Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

Testimony by The Correctional Association of New York Before the Senate Judiciary
Committee’s Subcommittee on the Constitution, Civil Rights and Human Rights
Reassessing Solitary Confinement – June 19, 2012
The Correctional Association of New York (CA) would like to thank the Subcommittee for the
opportunity to provide written testimony about New York State’s use of solitary confinement,
referred to in the state as special housing units (SHU), S-block, and keeplock.1 Our testimony will
document the extensive and expanding abuse of isolated confinement in New York prisons and its
devastating impact, particularly on those suffering from mental illness. We will also offer New York
as a model for beginning to address the isolation of persons with serious mental illness, while
documenting the ongoing challenges and limitations of the New York experience.
Recent History of Advocacy on Solitary Confinement in NYS
The CA is an independent, non-profit organization that has legislative authority to investigate prison
conditions in New York and report its findings and recommendations to the state legislature. The CA
has long reported on the use and conditions of solitary confinement in New York and advocated for
more humane alternatives. Over the last decade, the CA, along with many other advocates in New
York, focused on some of the worst abuses imposed by solitary confinement – isolation of those
suffering from serious mental illness. In reports published in 2003 and 2004,2 based on visits to
numerous disciplinary housing units in New York, the CA documented the terrible consequences for
people with mental illness who are sent to the harsh isolation of the SHU. For example, the CA found
people who smeared themselves with feces or lit their cells on fire and/or who were actively
demonstrating severe psychological harm. The CA also found long SHU sentences of up to more than
a decade, extremely high rates of suicide and self-harm, and people with overwhelming feelings of
isolation and sensory deprivation resulting in depression and withdrawal even for those individuals
who did not suffer from a mental illness prior to entering the SHU. Subsequent to those reports, based
on visits to nine Office of Mental Health (OMH) level 1 or 2 maximum security prisons with SHUs
between December 2004 and November 2008, the CA again documented the continued overuse and
harmful effects of isolation for the seriously mentally ill. Those visited prisons contained 546 SHU
cells and housed 515 individuals, nearly 50% of whom were on the OMH caseload. Several of those
prisons had very high numbers of people in the SHU requiring psychiatric hospitalization or transfer
to a Residential Crisis Treatment Program (RCTP) due to mental deterioration, such as at Auburn and
1

SHU units are segregated cellblocks in most maximum- and some medium-security prisons, where individuals must
spend 23 hours per day in their cell, are offered one hour per day of recreation, and have meals delivered to their cells.
Keeplock refers to individuals confined for 23 hours a day either in their cells or in a separate cellblock. S-blocks are
segregated freestanding high-tech lockdown units where individuals are double celled; New York State also has two
facilities, Southport and Upstate, which constitute entire prisons made up of these high security lockdown units and eight
additional S-blocks at other facilities. Because those individuals confined in double cells are held in isolation with a
second person, in this testimony we will use the term “isolated confinement” in place of solitary confinement.
2
Correctional Association, Mental health in the House of Corrections, June 2004 and Lockdown New York, Oct. 2003.

