Solitary Confinement has many names, but one purpose - to punish

What is Solitary Confinement?

End Solitary Washington defines solitary confinement as the confinement of an incarcerated person or detained person alone in a cell or similarly confined holding or living space for 20 hours or more per day under circumstances other than a partial or facility-wide lockdown.

The United Nations (UN) defines solitary confinement as "confinement of prisoners for 22 hours or more a day without meaningful human contact". In 2015, the UN adopted the Standard Minimum Rules for the Treatment of Prisoners, known as the Nelson Mandela Rules, which prohibited indefinite and prolonged solitary confinement exceeding 15 consecutive days, deeming it torture.

Why is it Torture?

In a 2011 report to the UN General Assembly, UN Special Rapporteur on Torture Juan E. Méndez warned that prolonged isolation can cause irreversible psychological harm, including anxiety, hallucinations, and suicidal thoughts, even in healthy individuals. Méndez emphasized that solitary should never be used on children or people with mental illness, and the UN’s Mandela Rules prohibit its prolonged or indefinite use (Méndez, 2011). The UN’s position is grounded in human rights principles, particularly the Convention Against Torture, which prohibits treatment that causes intense suffering or humiliation.

How is Solitary Confinement Used?

In Washington State, solitary confinement is used to separate individuals deemed unsafe for general population. People are put into restrictive housing for varied reasons—including maximum custody level, disciplinary infractions, administrative segregation, safety concerns, medical or mental-health isolation, suicide-watch cells, and protective custody.

Where is Solitary Confinement used?

In Washington State, solitary confinement is used in the Washington Department of Corrections, county and city jails, and the Northwest Detention Center. While prisons and jails for youth do not use special solitary confinement cells, their use of room confinement resembles the conditions of solitary confinement and has similar impacts on the health of incarcerated youth. State psychiatric hospitals permit the use of seclusion only as a last resort in emergencies and for no longer than four hours for adults.

The Human Cost of Solitary Confinement

Solitary confinement takes a serious toll on the body and mind, with especially harsh effects on vulnerable groups like youth, the elderly, and people with mental health conditions. This section explores the deep and lasting harm caused by isolation. Click on the tabs to learn more.

Alters Brain Function

Solitary confinement significantly impacts the brain, causing both immediate and long-lasting effects. Extended periods of social isolation and sensory deprivation can damage key brain regions involved in memory, emotional regulation, and decision-making. Neuroimaging studies have shown that individuals subjected to prolonged isolation often exhibit reduced gray matter in the hippocampus and prefrontal cortex—areas critical for cognitive functions like memory formation and impulse control. These changes can lead to difficulties with attention, reasoning, and managing emotions (Haney, 2018).

Moreover, solitary confinement disrupts the brain’s stress-response system, particularly the hypothalamic-pituitary-adrenal (HPA) axis, which regulates cortisol release. Chronic stress from isolation causes excessive cortisol production, which can be neurotoxic—damaging brain cells and reducing neural plasticity. This biological imbalance increases the risk of anxiety, depression, and psychosis among individuals in solitary. These neurological effects explain many of the psychological symptoms linked to isolation and suggest that the damage to brain function can be long-term or even permanent (Moser et al., 2020).

Worsening Pre-existing Mental Health Conditions

Solitary confinement significantly worsens mental health for people with existing psychiatric disorders such as depression, bipolar disorder, schizophrenia, and PTSD. The isolation, lack of social contact, and sensory deprivation intensify symptoms like anxiety, paranoia, and hallucinations, increasing the risk of self-harm and suicide attempts (Metzner & Fellner, 2010). Mental health professionals have observed that these conditions often deteriorate rapidly in solitary, making treatment and management much more difficult within prison settings. Without consistent access to support, vulnerable individuals’ symptoms can spiral out of control, leading to severe and lasting consequences.

New Mental Health Issues

Solitary confinement can cause serious mental health problems in individuals with no prior psychiatric history. A study by Andersen et al. (2000) found that Danish prisoners held in isolation experienced significantly more mental health symptoms—including depression, anxiety, and emotional flatness—compared to those in the general prison population, regardless of their mental health history (Andersen et al., 2000). Similarly, a longitudinal study by Reiter et al. (2020) found that even short periods in solitary confinement increased the risk of developing new psychiatric symptoms such as panic attacks, paranoia, and intrusive thoughts, particularly among those previously considered psychologically healthy (Reiter et al., 2020). These findings confirm that the extreme isolation and lack of stimulation in solitary confinement environments can lead to the development of serious mental health conditions, even among individuals with no prior diagnoses.

Physical Toll

Solitary confinement severely damages inmates’ physical health in both the short and long term. According to a Medical News Today summary of peer-reviewed studies, individuals confined for 22.5+ hours daily often experience chronic headaches, dizziness, heart palpitations, excessive sweating, digestive issues, muscle and joint pain, tremors, and significant weight loss (medicalnewstoday.com). Neurological and visual deterioration is also common, with many reporting eyesight decline due to restricted movement and sensory deprivation . These symptoms arise from the combined effects of environmental deprivation, physical inactivity, and elevated stress levels.

