The boring, monotonous or even soul-crushing experience of being locked up in solitary confinement has been brought to the silver screen by actors like Tim Robbins in Shawshank Redemption and Paul Newman in Cool Hand Luke, lonely and idle in a concrete box the size of a bathroom. Yet many people are unaware of the lasting harm it can wreak or of its widespread use: Solitary confinement is a common practice in nearly every state of the United States, where tens of thousands of inmates are being held in isolation at any time, and in dozens of other countries around the globe.

Many experts and human rights advocates oppose the practice, citing a growing body of research that has revealed its pernicious impacts on mental health. One of those is Craig Haney, a social psychologist at the University of California, Santa Cruz and author of a 2018 article on the subject in the Annual Review of Criminology. In the article, Haney writes that not only are there serious psychological repercussions of solitary, but also that there’s an emerging consensus that the practice is costly and ineffective, in that it “does not achieve its intended objectives and may even worsen the problems it was designed to solve.”

Haney’s scholarship has had impacts on prison policy. His studies showed that prisoners held for long periods in solitary confinement at Pelican Bay State Prison in California reported nearly twice the number of symptoms of stress and trauma compared with the general prisoner population. Oprah Winfrey interviewed Haney about his research last year on 60 Minutes. He serves on the advisory board for the Vera Institute of Justice’s Safer Alternatives to Segregation Initiative.

Haney spoke with Knowable Magazine about how solitary confinement is used and its persistent effects on people’s minds and behavior.

This conversation has been edited for length and clarity.

Could you describe a typical solitary confinement unit?

They tend to be austere in nature. A prisoner spends up to 23 hours a day inside a solitary confinement unit, where they engage in all the activities of life: They eat, sleep and defecate all in the same 60 to 80 square feet of their cell. Sometimes the cells lack natural light; they may not even have a window. Many solitary confinement units have solid doors, so prisoners are literally encased in concrete and steel.

They don’t have anything to do. They’re not given education or vocational training. They’re basically sitting idle in their cells. There’s a monotony: They’re surrounded by the same voices, the same smells, the same light, the same four walls. They’re also deprived of human touch; many of these places deny prisoner contact visits.

When prisoners do get out of their cells, many are restricted to individual exercise areas that resemble cages where you would expect to see an animal in a zoo. They’re typically not engaged in any kind of group activity but are isolated simply in a different place. These are grim, dehumanizing and depriving environments. Often the prisoners say they don’t bother going out.

How long do prisoners spend in solitary confinement?

The length of time varies widely, depending on the purpose for which someone’s put in there. People can spend a short amount of time, measured in hours or days. But there are cases I’ve worked on where prisoners were in not just for years but decades. The longest-serving member of the Angola Three, Albert Woodfox, was in solitary confinement for 46 years. I’ve worked on cases in California where people were in solitary confinement for decades — 30, almost 40 years. Those are the extremes, but it’s possible and it’s happening still.

Graph showing that 18 percent of those in solitary were there less than one month; 29 percent from 1 to 3 months; 16 percent from 3 to 6 months; 13 percent from 6 months to 1 year; 13 percent from 1 to 3 years; 5.5 percent from 3 to 6 years; and 5.4 percent more than 6 years.

The majority of US prisoners held in solitary confinement spend months in isolation, but nearly a quarter of them must endure years or even decades.

You said there are different purposes for solitary confinement. What are they?

In theory, it has two general purposes. One is a punitive or disciplinary purpose: If somebody violates a prison rule, they can be placed in solitary confinement. The more serious the infraction, the longer amount of time somebody spends there.

The other purpose is if the prison system decides that the prisoner represents a threat to the security of the institution, they can be held in solitary confinement for administrative purposes. The most typical use for this is for suspected or alleged gang members, who can be placed there indefinitely. That’s part of what leads to people being left in solitary confinement for years. Prisoners who have a term to serve can steel themselves to try to withstand the time they have. They count the hours, the days. They have the sense that there’s light at the end of the tunnel. People who are in solitary confinement indefinitely don’t have any sense of that.

You have written that not only is solitary confinement harmful, but it’s also not clear that it actually works to deter bad behavior or stop gangs.

There is no evidence that “administrative” uses of segregation have any positive effect reducing or controlling gangs in prison. For example, the California prison system has had one of the most aggressive segregation policies segregating gang members in the country and continues to have one of the most serious gang problems. In my opinion, segregating gang members actually worsens the problem. Gang members have nothing to do in segregation, and they become more committed to something they’ve suffered for.

In your experience, how are people who have spent a lot of time in solitary confinement affected psychologically?

People vary in the extent to which they’re affected and in how rapidly this happens. Some have an adverse reaction immediately, particularly prisoners in jails [local facilities usually meant for short-term sentences]. People come off the streets who are not used to confinement, and if they’re placed in solitary confinement, it’s overwhelming. Though it’s generally the case that the longer you’re there, the worse the effects, there’s also a period of vulnerability in the beginning, especially for inexperienced prisoners who don’t know what to make of it or whether they can survive it.

Graphs showing self-reports of psychological symptoms and frequency of symptoms in prisoners kept in solitary vs the general population.

Prisoners held for long periods in solitary confinement at Pelican Bay State Prison in California report nearly twice the number of symptoms of stress and trauma, and with higher frequency (as noted by intensity), compared with the general prisoner population, research by Craig Haney has shown. A majority of those in solitary reported having anxiety attacks, headaches, lethargy, trouble sleeping, a feeling of impending nervous breakdown, perspiring hands and heart palpitations.