1

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

Elmira, where people in SHU were 20 to 30 times more likely to require psychiatric hospitalization
than those in general population. Moreover, the CA documented the repeated cycling of people
between the SHU and RCTPs or hospitalization, as well as the disproportionately high prevalence of
suicide and self-harm amongst people with mental illness and/or confined in SHU or keeplock units.3
As a result of the intense focus on isolation of the seriously mentally ill by numerous advocates, and
through a combination of litigation and legislation, New York implemented historic restrictions on
solitary confinement for the seriously mentally ill. The SHU Exclusion Law4 was passed by the New
York State Legislature in January 2008 – expanding upon a 2007 litigation settlement in Disabilities
Advocates, Inc. v. NYS Office of Mental Health – and took full effect in July 2011. The effect of the
settlement and the law has begun to produce positive results for people suffering from serious mental
illness. However, significant implementation challenges remain to ensure those protected by the law
receive treatment and care. Also, the law does not cover large numbers of people with significant
mental illnesses, and has not had any impact on stemming the extensive and expanding use of
isolated confinement for the majority of people in NYS prisons. Isolation is routinely used, not
primarily to address chronically violent behavior or serious security or safety concerns, but often in
response to non-violent prison rule violations, or even as retaliation for questioning authority, talking
back to an officer, or filing grievances. Moreover, people often accumulate SHU time while in
disciplinary confinement, resulting in long-term isolation, sometimes lasting a decade or more.
New York’s Extensive and Expansive Use of Isolated Confinement
Despite a substantial decline in the prison population since 2000, DOCCS continues to discipline an
extraordinarily high number of individuals in its prisons, and many of these persons are placed in
disciplinary confinement for extended periods of time under harsh conditions.
The DOCCS population reached its maximum of 71,538 in December 1999 and has dropped 23% to
its January 2012 level of 55,073 individuals. During this time, the number of DOCCS facilities has
been reduced from 70 to 60 institutions. Despite this impressive reduction in the prison population,
there has not been a concomitant decline in the population in disciplinary confinement. In fact, the
percentage of the population in the most severe isolation, the SHU, has increased during the past ten
years. Table 1 – Summary of DOCCS Population and SHU Confinement, on page 3, illustrates
this unfortunate trend. The most recent data represents a 46% increase in the percentage of the prison
population in the SHU compared to the 2003-0 period. It should be noted that during the period
2003-05 there was a significant population in keeplock status in the prisons, generally in the range of
1,500 residents; but even with these figures added to the total, the percentage of individuals in
disciplinary confinement during that period was still less than the percentage now in SHU. Further,
keeplock is still used by DOCCS, and although we believe it is used less frequently than during 200305, we have documented a keeplock census that would appear to exceed 1,000 individuals. It should
also be emphasized that keeplock can involve significant periods of isolation. During the 2003-06,
annually there were more than 800 individuals sentenced to 90 days or more in keeplock.
3

According to a DOCS’ Inmate Suicide Report, 1998-2007, from 1998-2004, 34% of the suicides were in a SHU or
disciplinary keeplock unit, and even the slightly decreased percentage of 18% for the period 2005-2007 represented a
suicide rate more than twice the rate for the general population. Similarly, 57% of DOCS suicide victims were classified
as OMH level 1, 2 or 3 patients at the time even though they represented only 15% of the prison population; and in 2007,
just prior to the passage of the SHU Exclusion Law, 11% of the total self-harm unusual incident reports in NYS prisons
and 39% of the suicide attempts occurred in a special housing unit.
4
SHU Exclusion Law of 2008, 2008 N.Y. Laws 1 (codified as amended at N.Y. CORRECT. LAW §§ 137 & 401-a
(McKinney 2012) and N.Y. MENTAL HYG. LAW § 45 (McKinney 2012)

2

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

Table 1 – Summary of DOCCS Population and SHU Confinement
Population
Prison Pop
Total SHU Pop
SHU % of Pop
S-Block Pop *

2003
66,745
3,450
5.17%

2004
65,197
3,500
5.37%

2005 2006 2007 2008 2009 2010
2011
2012
63,698 62,732 63,304 62,599 60,081 58,378 56,315 55,073
3,500
n/a
4,500 4,504 4,329 4,273 4,331 4,308
5.49%
7.11% 7.20% 7.21% 7.32% 7.69% 7.82%
1,300 1,280 1,300 1,300 1,250 1,270 1,216 1,446

* Residents in S-Block units, each with capacity for 200 disciplinary prisoners, are included in the SHU census total.

The data presented in Table 1 illustrates the unusually high rates of isolation employed by DOCCS.
According to data presented by the Vera Institute, taken from a DOJ Bureau of Justice Statistics
report about the prison population in the United States in 2005, 81,622 individuals were in some
restrictive housing in federal and state prisons, representing 5.7% of the entire prison population in
the country.5 New York’s 2012 figure is 37% higher than the national average and does not include
individuals in keeplock, administrative segregation or some other form of restrictive housing.
The census in the SHU at any one time does not measure the full impact of disciplinary confinement
on the NY prison population. Our project surveys incarcerated individuals during prison visits and of
the 4,440 individuals who have responded to our survey, 21% stated that they had been in the SHU at
the prison at which they were currently confined; at several facilities that figure rose to 28% to 38%
of all survey respondents. Since most individuals have been at multiple prisons, this figure would be
substantially higher if we asked whether they were ever in the SHU. The only conclusion to draw is
that the SHU impacts a large portion of the prison population.
New York’s disciplinary population is so high because DOCCS issues a large number of disciplinary
actions against its population. Each year, approximately 150,000 violations of the prisons rules are
prosecuted by DOCCS. Since approximately 95% of individuals charged with a prison violation are
generally found guilty, most of these violations result in some form of punishment. SHU confinement
is given for the more serious offenses. The vast majority of SHU sentences are 60 days or more, and
in practice most SHU residents spend many months in isolation.
Our project has analyzed DOCCS data for all disciplinary dispositions for the period 2003 through
August 2006. During these three and two-third years, each year12,200 SHU sentences were imposed,
affecting a total of 22,525 individuals. Of these, approximately 4,500 individuals each year were
given six months or more of SHU time, and annually more than 1,600 individuals were given a year
or more in the SHU for a single violation. Although these numbers are disturbing, they do not fully
present the true impact on these individuals. The 2003-06 data allowed us to link SHU sentences to
specific individuals, revealing that a majority of individuals given lengthy SHU sentences were given
multiple SHU sentences during this time period. Nearly 80% of people with a six month or more
SHU sentence had at least one additional rules violation resulting in additional SHU time. Similarly,
nearly 80% of those with a year or more SHU sentence had multiple SHU dispositions. Due to these
multiple SHU sentences, many people spend many months and even years in the SHU.
During our prison visits we survey individuals in the SHU and ask about their total disciplinary
sentence. Nearly one-quarter of the more than 500 survey respondents reported a cumulative SHU
5

