ENTOMBED

IsolAtIon In the Us
fedeRAl pRIson systeM

Amnesty International is a global movement of more than 3 million supporters,
members and activists in more than 150 countries and territories who campaign
to end grave abuses of human rights.
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First published in 2014 by
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© Amnesty International 2014
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Original language: English
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Cover photo: Interior of a SHU cell at ADX © Private

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TABLE OF CONTENTS
Introduction ................................................................................................................. 2
Restrictions on access to ADX: Lack of transparency regarding BOP use of isolation ......... 5
Long-term isolation in other parts of the federal system ................................................. 6
Prisoners held in solitary confinement in pre-trial federal detention ................................ 7
Further observations on conditions in ADX ...................................................................... 8
Conditions in General Population UNITS ..................................................................... 8
Exercise ................................................................................................................. 10
In cell activities and programing ............................................................................... 13
Contact with staff .................................................................................................... 16
The Step-Down Program (SDP) ................................................................................. 18
Prisoners in ADX more isolated than before ................................................................ 19
Length of time in isolation/access to the SDP ............................................................. 20
Lack of clear criteria or safeguards for progressions to the sdp ..................................... 21
Special Security Unit (SSU) - H-Unit ........................................................................ 24
Control Unit, SHU and Range 13 .............................................................................. 27
Mentally Ill Prisoners at ADX .................................................................................... 31
Overview of US obligations under international law and standards ................................... 34
US Law and Standards ............................................................................................ 36
Recommendations ...................................................................................................... 38
Endnotes ................................................................................................................... 41

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List of abbreviations

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ADX: United States Penitentiary Administrative Maximum facility, super maximum
security prison which forms part of the FCC at Florence, Colorado
BOP: Federal Bureau of Prisons
CAT: United Nations Committee against Torture
CU: Control Unit
ECHR: European Court of Human Rights
FCC: Federal Correction Complex at Florence, Colorado,
GAO: General Accounting Office
GP: General Population Units
H-Unit, also known as Special Security Unit
ICCPR: International Covenant on Civil and Political Rights
IU: Intermediate Unit, first stage of the SDP
MCC: Metropolitan Correctional Center
NCCHC: National Commission for Correctional Health Care
PTU: Pre-Transfer Unit, final stage of the SDP, located at USP Florence
SAMs: Special Administrative Measures
SDP: Step Down Program
SHU: Security Housing Unit
SMR: United Nations Standard Minimum Rules for Treatment of Prisoners
SMU: Special Management Unit
SSU: Special Security Unit, also known as ‘H-Unit’
TU: Transitional Unit, second stage of the SDP, located at USP Florence
USP Florence, a high security prison which forms part of the FCC at Florence, Colorado

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INTRODUCTION
“Though I know that I want to live and have always been a survivor, I have often wished for
death. I know, though, that I don’t want to die. What I want is a life in prison that I can fill
with some meaning”
Thomas Silverstein, confined for over 30 years in isolation, nine of which have been spent in ADX1

An isolation cell in a General Population Unit at United States Penitentiary, Administrative Maximum (ADX) © Private

The USA stands virtually alone in the world in incarcerating thousands of prisoners in longterm or indefinite solitary confinement, defined by the UN Special Rapporteur on Torture and
other Cruel, Inhuman or Degrading Treatment or Punishment as “the physical and social
isolation of individuals who are confined to their cells for 22 to 24 hours a day”. 2 More than
40 US states are believed to operate “super-maximum security” units or prisons, collectively
housing at least 25,000 prisoners.3 This number does not include the many thousands of
other prisoners serving shorter periods in punishment or administrative segregation cells –
estimated to be approximately 80,000 on any given day.4

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While US authorities have always been able to segregate prisoners for their own protection or
as a penalty for disciplinary offences, super-maximum security facilities differ in that they are
designed to isolate prisoners long-term as an administrative control measure. It is a
management tool that has been criticized by human rights bodies, and is being increasingly
challenged by US penal experts and others, as costly, ineffective and inhumane.
The federal government currently operates one super-maximum security prison, the United
States Penitentiary, Administrative Maximum (ADX) facility in Colorado. With capacity for
490 male inmates, the vast majority of ADX prisoners are confined to solitary cells for 22-24
hours a day in conditions of severe physical and social isolation. The cells have solid walls
preventing prisoners from seeing or having direct contact with those in adjacent cells. Most
cells have an interior barred door as well as a solid outer door, compounding the sense of
isolation. Prisoners eat all meals inside their cells, and in most units each cell contains a
shower and a toilet, minimising the need for the inmate to leave his cell. Visits by prison
staff, including routine checks by medical and mental health staff, take place at the cell door
and medical and psychiatric consultations are sometimes conducted remotely, through teleconferencing. All outside visits are non-contact, with prisoners separated from their visitors
by a glass screen. Prisoners in the General Population (GP) (the majority of prisoners at ADX)
are allowed out-of-cell exercise for up to ten hours a week, in a bare interior room or in small
individual yards or cages, with no view of the natural world. Prisoners in some other units
receive even less out of cell time.5
Most prisoners assigned to ADX have reportedly been convicted of serious offences in prison,
such as assault, murder or attempted escape. ADX also houses a number of prisoners
convicted of terrorism-related offences; most of these prisoners were sent to the facility
based on their committal offence rather than for their conduct during incarceration and some
have Special Administrative Measures (SAMs) placed on them by the Department of Justice
which restrict their communications with the outside world. In a letter responding to
concerns raised by the UN Special Rapporteur on Torture, the US government said that ADX
is “designed to meet the exceptional security requirements of its inmates”, noting that
prisoners are sent there only after it is determined that they would pose a serious risk to
themselves or the safety of other inmates, staff, or the public if placed in a less secure
setting.6 The letter asserts that the regime, while restrictive, is humane, pointing out that the
cells have windows which allow access to natural light; that most inmates have TVs with
multiple channels and access to in-cell educational and other programs; and that they have
daily contact with staff. It also states that GP inmates have an opportunity to participate in a
Step Down Program (SDP) where they can earn their way to a less restrictive setting and
ultimately to another facility.
As discussed in this report, Amnesty International believes that the conditions at ADX are
unacceptably harsh and that in-cell programmes cannot compensate for the lack of
meaningful social interaction which many prisoners endure for years on end. The poverty of
the exercise facilities at ADX is also disturbing, particularly given the long periods in which
prisoners are otherwise confined to cells. Failure to provide suitable, daily outdoor exercise
falls short of the United Nations (UN) Standard Minimum Rules (SMR) for the Treatment of
Prisoners. Amnesty International recognizes that the authorities have an obligation to ensure
the safety of staff and inmates and that it may be necessary at times to segregate prisoners.
However all measures must be consistent with the USA’s obligation to treat all prisoners
humanely, without exception.
In recognition of the psychological harm that can result from isolating people even for
relatively brief periods, international human rights experts and organizations have called on
governments to restrict their use of solitary confinement so that it is applied only in

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exceptional circumstances, for the shortest possible period of time. US professional bodies
such as the American Bar Association have made similar recommendations. However,
prisoners at ADX must spend a minimum of 12 months in isolation, and often far longer,
before becoming eligible for the SDP. There is no detailed public information on the time
prisoners spend in each unit at ADX. However, a Federal Bureau of Prisons (BOP) analysis
based on a limited survey of 30 inmates in 2011 for a case before the European Court of
Human Rights (ECHR) showed prisoners were likely to spend at least three years in the GP
(confined to solitary cells 22-24 hours a day) before being admitted to the SDP.7 Other
sources based on a wider sample of prisoners have found that scores of prisoners have spent
more than twice as long in solitary confinement. 8 Prisoners in the Control Unit, the most
isolated section of the facility, are ineligible for the SDP as they are serving fixed terms in the
unit for disciplinary infractions, terms which can extend to six or more years.
While all prisoners now receive a hearing prior to placement at ADX, advocates have criticised
the internal review procedures – including those for deciding when a prisoner can access and
progress through the SDP – as over-discretionary and lacking clear criteria. According to
lawsuits and other sources, this means that some prisoners effectively remain in isolation
indefinitely, without being able to change their circumstances.9 Amnesty International
believes that the conditions of isolation at ADX breach international standards for humane
treatment and, especially when applied for a prolonged period or indefinitely, amount to
cruel, inhuman or degrading treatment or punishment in violation of international law.
Amnesty International is further concerned that prisoners with serious mental illness are
detained at ADX and, according to an ongoing lawsuit, have not been adequately screened,
treated or monitored.10 While not in a position to assess the quality of mental health
provision currently at ADX, the organization is concerned by the cases cited in the litigation
and believes that no prisoner with mental disabilities should be held in solitary confinement.
Such practice is against international standards and the recommendations of mental health
experts and organizations. US courts have also consistently found that isolating people who
are seriously mentally ill in “super-maximum security” facilities is incompatible with the US
constitutional prohibition of “cruel and unusual punishment”.
In putting together this report at a time when the BOP is conducting a “comprehensive
review” into its restricted housing operations11, Amnesty International is seeking to ensure
that the audit be guided by the organizations’ concerns, including pre-trial isolation, and that
its recommendations for best practise reflect those contained within this report.
This report will detail how conditions in ADX breach international standards for the humane
treatment of prisoners. By doing so, it seeks to oppose any replication of the ADX regime as
currently proposed by the BOP in the newly acquired Thomson facility. The prison, due to
open within the next years has been designated as a maximum high security prison with ADX
and SMU cells.12
This report will also show how in the period of time since ADX was built, conditions have
become increasingly restrictive with prisoners held in more severe conditions of isolation for
longer periods. As conditions have become more restrictive, so has access to the facility for
human rights groups, experts and the press. In detailing how the original purpose of the
prison- to provide a route out of isolation within a defined period – has eroded over the years,
the organization seeks to underscore the increased need for external scrutiny including
access to the facility for the UN Special Rapporteur on Torture.

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RESTRICTIONS ON ACCESS TO ADX: LACK OF TRANSPARENCY REGARDING BOP
USE OF ISOLATION
In producing this report, Amnesty International relied on a range of sources including court
documents available through lawsuits and other information provided by attorneys
representing ADX inmates, as well as policy directives issued by the BOP. However, there is a
lack of detailed publicly available information on the facility, including length of time
prisoners are held in each unit (see below). In June 2001 an Amnesty International
representative was given a tour of ADX and was provided with access to most parts of the
facility and an opportunity to speak to the Warden, senior staff and some prisoners. Some of
the observations in this report are thus based on first-hand viewing of conditions in the
facility and on policies in place at that time. However, the organization’s further requests to
visit the prison in 2011 and 2012 were turned down by the Bureau. This appears to reflect a
more general tightening of access to the facility in recent years, including by members of the
media.13
While Amnesty International welcomes the review of the use of segregation in federal prisons
currently being carried out by outside contractors, it believes that prisons should not be
insulated from outside scrutiny by human rights groups and experts. In this regard, the
organization has joined with other NGOs in calling on the State Department to extend an
invitation repeatedly requested by the UN Special Rapporteur on Torture to visit the USA to
examine, among other things, the use of solitary confinement in federal and state facilities,
including through on-site visits.14 Such an invitation would be consistent with the
commitment made by the US government to support the work of the Special Rapporteurs and
UN human rights mechanisms, and to encourage the full enjoyment of the human rights of
persons deprived of their liberty.
External scrutiny is of particular importance in the case of “super-maximum” security
facilities where prisoners are isolated within an already closed environment. In ADX there is
little publicly available information about the current operation of the facility beyond a few
institutional supplements giving a bare outline of the various units and programs. Lack of
information on conditions and their impact on individual cases is compounded by the fact
that prisoners under Special Administrative Measures (SAMs) often have severe restrictions
placed on their communication with the outside world, including through visits and
correspondence. A report by the General Accounting Office (GAO) in May 2013 noted more
generally that “there is little publicly available information on BOP’s use of segregated
housing units.”15
The GAO study also found that, while the BOP had an Internal Review Division which
periodically inspected compliance with policies in other federal segregation units (including
in Security Housing cells and Special Management Units in other prisons), “BOP does not
have requirements in place to monitor similar compliance for ADX-specific policies”.16
Overall, the GAO study found that BOP had not assessed the impact of segregated housing on
institutional safety or the impact of long-term segregation on inmates. While the BOP has
agreed to develop specific ADX internal monitoring procedures in line with GAO
recommendations, Amnesty International believes there should be regular, external reporting
and review of conditions at ADX and other isolation facilities.
The need for external scrutiny is heightened by information suggesting that ADX prisoners are
held under more isolated conditions than before, including than at the time of Amnesty
International’s 2001 visit, and that the original purpose of the prison – to allow a clear route
out of isolation within a defined period – has been eroded over the years. As described below,
there are also conflicting accounts given by prisoners and their attorneys and ADX

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administrators about aspects of the regime, such as the amount of contact prisoners have
with staff and the value of programs provided.

LONG-TERM ISOLATION IN OTHER PARTS OF THE FEDERAL SYSTEM
The US Government has pointed out that only 0.25% of the federal prison population is held
at ADX. This is less than the national average of around 2% of prisoners in state “super-max”
facilities and significantly less than in states such as Arizona or Texas. However, other federal
facilities also confine prisoners in prolonged isolation.17 Several BOP prisons operate Special
Management Units (SMUs) in which prisoners are confined – usually with one other inmate -to small cells for at least 23 hours a day for 18-24 month periods, terms which are
frequently extended. According to figures provided by the BOP, the numbers in SMUs had
risen from 144 prisoners when the first unit opened in Lewisburg Federal Penitentiary to
1,960 inmates as of February 2013.18 Conditions in the units are harsh, with prisoners
allowed only five hours exercise a week, falling below the SMR. Although having a cell-mate
may relieve some of the effects of isolation, confining two people in a small, enclosed space
for 23-24 hours a day can lead to severe additional stresses. A lawsuit filed in July 2011 has
challenged conditions in the SMU at Lewisburg Penitentiary as amounting to “cruel and
unusual punishment”, citing, among other things, a series of assaults by prisoners on their
cell-mates, including two murders and the punitive use of restraints, often for prolonged
periods, for those who refuse a cell mate.19 Amnesty International believes there should be
urgent review of conditions in the SMUs and that the current review of federal segregation
policies should include units where prisoners are double-celled in an otherwise isolated
environment.
The US government is reported to have reduced the overall number of prisoners in segregated
confinement in the past year by nearly 25 percent (such confinement includes SHU cells
situated in most prisons) and subsequently closed two of its segregated housing Special
Management Units.20 Despite this reduction, the BOP 2014 budget request to Congress
includes a funding proposal to open Thomson Correctional Center, a former state maximum
security facility in Illinois, purchased by the BOP in 2012, as a second federal “supermax”
prison to “begin activating the facility as an Administrative-Maximum U.S. Penitentiary in
Fiscal Year 2014”.21
The BOP explained the need to expand segregation cells at a time when the use of
segregated confinement was declining with the following: “The reduction in our special
housing unit population does not lessen the need for these beds…Special Housing refers to
units within our prisons where inmates are placed on a temporary basis as a result of
misconduct or as a result of circumstances that warrant their separation from the general
population”. This response suggests that the new facility will house those held in long-term
rather than short-term isolation.22
While the exact conditions under which prisoners would be held in Thomson remain unclear,
Amnesty International is concerned that the facility will replicate the regime at ADX,
Florence. Any expansion of the use of long-term solitary confinement as seen at ADX,
Florence, would be a retrograde move, contrary to international human rights standards 23.
Such a move would also run counter to growing recognition among mental health, legal and
correctional experts, of the harm caused by conditions in isolation units, and trends across
states towards reducing the numbers of prisoners in solitary or isolated confinement.

