Medical consensus has emerged that solitary confinement is extremely harmful to the mental and physical health of individuals, and international soft law has followed suit, with efforts to limit its use. Yet despite consensus on the damage caused by solitary confinement, it is still widely used in Europe and elsewhere as a tool for managing prison life. In France, individuals accused of terrorism or organized crime are placed in solitary confinement, for years at a time. In Iceland, solitary confinement is used vis-à-vis remand prisoners.
Among the central challenges is that – until now – there has been no international consensus on what to do instead of solitary confinement. To address the gap between medical consensus and the ongoing practice of solitary confinement, Physicians for Human Rights Israel and Associazione Antigone gathered a group of experts - correctional staff, prison administrators, mental health professionals, and academics – to create the International Guiding Statement on Alternatives to Solitary Confinement. The Guiding Statement establishes a broad agreement on short- and long-term measures that should replace solitary confinement to decrease and hopefully eliminate its use.
The Guiding Statement includes suggestions for tackling the broader systemic issues within prison systems, such as prison conditions and wider structural problems within our societies, including mass incarceration, criminalization of marginalized groups (across Europe, many of those in solitary confinement are immigration detainees ahead of deportation) and the lack of community-based mental healthcare – also known as ‘the solitary confinement pipeline’. Simultaneously, while working towards implementing structural changes, immediate steps should be taken to remove individuals from solitary confinement.
These suggestions are divided into 5 overlapping sections:
Documentation, oversight, and accountability to expose how solitary confinement is used and for whom. The Guiding Statement emphasizes the need for precise and individualized record-keeping, including whether the individual belongs to a vulnerable population or an underprivileged group. To break any automatic imposition of solitary confinement, it requires prisons to note any alternative measures that were taken prior to placement. Improved oversight, including on-site visits by judges involved in solitary confinement cases, is also recommended. These steps are critical as the restrictions on movement and communication imposed through solitary confinement also increase the likelihood of other human rights violations. Antigone has reported several incidents of torture occurring in solitary confinement, including one in Asti prison for which Italy was condemned by the European Court of Human Rights in 2017.
Intermediate measures to get individuals out of solitary confinement. Worldwide, prison authorities cite several justifications for using solitary confinement. This may include self-harm prevention, in response to violent acts, to minimize friction, for security concerns, and upon a request of an individual. The Guiding Statement provides recommendations on how to remove people who are currently placed in solitary confinement in each of these situations. In the case of individuals who self-harm, they are to be immediately assessed by independent mental health professionals, with a time-bound individualized care plan to remove the individual from solitary confinement drawn up by mental health professionals, and de-escalation measures put in place by prison staff. As part of more long-term measures, the Guiding Statement recommends the creation of an independent body comprising mental health professionals, empowered to advocate for an individual's release from prison. Moreover, bearing in mind the role of physicians in rubber stamping solitary confinement, for example in Serbia, the Guiding Statement has specific recommendations for healthcare workers, including the need to automatically recommend removing the individual.
Individualized care plan to combat the standardized environment of correctional facilities. Those placed in solitary confinement are often those who face the most difficulties with this uniformity, as their specific needs are not adequately addressed by prison procedures, leading them to act out. The Guiding Statement recommends that individuals, including those currently in solitary confinement, are to have an individual care plan collaboratively developed by mental health professionals and prison staff. This plan should transparently, responsively, and compassionately address their unique circumstances, with the ultimate aim of reintegrating them into the prison population and, eventually, society.
Staff competency and well-being, as the staff’s approach significantly impacts an individual’s well-being and whether they end up in solitary confinement. Insufficient training and tools often result in punitive approaches and a misunderstanding of individual behavior. To address this, the Guiding Statement details the training content and evaluation required, as well as the need to provide support for prison staff, including secondary trauma care.
Solitary Confinement Pipeline, namely the holistic framework needed to address the systemic issues underlying the use of solitary confinement, complementing the more short-term measures outlined earlier. This section includes recommendations on overcrowding – a significant factor leading to friction among individuals, which often results in their placement in solitary confinement. It also advocates for community-based mental health support, aiming to prevent the unnecessary incarceration of individuals with mental health disorders.
Furthermore, this section confronts the disproportionate criminalization and mass incarceration of marginalized groups, who frequently face overrepresentation in solitary confinement. To rectify this injustice, it suggests, e.g., introducing reports on underprivileged backgrounds during pre-sentencing and bail hearings and the establishment of an independent committee that would analyze the causes of inequality and give steps to address them.
The International Guiding Statement is a consensus-driven document intended for prison authorities and legislators, as well as for the use of civil society organizations in local and international advocacy, legal petitions, and vis-à-vis governmental and international bodies, including the CAT, SPT, and Special Rapporteurs. We hope you will find it of use, as we work towards the reduction and eventual elimination of solitary confinement.