Browne, Cambier, & Agha, Prisons Within Prisons: The Use of Segregation in the United States. Federal Sentencing
Reporter, Vol. 24, No. 1, Sentencing Within Sentencing (October 2011), pp. 46-49; Stephen, James, J, Census of State
and Federal Adult Correctional Facilities, 2005 (Bureau of Justice Statistics, U.S. Department of Justice, October 2008).

3

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

sentence of one year or more. At certain maximum security prisons a majority of respondents were
serving a year or more, and many indicated they were facing multiple years. This accumulation of
additional SHU time is particularly prevalent for people already in disciplinary confinement.
Although these individuals have very limited opportunity to leave their cell, we find very high
numbers of SHU residents receiving additional disciplinary tickets. The SHU becomes a vicious
cycle of: isolation, actual or perceived misconduct in the SHU, and additional discipline; many
residents surrender to the proposition that they will never be able to leave the SHU until released
from prison. Not surprisingly, the despair and anger that results from this hopeless cycle makes
getting out of the SHU even more difficult.
General Impact of Isolation
People in the SHU and other forms of isolated confinement are not able to participate in any
meaningful programs, jobs, or group interactions, are generally denied such basic “privileges” as
making phone calls or purchases from commissary, are allowed a maximum of five books, letter
writing supplies, and religious materials, receive food in their cells, and often receive increasingly
harsh deprivation orders for rule violations, including restrictions on such basic amenities as food,
showers, recreation, and haircuts.6 The sensory deprivation, lack of normal interaction, and extreme
idleness can cause intense suffering and severe psychological debilitation for any person subjected to
it, and can have even more devastating impacts on those suffering from mental illness. Incarcerated
women face additional special issues related to solitary confinement and its impact on emotional and
physical health.7 For example, isolation can have particularly damaging affects on survivors of
domestic violence and abuse, which represents the overwhelming majority of incarcerated women.
Extended isolation may trigger symptoms of Post Traumatic Stress Disorder (PTSD) such as
flashbacks, self-destructive acts, emotional dissociation, difficulty sleeping, and irritable and
aggressive behavior. In addition, isolation can have a devastating affect on women’s sense of selfworth and ability to access needed supports, as women often place particular importance on
sustaining relationships and community.8 Moreover, isolation can compromise women’s ability to
fulfill their particular needs related to reproductive health care, for instance by impeding pregnant
women’s access to critical obstetrical services, preventing them from getting the regular exercise and
movement vital for a healthy pregnancy. Similarly, women in isolation may be dissuaded from
requesting care related to sensitive gynecological issues because they are required to inform
correction officers about details of their medical problem, may have serious difficulty accessing
appropriate medical staff when they do reach out, may be shackled during gynecological
appointments that do occur, and will often interact with medical providers in full view of correction
officers and/or receive superficial evaluations through closed cell doors.
Mental Health and Disciplinary Confinement in NYS – the SHU Exclusion Law
As noted above, people suffering mental illness face some of the most severe impacts of isolation,
and the CA and other advocates have thus far focused their advocacy related to solitary confinement
on improving conditions for that population. In part due to the closing of numerous psychiatric
6