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PRISONERS HELD IN SOLITARY CONFINEMENT IN PRE-TRIAL FEDERAL DETENTION

SYED FAHAD HASHMI
Syed Fahad Hashmi has spent over seven years in conditions of near total isolation. A US citizen who grew up
in Queens, New York, he was studying for a post-graduate degree in the UK when he was arrested in 2006 and
accused of allowing an acquaintance to use his London apartment to store sock and ponchos intended for alQaida in Pakistan. While detained in the UK pending extradition, he was allowed to associate with other
detainees without incident. However, on arrival in the USA he was placed in MCC SHU (see below), where he
remained for nearly three years in pre-trial detention, confined to a small, solitary cell with no view to the
outside and no association with any other inmate or access to outdoor exercise. He was placed under SAMs
and had only limited contact with his immediate family (brother and elderly parents). In June 2010 he was
sentenced to 15 years in prison after pleading guilty to one charge of providing material support to a terrorist
organization. He was transferred to ADX in March 2011, where he remained in isolation, confined to a concrete
cell for 22-24 hours a day until June 2014 when he was transferred to a Control Management Unit in USP Terre
Haute, Indiana.
Prisoners may also be held in solitary confinement while awaiting trial in the federal courts.
There is particular concern about conditions in the Security Housing Unit (SHU) on the 10th
floor of the federal Metropolitan Correctional Center (MCC) in New York, where pre-trial
detainees are confined for 23-24 hours a day to solitary cells which have little natural light
and with no provision for outdoor exercise. Lack of access to natural light and fresh air are in
clear breach of international standards for humane treatment. Detainees housed in the unit
have included foreign nationals charged with supporting terrorism who have been extradited
or subjected to a “rendition” to the USA; in addition to their harsh physical conditions of
confinement, some have had only limited contact with their families and few or no social
visits. Several prisoners have spent many months or years in the above conditions while
awaiting trial.24
Amnesty International considers that conditions under which detainees have been confined
in the MCC SHU constitute cruel, inhuman or degrading treatment and are incompatible with
the presumption of innocence in the case of untried prisoners whose detention should not be
a form of punishment.25 Lawyers who have represented detainees in the unit have described
the negative impact of the conditions on their clients’ state of mind, raising concern that
such conditions may impair a defendant’s ability to assist in his or her defence and thus the
right to a fair trial.

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FURTHER OBSERVATIONS ON
CONDITIONS IN ADX
The United States Penitentiary (USP) Administrative Maximum Facility (ADX), situated in
Florence, Colorado, opened in November 1994 as a purpose-built “super-maximum” security
facility. It is currently the only level 6 (highest security designation) prison in the federal
system.
The prison has eight units consisting of four General Population units (each with capacity to
house up to 64 prisoners); the Special Security Unit (H Unit) for prisoners under SAMs; the
Control Unit; the SHU (a disciplinary unit); and the Intermediate Unit for prisoners in the
Step-Down Program (SDP). There is also an ultra-high security four-cell unit known as Range
13, where prisoners are held in conditions of extreme isolation. Only prisoners in the SDP,
and a small number in phase 3 of H Unit, have any group association, which is limited to a
few hours a week; the vast majority of the ADX population are held alone, confined to cells
for 22-24 hours a day with only limited contact with staff and the outside world.

CONDITIONS IN GENERAL POPULATION UNITS
“Sitting in a small box in a walking distance of eight feet, this little hole becomes my world,
my dining room, reading and writing area, sleeping, walking, urinating, and defecating. I am
virtually living in a bathroom, and this concept has never left my mind in ten years.”
Mahmud Abouhalima, held under SAMS in H Unit, ADX, since 2005.

More than half the population at ADX (up to 256 prisoners) are held in the GP units, where
they spend at least 22 hours a day in 87 square foot individual cells. The cells have solid
concrete walls and all face the same way, so that prisoners cannot view other cells or have
direct contact with inmates in adjacent cells. Each cell also has an interior barred wall with
sliding door along the full width of the cell, followed by a small lobby with a solid steel outer
door and window looking onto the corridor. As the living space is sited behind the barred
interior wall, several feet from the corridor, prisoners are more cut off from human contact
than in standard maximum security cells where inmates can stand at the cell door and watch
or converse with anyone passing by. The cells have a narrow outside window at the back
which allows entry of natural light but provides no view other than buildings and sky.
Prisoners can control the lighting by a switch inside the cell. The cell furnishings are sparse,
consisting of a fixed bunk, desk and stool made of reinforced concrete. Each cell also has a
built-in shower and a metal toilet and sink unit.

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The inside of a cell in a General Population Unit at ADX © Private

The vast majority of prisoners are allowed out of their cells for only a few hours a week, for
exercise, occasional visits to a “law library” cell, social or legal visits, or for some medical
consultations.26 All meals are delivered to and eaten inside the cells. As Amnesty
International has observed elsewhere, there is concern about the possible health risks from
spending so much time in a confined space, and eating all meals in close proximity to the
open toilet. Prisoners are placed in full restraints and are accompanied by two guards when
being escorted out of their cells. Otherwise nearly all contact with staff takes place either
remotely (e.g. through medical teleconferencing) or at the cell front.

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EXERCISE

An outdoor recreation cage for prisoners in the Step Down Program at ADX © Private

GP prisoners are allowed up to ten hours out-of-cell exercise a week, in two hour slots five
days a week, alternating between indoor and outdoor exercise. Prisoners always take indoor
exercise alone, in a windowless room with only a pull-up bar. Outdoor exercise takes place
either in an enclosed solitary yard attached to the unit or in one of five individual cages in a
larger yard. The only time a prisoner can communicate directly with another inmate is when
conversing with a prisoner in an adjacent cage, an opportunity which takes place, at most, on
two or three days a week.
As shown in photographs, the exercise facilities are stark. The outdoor cages are only a little
larger than the cells and have no equipment so that prisoners can do nothing other than walk
a few paces. Both the individual yards and the larger concrete yard in which the cages are
situated have high walls and a chain link roof, giving no view of the natural world other than
sky. Lawyers have told Amnesty International that some prisoners decline to take exercise
and remain in their cells all day due to depression or other illness (see section on Mental
Illness, below).

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An outdoor recreation area in the Control Unit at ADX © Private

According to BOP regulations, prisoners may have their exercise in the larger yards
suspended for three months at a time for a single rule violation, with increased suspensions
for further offences.27 It is alleged that prisoners are sometimes punished for minor rule
violations, such as in one case for feeding crumbs to birds.28 The regulations list violations
for which the yard exercise can be suspended as including “sexual acts or gestures, suicidal
attempts or gestures, smearing or throwing human waste”. 29 Amnesty International is
concerned that prisoners who have not committed serious violations, or whose behaviour may
be indicative of mental health or behavioural problems, should have their outdoor yard
exercise -- and thus their only limited association with other inmates -- withdrawn for such
extended periods. It urges that this rule be reviewed.

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The SMR state that “every prisoner not employed in outdoor work shall have at least one hour
of suitable exercise in the open air daily if the weather permits” (Rule 21 (1)). These are
minimum standards applying to all prisoners without exception.
The opportunity to exercise is particularly important for the physical and psychological
wellbeing of prisoners who are cut off from normal activities and are confined to cells for
prolonged periods. Neither the cages nor the enclosed individual yards in Amnesty
International’s view meet the standard of “suitable exercise in the open air” as provided
under the SMR, nor, under the present regime at ADX, is outdoor exercise provided to each
prisoner daily.

Indoor recreation area in the Control Unit at ADX © Private

Amnesty International is concerned that conditions for prisoners at ADX have become more
isolated and restrictive in recent years. When the prison first opened, and at the time of the
organization’s visit to ADX in June 2001, GP prisoners were allowed “12 hours or more” out
of cell exercise a week which could be taken in small groups of up to 12 prisoners at a time;
prisoners were also allowed balls and board games during this period.30 Unit staff members
told Amnesty International’s representative during her visit that one of the measures used to
assess prisoners’ progress and suitability for the step down program was how they interacted
with others on the recreation yard.
Group recreation was reportedly withdrawn after two prisoners were killed by other inmates in
separate incidents in 2005, one occurring in the Transitional (Step Down) Unit, allegedly in
full view of ADX staff members.31 Prison administrators have a clear duty to take all
reasonable measures to prevent such deaths. However, the blanket ban on any form of group
recreation in the GP, given the length of time prisoners are confined to the unit, is
inconsistent with standards for humane treatment. In addition to the potential adverse
mental health impact of prolonged confinement to solitary cells, it is difficult to see how a
prisoner’s behaviour can be effectively measured in the absence of any meaningful social and

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group interaction. As described below, prisoners in the step-down program also have
significantly less association and out of cell time than previously. According to a lawsuit,
more could be done to ensure the safety of prisoners in group recreation. 32

Outdoor recreation cages at ADX © Private

IN CELL ACTIVITIES AND PROGRAMING
Most prisoners in ADX are provided with televisions in their cells with around 60 broadcast
channels, including news channels such as CNN and ABC and a range of cable and other
network programs. Institutional programs are also provided to each cell through close-circuit
channels; these include educational, religious and recreational programs as well as classes
on psychology and issues such as anger management. There is no congregate prayer and
religious services are conducted through close-circuit TV.
Prisoners also have access to books, newspapers and periodicals, art and hobby-craft
materials, and may write and receive correspondence (although limits on the latter may be
imposed on prisoners under SAMs, see below). Correspondence courses are also available to
some prisoners (not for example, those under SAMS) and prisoners must be able to afford it
which limits their reach further. Prisoners are also allowed access to religious materials.

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Outer door of a cell in the Control Unit at ADX, picture take from the corridor © Private

A stipulated court agreement in 2008 provided that an Imam visit ADX four times a month to
speak with inmates individually. Prison attorneys have reported that since there is no longer
an Imam on site, inmates in the past few years have received far fewer visits from an Imam
than the limit set in the court agreement.33
The visits take place at the cell door, often, for only a few minutes at a time. It is alleged that
most prisoners may confer with the Imam or other religious adviser only when both cell doors
are closed with the minister standing in the hall outside, thus requiring inmates to speak at
loud volume that renders private consultations impossible. 34 Prison advocates report that in
the case of visiting priests or chaplains, they will generally be allowed beyond the solid steel

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door to pray in the sally-port area, right up next to the inmate in the cell, but this does not
happen in the case of most Imam visits with Muslim prisoners.
While Amnesty International’s delegate recognized that there were a number of in-cell
programs available at the time of her 2001 visit, these cannot compensate for the prolonged
cellular confinement and social isolation experienced by ADX prisoners for many months or
years, or even indefinitely. The value of in-cell programs becomes more questionable the
longer a prisoner is held in isolation and unable to interact meaningfully with others. Prisoner
advocates have also reported that, apart from some basic educational courses such as GED
(which are required by a minority of inmates), there is not much structured educational or
rehabilitative programing leading to formal qualifications or defined outcomes or goals. 35

Inner door of a General Population cell at ADX, picture taken from the corridor © Private

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CONTACT WITH STAFF
The authorities have stressed in court filings that all prisoners have daily contact with unit
staff and regular contact with correctional counsellors, medical and mental health and
religious staff. However, lawyers representing prisoners report that there is little meaningful
contact in practice between staff and inmates, and that prisoners routinely go days with only
a few words spoken to them. According to testimony to the ECHR contact could be “as little
as one minute per day”.36 Advocates also reported that prisoners would need to call out
proactively to seek attention from staff as they walk past cells doing their daily rounds,
something many prisoners are reluctant to do. Contact when it does take place is usually at
the cell door. A prisoner’s isolation is compounded by the fact that psychiatric and medical
consultations may also in some cases take place remotely, through teleconferencing.
There is no interaction with the teacher during the classes, all of which are delivered
remotely. Although Amnesty International was told during its visit that teachers may visit
prisoners at the cell door to discuss their assignments, it was acknowledged that this could in
some cases be only be for a few minutes per inmate. A lawyer who has represented a number
of prisoners at ADX told the organisation that none of her clients to her knowledge had ever
been seen by a teacher at the cell door.

VISITS AND COMMUNICATION WITH THE OUTSIDE WORLD
“We’re poor folk,” he says of his family, “and coming to visit is too expensive…from what I
can tell very few people get visits…this place is too far from anyone’s family.”
Letter sent to the ‘Solitary Watch’ website from a prisoner in ADX who has not seen or spoken to his family in the last five years37

Prisoners in the GP units may write letters and make two 15-minute non-legal phone calls a
month (or, six hours per year in total to speak with their family). All social and legal visits at
the facility take place in a non-contact setting, behind a thick plexiglass screen. Other than
when being placed in restraints and escorted by guards, prisoners may spend years without
touching another human being.
Prisoners are allowed five social visits a month for up to seven hours at a time, with a
maximum of three visitors per inmate allowed in the visiting room at any one time. However,
it is reported that prisoners at ADX generally do not have many visits, in part because of the
remote location of the facility. ADX staff told Amnesty International’s representative in 2001
that it was usual for there to be only five or six visitors in total at the week-end. According to
a court brief, three prisoners who were transferred to ADX from other prisons after September
2001 had no social visits for the entire time (six and seven years) they were held at the
facility; a fourth prisoner named in the lawsuit had received only two visits from
family/friends in 13 years.38
Prisoners are routinely shackled during non-contact attorney visits which usually take place in
booths where the plexiglass barrier has a small slot to allow the passing of documents.39
Prisoners are placed in three-point restraint during visits, with their wrists and ankles
attached to a belly chain and waist belt. The wrist cuffs may be further secured in a black
box attached to the front of the belt; this severely restricts hand movement and can cause
pain and discomfort, especially when the restraints are worn for an extended period.
One lawyer told Amnesty International that the shackles worn by his client during visits (belly
chain and black box) restricted his hand movements and made passing documents difficult.
He said the set-up in the visiting room was very uncomfortable, with his client having to sit
up on the small table by the glass screen in order to communicate with him.