Long-term isolation is linked to serious chronic conditions and premature mortality. A study in California found nearly threefold higher rates of hypertension among inmates in solitary compared to those in general housing (vera.org). Furthermore, national research reveals that post-release mortality is 24% higher for those who experienced solitary, with dramatically increased risks of suicide (78%), homicide (54%), and opioid overdose (127% within two weeks) (journalistsresource.org). Vitamin D deficiency from lack of sunlight contributes to bone fragility and higher fracture risk, and the inability to exercise worsens conditions like diabetes and cardiovascular disease. These findings underline that solitary confinement inflicts not only immediate physical suffering but also long-lasting health consequences that persist well beyond incarceration.

Impact on the Youth

Solitary confinement has particularly harmful effects on young people, whose brains and emotional regulation systems are still developing. Research shows that isolation can severely impact cognitive growth, emotional stability, and behavior in youth. According to the American Academy of Child and Adolescent Psychiatry, even short periods in solitary confinement can increase the risk of depression, anxiety, and suicide among adolescents (AACAP, 2012). Youth are more vulnerable to the psychological stress caused by extreme isolation, with many experiencing lasting trauma, emotional withdrawal, and self-harm. The lack of access to education, family contact, and mental health services in solitary further disrupts healthy development and undermines rehabilitation efforts.

Impact on the Elderly

Elderly incarcerated individuals are also highly susceptible to the damaging effects of solitary confinement. As people age, they are more likely to suffer from physical disabilities, chronic illnesses, and cognitive decline, all of which are worsened by isolation. A study by the Vera Institute of Justice found that solitary confinement contributes to accelerated aging, worsened physical health, and increased risk of dementia in older prisoners (Vera Institute, 2018). The combination of social isolation and limited access to medical care can result in both psychological and physical deterioration. For elderly individuals, solitary confinement is not only psychologically harmful but can also be life-threatening.

Long-Term Consequences

The consequences of solitary confinement often extend far beyond the period of isolation, with lasting impacts on mental health and overall functioning. Research shows that individuals subjected to solitary are significantly more likely to experience anxiety, depression, psychosis, and self-harm—even after the isolation ends.

These effects are not merely short-term stress responses but often evolve into chronic conditions like emotional blunting, social withdrawal, and cognitive impairment. Reintegration becomes especially difficult, as the psychological toll of isolation can undermine a person’s ability to connect with others, follow social norms, or engage in rehabilitative programs.

Studies also indicate an increased risk of unnatural death—including suicide, overdose, and homicide—among those who have experienced solitary. These long-term harms make it harder for individuals to function both within prison environments and in the community after release, ultimately weakening the prospects for rehabilitation and successful reentry.

Staff Wellness

Solitary confinement, also known as restrictive housing, negatively affects correctional staff by increasing stress, burnout, and mental health strain. A National Institute of Justice (NIJ) study found that staff working in long-term restrictive housing units face higher emotional exhaustion and secondary trauma due to constant exposure to inmate self-harm, aggression, and the ethical challenges of enforcing isolation (OJP, 2020). The high-stress environment contributes to job dissatisfaction and turnover, weakening institutional stability.

Additionally, a 2020 report by the Vera Institute of Justice highlights that correctional officers in solitary units experience disproportionately high rates of anxiety, depression, and even suicidal ideation compared to peers in general population housing. The report emphasizes that prolonged exposure to these environments without sufficient training or mental health support can have lasting psychological and physical health consequences (Vera Institute, 2020). These findings suggest that solitary confinement harms not only incarcerated individuals but also the staff tasked with overseeing it.

The Anatomy of a Solitary Cell

These interactive images allows you to explore a typical solitary confinement cell, with clickable areas that highlight common features such as the size, lighting, and amenities.

"I held on through the screams of people breaking, through a guard urging me to kill myself. I hate that their pain gave strength. I broke when all went silent. I lost part of my soul to that silence."

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The lighting is usually artificial and remains on 24 hours a day, disrupting natural sleep cycles.

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Many cells lack windows entirely, or have narrow slits that allow minimal or no natural light.

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A 54 sq ft (6x9) cell is about a 3rd the size of a typical parking space, leaving little room for movement

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Cells generally contain only a toilet, sink, and a concrete or steel bed with a thin mattress, offering no personal belongings or comfort.

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There are sometimes 2 people put into solitary cells together. Being forced to share space 22-24 hours a day.

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People in solitary have almost no human contact. Food, medications, wellness checks, etc. are handled through a slot in the cell door

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Access to healthcare is often delayed or inadequate, and mental health support is minimal despite the extreme psychological toll.

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The environment is eerily quiet or filled with echoes, interrupted only by occasional distant screams, metal doors slamming, or guards' footsteps.

In 2023, the Office of the Corrections Ombuds (OCO) was tasked with completing a three-part report examining the use of solitary confinement in Washington State prisons—made possible by years of persistent advocacy from us. Part I provides a statewide analysis of restrictive housing practices, Part II shares powerful firsthand accounts from those who have endured solitary, and yet to be released Part III will outline concrete policy recommendations for ending its use.

Office of Corrections Ombuds Reports on Solitary Confinement

The Many Faces of Solitary Confinement

Disability Rights Washington’s AVID (Amplifying Voices of Incarcerated Individuals with Disabilities) program works to protect the rights and amplify the voices of incarcerated people with disabilities, advocating for humane treatment and systemic reform in Washington’s prisons.

We encourage you to explore The Many Faces of Solitary Confinement in Washington Prisons report to better understand the hidden realities of isolation in our prison system. Be sure to watch the powerful videos below - featuring the voices of those directly impacted.