As a particularly harsh deprivation order, individuals are placed on a restricted diet where all meals consist of what is
known as “the loaf,” a dense, binding, tasteless, one pound loaf of mixed ingredients with a side of raw cabbage.
7
Bedford Hills and Albion are the only two women’s facilities with a SHU – Bedford’s unit has 24 cells and Albion’s has
48 – and all facilities except Beacon have a Keeplock area.
8
Barbara Bloom, Barbara Owen, and Stephanie Covington, Gender-Responsive Strategies: Research, Practice, and
Guiding Principles for Women Offenders, the National Institute of Corrections

4

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

hospitals across New York, and the limited availability of community based treatment options, the
state has seen a significant rise in the number of individuals with a mental illness who are confined in
correctional facilities. Over the past decade the number of individuals on the prison mental health
caseload has soared, reaching a high of 9,067 patients in 2008, before dropping to 7,958 as of January
1, 2011. Individuals with a mental illness are often subjected to disciplinary sentences because of
difficulty complying with strict prison rules, and isolation often exacerbates any mental illness, and
leads to more behavioral issues and SHU time. The devastating effect of isolation on people with
mental illness is particular pressing for incarcerated women as they suffer from mental illness at
substantially higher rates than their male counterparts, with more than 42% of women in NY prisons
having been diagnosed with a serious mental illness as of January 2007. The SHU Exclusion Law
aims to limit some of the worst forms of abuse of isolated confinement for those with serious mental
illness, and has made significant progress in improving conditions for these patients. Data, primarily
provided by DOCCS and OMH,9 indicates both that the law has already achieved substantial results
and that serious challenges remain in its implementation.
Provisions of the SHU Exclusion Law
The SHU Exclusion Law requires that any individual who suffers from a serious mental illness and is
sentenced to a period of disciplinary confinement that could exceed 30 days must be diverted from a
SHU or separate keeplock unit to a Residential Mental Health Treatment Unit (RMHTU), except in
“exceptional circumstances.”10 RMHTUs must be therapeutic in nature, jointly operated by DOCCS
and OMH, and include all NYS Residential Mental Health Units (RMHU), Behavioral Health Units
(BHU), Therapeutic Behavioral Units (TBU), Intermediate Care Programs (ICP), and the Intensive
Intermediate Care Program (IICP).11 The law requires that individuals in RMHTUs be offered at least
four hours a day, five days a week, of structured out-of-cell therapeutic programming and/or mental
health treatment.12 The law also requires RMHTU residents to “receive property, services, and
privileges” similar general population,13 and places restrictions on discipline in RMHTUs, including
prohibiting: restricted diets, misbehavior reports for refusing medication or treatment, and removal to
disciplinary confinement absent a significant and unreasonable safety or security risk; as well as
creating a presumption against disciplinary charges for acts or threats of self-harm.14 In addition to
the provisions related to diversion, the law requires all new DOCCS staff who will regularly work in
programs providing mental health treatment to receive eight hours of training on such topics as types
and symptoms of mental illness, treatment goals, suicide prevention, and effective and safe
management of individuals with mental illness.15 The law empowers the NYS Commission on
Quality Care & Advocacy for Persons with Disabilities (“CQC”) to monitor the quality of mental
health care provided to incarcerated individuals, ensure compliance with the law, make
9

Some of the data analyzed was provided by the Office of Mental Health’s (OMH) Central New York Psychiatric Center
(CNYPC), which operates a forensic psychiatric wing for patients in prison who require hospitalization. The data
analyzed included annual summaries of the services provided both within DOCCS facilities by OMH staff and data about
people in DOCCS prisons transferred to the inpatient unit at CNYPC for psychiatric hospitalization. We also reviewed
OMH annual reports for specific mental health programs for the periods 2007 through 2011, where such data was
available, and system-wide data provided by DOCCS concerning its prison population.
10
See N.Y. CORRECT. LAW § 137.6(d)(i).
11
N.Y. CORRECT. LAW § 2.21. If a diverted individual is placed in an RMHU or BHU, the time spent in those units will
be credited toward any disciplinary sanction that has been imposed.
12
N.Y. CORRECT. LAW § 2.21. The law carves out an exception to the four hour requirement for the 38 BHU unit beds
currently at Great Meadow Correctional Facility, where only two hours of out of cell time are required.
13
N.Y. CORRECT. LAW § 401.2(b).
14
N.Y. CORRECT. LAW § 401.2(b), 3, 5(a)
15
N.Y. CORRECT. LAW § 401.6.

