Solitary Confinement and Risk of Self-harm Among Jail Inmates

• NCJ Number: 247439
• Journal: American Journal of Public Health Volume: 104 Issue: 3 Dated: March 2014 Pages: 442-447
• Author(s): Fatos Kaba M.A.; Andrea Lewis Ph.D.; Sarah Glowa-Kollisch, M.P.H.; James Hadler, M.D., M.P.H.; David Lee, M.P.H.; Howard Alper, Ph.D.; Daniel Selling, Psy.D.; Ross MacDonald, M.D.; Angela Solimo, M.S.; Amanda Parsons,M.D., M.B.A.; Homer Venters, M.D., M.S.
• Date Published: March 2014
• Length: 6 pages
• Publication Format: Article
• Publication Type: Research (Applied/Empirical); Report (Study/Research)
• Language: English
• Country: United States of America

Annotation

With a focus on the New York City jail system, this analysis identifies the risk factors for inmate self-harm and considers whether such inmates might be better served with innovative approaches to their behavior rather than the use of solitary confinement, which may provide an incentive for self-harm.

Abstract

The study found that self-harm acts were strongly associated with the assignment of inmates to solitary confinement. Inmates punished with solitary confinement were approximately 6.9 times more likely to commit self-harm after controlling for the length of jail stay, serious mental illness (SMI), age, and race/ethnicity. "Self-harm" is defined as "an act performed by individuals on themselves with the potential to result in physical injury;" "potentially fatal self-harm" is defined as "an act with a high probability of causing significant disability or death, regardless of whether death actually occurred." In addition to being in solitary confinement at least once, other risk factors for self-harm were found to be SMI, being 18 years old or younger, and being Latino or White, regardless of gender. Because of this concern about solitary confinement as a risk factor for self-harm, the New York City jail system has modified its practices to direct inmates with mental illness who violate jail rules to more clinical settings, eliminating solitary confinement for inmates with SMI. The study analyzed data from medical records on 244,699 incarcerations in the New York City jail system from January 1, 2010, through January 31, 2013. In 1,303 (0.05 percent) of these incarcerations, 2,182 acts of self-harm were committed (103 potentially fatal and 7 fatal). Although only 7.3 percent of admissions included any solitary confinement, 53.3 percent of acts of self-harm and 45 percent of acts of potentially fatal self-harm occurred within this group. 3 tables, 1 figure, and 12 references