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Another legal representative told the organization that prisoners may have their ankles
shackled during social visits also.
Amnesty International believes the degree of restraint applied routinely during non-contact
visits appear to be unnecessarily punitive, especially for prisoners who do not have a history
of serious rule violations or acts of institutional violence within the facility, and for prisoners
needing to communicate with attorneys. International standards provide that restraints should
be applied only when “strictly necessary” as a precaution against escape or to prevent
damage or injury.40

The inmate side of the social visits compartment © Private

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Recommendations
Amnesty International recommends that conditions in the ADX General Population be
improved so that prisoners are not held in conditions of severe isolation but have more
opportunities for interaction with staff, including educational staff, as well as access to
meaningful rehabilitation programs. The exercise facilities should be modified to allow more
space and equipment; prisoners should be allowed daily outdoor exercise41.


Amnesty International recommends that opportunities be reinstated for prisoners to have
some social interaction with other inmates, even at the most restrictive levels of confinement,
both to aid their rehabilitation and to allow their progress to be measured.


The use of restraints should be prescribed by law and be restricted by the principles of
necessity and proportionality. Prisoners should be placed in restraints only when strictly
necessary; restraints should not be applied that cause pain or unnecessary discomfort. 42


Facilities should be provided for prisoners to meet with their attorneys in a suitable
environment that does not impede communication; when receiving visits from lawyers,
prisoners behind barriers should not be restrained in such a way as to restrict their hand
movement, making passing documents difficult.


THE STEP-DOWN PROGRAM (SDP)
Prisoners are assigned to ADX if it is determined that they “have demonstrated an inability to
function in a less-restrictive environment” and would pose a serious risk to the safety of other
inmates or staff or the public if held in a less secure setting. 43 Writing to the UN Special
Rapporteur on Torture in 2011, the US Ambassador to the UN gave the primary reasons for
referral to the facility as “murder or assault at another facility, escape behaviour or rioting”. 44
Prisoners may also be assigned to the facility if the offence for which the person has been
convicted or profile prior to arrest is deemed to create a sufficient security risk; thus, some
prisoners with particular connections outside prison or who have been convicted of
involvement in or support of terrorism have been assigned to the facility without regard to
their institutional behaviour.
The ADX mission is described as having a dual purpose: to 1) to maintain the safety of staff
and inmates while eliminating the need to increase security in other institutions and 2)
confine inmates under close controls while providing them with opportunities to demonstrate
progressively responsible behaviour; participate in programs in a safe, secure environment;
and establish readiness for transfer to a less secure institution”.45
Prisoners may move into the SDP only after a minimum of 12 months clear conduct and
“positive institutional adjustment” in the ADX GP. The SDP consists of an Intermediate Unit
(IU), a Transitional Unit (TU) and a Pre-Transfer Unit (PTU) which is the final phase before a
prisoner is ordinarily considered for transfer to an open population institution. Only the IU is
currently sited at ADX (see below).
The IU at ADX (with capacity for up to 32 inmates): has standard single occupancy maximum
security cells looking onto the unit range, with a narrow outside window providing natural
light. The furnishings are the same as in the GP cells except that showers are on the range.
The only difference between the GP and IU regime is that prisoners may associate in groups
of up to eight prisoners on the range for an hour and a half a day five days a week, in
addition to the 10 hours exercise as described above. They are also allowed three 15-minute
telephone calls a month. All meals are eaten inside the cells and the same programs are
provided as in GP.

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Prisoners in the TU (capacity of up to 32 inmates) are assigned to groups of up to 16
inmates with whom they are allowed to associate on the range for up to three hours a day;
they consume meals on the range with their assigned group. The Unit also provides outdoor
group recreation and prisoners are allowed an additional 15-minute social phone call a
month.
Prisoners in the PTU are usually double-celled, consume meals on the range, are
unrestrained when out of their cells and participate in various work assignments.

PRISONERS IN ADX MORE ISOLATED THAN BEFORE
As with the GP (where there is no longer group exercise), conditions in the first two phases of
the SDP have become more restrictive than when the prison initially opened. At the time of
Amnesty International’s 2001 visit to ADX prisoners in the IU were allowed out of their cells
onto the ranges for several hours a day, with meals consumed in common areas located on
the ranges. Recreation included use of a gymnasium. Prisoners in the TU had religious
services and group recreation of up to 35 hours a week.
The TU and the Pre-Transfer Unit were both originally sited at the ADX facility but are now
located at USP Florence, a high security prison which, like ADX, forms part of the Federal
Correctional Complex (FCC) at Florence. ADX itself has therefore become almost entirely a
“lock-down” facility in which prisoners are locked in solitary cells for all but a few hours a
week. Amnesty International is concerned that, at a time when there is growing recognition of
the damaging effects of isolation and moves to restrict such practice in some states,
conditions in ADX have become more restrictive in recent years.

Inside of a cell in the Control unit at ADX © Private

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LENGTH OF TIME IN ISOLATION/ACCESS TO THE SDP
The SDP from GP to the PTU is described as a four-phased program, with prisoners expected
to spend at least 12 months in the GP, six months each in the IU and TUs and 12 months in
the Pre-Transfer phase before being considered for transfer to an open population institution.
It is clear from BOP policy as set out in the Institutional Supplements on General Population
and Step-down Operations that the purpose of the program is to provide inmates with
incentives and an opportunity to demonstrate conduct that will enable them to progress from
GP through progressively less restrictive units. The Supplements state:
“Every inmate has the opportunity to demonstrate he may be housed in a less restrictive
unit”.
While the minimum period from placement in the ADX GP to transfer from USP Florence to a
less restrictive facility is 36 months, it is reported that, in practice, most prisoners take much
longer than this to complete the program. Most disturbing are statistics indicating that most
prisoners spend far longer than the minimum 12 months at the base-line level in the GP and
thus in conditions of severe social isolation.
There is no publicly available breakdown of the length of time prisoners spend in each stage.
However, in October 2011, following a request by the European Court of Human Rights
(ECHR) in the Babar Ahmad extradition case, the Bureau of Prisons provided an analysis
based on a random sample of 30 prisoners from the ADX GP and SDP, which showed that
“an inmate was likely to spend three years at ADX before being admitted to the Step Down or
Special Security Programs.”46 Lawyers for the applicants submitted evidence based on a
much larger sample of more than 100 ADX prisoners which identified an average solitary
confinement length of 8.2 years (see chart below).47 The US government reported to the
ECHR that the numbers of prisoners moving into the SDP had increased since their survey
was conducted. However, it appears that few prisoners pass through the system within the
minimum period specified. Some prisoners have spent several years in isolation in GP despite
reportedly having completing programs necessary to quality for “consideration of”
advancement. According to the GAO report on segregation, there were only 15 prisoners in
the ADX SDP units located at USP Florence (the TU and PTUs) in February 2013.48

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Prisoners known to be designated to ADXFlorence for more than three years
(as of 03 October 2013)
Source: United States v Caro

4 years
5 years
6 years
7 years
8 years
9 years
10 years
11 years
12 years
13 years
14 years
15 years
16 years
17 years
18 years
19 years
0

2

4

6

8

10

12

14

16

18

Prisoners known to be designated to ADX-Florence for more than three years
(as of 03 October 2013)

LACK OF CLEAR CRITERIA OR SAFEGUARDS FOR PROGRESSIONS TO THE SDP
“My involvement in my reviews is usually just my presence and the time it takes me to sign
the forms. However it is not uncommon for prison staff to slide my prison review form under
my door when I am in recreation and expect me to sign them without speaking to me at all”.
Thomas Silverstein, confined for over 30 years in isolation, nine of which have been spent in ADX49

Following litigation, all prisoners assigned to ADX now receive an administrative hearing prior
to their placement at the facility, which provides some minimal procedural safeguards. 50
Prisoners assigned to the ADX GP also have six monthly Program Reviews which, according to
BOP regulations, prisoners are expected to attend and can raise question and concerns about
his placement in, advancement through, or transfer out of the program. Amnesty
International has been told that this rarely happens. Instead, typically the review meetings
take place at the cell doors, and the ‘program review report’ which has already been filled out
by prison staff, is slid under the door for prisoners to sign. These routine reviews do not make
decisions on whether a prisoner may proceed to the SDP.
The process for allowing a prisoner to move from GP to the SDP appears to be highly
discretionary. There is no hearing and determinations on eligibility for, and advancement
through, the SDP are carried out by an internal prison SDP Screening Committee in
consultation with the unit team, with the Warden having the final decision. 51 If a prisoner is
determined to be “eligible” for the SDP (listed criteria for eligibility including, for example,
12 months’ clear conduct in GP and active participation and completion of programs), this
does not mean that he will necessarily be considered for entry into the SDP.52 Prisoners take

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no part in the SDP Committee review of placement/advancement determinations and are not
present at such reviews. Even if admitted to the SDP, prisoners may be sent back at any
time, including, it has been alleged, for minor incidents.

PB, a developmentally disabled and severely depressed inmate, in the phase 2 in of the SDP in USP Florence
received an incident report for a “minor rules infraction” and was returned to ADX where he was placed in the
SHU. The following month, after he learned of the death of his mother and after pleading for psychiatric help
for several hours, he attempted suicide. Guards who witnessed the incident gave him an incident report for
“tattooing or self-mutilation”. Although this incident report was subsequently expunged after intervention by
his lawyer, he remained at ADX having to accrue again a sustained period of clean conduct.
Although decisions may be appealed through an administrative remedy process, this has
been described by attorneys as an ineffective remedy in practice, given the discretionary
nature of the process and the wide deference afforded to prison administrators in decisions
relating to institutional security53. The process has been described in court documents as
“meaningless because no administrative remedy challenging a Step-Down denial has ever
been successful”.54 In reporting on the practice of solitary confinement, the UN Special
Rapporteur on Torture has stressed the importance of procedural safeguards when assigning
prisoners to segregation, stating inter alia that prisoners “must be provided with a genuine
opportunity to challenge both the nature of their confinement and its underlying justification
through a process of administrative review”.55
BOP regulations state that each inmate will receive written notification of the decision to
deny entry to, or advancement through, the SDP, which will include “The reason(s) for the
denial, unless it is determined that the release of this information could pose a threat to
individual safety or institutional security” (Amnesty International emphasis). Advocates report
that within the past year, prisoners have not been told that they have been considered and
rejected for the SDP as they have not received any documentation at all. As a result, there is
no actual “decision” that they have access to that they could challenge via the grievance
process. It is alleged that some prisoners have been repeatedly denied entry to the SDP for
years without being given any specific or detailed explanation, and thus without knowing
what they can do to advance through the program. This has included prisoners with no history
of serious misconduct, or with clear conduct records, some of whom have remained in
isolation at the base-line level of ADX for many years.


Mohammed Saleh, Ibrahim Elgabrowny and El-Sayyid Nosair were transferred to ADX
without a hearing following the September 11th 2001 attacks.56 While convicted of
terrorism-related offences, all three had previously spent six years confined without
serious incident at high security open population prisons, where they had jobs, were out
of their cells for most of the day and could move freely with other inmates. According to
court documents, once in ADX they were held in isolation in the GP and were repeatedly
denied access to the SDP without explanation, apart from notices containing formulaic
language such as that their “reasons for placement have not been mitigated” and/or that
“safety and security” prevented them from being progressed. 57 The prisoners were
placed into the SDP (in 2007 and 2009) only after filing lawsuits and following several
years of unexplained denials, without any change in their conduct. They were later
transferred to other prisons while the case was still in litigation and before completing
the SDP. Omar Rezaq, another prisoner named in the lawsuit, spent over 12 years in
isolation in the ADX GP before being placed in the SDP.58



While detailed information is lacking on the length of time prisoners currently in ADX
have spent in the GP, cases of long-term isolation continue at the prison, with prisoners
continuing to be denied access to the SDP despite reportedly having clear conduct

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records.59 According to a lawsuit filed in 2012, some prisoners with mental illness had
spent more than a decade at ADX without adequate treatment or admission to the SDP
or, if admitted to the SDP, were returned to the ADX GP for failure to complete the
program (see section on Mental Illness, below).


Norman Matthews, convicted for a number of criminal offences, died last year in ADX
after being held for 18 years in the GP unit without being admitted to the SDP.



John Powers, incarcerated in 1990 after conviction for bank robbery, was sent to ADX in
2001 and suffering from mental health problems spent years being transferred between
the special mental health prison facility in Missouri and the Control Unit in ADX. During
his 11 years in ADX he was never placed in the SDP.



Ralph Gambina, serving a life sentence, was transferred to ADX in 1995 from the
Control Unit at USP Marion and has spent 21 years in solitary confinement without
being entered into the SDP.



Syed Fahad Hashmi was transferred to ADX in March 2011 after being convicted of one
count of providing material support for terrorism after nearly three years in pre-trial
solitary confinement (see box) and a further period in isolation in another federal prison.
He was initially placed in H-Unit under SAMs but was moved to the ADX GP in January
2012, after his SAMs expired and were not renewed. More than two years on, without
being granted access to the SDP, and with no history of any serious institutional
misconduct involving physical violence, nor having been convicted of any direct
involvement in acts of violence or terrorism he was eventually transferred on 17 June
2014 to the Control Management Unit in Terre Haute, Indiana.



According to a US government declaration in the Babar Ahmad case, “mitigation of the
original reason for placement at ADX” is no longer an explicit factor used to determine
entry to the SDP; however, it acknowledged that the SDP Committee could still have
regard to the initial reasons for placement at ADX in making its decision. 60 The criteria
listed in BOP procedures for placement into or advancement through the SDP are
extremely broad and include such vague wording as “the inmate’s conduct while housed
at the ADX” and “overall institutional adjustment”, “the institution’s safety and security
needs”, as well as “The reason(s) the inmate was designated to the ADX” and criminal
history. Amnesty International has been told that a number of prisoners remain confined
indefinitely to the ADX GP based solely on their committal offence, and without access
to the SDP.