5

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

recommendations related to the diversion and removal of individuals with serious mental illness from
disciplinary confinement, and have an advisory committee composed of mental health experts,
advocates, and family members of incarcerated individuals with serious mental illness.16
Positive Outcomes of the SHU Exclusion Law
Although implementation of the SHU Exclusion Law remains in its early stages and thus it is difficult
to assess the law’s effectiveness, positive outcomes have resulted from the preparation for and
implementation of the law. Evidence suggests that a significant number of individuals with serious
mental illness have been diverted from the SHU to RMHTUs. New York has expanded the number of
treatment beds available for individuals with a serious mental illness sentenced to disciplinary
housing, meaning more people receive increased mental health services, the opportunity for
disciplinary time-cuts, and the use of non-punitive information reports in response to problematic
behavior, instead of discipline that results in additional SHU time. As seen in Table 2, in the years
leading up to full implementation of the law, and presumably in anticipation of its required
implementation, the number of patients with serious mental illness housed in the SHU dropped
significantly from 174 in 2007 to 47 in June of 2011, just prior to the law taking full effect. While the
total number of people with serious mental illness in disciplinary units has remained fairly constant
with a slight decline from 260 patients in 2007 to 241 in 2011,17 the vast majority of these patients
were in a disciplinary mental health treatment program as of June 2011, whereas in 2007, only 35%
were receiving intense mental health services. Similarly, the percentage of the SHU population on the
OMH caseload has dropped from under 19% to under 14%, indicating that although the total number
of OMH patients in some form of disciplinary mental health housing has remained at nearly 800
patients or 18% of those units, a greater number are receiving more intense mental health services.
Table 2 – Disciplinary Confinement for DOCCS Patients with Mental Illness
Disciplinary
Units
Total SHU Pop
S-Block Pop *
SHU Patients on
OMH caseload
“S” Designated
SHU Patients**
BHU Patients †
RMHU Patients††
Total SHU, BHU,
RMHU on OMH

2003

2004

2005

2006

2007

2008

2009

2010

6/2011

3,450

3,500

3,500
1,300

n/a
1,280

4,500
1,300

4,504
1,300

4,329
1,250

4,273
1,270

4,254
1,216

849

798

753

711

660

644

606

561

579

n/a

n/a

n/a

n/a

174

166

125

104

47

n/a
-

n/a
-

76
-

83
-

96
-

90
-

62
-

60
67

78
88

829

794

756

734

668

688

792

* S-Block unit residents, each with capacity for to hold 200 people, are included in the SHU census total.
** The number of “S” designated patients in SHU includes patients in the STP and GTP but not the BHU or RMHU.
† BHU census data was obtained from DOCS population data from 7/2005, 9/2006, 6/2007, 9/2008, 6/2009 and 9/2010.
†† RMHU census figures were obtained from DOCCS 9/2010 population data.

16

N.Y. CORRECT. LAW § 401-a(1), (2), (3).
Prisoners with serious mental illness (SMI), or an "S" designation according to OMH, meet the criteria specified in the
SHU Exclusion Law. We have computed this census by adding the patients in the BHU and RMHU to the SHU residents
listed as "S" designated. In 2011, it appears STP patients were not included in the listing of "S" designated patients in the
SHU, so we added that population of 28 prisoners to the group of SHU, BHU and RMHU patients.
17