When you do enough interviews with prisoners as I’ve done over the years, you find that this is a difficult environment for people to tolerate. People suffer in these environments, experiencing a range of what can be severe, negative psychological effects, including forms of depression and hopelessness. Sometimes they become so despondent they attempt to take their own life. The highest rates of suicide and self-harm occur in solitary confinement units.

People experience anxiety attacks. They feel as if they’re on the verge of a breakdown. I’ve had prisoners tell me they spend countless hours worried about whether they’re going to be able to come out of this with their sanity intact. Frankly, some of them are unable to. Some people lose their grip on reality.

Over time, something less obvious but more insidious happens. Solitary confinement requires people to learn to live in a world without people. It’s the denial of meaningful social engagement with others. To tolerate that, you begin to structure your world, your psyche around not having the presence of other people in your life. Then other people start to become aversive stimuli to you. You’ve been isolated so long, your social skills begin to atrophy. Many prisoners have told me they now feel uncomfortable around people. You get instances where they tell their family members not to visit. They just sit in their cells and don’t want to engage with others anymore.

What about the physical effects of solitary confinement?

We’re just beginning to study that. There’s new research on a range of effects as a result of reduced access to sunlight, fresh air, exercise, physicality. There’s also stress-related illness. The research is still in its early stages, but researchers are looking at whether this is more frequent among people who have been placed in solitary confinement.

How do you do your research? Do you speak to different people at different facilities?

Yes. It involves going into a solitary confinement unit, and I select a representative sample of prisoners. I do it randomly from prisoner rosters so I don’t get a biased group of respondents. Then I have a standard systematic interview format where I take a social and institutional history from them. I ask detailed questions about their background in prison and how long they’ve been in solitary confinement.

I have a list of 25 isolation-related symptoms I ask about. I make it clear that some people experience these and some don’t. I ask whether they’ve been bothered by these things in the past three months and how much they’ve been bothered by them. That allows me to form an impression of the patterns of the symptoms people suffer.

Can there be lasting effects, even after someone is released from solitary or from prison?

A lot depends on how long you were in and the changes that took place inside of you. Some people make it out, and if they’re fortunate enough to get into a warm and caring environment outside of solitary confinement, they manage to begin to regain their social skills. Even then I’ve had conversations with people who take me aside and tell me, “You know, I may look like I’m doing OK but I’m really not. I have problems all the time. I’m anxious, I don’t feel comfortable around people.”

Prisoners housed in solitary confinement vs general population in US broken down by race.

In a survey, researchers found racial disparities in the use of solitary confinement. In 31 of 43 reporting jurisdictions, those housed in solitary contained a greater percentage of African American men than did the general prison population. In 22 jurisdictions, Hispanic prisoners were overrepresented in solitary. In 36 jurisdictions, white men were underrepresented in solitary, compared with their numbers in the general prison population. Totals for all jurisdictions surveyed are shown here.

I’ve had more extreme cases. A couple years ago, a former prisoner’s wife called me, she was crying, she said, “My husband just got out of prison and won’t come out of the bathroom. Every day he gets up in the morning and locks himself in the bathroom. Sometimes he won’t even sleep in the bed.” So I went to see him — he doesn’t live far from here — and he told me, “I never told my wife this, but I’m not just locked in the bathroom, I sit in the bathtub. The coldness of it makes me feel like I’m back in my cell, and it’s the only place I feel comfortable. My wife wants me to sleep in the big bedroom we have, but I feel like I’m in the ocean or something. I can’t get used to it. It’s very disorienting. So I go in the bathroom and it calms me down.” That is how extreme it can be.

What about the effects on someone who already has mental health issues, or a juvenile, or an elderly person?

This is one of the reasons that most professional organizations have issued either recommendations or mandates to prohibit putting vulnerable populations in these environments. You mentioned the three most obvious ones: juveniles, the physically aged or infirm, and a currently large group of people in solitary confinement who should not be there — the mentally ill. Many prison systems unfortunately still have mentally ill prisoners in isolation, and it’s a dangerous practice, often worsening their conditions.

Is there a movement to limit or even ban solitary confinement?

Yes, there have been positive developments in just the last five years. For example, the United Nations promulgated what have come to be called the Mandela rules, which provide for the humane treatment of prisoners around the world. They have banned the use of solitary confinement for longer than 15 days, indicating that longer than that constitutes cruel, degrading and inhumane treatment, or torture. Not every country and not every state in the US has endorsed them, but that’s a standard to which human rights organizations have pointed.

Other organizations, like the American Psychiatric Association, hold that mentally ill prisoners should not be held in solitary confinement for longer than four weeks. The National Commission on Correctional Healthcare, an organization of everybody in the prison health care profession, psychiatrists, medical people and so on, have endorsed the Mandela rules. Many organizations have reached a consensus that solitary confinement should be used only as a last resort, only for the shortest amount of time absolutely necessary and never for certain vulnerable populations.

Are there cities and states considering limiting or putting a maximum time limit on solitary?

The place to point to is Colorado, which has eliminated it for juveniles and the mentally ill and has endorsed and embraced the Mandela rules. That’s the state where the most aggressive policies have been implemented by the director of corrections there, Rick Raemisch, who’s been leading the way in the country. A number of other states are moving in the same direction.