Thomas Silverstein, 62, originally convicted of armed robbery, and serving life without
parole for the murder of two inmates and a correctional officer has been confined for 30
years in isolation, nine of which have been spent in ADX. During this time, despite a
clean conduct record for 22 years, he has been denied access to the SDP on the basis of
the nature of his convictions. On the 10th May, 2014, the US Circuit Court of Appeals
ruled that his 30-year confinement in isolation does not violate his rights. The Judges
noted that the nature of Silverstein’s convictions make it reasonable to keep him in
solitary confinement. “In this case,” the ruling states, “the risk of death and physical or
psychological injury to those exposed to Mr Silverstein must be balanced with the
psychological risk he may face if left in administrative segregation.”

Some margin of appreciation may be necessary when officials are assessing complex factors
relating to behavioural and security needs. However, the organization shares the concerns
expressed by advocates about the lack of clear criteria for enabling prisoners to work their

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way through the ADX SDP, and the very broad grounds that can be used to deny progress,
including the original reason for assignment. This has meant prisoners spending years – or in
some cases being held indefinitely – in conditions of severe isolation.

Recommendations
Amnesty International recommends that clear criteria be established for SDP placement
decisions, with a fair process and meaningful review. Prisoners should be provided with
detailed reasons if they are denied advancement through the SDP, with an opportunity to
participate in, and challenge, decisions, with clear guidance on how they can progress
through the system. No-one should be held continuously in isolation based solely the original
reason for placement in ADX. Rehabilitation programs should be meaningful and ensure
behaviour can be measured. There should be a presumption that prisoners who are eligible
for the SDP will progress at the earliest opportunity.


SPECIAL SECURITY UNIT (SSU) - H-UNIT
“The longer I spent in this period of segregation, the worse it gets on my efforts to survive, to
maintain my state of mind and my mental capacity. I lost fifty pounds from being on hunger
strike in H-Unit and hunger strikes became a regular occurrence in the unit, with medical
staff coming every weekend to weigh each inmate. This was the first time in my life that I
experienced the brutality of force feeding.”
Mahmud Abouhalima, held under SAMS in H Unit, ADX, since 2005.

ADX prisoners who are under Special Administrative Measures (SAMS) are housed in the
SSU, commonly known as H-Unit. SAMs are special restrictions that may be imposed on an
inmate under the direction of the Attorney General, when it is determined that such measures
are “reasonably necessary” to “prevent disclosure of classified information” or to “protect
persons against the risk of death or serious bodily injury” (28 C.F.R. Section 501.3 (a)
(2008). The restrictions under SAMs may include housing an individual in administrative
segregation and/or limiting privileges such as correspondence and visits. The measures may
be renewed annually on the basis of written notification from the DOJ to the BOP that there
remains a “substantial risk” that “a prisoner’s communications or contacts with persons
could result in death or serious bodily injury to persons or substantial damage to property that
could entail the risk of death or serious bodily injury to persons”.
Prisoners in H-Unit are held in single cells similar to those in the SDP with a narrow window
to the outside and solid door with a window looking onto the range. Showers are sited on the
range rather than inside the cells. Otherwise the basic regime is identical to that in the GP,
with prisoners locked in their cells for 22-24 hours a day with 10 hours out of cell exercise a
week, alone or in individual cages with up to five other prisoners. They have access to the
same in-cell programs delivered through close-circuit TV as the GP as well as to most books61
and other TV channels.62 Most prisoners under SAMs have severe restrictions placed on their
communication with the outside world, compounding their isolation. Visits and
correspondence are typically limited to approved attorneys and immediate family members
only; lawyers may further be prohibited from reporting on their clients’ conditions of
confinement.63 Correspondence to or from approved contacts, which is monitored along with
the twice-monthly non-legal phone calls allowed, may be limited to only one letter a week.
In February 2014 it was reported that between 8 to 10 prisoners in H Unit were being force
fed after initiating a hunger strike in protest against their restrictive conditions of
confinement.64 BOP records, seen by CBS News “60 Minutes,” indicate that this is not an
isolated incident, according to the program, “there have been as many as 900 of what the
Bureau calls ‘involuntary feedings’ of terrorists in H unit since 2001”.65

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“I have engaged in two hunger strikes while on H Unit. Both of them were my decision and
had nothing to do with other people. No one I corresponded with encouraged me to strike. I
did not strike because other prisoners were doing it. I felt like an animal – just eating and
sleeping. I decided to stop eating to object to my treatment”.
Nidall Ayyad placed under SAMS in 2005 and held in H unit between 2006 and 2012. A few months
after his SAMS were removed in 2012 he was transferred to a CMU where he remains today.

Prisoners assigned to H-Unit have no opportunity to enter the GP SDP – the only clear route
out of ADX for most prisoners - other than through the lifting of the SAMs which is a decision
made by the DOJ rather than the prison administration. However, in May 2008, the prison
instituted a separate, internal step-down program for H-Unit. This consists of three “phases”
each lasting a minimum of one year. At phase 2, prisoners are allowed certain limited
additional privileges, while remaining confined to solitary cells for 22-24 hours a day. Only at
phase 3 are H-Unit prisoners allowed some group association, with up to four other prisoners
on the range for one and a half hours a day. Decisions on whether a prisoner is eligible for
progression through the phases are made by an H Unit Review Committee; decisions are
based on criteria relating to safety concerns, the inmate’s conduct and participation in
programs.
In practice, progression to phase 3 of the H-Unit program is conditional upon modification of
the prisoner’s SAMs restrictions, a decision which rests with the DOJ and may not depend
upon the prisoner’s institutional behaviour but on more general security considerations,
including the committal offence. Amnesty International does not have a breakdown of the
current numbers of prisoners in each phase of H-Unit or the length of time spent at each
phase. However, litigation documents describe how some prisoners spent several years in HUnit without progressing to phase 3 because their SAMs had not been modified, despite clear
conduct records. The only way out of H-Unit altogether is generally for the SAMs to be lifted.
At least one prisoner remains confined to H-Unit indefinitely, in conditions of severe
isolation.


Ramzi Yousef is serving two life sentences plus 240 years for his role in two terrorist
attacks, including the 1993 World Trade Center bombing in New York City in which six
people died. He has spent more than 15 years in solitary confinement. He is currently
confined in H-Unit under SAMs; he has spent over two years on step 2 of the phased
program, and despite a clear conduct record for 5 years, and an orderly appointment
which allows him out of cells for few hours a week to clean cells, he continues to be
denied access to phase 3. When his SAMS come up for renewal he will have a meeting
with his counsellor to discuss, but he is not told when the SAMS will be renewed, nor
given the opportunity to refute anything in the decision. According to a lawsuit filed in
2012, his SAMs are renewed every year based on his original conviction, without regard
to his institutional behaviour and without a finding that he continues to pose any
specific threat behind bars. In May, the Judge is his case ruled that there was no liberty
interest under the Constitution in challenging SAMS.



Mahmud Abouhalima was sentenced to 240 years for his role in the 1993 World Trade
Center bombing. Between 1992 and 2001 he was held in GP in USP Lompoc and USP
Leavenworth; on September 11 2001 he was placed in segregation and transferred to
ADX in 2003 and held in GP unit for two years until his transfer to H Unit in 2005 when
he was placed under SAMS. In 2008, Mahmud Abouhalima was placed in the H-Unit
step-down program. Despite progress records that reportedly indicate he had positive
behaviour and interactions with staff and inmates, as well as participation in education
and psychology programs, in June 2011 he received a written denial for phase three of
the program and was subsequently returned to phase one. He is now in phase three.

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Amnesty International has joined other human rights advocates in expressing concern about
the lack of transparency and fairness in the way in which SAMs have been applied in some
cases.66 Lawyers have reported that prisoners are not always provided with the reasons SAMs
are imposed or renewed, and that they do not have adequate opportunity to contest the
decision or know what they can do to have them lifted. As shown in Ramzi Yousef’s case,
SAMs have been imposed and extended on the basis of the original offence, rather than any
specific or ongoing threat posed by the prisoner while incarcerated.
Any measure which imposes significant restrictions on an inmate’s living conditions and
access to the outside world should be subject to a rigorous and accountable review process.
All prisoners, regardless of their security classification, must be provided with humane
conditions.
International standards provide that prisoners should not be subjected to any hardship
beyond that inherent in the deprivation of liberty and maintenance of discipline.67 In line
with this principle, they should be held in the least restrictive conditions practicable,
consistent with humane treatment and the aim of rehabilitation.

Recommendations
Amnesty International recommends that prisoners in H-Unit be afforded more out of cell
time, better exercise and recreational provision, and an opportunity for some association with
other inmates in the unit at all stages of their confinement rather than, as presently, only
after progression to phase 3.


Prisoners should be provided with a meaningful opportunity to challenge the imposition
of SAMs. In any event, consistent with international standards, restrictions should be limited
to the minimum necessary and ensure that a prisoner is not subjected to undue hardship. No
prisoner should be held in indefinite solitary confinement.


As a general rule, hunger strikers should not be forcibly fed. Any decision whether to
carry out non-consensual feeding of a hunger striker should be made only by qualified health
professionals and any such feeding should be done only by medically trained personnel under
continuing medical supervision, and only after assessing the individual’s health needs and
mental competence. The authorities must never require health professionals treating hunger
strikers to act in any way contrary to their professional judgment or medical ethics.


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CONTROL UNIT, SHU AND RANGE 13

The SHU range in ADX © Private

The Control Unit (CU), together with the SHU and Range 13, are the most isolated units in
ADX as prisoners recreate alone and have no contact with anyone other than staff. Prisoners
are assigned to the CU for fixed terms for serious offences, usually committed in other
prisons, after a hearing which is similar to a disciplinary hearing. The fixed terms can be as
long as six years or more,68 and may be extended if further offences are committed while the
prisoner is in the Unit.
The cells are the same as in the GP, with showers and double-doors cutting off direct contact
with anyone on the range or in adjacent cells. CU prisoners have access to TVs and the same

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in-cell programs as GP inmates. However, they are allowed exercise for only seven hours a
week, and they do not have even the limited contact that GP inmates may have with prisoners
in adjacent cages. Contact with the outside world is more restrictive in that they are allowed
only one 15-minute non-legal phone call a month.
Prisoners in the CU have no access to the SDP but they can receive monthly credits for
positive behaviour which can reduce their terms; they may also lose credit for disciplinary
offences or failure to adjust. ADX regulations require that all prisoners receive monthly
reviews by a CU Team attended by a psychologist. An Executive Panel reviews each CU case
every 60-90 days to determine an inmate’s readiness for release (to another prison or to the
ADX GP).69

Interior of a SHU cell at ADX © Private

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BOP regulations exclude prisoners with serious mental illness from being housed in the CU,
and all inmates are supposed to undergo mental health screening before being assigned to
the unit and assessed at the monthly reviews. However, according to an ongoing lawsuit
(Cunningham v Bureau of Prisons, see below) prisoners with serious mental illness have been
held in the CU, sometimes for years, with some prisoners having their terms extended for
behaviour caused by their illness, including incidents of extreme self-mutilation. Factors used
in awarding good conduct credits, or in evaluating a prisoner’s readiness for release from the
unit, include “Self-improvement Activities”, “Personal Grooming and Cleanliness” and
“Quarters Sanitation”.70 Lawyers have described how some prisoners are too ill or depressed
to maintain personal hygiene and smear their cell walls with excrement; as they fail to meet
positive conduct criteria they too can remain in the unit for extended periods. According to a
prison mental health expert, behaviour such as self-harm and smearing excrement is often a
symptom of mental health or behavioural disturbance stemming from, or exacerbated by
conditions of isolation.71 While some changes have been instituted as a result of the lawsuit,
Amnesty International is concerned that prisoners with mental or behavioural problems may
remain in isolation, in the CU or elsewhere at ADX, effectively punished for behaviour they
are unable to control, in conditions that are liable to make them worse.
Prisoners in the SHU live in similar conditions of isolation as in the CU, confined to the same
double-door cells, with solitary recreation. Many prisoners in the SHU are serving fixed terms
for disciplinary offences; some are held there pending investigation of an incident. ADX
prisoners usually spend at least a few days in the SHU upon their arrival at the institution.
Most inmates in the SHU (those confined for disciplinary reasons) are denied televisions and
radios or access to programs. Although prisoners generally spend shorter periods in the SHU
than in other units, prisoners’ terms can be extended for repeated disciplinary infractions.
According to the Cunningham lawsuit, seriously mentally ill prisoners have been confined in
the SHU for many months, and in some cases for years, due to disturbed behaviour
exacerbated by their conditions of confinement.
Range 13
“The outdoor recreation area was a concrete pit surrounded by high, featureless walls on all
sides. It felt like being inside of a deep, empty, swimming pool. I couldn’t see any of the
mountain, even though I knew they had to be close by. I also couldn’t see a single tree, a
blade of grass, or any sign of nature”.
Description of outdoor recreation area on Range 1372

The most isolated section of the facility is a small high security unit known as Range 13. The
cells have no view of the outside and light comes from a small window at the top of each cell
too high to see through. Cameras are positioned on the cells 24 hours a day. Amnesty
International was told during its 2001 visit to ADX that very few inmates were ever held
there, and for no more than 12-30 days at a time. However, the organization has received
information indicating that in recent years prisoners have spent significantly longer periods in
Range 13.


Thomas Silverstein, 62, convicted in 1975 for armed robbery, and implicated in the
murder of a guard and two inmates, was held on Range 13 for almost three years
between 2005 and 2008. He has had a clean conduct record for over two decades. Held
under a “no human contact” order issued by the Director of the BOP in 1983 he was
moved to ADX GP in 2008 after he filed his lawsuit. According to court documents, Mr
Silverstein, while incarcerated on Range 13, was given no information from prison
officials about the ‘behavioural standards that were being applied to him and the
“program” he would need to follow to have his extreme level of isolation reduced”. It was

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‘unclear what if any objective or clear standards the BOP applied in making the decision
to transfer him out of Range 13 and into D Unit’.73Even after the move to GP, he still
was, and has been, treated differently from other GP prisoners in the sense that for the
majority of the time he has been in GP, he has been forced to recreate alone, not even
being able to interact with other prisoners in the outdoor cages.


Ramzi Yousef, was held for seven years and eight months on Range 13.