6

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

In addition, all individuals with serious mental illness who were previously confined in Special
Treatment Program (STP) units – where patients remained in the SHU and participated in two hour
group sessions five days a week in caged therapeutic cubicles in which participants were physically
separated from each other – were transferred to RMTHUs or non-punitive housing areas and
therefore are receiving more treatment in a more therapeutic environment. As an indication of the
positive impact, the percentage of patients discharged from the STP to the ICP rose significantly18 at
the same time that, because of the DAI litigation, the number of ICP beds and patients in the ICP both
rose more than 35% from 2007 to 2010.19 To the extent that more individuals have been transferred
to the ICP as a result of the DAI litigation and the SHU Exclusion Law, patients receive much more
intensive mental health services in a more therapeutic environment, as the vast majority of ICP
patients receive 20 hours of therapy per week. Moreover, the feasibility of transitioning disciplinary
patients with serious mental illness to non-punitive treatment programs is amply demonstrated by
data from 2008 to 2010 whereby discharges from STPs to all non-punitive mental health programs
were routine, remained stable at approximately 40%, and constituted the largest single disposition of
patients leaving STPs. This increased number of such transfers is a marked change from a decade ago
when few disciplinary prisoners left the SHU.
Significant Areas of Concern
1. Individuals Not Protected by the Law and Under-Diagnosis
Although the SHU Exclusion Law has resulted in substantially improved treatment and programs for
people with serious mental illness, significant challenges remain. The law has not had an impact on
the extensive and expanding use of disciplinary confinement for people in prison without serious
mental illness. In addition, people in keeplock, where isolation can be just as devastating, are not
afforded the law’s protections unless placed in a SHU or separate keeplock unit. Even for those in
SHU with some form of mental illness, including diagnoses many would consider serious, the law
creates a hard line set by its definition of “serious mental illness,” with those who fall above the line
receiving intensive mental health treatment and those who fall below receiving little to none. Under
the law an individual has a serious mental illness if: a) diagnosed with listed Axis I disorders;20 b)
actively suicidal or engaged in a serious suicide attempt; c) diagnosed with a mental condition,
organic brain syndrome, or severe personality disorder with particular characteristics that leads to a
significant functional impairment involving acts of self-harm or their equivalent; or d) determined to
have substantially deteriorated in isolation to the point of experiencing impairments indicating
serious mental illness and involving acts of self-harm or their equivalent. Those not assessed to be in
these categories do not receive diversion, treatment, programs, or other protections of the law.
Moreover, the creation of a hard line inherently creates an incentive for OMH and DOCCS to classify
people below the line. Diagnoses data over the last few years raises concerns about potential underdiagnosis. For instance, as noted above, the number of patients on the OMH caseload precipitously
18

The percentage discharged from STPs to ICPs rose from 17.5% in 2008 to 31.5% in 2010; those discharged from STPs
to CNYPC dropped from 20.6% in 2008 to 14.3% in 2009 to 8.5% in 2010.
19
The number of ICP beds increased from 551 in 2007 to 743 in 2010, and the number of patients in the ICP increased
from 527 in 2007 to 715 in 2010.
20
The Axis I diagnoses include: schizophrenia, delusional disorder, schizophreniform disorder, schizoaffective disorder,
brief psychotic disorder, substance induced psychotic disorder other than intoxication or withdrawal, psychotic disorder
NOS, major depressive disorders, and bipolar disorder I and II.

7

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

dropped between 2008 and 2011. While the overall number of individuals incarcerated in New York
has also decreased by 6.3% from 2008 to 2011, the number of patients on the OMH caseload has
dropped by 12.2%, almost double the decline in the total prison population. More directly related to
the SHU Exclusion Law, between 2007 and 2011 the percentage of patients with a primary diagnosis
of schizophrenia or another psychotic disorder has significantly decreased while those diagnosed with
an anxiety, personality or adjustment disorder has increased.21 Given that, as discussed above,
patients diagnosed with a psychotic disorder automatically qualify for the most intensive mental
health services, while those with non-psychotic disorders will only qualify if significant additional
criteria are met, and therefore may not receive any protections under the law, this substantial change
in diagnoses raises serious concerns about the possibility of under-diagnosis.
2. Punitive Rather than Therapeutic Environment
Serious concerns also remain about the degree to which RMHTUs provide a therapeutic, rather than
punitive, environment. Although people with serious mental illness in these units are required under
the law to receive two or four hours per day in a therapeutic environment, patients spend the rest of
their time in the harsh punitive environment of a disciplinary confinement unit. Prolonged isolation,
even in units that provide some mental health services, can have devastating effects, which, for
instance, often manifest in incidents of self-harm. Moreover, many individuals with serious mental
illness in these units continue to receive large numbers of disciplinary tickets. Recent visits by the CA
to the Great Meadow and Attica Correctional Facilities22 provide examples of the difficult challenges
that remain for people in disciplinary units with a mental illness. Attica and Great Meadow are both
maximum-security facilities that confine a total of over 3,700 individuals, have SHU and keeplock
cells, and subject 350 individuals to some form of isolation. Both facilities have a significant portion
of their population on the OMH caseload,23 are OMH Level-1 facilities,24 and operate special
disciplinary housing units for people suffering from mental illness with a long-term disciplinary
sentence.
Great Meadow’s BHU25 exemplifies the tension between RMHTUs as treatment programs and
disciplinary units. A distressingly high number of BHU patients reported that it was common for
security staff to physically assault patients. One individual shared that before a particular group
therapy session began, he was expressing his concerns about security staff to his fellow patients,
when a mental health staff person walked in, heard him and immediately reported it to security staff,
who promptly removed him from therapy and physically assaulted him on the way back to this cell.
21

