solitary Confinement” (2011). Jeffrey L. Metzner, M.D., and Jamie Fellner, “Solitary Confinement and Mental Illness in U.S. Prisons: A Challenge for Medical Ethics”, The Journal of the American Academy of Psychiatry and the Law, vol. 38, No. 1, pp. 104-108 (2010). Heartland Alliance National Immigrant Justice Center, letter to the Special Rapporteur on torture dated 16 June 2011. 19