Several H-Unit prisoners were also placed there in response to initiating hunger strikes.
Amnesty International has seen documents in which an H-Unit prisoner appealed his
placement in Range 13 through the Administrative Remedy procedure, alleging that he was
placed there in retaliation for having gone on hunger strike in September 2010. In a letter
dated 5 January 2011, the Warden replied to the prisoner denying his appeal, stating that
“On October 4, 2010, while you were engaged in the hunger strike, you were removed from
H-Unit and placed on Range 13, in SHU, for medical observation and monitoring”.74 The
letter goes on to state that “The decision was then made that upon completion of your hunger
strike and your monitoring/observation by the Clinical Director, we would continue to house
you on Range 13, in the SHU, with other H-Unit inmates”. Thus, he was still in Range 13
nearly four months after being placed there, and no longer for observation or monitoring
purposes.
Although the Warden states in his letter that H Unit prisoners in Range 13 were afforded “all
of the same privileges and restrictions as H-Unit inmates”, given the extremely isolated
conditions on Range 13 it is hard to see this as other than a punitive measure taken to deter
prisoners from going on hunger strike. Amnesty International opposes the imposition of
punitive measures against prisoners for going on hunger strike, and is particularly concerned
that where a prisoner is on hunger strike in protest against their isolated conditions of
confinement, such measures place them in conditions of even more severe isolation.

Recommendations
Prisoners with mental illness, mental disabilities or severe behavioural disorders should
not be housed in ADX but should be treated in an appropriate therapeutic setting. All
prisoners in ADX should be regularly monitored by mental health professionals.


All prisoners, wherever they are housed, should have access to adequate provision for
outdoor exercise and recreation and, to the maximum extent possible, opportunities for social
contact with other inmates. No prisoner should be confined for prolonged periods in the
conditions of severe isolation as exist in the CU or SHU.


Given the very severe conditions of isolation in Range 13 cells, and the risk of
psychological harm that can result from even short periods in isolation, Amnesty International
considers that Range 13 should be discontinued for use.


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MENTALLY ILL PRISONERS AT ADX
"The minds of some prisoners are collapsing in on them. I don’t know what internal strife lies
within them, but it isn’t mitigated here. One prisoner subjected to four point restraints
(chains, actually) as shock therapy, had been chewing on his own flesh. Why is a prisoner
who mutilates himself kept in ADX? Is he supposed to improve his outlook on life while
stripped, chained and tormented”
Excerpt from a letter written by Raymond Luc Levasseur a prisoner held in ADX, published on the ‘Solitary Watch’ website75

There is a significant body of evidence that confining individuals in isolated conditions, even
for relatively short periods of time, can cause serious psychological and sometimes
physiological harm, with symptoms including anxiety and depression, insomnia,
hypertension, extreme paranoia, perceptual distortions and psychosis. This damaging effect
can be immediate and increases the longer the measure lasts and the more indeterminate it
is.76 Isolation has been found to have negative effects on individuals with no pre-existing
illness and to be particularly harmful in the case of those who already suffer from mental
illness.77
In recognition of such effects, international and regional human rights bodies, mental health
organizations and others have called for strict limits on the use of solitary confinement and
an absolute prohibition of the practice in the case of prisoners who are mentally ill. 78 In
2012, the American Psychiatric Association approved a policy opposing the prolonged
segregation of prisoners with serious mental illness. 79 There is a growing consensus among
US courts that housing prisoners who are seriously mentally ill in “super-maximum security”
conditions is “cruel and unusual punishment” in violation of the Eighth Amendment to the
U.S. Constitution.
BOP policy also prohibits housing prisoners who are seriously mentally ill in ADX. Its written
procedures for transferring prisoners to ADX state that prisoners “currently diagnosed as
suffering from serious psychiatric illnesses should not be referred for placement at … ADX.”
(BOP Program Statement 5100.08, “Prisoner Security Designation and Custody
Clarification”, Chapter 7).
However, in declarations presented to the ECHR asserting that inmates considered seriously
mentally ill would not be housed at ADX, the US government stated that “The main mental
health disorders such as bipolar affective disorder, depression, post-traumatic stress disorder
and schizophrenia would not preclude a designation to ADX and could be managed
successfully there”.80 Thus, it appears that, in practice, BOP has taken the position that
prisoners with a diagnosis of serious mental illness need not be excluded from assignment to
ADX and placement in isolation if they can be managed and are not actively psychotic. This
position and definition of when a person is seriously mentally ill has been challenged as
contrary to accepted practice in other systems and with recommendations and findings of the
US Department of Justice Civil Rights Division investigations into other jurisdictions.81
"I heard the head of the BOP in Congress (on radio) saying that they do not have insane
inmates housed here...I have not slept in weeks due to these non-existing inmates beating on
the walls and hollering all night. And the most "non-insane" smearing feces in their cells"
Letter sent to the website ‘Solitary Watch’ by an inmate confined in ADX who has spent the last 12 years in solitary confinement82

A lawsuit filed in 2012 and still in litigation (Cunningham v BOP) has presented evidence
that a significant number of inmates suffering from serious mental illness have been confined
at ADX without adequate screening, diagnosis or treatment, in violation of BOP’s own policies
and the Eighth Amendment to the US Constitution.83

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While all prisoners are required to be screened upon arrival at the prison, the lawsuit
described the process as consisting of “perfunctory interviews that are wholly inadequate as a
form of screening or diagnosis”.84 It further stated that, even where prisoners were identified
as having a serious mental illness, many were not given appropriate treatment or monitoring.
Because of the particularly severe conditions in the CU, BOP policy provides that, even if
referred to ADX, any prisoner with evidence of a serious mental disorder or physical disability
for which they require to be medicated should not be placed in the CU. However, cases cited
in the lawsuit include several prisoners who had spent years in the CU, despite histories of
mental illness and actively psychotic behaviour, including acts of self-mutilation. Some had
been taken off their prescribed psychotropic medication in order to be assigned as “eligible”
for placement in the unit. The lawsuit claimed that the 30 day evaluations were in practice
“rarely performed on inmates in the Control Unit”.85

JP, a prisoner with a history of mental illness, was transferred to ADX in 2001 and placed in the CU to serve a
60 month sentence imposed after he escaped from a medium security prison.86 The lawsuit describes how he
was repeatedly transferred for brief periods to the federal medical facility at Springfield for psychiatric
evaluation after a series of incidents of self-harm, only to be returned to the CU after being “stabilised” with
medication. The self-harming incidents included lacerating his scrotum with a piece of plastic (2005); biting
off his finger (2007); inserting staples into his forehead (2008); cutting his wrists and being found
unconscious in his cell (2009). He finally completed his CU term in 2011, ten years and five months after his
original term would have expired had he been able to comply with the behavioural requirements. According to
the lawsuit, he continued to be deprived of mental health care after being placed in the ADX GP. In January
2012, he reportedly sliced off his earlobes and in March 2012 sawed through his Achilles tendon with a piece
of metal; after he again mutilated his genitals in May 2012 he was placed on the anti-psychotic medication
Haldol but had no access to other treatment such as mental health counselling. In August 2013, he left ADX
on an emergency mental health transfer to Springfield, Missouri. In October 2013, he was sent to USP Tucson
but was transferred back to Springfield in about March 2014 after he rammed his head into an exposed piece
of metal in his cell, causing a skull fracture and brain injury, for which he refused most treatment. Since
arriving at Springfield he has inserted metal into his brain cavity through the hole that remain in his skull,
which BOP says cannot safely be removed.

MW had been treated for mental illness since childhood and was also diagnosed with mental retardation. He
was transferred to ADX despite a history of self-harming and attempted suicide at another prison. While in the
CU, he twice cut his wrist with a razor blade; he allegedly received no mental health treatment for his
behaviour but was punished with seven days loss of TV. He filed an administrative appeal against his
placement in the CU which was denied.87
According to the lawsuit, many prisoners housed in the SHU also suffer from chronic mental
illness and some routinely smear themselves and their cells with their own faeces, howl or
shriek continuously or bang their metal showers at all hours of the day or night. Mentally ill
prisoners have also been housed in the ADX GP. One prisoner, who had been stabilised with
regular psychotropic medication in another federal facility, deteriorated after being
transferred to ADX; after cutting a blood vessel in his neck he was treated in hospital then
returned to ADX where he was reportedly placed in the same cell and given a pail of water to
clean up the blood.88
The lawsuit further alleges that, as of the time of filing, there was inadequate mental health
staffing at ADX. The prison reportedly had only two mental health professionals – both
psychologists – serving around 450 inmates, assisted by a psychiatrist who spent only half a

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day a week at the facility. It was alleged that psychotropic medication was inconsistently or
incorrectly administered; that correction officers were not adequately trained to recognize
symptoms of serious mental illness crises; and that counselling sessions with mental health
staff almost invariably took place at the cell door, in the presence of correctional staff, rather
than in an appropriate private setting.
In 2013, two years after the lawsuit was filed, and following rejection by a federal judge of
BOP appeals to dismiss the case, both sides entered into a structured settlement process
overseen by an assistant federal judge. While at the point of writing no definitive agreement
had been reached, prison authorities have reportedly taken steps to address the concerns
raised, although, according to the lead attorney in the case, the BOP remains “far from
righting chronic treatment gaps”.89


In September 2013 a prisoner with a history of serious mental illness hanged himself in
his cell in the ADX GP. He had reportedly spent more than a decade at ADX with only
intermittent mental health care, having been transferred to a medical facility at least six
times to be medicated only to be returned to ADX where each time he deteriorated; he
suffered psychotic symptoms which had allegedly been ignored in the days before his
death.90 According to his lawyer, the BOP refused to allow the coroner to interview other
prisoners, enter prisoner cells or take witness statements. They also took the reportedly
unprecedented step of having three representatives attend the autopsy.

The changes under the above settlement negotiations are reported to include the creation of
two new long-term residential programs to treat high security prisoners with serious
psychiatric problems: the first in Atlanta, Georgia, opened in September 2013 with capacity
for 30 patients –all but one of whom were transferred from ADX. In addition, a number of
mentally ill prisoners have been transferred to a federal medical facility in Springfield,
Missouri.
Other improvements include a new policy statement on SMI; some improvement in staff
training; an increase in the size of mental health staff from two psychologists to four, and a
psychiatric nurse; an improved pre-admission evaluation for inmates entering prison; and the
employment of an outside consultant to evaluate all prisoners at ADX. Additionally, a change
has been made to the policy that previously prohibited the administration of psychotropic
drugs to inmates in the CU so that some prisoners in the unit may now receive such
medication. While Amnesty International recognizes this latter change as an improvement on
withholding medication from mentally ill prisoners, it is deeply concerned that prisoners with
SMI should be held at all in the CU given its severe conditions of isolation.
According to information provided to Amnesty International by plaintiff’s attorneys, a number
of critical objectives are being sought through the settlement process, including better
evaluation and diagnostic processes for those being referred to ADX, effective treatment for
mentally ill prisoners in an appropriate therapeutic setting, routine monitoring and
psychological services for all prisoners at ADX and, for all prisoners, a reduction in extreme
isolation time with monitoring and enforcement mechanisms to ensure changes are properly
introduced.
International standards, and those set by US professional organizations, require careful
monitoring of all prisoners held in isolation due to the negative impact this can have on the
psychological health of individuals even without pre-existing illness. The SMR require daily
monitoring of prisoners placed in “close confinement” (Rule 32). The National Commission
for Correctional Health Care (NCCHC) in the USA has observed that conditions in supermaximum security isolation facilities “Even for the most stable individuals … may precipitate

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mental health or health difficulties” and that “daily contact by medical staff and at least
weekly contact with mental health staff is required”, noting that such contacts “must be
meaningful and allow sufficient interaction for such assessments to take place”. 91 Although
the standards are not binding on non-accredited facilities, they represent best practice.

Recommendations
Amnesty International recommends that prisoners who are mentally ill are not housed at
ADX; and that all prisoners in isolation have an opportunity for meaningful consultation with
mental health staff on at least a weekly basis as recommended under NCCHC and
international standards.


Prisoners with a diagnosis of mental illness, mental disability or severe behavioural
disorders should not be housed in ADX and should have access to treatment in an
appropriate therapeutic setting.




All prisoners in ADX should be regularly monitored by mental health professionals.

Health care staff should report to the prison authorities if a prisoner’s health is being
put as serious risk by being held in isolation.




