Systematic Review of Participation of Mental Health Staff in Solitary Confinement in the U.S

Background: The practice of solitary confinement is tightly bound to the mental health services in U.S. jails and prisons.  As use of solitary confinement has increased, correctional administrators rely on mental health staff participation in aspects of the punishment process; one of the most common examples of dual loyalty issues in this environment that erodes the overall mission of patient care.  To our knowledge, there have not been any systematic literature reviews examining involvement of mental health professionals in the administration of solitary confinement and the legal framework that formalizes this relationship.  

Methods: This paper describes a systematic review of the public health, biomedical and legal literature from peer-reviewed sources between 1980 – 2014.  The review includes two components.  (1) A review of scholarly literature from multiple databases to determine the nature of mental health professionals’ participation in solitary confinement in U.S. prisons and jails. (2) A review of solitary confinement studies in the broader legal system, with special attention to the social and medical standards, which inform judicial and legislative treatment of this issue. 

Findings: Based on PubMed keyword searches using six variants of the term “solitary confinement,” we found 57% of the associated literature focused on prisons, whereas 5% detailed issues in prisons and jails and 2% focused on jails.  Further results will be discussed, particularly within the context of reforms to solitary confinement and the correctional health service in the New York City jail system.

Implications: This research fills a gap in the existing literature and contributes to greater understanding of the relationship between mental health professionals and the practice of solitary confinement in the U.S.