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Abstract: 

A big part of the psychological harm of solitary confinement in prison and jail is the extraordinarily high risk of suicide and self-harm. Averaging the various states for which we have figures for prison suicide rates, 50% of prison suicides—actions leading to death, as distinct from attempts—occur among the 3% to 6% or 8% of the prison population consigned to some form of solitary confinement. This article, written by one of the field’s foremost experts and advocates, examines the link between solitary confinement on the one hand, and prison suicide and self-harm on the other. It explores the role of anxiety and trauma in self-harm, and argues that the widespread under-diagnosis of serious mental illness (SMI) as merely Antisocial Personality Disorder (ASPD) tends to support an attribution of “manipulating” or “malingering” where none is actually present.

Keywords: Anxiety; Cutting and Mutilation; Under-Diagnosing Serious Mental Illness

Affiliations:  1: The Wright Institute.