No prisoner with a history or risk of mental illness should be housed in ADX

OVERVIEW OF US OBLIGATIONS
UNDER INTERNATIONAL LAW AND
STANDARDS
The USA has ratified the United Nations (UN) Convention against Torture and other Cruel,
Inhuman or Degrading treatment or Punishment and the International Covenant on Civil and
Political Rights (ICCPR) both of which affirm the absolute prohibition of torture and other
cruel, inhuman or degrading treatment or punishment (articles 1 and 16 of the Convention
against Torture and article 7 of the ICCPR). Additionally, the ICCPR in article 10, requires
that “all persons deprived of their liberty shall be treated with humanity and respect for the
inherent dignity of the human person”, an obligation the UN Human Rights Committee (the
treaty monitoring body) has stated is a “fundamental and universally applicable rule” 92.
The Human Rights Committee has further emphasized that the prohibition of torture and
other cruel, inhuman or degrading treatment under international law “relates not only to acts
that cause physical pain but also that acts that cause mental suffering” and has stated,
specifically, that prolonged solitary confinement may breach this prohibition (Human Rights
Committee General Comment 20 on article 7).
The Human Rights Committee and the Committee against Torture (CAT) (the monitoring body
of the Convention against Torture) have criticised conditions in US “super-maximum”
facilities as inconsistent with the USA’s obligations under the above treaties. In 2006, the
Human Rights Committee reiterated its concern that “conditions in some maximum security
prisons are incompatible with the obligation in Article 10(i) to treat detained persons
humanely”, citing, in particular, prolonged cellular confinement, lack of adequate exercise

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and the “depersonalized environment” found in such units.93 The Committee also observed
that such conditions “cannot be reconciled with the requirement in article 10(3) that the
penitentiary system shall comprise treatment the essential aim of which shall be the
reformation and social rehabilitation of prisoners”. 94 The CAT has urged the USA to review
“the regime imposed on detainees in supermaximum prisons, in particular the practice of
prolonged isolation”, noting the effect of such treatment on prisoners’ mental health. 95
Most recently, the Human Rights Committee issued its Concluding Observations following its
consideration of the USA’s Fourth Periodic Report in March 2014. It again expressed
concern about holding prisoners in prolonged isolation, including in pre-trial detention, and
recommended that the USA monitor conditions with a view to ensuring that persons deprived
of their liberty be treated in accordance with the requirements of article 7 and 10 of the
ICCPR and the SMR. The Committee recommended that the USA “impose strict limits on the
use of solitary confinement, both pre-trial and following conviction, in the federal system, as
well as nationwide, and abolish the practice in respect of anyone under 18 and prisoners with
serious mental illness”.96
The USA has sought to limit its obligations under article 7 of the ICCPR and Article 16 of the
Convention against Torture, by entering reservations upon ratification of the treaties stating
that it considers itself bound by the articles 7 and 16 only to the extent that “cruel, inhuman
or degrading treatment or punishment” means the “cruel and unusual punishment”
prohibited under the US Constitution. Amnesty International has repeatedly called on the
USA to withdraw its reservations as defeating the object and purpose of the treaties and
therefore incompatible with international law. 97 The Human Rights Committee has also noted
with concern the restrictive interpretation made by the USA of its obligations under the
Covenant, as has the Committee against Torture. In any event, the USA has made no similar
reservation to Article 10 of the ICCPR which requires that all prisoners must be treated
humanely, without exception.
As noted above, Amnesty International has found conditions in ADX, and in some other pretrial or post- conviction federal facilities, to be in specific breach of standards under the
SMR. They include standards on access to adequate outdoor exercise and fresh air,
conditions essential to health and quality of life. The SMR, although not as such having the
legally binding force of a treaty, set out minimum standards which the UN Special
Rapporteur on Torture has said are “widely accepted as the universal norm for the humane
treatment of prisoners”.98 They have also been cited by the Human Rights Committee in its
General Comment on Article 10 and, as shown above, in assessing state parties’ reports. Key
standards for the treatment of prisoners are also set out in the Basic Principles for the
Treatment of Prisoners, adopted by the UN General Assembly (GA) in 1990, and the Body of
Principles for the Protection of all Persons under any form of Detention or Imprisonment
adopted by the UN GA in 1998.
International norms also provide, as an abiding general principle, that imprisonment should
not impose hardship or constraint other than that resulting from the deprivation of liberty or
restrictions that are unavoidable in an enclosed environment.99 While acknowledging the
need for heightened security measures for some prisoners, Amnesty International considers
that the conditions of prolonged isolation and other deprivations endured by many prisoners
in ADX are unnecessarily harsh and breach the above principle.
International and regional human rights treaty bodies and experts have consistently called on
states to restrict their use of solitary confinement, in recognition of the physical and mental
harm and suffering this can cause even when imposed for limited periods. 100 This was
reiterated by the UN Special Rapporteur on Torture in a detailed report issued in August

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2011 in which he called on states to apply solitary confinement “only in exceptional
circumstances and for the shortest possible period of time”. 101 He defined solitary
confinement as “the physical and social isolation of individuals who are confined to cells for
22-24 hours a day”. He called for the abolition of solitary confinement in the case of
children under 18 and people with mental disabilities on the ground that its imposition in
such cases, for any duration, constitutes cruel, inhuman or degrading treatment. He stressed
the importance of safeguards for prisoners placed in segregation, including regular
monitoring and review of prisoners’ mental and physical condition by qualified, independent
medical personnel, and a meaningful opportunity for prisoners to challenge their confinement
through a process of administrative review and through the courts. In a statement issued on 7
October 2013, the Special Rapporteur urged the US government to take “concrete steps to
eliminate the use of prolonged and indefinite solitary confinement in US prisons and
detention facilities”.102

US LAW AND STANDARDS
As outlined in this report, there is concern that the federal system (as well as many state
jurisdictions) has failed to put in place the safeguards called for above, including an effective
system to enable prisoners to challenge their confinement through administrative review. US
courts also provide only a limited remedy for prisoners held in isolation, generally deferring to
prison administrators in deciding what restrictions are necessary on security grounds. The US
Supreme Court has not ruled that solitary confinement, even when imposed indefinitely, is
per se a violation of the Constitution.103 It has set a high threshold for judging when prison
conditions violate the Eighth Amendment prohibition of “cruel and unusual punishment”,
holding that they must be so severe as to deprive inmates of a “basic necessity of life” –
interpreted to mean the physical requirements of food, clothing, shelter, medical care and
personal safety – and that the authorities must have shown “deliberate indifference” to a risk
of harm.104 The courts have been less willing to consider mental and psychological pain or
suffering as sufficient to render conditions unconstitutional, a situation where US
jurisprudence falls short of international human rights law (see Human Rights Committee
General Comment 20, above).105
While the US courts have generally allowed prison administrators broad leeway in housing
prisoners in isolation, other US bodies have been more robust in calling for rigorous
standards and safeguards on the use of solitary confinement.
In its 2006 report Confronting Confinement, the Commission on Safety and Abuse in
America’s Prisons called for an end to conditions of isolation in US prisons. 106 The report
stated that “Separating dangerous or vulnerable individuals from the general prison
population is part of running safe correctional facility”. However, it found that in some
systems, the “drive for safety, coupled with public demand for tough punishment, has had
some perverse effects”, with prisoners who were justifiably separated from the general prison
population locked in cells with little opportunity to be productive or to prepare for release,
and others who were not a serious threat confined under the same conditions.
The Commission recommended making segregation a last resort, for as brief a period as
possible, with tighter admissions criteria and segregated prisoners given an opportunity to
engage in productive activities. Noting higher recidivism rates from prisoners released
directly from segregation, the Commission also recommended that inmates should spend
time in a normal prison setting before being released to the community. The Commission
called on US jurisdictions to “End conditions of isolation” and “Ensure that segregated
prisoners have regular and meaningful human contact and are free from extreme physical
conditions that cause lasting harm”. 107

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In 2010, the American Bar Association (ABA) promulgated standards on the treatment of
prisoners which included standards on segregation.108 These state that segregated housing
“should be for the briefest term and under the least restrictive conditions practicable and
consistent with the rationale for placement and with the progress achieved by the prisoner”
(Standard 23-2.6). The standards state that segregation for more than one year should be
imposed only if the prisoner poses a “continuing serious threat” (23-2.7); that “conditions of
extreme isolation should not be allowed regardless of the reasons for a prisoner’s separation
from the general population” (23-3.8 (b)); and that all prisoners in segregated housing
should be provided with “meaningful forms of mental, physical and social stimulation”,
including, where possible, more out-of-cell time and opportunities to exercise in the presence
of other prisoners (23-3.8 (c)). The standards also recommend a number of procedural
protections for prisoners placed in segregated housing, including a hearing at which the
prisoner has a reasonable opportunity to present witnesses and information and to participate
in the proceedings, with regular, meaningful review (23-2.9).

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RECOMMENDATIONS
GENERAL RECOMMENDATIONS ON USE OF ISOLATED CONFINEMENT
In line with international human rights law and standards, all jurisdictions should ensure
that solitary or isolated confinement, whether imposed for administrative or disciplinary
purposes, is imposed only as a last resort and for the minimum period possible.




No prisoner should be held in prolonged or indefinite isolation.

All prisoners in segregated confinement should have access to meaningful therapeutic,
educational and rehabilitation programs.


Conditions in all segregation facilities should provide minimum standards for a humane
environment so that prisoners even in the most restrictive settings have adequate facilities for
outdoor exercise, access to natural light, and meaningful human contact both within the
facility and with the outside world.


There should be adequate opportunities for some group interaction and association for
prisoners at all stages of segregated confinement, both to benefit their mental and physical
health and to allow their behaviour to be measured and to encourage their progress to less
restrictive custody.



Children - that is those under 18 - should never be held in solitary confinement. All
youthful offenders should receive treatment appropriate to their age and developmental
needs with the primary goal of rehabilitation as required under international standards.

No prisoner with mental illness, mental disabilities or severe behavioural disorders or
who is identified as being at risk of developing these conditions should be held in solitary or
isolated cellular confinement.


There should be adequate mental health monitoring of all prisoners in segregation, with
frequent opportunities for prisoners to consult with mental healthcare professionals in
private.


Prisoners who have developed serious health care problems as a result of their isolated
confinement (whether physical or mental) should be removed and have access to treatment in
to an appropriate therapeutic setting.


Placement in segregated confinement should be made only after an impartial hearing at
which the prisoner has a fair and meaningful opportunity to contest the assignment and the
right to appeal. Prisoners should be provided with regular, meaningful review of any
continued segregation through a similar impartial proceeding, with clear criteria to enable
them to move to less restrictive settings within a reasonable time frame.



There should be regular, external review of conditions in segregation facilities and of the
procedures and operation of such facilities.


PRISONERS IN PRE-TRIAL DETENTION
All detainees in pre-trial detention should be held in conditions consistent with their
status as untried prisoners and the presumption of innocence. They should be held in the
least restrictive circumstances possible, with regular access to medical care and adequate


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facilities for the preparation of their defence and communication with their lawyers and
family members.
Amnesty International urges that the current review of federal segregation policies
include conditions under which prisoners are isolated during pre-trial detention, especially in
high security facilities such as those in the MCC SHU.


ADDITIONAL RECOMMENDATIONS SPECIFIC TO ADX
Conditions for all prisoners in ADX Florence should be improved so that prisoners are not
held in conditions of severe isolation and have more opportunities for social interaction with
staff and other inmates as well as access to meaningful rehabilitation and recreational
programs. The exercise facilities should be modified to allow more space and equipment;
prisoners should be allowed daily outdoor exercise109.


Opportunities should be reinstated for ADXGP prisoners to have group recreation even
at the most restrictive levels of confinement, both to aid their rehabilitation and to allow their
progress to be measured.


Amnesty International recommends that clear criteria be established for SDP placement
decisions, with a fair process and meaningful review. Prisoners should be provided with
detailed reasons if they are denied advancement through the SDP, with an opportunity to
participate in, and challenge, decisions, with clear guidance on how they can progress
through the system. No-one should be held continuously in isolation based solely on the
original reason for placement in ADX.


Amnesty International recommends that prisoners in H-Unit be afforded more out of
cell time, better exercise provision, and an opportunity for some association with other
inmates in the unit at all stages of their confinement rather than, as presently, only after
progression to phase 3.


Prisoners should be provided with a meaningful opportunity to challenge the imposition
of SAMs. In any event, consistent with international standards, restrictions should be limited
to the minimum necessary and ensure that a prisoner is not subjected to undue hardship. No
prisoner should be held in indefinite solitary confinement.


Amnesty International recommends that prisoners who are mentally ill are not housed at
ADX; and that all prisoners in isolation have an opportunity for meaningful consultation with
mental health staff on at least a weekly basis as recommended under NCCHC and
international standards.


Prisoners with a diagnosis of mental illness, mental disability or severe behavioural
disorders should not be housed in ADX and should have access to treatment in an
appropriate therapeutic setting.




All prisoners in ADX should be regularly monitored by mental health professionals.

Health care staff should report to the prison authorities if a prisoner’s health is being
put as serious risk by being held in isolation.




No prisoner with a history or risk of mental illness should be housed in ADX



Range 13 cells should be discontinued.

The BOP should provide publicly accessible information on ADX programs and operating
policy. It should also report regularly on the number of prisoners in ADX and in the various


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units and step down programs and the time spent in each program or unit.

RECOMMENDATIONS TO THE FEDERAL GOVERNMENT AND CONGRESS
Congress should require, and the federal government institute, reforms to the use of
solitary and isolated confinement in all BOP facilities so that they meet with the above
standards and fully conform to international law and standards for humane treatment.


The US Government should allow visits by human rights groups and the media and invite
the UN Special Rapporteur on Torture to investigate the use of solitary confinement in US
prisons, including through on-site visits under the terms requested by the Special
Rapporteur.


A national reporting system to the Bureau of Justice Statistics should be established
under which state and local prison and detention facilities, including juvenile facilities, are
required to provide data on their use of solitary confinement, including statistics on the
numbers of prisoners held in segregated facilities, the length of confinement, the
effectiveness of programs instituted, the costs of confinement and the impact on prisoners,
on institutional safety and on recidivism.


The above data and input from experts, including mental health experts and penal
reformers, should be studied to provide guidance on best practice and effective measures to
reduce the use of solitary or isolated confinement.


National guidelines should be drawn up to limit the use of solitary and isolated
confinement based on international standards, the ABA standards and best practice.


Amnesty International urges that Thomson Correctional Center not be funded or
designated as a super-maximum isolation facility and that the federal government take steps
to reduce and provide alternatives to its use of isolated confinement.


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ENDNOTES
Silverstein v. Federal Bureau of Prisons et al, Civil Action No. 07-cv-02471-PAB-KMT, Exhibit 1
(Silverstein v. BOP).

1

Juan E. Méndez, “Interim report prepared by the Special Rapporteur of the Human Rights Council on
torture and other cruel, inhuman or degrading treatment or punishment”, A/66/268, 2011, para 26.
2

No exact current figures are available. However, a survey by the Urban Institute found that, as of
2004, 44 states had “supermax” facilities housing some 25,000 inmates (Daniel P. Mears, A Critical
Look at Supermax Prisons, Corrections Compendium, 2005). Few US jurisdictions use the term
“supermaximum” custody nowadays: maximum custody isolation facilities which fit that description are
known by various terms including Special Management Units (SMUs), Security Housing Units (SHUs) or
Administrative Segregation Units (ASUs).
3

A census of state and federal prisons in 2005 conducted by the US Department of Justice’s Bureau of
Justice Statistics found there were 81,622 prisoners held in some form of “restricted housing” at that
time.
4

Written Testimony of Professor Laura Rovner, University of Denver, Before Senate Judiciary Committee,
Subcommittee on the Constitution, Civil Rights and Human Rights, June 15, 2012 available at
http://www.law.du.edu/documents/student-law-office-clinical-programs/laura-rovner-university-of-denversturm-college-of-law.pdf (accessed 8 July 2014).
5

6

Letter from Eileen Chamberlain Donahoe, US Ambassador to the United Nations Human Rights

Council, Geneva, 30 November 2011.
The case of Babar Ahmad and Others v The United Kingdom, 10 April 2012 (Babar Ahmad and Others
v. UK) before the European Court of Human Rights, an appeal against the extradition from the UK of five
individuals to the USA on claims including that they would risk being subjected to cruel, inhuman or
degrading treatment if confined in ADX. In a judgment in April 2012, the Court rejected this claim on
finding that isolation at the facility was “partial and relative” (noting that while ADX prisoners had no
physical contact with others, they could communicate through the air vents in their cells; and during
limited exercise); that they had TVs and access to programs in their cells; and that the applicants had a
“real possibility” of gaining to the SDP or its equivalent in H-Unit. The ruling was criticized by US
human rights lawyers and NGOs as giving too much weight to the evidence submitted by the USG (
which they claimed grossly understated the amount of time a prisoner spends at the facility), in the face
of other evidence presented on behalf of the applicants on the extent and duration of isolation at the
facility. Amnesty International also expressed concern about the reasoning that led to the decision
(Amnesty International, USA must respect rights of individuals extradited from the UK, 8 October 2010,
Index: AMR 51/086/2012). The Court itself stated in its ruling that “solitary confinement, even in cases
entailing relative isolation cannot be imposed indefinitely” and that “If an applicant were at real risk of
being detained indefinitely at ADX it would be possible to reach the minimum level of severity required
for a violation of article 3” and that “Indeed, this may well be the case for those inmates who have spent
significant periods of time at ADX”. (Babar Ahmad and Others v. UK Judgment, 10 April 2012, para
223).