Between 2007 and 2011, the percentage of patients diagnosed with schizophrenia or psychosis dropped from 21.4% to
17.8%, representing a decline of 16.8%. In contrast, there was an increase in the diagnosis of personality disorders, from
7.2% to 10.1% from 2007 to 2011, a 40% increase. Similarly, there has been a significant increase in the diagnosis of
adjustment disorder, rising from 6.6% in 2007 to 11.6% in 2011, representing a 76% increase. Patients diagnosed with
anxiety disorders also rose from 9.8% to 10.5% during this four-year period.
22
PVP visited Attica Correctional Facility in April of 2011 and visited Great Meadow Correctional Facility in 2009 and,
due to serious concerns, returned to Great Meadow again in 2010 and 2011.
23
At Attica, staff estimated that 21% of the entire population was on the OMH caseload; at Great Meadow 24% of the
entire population was on the OMH caseload. The number of patients requiring mental health treatment at these facilities is
significantly higher than the estimated 14% of prisoners system-wide who require mental health treatment.
24
OMH designates facilities from Level 1 to Level 6 according to the availability of mental health staff and the treatment
provided. Level 6 facilities have no mental health staff and Level 1 have full-time staff and provided the most intensive
services.
25
The BHU operates in three phases, Phase I, which operates at Great Meadow, is the most restrictive, but provides two
hours of out-of-cell therapy and incentives to increase positive behavior; Phase II and III, which operate at Sullivan
Correctional Facility provide more freedoms, with additional out-of-cell time and decreased physical constrictions.

8

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

Similarly, individuals reported that when they expressed concerns regarding self-harm or suicide,
they were met with hostility and physical threats. One person reported that when he told security staff
he was feeling suicidal and wanted to see mental health staff, the security staff person responded
“Just hang up if you want. It would make it easier for us.” Moreover, at both the Great Meadow and
Sullivan Correctional Facility BHUs, the vast majority of residents continue to receive disciplinary
sanctions, and the practice not only persists, but has increased according to the last two years of
available data.26 This frequent use of discipline seriously undermines the therapeutic nature of the
units and the ability of patients to progress to less restrictive mental health housing. Similarly, many
patients in BHUs are being transferred to another program with significant SHU or keeplock time
remaining, which they will be required to serve. According to data from 2010, the average amount of
SHU time and keeplock time remaining for individuals released from the BHU were both over one
year. In a related manner, the time-cuts individuals should be receiving are insignificant in terms of
their disciplinary sentence. The average amount of time cut for people in the BHU was 78 days,
which is relatively small for individuals who may be serving years.
Attica’s STP, initially established as a disciplinary unit for people with serious mental illness but now
no longer recognized as an RMHTU under the SHU Exclusion Law,27 similarly demonstrates the
difficult challenges facing individuals with serious mental illness confined in disciplinary units.
Attica STP patients reported long SHU sentences with a median of three years and some reported
sentences of up to 10 years. In addition, many of the individuals had been in other residential
treatment programs across the state and had received additional SHU time while on those units.
Further, although individuals were offered two hours of out-of-cell therapy everyday, a significant
percentage of those in the STP refused to participate. As a further indication of the negative
psychological impact of prolonged confinement in the harsh environment of the STP, the number of
individuals in all STP units across the state requiring psychiatric hospitalization represents a
disproportionately large portion of the total admissions to CNYPC,28 with a rate roughly three times
higher than for non-punitive mental health treatment program patients. Also, as in the BHUs, the
majority of STP patients continued to receive disciplinary tickets, and were discharged with
significant SHU or keeplock time, with less than half of those on the unit receiving a time-cut while
in the STP. In 2010, CNYPC reported that 98% of patients discharged from the STP had received a
serious disciplinary sanction while on the unit, only 45.5% had received a time-cut, and the average
amount of SHU time remaining was just under one year. This data illustrates the continued use of
discipline on the unit, the failure of the time cut process to significantly reduce SHU sentences, and a
pattern of STP patients leaving the program with substantial time to serve in restricted housing.