7

A survey for the litigants in Babar Ahmad and Others v. UK, found 43 inmates at ADX had spent eight
years in isolation (including, in some cases, periods spent in solitary confinement in other prisons before
transfer to ADX); similar findings were revealed from a larger sample of 110 ADX prisoners.
8

9
10

Silverstein v. BOP.
Cunningham v BOP, Case 1:12-cv-01570 (formerly Bacote v BOP), filed 06 June 2012. At the time

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of writing the case was pending a decision on a motion to have it certified as a class action. The case is
one of a number of lawsuits filed in recent years on behalf of inmates mentally ill in ADX including Jose
Martin Vega, who committed suicide by hanging in his ADX cell in 2010 (Cunningham v. BOP).
The BOP awarded the contract for the ‘Special Housing Unit Review and Assessment’ to CNA
Corporation. The review will include an operational assessment of eight BOP special housing units; the
Bureau’s mental health assessment process; and inmate due process rights. It will not include inmates
under SAMS, H Unit, or prisoners held in pre-trial isolation. For further information, see James Ridgeway
& Jean Casella, “Federal Bureau of Prisons details limited audit of solitary confinement practices”,
‘Solitary Watch’, http://solitarywatch.com/2013/11/22/federal-bureau-prisons-details-limited-auditsolitary-confinement-practices/ (accessed 08 July 2014).
11

12 Lisa Dawson, “Funding Approved for Activation of ADX/USP Thomson, New Federal Supermax Prison”,
‘Solitary Watch’ website, March 2014, http://solitarywatch.com/2014/03/14/funding-approved-foractivation-of-adxusp-thomson-new-federal-supermax/ (accessed 8 July 2014).

According to documents obtained under Freedom of Information Act requests in 2007, from January
2002 through May 2007, officials denied every single media request for face-to-face interviews with ADX
prisoners, or tours of the facility (source: Fortress of Solitude, by Alan Pendergast, 16 August 2007.
(http://www.westword.com/2007-08-16/news/fortress-of-solitude/full/). Prior to this, some journalists had
had regular access to the facility. Following criticism of lack of access, the BOP arranged a restricted
tour of the facility in September 2007 for some major media: the Washington Post, the Los Angeles
Times, CNN, FOX News, CBS 60 Minutes and two local papers. No similar tours are believed to have
been arranged since then.
13

http://www.aclu.org/files/assets/coalition_letter_to_department_of_state_re_juan_mendez_visit.pdf
(accessed 08 July 2014).
14

GAO report, “Improvements Needed in Bureau of Prisons’ Monitoring and Evaluation of Impact of
Segregated Housing”, May 2013, p. 2. The GAO is the audit, evaluation and investigative arm of the US
Congress and examines and reports on the use of public funds and federal programs and policies (GAO
report).

15

16

GAO report, p 18.

Amnesty International uses the term “solitary confinement” and “isolation” interchangeably to
describe circumstances in which prisoners are confined to small, usually single (but sometimes double)
cells for 22 hours or more a day, with no group activities and only limited contact.

17

18

GAO report, p 15.

19

Richardson v Kane, filed December 2011 (Richardson v. Kane).

According to the GAO report some 7% of federal prisoners were in some form of segregated
confinement as of February 2013; they included prisoners in SMUs as well as in SHUs where prisoners
are often confined for fixed terms for rule violations; for their own protection; or while awaiting
classification on entry to the prison system. The GAO found this constituted an increase in use of
segregation over five years which exceeded the rate of increase in the prison population as a whole,
mainly due to the expansion of SMUs. However, a press release issued from Office of Dick Durbin, US
Senator for Illinois, Durbin Statement on Federal Bureau of Prisons Assessment of Its Solitary
Confinement Practices, 4 February 2013, noted the BOP has reduced its segregated population by nearly
25 per cent in the past year. It is unclear how far this reduction is due to closure of some SMU units or
relates to short-term isolation (e.g. as short fixed penalties or short periods in administrative detention
while awaiting classification or during an investigation) or applies to those held for long periods in
administrative or disciplinary segregation.

20

21

http://justice.gov/jmd/2014factsheets/prisons-detentions.pdf (accessed 8 July 2014).

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Jean Casella & James Ridgeway, “Feds to Open New Supermax Prison Cells at ‘Gitmo North’’’,
‘Solitary Watch’ website, 8 February 2013, http://solitarywatch.com/2013/02/08/feds-to-open-newsupermax-prison-cells-at-gitmo-north (accessed 8 July 2014)
22

Basic Principles on Treatment of Prisoners state that “7. Efforts addressed to the abolition of solitary
confinement as a punishment, or to the restriction of its use, should be undertaken and encouraged.”

23

They include Syed Hashmi who spent nearly three years in solitary confinement in MCC SHU and
Oussama Kassir and Victor Bout who spent 18 months and 15 months respectively in solitary
confinement at MCC, all confined to cells 23 or 24 hours a day with only one hour a day exercise in a
small inside room not much larger than their cell.
24

Amnesty International, Cruel conditions for pre-trial prisoners in US federal custody, 12 April 2011
(Index: AMR 51/030/2011); Open Letter to US Attorney General Eric Holder on Special Housing Unit in
the Metropolitan Correctional Center, New York, 16 February 2011 (Index: AMR 51/2011/27).

25

The only job available is a three-month position as an orderly, cleaning the unit tiers. It is alleged that
some prisoners have repeatedly applied for this coveted position and been turned down. Rezaq v Nally,
11-1069, 10th Circuit Court of Appeals (Rezaq v Nalley).

26

BOP Institutional Supplement, October 8, 2009, 6a-5 (BOP Institutional Supplement 2009). The
ruling of the ECHR in the case of Babar Ahmad and Others v UK also noted information in the
declarations of General Population Unit Manager Patricia Rengel that “Restrictions on outdoor recreation
were in three-month increments (three months for a first offence, six for a second offence and so on”).
Babar Ahmad and Others v. UK Judgment, 10 April 2012, para 88.

27

Lawyers for the plaintiffs in Babar Ahmad and Others v. UK submitted testimony that some ADX
prisoners were placed on “single recreation status” for minor violations. In one case, a prisoner was
denied outdoor exercise for 60 days for trying to feed crumbs to birds; when he challenged this through
the internal grievance process, it was increased to 90 days (Judgment in the case Babar Ahmad and
Others v the United Kingdom, ECHR 10 April 2012, para 101).

28

29

BOP Institutional Supplement 2009 6a.

Information from Amnesty International’s representative Angela Wright. Institutional Supplement No.
FLM 5321.1B, May 26, 1995 on General Population and Step-Down Unit Operations: Procedures for
General Population Units state inter alia that “These units have multiple and single occupancy exercise
areas … Inmates will ordinarily be afforded twelve (12) hours or more out of cell exercise per week.”
(4.A). (see also Design Meets Mission at New Federal Max Facility, by John M. Vanyur, Corrections
Today, July 1995, a detailed description of the operation of the facility at that time, noting, inter alia
that General Population inmates “are fed in their cells but are permitted to recreate in small groups of
up to 12 inmates for 12 hours per week”.
30

Cunningham v. BOP, p. 14. The lawsuit alleges that two prisoners in K Unit (the Intermediary Unit)
“stomped and beat a third prisoner to death over a period of many minutes in full view of ADX staff
members, who made no effort to intervene until the victim was lying still…”.

31

Cunningham v. BOP. The lawsuit alleges that, while inmates in the TU are grouped so that they are
separated from hostile inmates (e.g. rival gang members) during recreational periods, guards often fail to
take adequate precautions, for example, opening cell doors unexpectedly so that hostile inmates have
sometimes gained unauthorized access to others in the day room.

32

As with a number of current privileges as ADX, inmates were provided with access to religious
materials only after extensive litigation. According to a Stipulated Agreement dated December 2008 in
Saleh et al v BOP, ADX inmates may meet with the prison approved Imam at least weekly, and may
communicate with him in Arabic or English at the cell door from within their cells without restraints. The
agreement stipulates that if he opens an ADX cell door, the Imam must be accompanied by a BOP

33

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official.
34

Nidal Ayyad et al v Nalley, Third Amended Complaint, April 2009, p. 13-14

Examples have been given in litigation documents of programming consisting of shows broadcast on
TV, from parenting shows to those on Greek history such as the Peloponnesian wars (Rezaq v Nalley, 111069, 10th Circuit Court of Appeals).

35

36

Laura Rovner, testimony to ECHR, Babar Ahmad and Others v. UK Judgment para 101.

Sal Rodriguez, ‘Profile of an ADX prisoner: “Just half crazy and trying to hold on to the other half”’,
‘Solitary Watch’ website, http://solitarywatch.com/2012/12/09/profile-of-an-adx-prisoner-just-half-crazyand-trying-to-hold-on-to-the-other-half/ (accessed 8 July 2014)
37

38

Rezaq v Nalley and Saleh, Nosair et al v Federal Bureau of Prisons, Appellants Brief May 2011.

According to a letter Amnesty International received from the Warden at ADX in 2012, in response to
the organization’s concerns about the conditions of Syed Fahad Hashmi at ADX, Hashmi was allowed to
visit with his attorney unrestrained through a telephone handset, rather than in a room where there was a
slot in the barrier and through which correspondence could be exchanged.

39

UN Standard Minimum Rules for the Treatment of Prisoners (SMR) stipulate that: “Instruments of
restraint, such as handcuffs, chains, irons and strait-jackets, shall never be applied as a punishment.
They further provide that restraints may only be used when other measures are ineffective and only for so
long as is “strictly necessary” (Rules 31, 33 and 34).

40

International standards require that prisoners not engaged in outdoor work should have at least an
hour of suitable exercise in the open air daily (SMR 21 (1)). The SMR further provide that “Young
prisoners and others of suitable age and physique shall receive physical and recreational training during
the period of exercise” and that, to this end, “space, installations and equipment should be provided”
(SMR 21 (2). While the time allowed in the yard meets the above minimum standard, if adhered to daily,
Amnesty International does not believe that conditions in the exercise yards at ADX are adequate to
qualify as “suitable outdoor exercise”, particularly for prisoners otherwise confined to cells for long
periods. The need for adequate exercise is particularly important where prisoners are cut off from normal
activities and spend long periods in their cells, and in view of the detrimental effects on health of lack of
exercise.

41

The use of restraint techniques and/or instruments may amount to ill-treatment when they are applied
unnecessarily or in a degrading manner. See also report of the Special Rapporteur on Torture
E/CN.4.2004/56 (2003), para 45.
42

Inmate Security Designation and Custody Classification, Fed. Bureau of Prisons, 92 (12 September
2006).

43

Letter from Eileen Chamberlain Donahoe, US Ambassador to the United Nations Human Rights
Council, Geneva, 30 November 2011.

44

This language has been repeated in a number of documents, including letter from Ambassador Eileen
Chamberlain Donahoe, US Representative to the Human Rights Council, in her letter to the UN Special
Rapporteur on Torture on 30 November 2011, in which she refers to the “penological missions” of ADX.
See identical language used also in the Declaration of Mark Collins, Unit Manager for the General
Population of ADX on the missions of ADX in Reid v Wiley et al, Civil Action No. 07-cv-01855-PAB-KMT,
US District Court for the District of Colorado, November 2009; and Rezaq v Nalley, et al, 10th Circuit
Court of Appeals, April 2012.

45

Judgment in Babar Ahmad and Others v. UK, para. 96. The 30 prisoners in the sample were almost
entirely from the GP and SDP but also included two prisoners from the Special Security Unit (housing
prisoners held under SAMs) where a separate step down program had been recently instituted.

46

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Judgment in Babar Ahmad and Others v. UK, para 101, noting a survey by lawyer Mark Donatelli
which found that at least 43 inmates of ADX had spent eight years or more in “lock-down” conditions
there and at previous institutions. Also included in the defence team’s rebuttal evidence was a chart
using a sample of 110 ADX prisoners which identified an average solitary confinement length of 8.2
years.
47

48

GAO report, p. 13

49

Silverstein v. BOP.

These safeguards are less than would be required if a prisoner was facing removal to a disciplinary
segregation unit. The procedures for transfer to ADX provide that the inmate has at least 24 hours’ notice
of, and an opportunity to appear before, an administrative hearing at which he can make an oral
statement and provide documentary evidence (but without legal representation or an opportunity to
present witnesses); is provided with a written summary of the reasons for transfer; has right of
administrative appeal of the Regional Director’s decision by BOP General Counsel.

50

While the Institutional Supplement (October 2009) states that the unit team’s review of the eligibility
of a prisoner to enter into, or advance through, the SDP will “ordinarily” be “conducted in connection
with” the regularly scheduled Program Reviews which the inmate can attend and “raise questions and
concerns” about his situation, this is not the same as participation in the SDP Committee review itself.
Furthermore, as already noted, “eligibility” does not mean that the prisoner will be considered for
advancement through the Program. It has also been reported that the regular Program Reviews
themselves often consist of nothing more than a visit to the cell door and a few minutes discussion with
the prisoner.
51

The Institutional Supplement setting out the review procedure states, “Eligibility for consideration
does not equate to appropriateness for placement into or advancement to the next phase of the
Program”, FLM 5321.061(1) CN-01, C1(d).
52

Admission and Orientation Handbook, USP Administrative Maximum Facility Florence, Colorado,
November 2008. The first step in the Administrative Remedy procedures is for the inmate to informally
resolve his complaint documenting the procedure using an Informal Resolution form. Should this not
succeed, the second step is for the inmate to file a formal complaint, an ‘Institution Administrative
Remedy’, which a staff member will review and the decision is then approved by the Warden. Inmates
may appeal the decision within 20 calendar days to the Regional Director, FBOP, in Kansas City. The
Regional Director will normally respond within 30 days. This decision can then be appealed to the
General Counsel who will have a further 30 days to respond.