26

Sixty-one percent of BHU patients with serious mental illness released in 2009 received a serious disciplinary ticket
(Tier 3 misbehavior reports), and that figure increased to 71% in 2010.
27
The Special Treatment Program for disciplinary prisoners with serious mental illnesses was opened at Attica C.F. in
2000 as a treatment program for disciplined people confined to SHU. STP units were subsequently created in the SHUs at
Five Points C.F. and Green Haven C.F. The SHU Exclusion Law does not recognize these units as RMHTUs and,
therefore, as of July 1, 2011, disciplined persons with serious mental illness could no longer be housed there. Although
these units are no longer operational, data analyzing the census and treatment of STP patients is relevant to understand the
challenges faced by individuals with serious mental illness in disciplinary units with mental health services, particularly
since the STPs at Attica and Five Points were converted into RMHUs. Moreover, although in preparation for full
implementation of the SHU Exclusion Law DOCCS began to phase out use of the STP, in 2008 through 2010 there was a
substantial increase in STP admissions mostly from the SHU and other disciplinary residential mental health treatment
units, demonstrating the continuing need for residential mental health treatment for disciplinary patients.
28
In CY 2010, STP patients accounted for nearly 5% of all CNYPC admissions even though the STP population is only
1.25% of the patients on the OMH caseload.

9

Testimony Before the Senate Judiciary Committee
Subcommittee on the Constitution, Civil Rights and Human Rights

Correctional Association of New York
Reassessing Solitary Confinement – June 19, 2012

Although the SHU Exclusion Law strives to reduce the number of individuals with a mental illness
placed in disciplinary confinement, lessen the time served, and limit the use punishment, as
demonstrated by data on the BHU and the STP, the practice of continuing to punish and isolate those
individuals with a mental illness persists in units across New York State.
3. Suicide and Self-Harm
Self-harm and suicides are perhaps the most devastating manifestation of continued challenges for
people with mental illness in isolated confinement. NYS prisons have a comparatively large number
of suicides, with a disproportionate number occurring in isolation. The most recent national data for
2001-2004 demonstrates that New York’s average annual suicide rate over the past 12 years of 19.7
incidents per 100,000 people in prison is 30% higher than the national average of 15 suicides per
100,000.29 In 2010, New York’s suicide rate of 35 per 100,000 was more than double the national
average, and was the highest rate for the past 28 years.30 Equally disturbing, far too many of the
individuals committing suicide are confined in the SHU or keeplock and/or suffer from mental
illness. Between 1998 and April 2004, 34% of prison suicides occurred in disciplinary confinement,
although prisoners in these units comprised less than 7% of the total prison population.31 That rate
only slightly declined, to 29%, for the period 1998 to 2009.32 In 2010, although the percentage of
suicides in disciplinary confinement dropped to 10%, there is still a concern that many of the
individuals who committed suicide had been recently transferred from disciplinary housing.
Suicides can not be viewed in isolation, as they are the devastating final product of often multiple
attempts of suicide or acts of self-harm. By analyzing Unusual Incident Reports (UIR) data for 20072010,33 we found a disturbing pattern of destructive behavior indicating that suicides often occurred
at facilities that have the highest rates of self-harm. The data also revealed that facilities with the
highest incidence of self-harm are facilities with a high percentage of mentally ill patients and large
disciplinary housing units, including the two facilities that only confine individuals with long-term
disciplinary sentences. Moreover, the rates of self-harm and suicide attempts at the most problematic
facilities are five to 10 times higher than the department-wide average.
Conclusion
New York State has begun to make significant progress in addressing the devastating impacts of
isolation on people with serious mental illness, and the SHU Exclusion Law can serve as a model for
other states still subjecting such patients to solitary confinement. At the same time, any reliance on
the New York system must take into account the limitations of the law, the challenges faced in
implementation, and the gaps in coverage even for significant numbers of people with debilitating
mental illnesses. Moreover, the New York experience demonstrates that providing protections for a
particularly vulnerable population is only an initial step in addressing the abhorrent infliction of
isolation, with the state remaining one of the worst examples in terms of the frequency and duration
of the imposition of disciplinary confinement.
29

BJS,US DOJ, Medical Causes of Death in State Prisons, at Appendix Table 1, p. 5 (2007).
Pfeiffer, M., Prison Suicides Rise; Officials Deny Trend, Poughkeepsie Journal, 12/26/2010 (available at
http://www.nyaprs.org/e-news-bulletins/2011/2011-01-04-PJ-Prison-Suicides-Rise-Officials-Deny-Trend.cfm). Mary
Beth Pfeiffer is an independent reporter who has been investigating suicides in DOCCS for several years.
31
Correction Association, Mental Health in the House of Corrections at 57 (2004).
32
Pfeiffer, supra note 29.
33
In New York State, UIRs must be completed after every incident of suicide and self-harm.
30

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