53

54

Saleh v Federal Bureau of Prisons, Objections, ECF No. 352, at 12.

Interim Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading Treatment
or Punishment to the United Nations General Assembly, 5 August 2011 (A/66/268).
55

56

Following lawsuits, they were given retroactive hearings some years after placement at ADX.

Rezaq v Nalley (Case No. 11-1069) and Mohammed Saleh, Ibrahim Elgabrowny, and El-Sayyid Nosai
v Federal Bureau of Prisons (Case No. 11-1072), Appellants’ Opening Brief before US Court of Appeals
for the Tenth Circuit, 31 May 2011, at p. 13

57

58

Rezaq v Nalley et al, Case No. 11-1069.

See Written Testimony of Professor Laura Rovner, University of Denver, Before Senate Judiciary
Committee, Subcommittee on the Constitution, Civil Rights and Human Rights, June 15, 2012, pointing
to lack of clear guidelines for moving to SDP available at http://www.law.du.edu/documents/student-lawoffice-clinical-programs/laura-rovner-university-of-denver-sturm-college-of-law.pdf (accessed 8 July
2014).
59

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60

Judgment in Babar Ahmad and Others v. UK, para 88.

Staff can reject books if they believe they present a risk; One of the books they rejected for a man
under SAMS was President Obama’s autobiography. See
https://www.prisonlegalnews.org/news/2009/oct/15/news-in-brief/ (accessed 8 July 2014)
61

Initially H-Unit prisoners had severe restrictions imposed on access to news channels, journals and
other materials but these were largely lifted following litigation.

62

Prisoners under SAMs have their communications, including social calls and visits, monitored; there
have reportedly been delays at times in receiving communications due to these needing to be translated.

63

James Ridgeway & Lisa Dawson, ‘ADX H-Unit on Hunger Strike, Prisoners Being Force-Fed’, ‘Solitary
Watch’ website, 25 February 2014, http://solitarywatch.com/2014/02/25/adx-h-unit-hunger-strikeprisoners-force-fed (accessed 8 July 2014).
64

CBS News, 60 Minutes, ‘Supermax. A Clean Version of Hell’. 21 June 2009
http://www.cbsnews.com/videos/a-clean-version-of-hell/ (accessed 8 July 2014)
65

See Center for Constitutional Rights, “Rights Groups Issue Open Letter on Upcoming Trial of Syed
Fahad Hashmi and Severe Special Administrative Measures”, 23 April 2010,
http://ccrjustice.org/newsroom/press-releases/rights-groups-issue-open-letter-upcoming-nyc-trial-syedfahad-hashmi-and-sev (accessed 8 July 2014)
66

See section on International Standards and reference inter alia to UN Human Rights Committee
General Comments. The SMR also state as a guiding principle that: “Imprisonment and other measures
which result in cutting off an offender from the outside world are afflictive by the very fact of taking from
the person the right of self-determination by depriving him of his liberty. Therefore the prison system
shall not, except as incidental to justifiable segregation or the maintenance of discipline, aggravate the
suffering inherent in such a situation.” (Article 57)

67

During her 2001 visit to ADX, Amnesty International’s representative was told the longest fixed term
assignment on the unit at that time was 104 months; the prisoner in question had his term extended still
further after a serious assault on a staff member.

68

69

Institution Supplement, Control Unit Programs, May 17, 2010

70

Institution Supplement, Control Unit Programs, May 17, 2010

Kupers, Terry A, “How to Create Madness in Prison”, David Jones, Ed; Humane Prisons, Oxford:
Radcliffe Publishing, 2006.

71

72

Silverstein v. BOP, Exhibit 1.

73

Silverstein v. BOP

BP-229 Response, Case Number:614359-F1, attached as Exhibit B to Declaration of Edwin P. Aro,
Cunningham v BOP, Plaintiffs’ Response to Motion to Dismiss, filed 11/21/12.

74

Raymond Luc Levasseur, “Trouble Coming Every Day: ADX–The First Year”, a letter written by a
prisoner held in ADX, republished on the ‘Solitary Watch’ website, http://solitarywatch.com/solitaryvoices/trouble-coming-every-day-adx-the-first-year/ (accessed 8 July 2014).
75

The European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or
Punishment, 21st General report, 11 November 2011, para. 53. The European Committee for the
Prevention of Torture has also pointed to the higher rate of suicide among prisoners subjected to solitary
confinement than that among the general prison population.

76

Findings of studies published in numerous articles, e.g. Grassian, Psychiatric Effects of Solitary
Confinement, Wash U.J.L. and Policy (2006) and in court rulings and testimony. See generally Peter

77

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Scharff Smith, The Effects of Solitary Confinement on Prison inmates: A Brief History and Review of the
Literature, 34 Crime and Just. 441 (2006).
See for example, Istanbul Statement on the use and effects of solitary confinement, Adopted on 9
December 2007 at the International Psychological Trauma Symposium, Istanbul (Istanbul Statement on
the use and effects of solitary confinement); Interim Report by the Special Rapporteur on Torture and
Other Cruel, Inhuman or Degrading Treatment or Punishment, 5 August 2011, United Nations General
Assembly A/66/268, para 46.

78

79

http://www.psych.org/advocacy--newsroom/position-statements (accessed 8 July 2014)

Babar Ahmad and Others v. UK, ECHR Judgment, 10 April 2012, para.90 (citing information from Dr
Paul Zohn, psychologist assigned to ADX).
80

The Federal Bureau of Prison’s Abuses of Solitary Confinement, testimony of Deborah M. Golden,
Washington Lawyers’ Committee, submitted to hearing before the Senate Judiciary Sub-committee on the
Constitution, Civil Rights and Human Rights, 25 February 2014
http://www.washlaw.org/pdf/testimony_wlc.pdf (accessed 8 July 2014) (Testimony of Deborah M.
Golden).
81

82
Jesse Wilson, “Loneliness Is a Destroyer of Humanity”, article written by an inmate who has spent 12
years in isolation at ADX. Published by Sal Rodriguez as part of the ‘Voices from Solitary’ series on the
‘Solitary Watch’ website http://solitarywatch.com/2012/07/07/voices-from-solitary-loneliness-is-adestroyer-of-humanity/
83

Cunningham v. BOP.

84

Cunningham v. BOP p.20.

85

Cunningham v. BOP p.22.

According to the Cunningham v. BOP lawsuit he had spent time in protective custody after testifying
against three inmates he had witnessed murder another prisoner; he reportedly escaped from a medium
security prison after learning that he was to be placed back in the prison’s general population.

86

87

Cunningham v. BOP p. 77.

88

Cunningham v. BOP p.94.

The Denver Post, “Lawyer: Supermax inmates moved amid lawsuit”, 9 December 2013,
http://www.denverpost.com/news/ci_24689930/lawyer-supermax-inmates-moved-amid-lawsuit (accessed
8 July 2014).
89

90 Andrew Cohen, A Handwritten Letter the Prison System Doesn't Want You to See, The Atlantic, 18
September 2013, http://www.theatlantic.com/national/archive/2013/09/a-handwritten-letter-the-prisonsystem-doesnt-want-you-to-see/279751/ (accessed 8 July 2014) describing the case of Robert Gerald
Knott, diagnosed with schizophrenia and other severe mental disorders, found hanged on 7 September
2013. See also Testimony of Deborah M. Golden.
91

2008 NCCHC Standard for Health Services for Jails and Prisons, Standard E-09

92

Human Rights Committee General Comment 21

Concluding Observations of the Human Rights Committee on the Second and Third U.S. Reports to
the Committee, 2006, (CCPR/C/SR.2395, 27 July 2006), para 36

93

Concluding Observations of the Human Rights Committee on the Second and Third U.S. Reports to
the Committee, 2006, (CCPR/C/SR.2395, 27 July 2006), para 32

94

95

Conclusions and recommendations of the Committee against Torture on the second report of the USA,

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Entombed: Isolation in the US federal prison system

para 36, CAT/C/USA/CO/”, 18 May 2006.
96

Concluding Observations, Adopted by the Committee at its 110th Session (10-28 March 2014).

Under treaty-based and customary rules of international treaty law, states may not enter reservations
which are incompatible with the object and purpose of a treaty (Vienna Convention on the law of
Treaties, adopted 22 May 1969, entered into force 23 May 1980).

97

Interim Report of the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading
Treatment or Punishment, 5 August 2011, United Nations General Assembly A/66/268/, para 46.

98

Human Rights Committee General Comment 21; similar provisions are affirmed under the UN
Standard Minimum Rules (Article 57) and the Basic Principles for the Treatment of Prisoners (Principle
5).

99

E.g. the Basic Principles for the Treatment of Prisoners states under Principle 7 that efforts to
abolish solitary confinement as a punishment, or to restrict its use, should be undertaken and
encouraged. The European Prison Rules, adopted by the Council of Europe in 2006, state that solitary
confinement should be imposed as a punishment “only in exceptional cases and for a specified period of
time that shall be as short as possible”. See also the Istanbul Statement on the use and effects of
solitary confinement.
100

Interim Report by the Special Rapporteur on Torture and Other Cruel, Inhuman or Degrading
Treatment or Punishment, 5 August 2011, United Nations General Assembly A/66/268, para 46.
101

“US: ‘Four decades in solitary confinement can only be described as torture’ – UN rights expert”, 07
October 2013, http://www.ohchr.org/EN/NewsEvents/Pages/DisplayNews.aspx?NewsID=13832 (date
accessed 8 July 2014)
102

The Court has held only that some due process is required where prisoners are assigned to isolated
custody under conditions which impose “an atypical or significant hardship” in relation to the “ordinary
incidents of prison life” (Sandin v O’Connor). While courts have found that conditions in some US
supermax facilities constitute “atypical or significant hardship”, the Tenth Circuit Court of Appeals (the
judicial circuit covering Colorado where ADX is situated) has ruled more narrowly than some other
jurisdictions in rejecting a claim that conditions at ADX constituted “atypical or significant hardship; this
was based in part on the court’s finding that confinement at ADX was not indefinite because prisoners
had regular reviews, despite its acknowledging that the applicants had spent years at the facility; the
court also compared ADX conditions to those in other isolation facilities rather than the general prison
population, and it took into account the administration’s legitimate penological interest when assessing
the harshness of conditions (as opposed only to decisions on assignment) and whether these amounted
to atypical hardship, a ruling which has been criticized by human rights lawyers as contrary to
constitutional interpretation elsewhere. (US Court of Appeals ruling in Rezaq v Nally et al, April 20,
2012.)
103

104

Wilson v Seiter, 501 U.S. (1991) and Farmer v Brennan 511 U.S. (1994)

As noted above, one exception is that US courts have repeatedly ruled in recent years that housing
prisoners who are seriously mentally ill in isolation in super-maximum facilities is in violation of the
Eighth Amendment of the US Constitution. Some courts have specifically noted that isolation in extreme
conditions is likely to inflict some degree of psychological trauma on most inmates, but that this did not
under US law bring conditions to the level of constituting deprivation of a “basic necessity of life”
(Madrid v Gomez (1995). A further obstacle to prisoners bringing claims on grounds of mental injury or
suffering is the Prison Litigation Reform Act (PLRA) passed by Congress in 1995 which provides that
“[n]o Federal civil action may be brought by a prisoner confined in a jail, prison, or other correctional
facility, for mental or emotional injury suffered while in custody without a prior showing of physical
injury.” 42.U.S.C. section 1997e (e).
105

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Entombed: Isolation in the US federal prison system

The Commission on safety and abuse in America’s prisons, “Confronting Confinement”, Vera Institute
of Justice, 08 July 2006, http://www.vera.org/content/confronting-confinement (accessed 08 July 2014)
(Confronting Confinement). The Commission was established by the Vera Institute of Justice in 2005 and
conducted a year-long inquiry which included public hearings. It was co-chaired by former US Attorney
General Nicholas B. Katchenbach and the Hon. John Gibbons, former Chief Judge of the US Court of
Appeal for the Third Circuit. Its 20 members included prison administrators, prisoner rights advocates,
religious representatives and members of both main political parties.
106

107

Confronting Confinement p. 57

ABA Criminal Justice Standards on Treatment of Prisoners, approved by the ABA House of Delegates,
February 2010. ABA standards are not binding but are “grounded in legal and constitutional principles”
and have “guided the development of law and practice in the American criminal justice system”
(Statement submitted to Hearing before the Senate Judiciary Committee, 19 June 2012).

108

International standards require that prisoners not engaged in outdoor work should have at least an
hour of suitable exercise in the open air daily (SMR 21 (1)). The SMR further provide that “Young
prisoners and others of suitable age and physique shall receive physical and recreational training during
the period of exercise” and that, to this end, “space, installations and equipment should be provided”
(SMR 21 (2). The need for adequate exercise is particularly important where prisoners are cut off from
normal activities and spend long periods in their cells, and in view of the detrimental effects on health of
lack of exercise.
109

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Amnesty International July 2014

WhetheR In A hIGh-pRofIle ConflICt
oR A foRGotten CoRneR of the
GloBe, AMNESTY INTERNATIONAL
CAMpAIGns foR JUstICe, fReedoM
And dIGnIty foR All And seeKs to
GAlVAnIZe pUBlIC sUppoRt to BUIld
A BetteR WoRld
WHAT CAN YOU DO?
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the dangerous forces that are undermining human rights. Be part
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ENTOMBED

ISOLATION IN THE US FEDERAL PRISON SYSTEM
The USA incarcerates thousands of prisoners in long-term or indefinite
solitary confinement. This report describes Amnesty International’s
concerns about conditions of severe isolation at the United States
Penitentiary, Administrative Maximum (ADX) facility in Colorado,
currently the only super-maximum security prison operated by the
federal government. It also examines conditions in Special
Management Units (SMUs) and Security Housing Units (SHUs) operated
at other federal prison facilities.
Since Amnesty International toured ADX prison in 2001 subsequent
requests to return to the facility have been denied. The organisation is
concerned that as conditions of isolation within federal prisons have
become more severe, external oversight of the facilities has declined.
With prisoners held in their cells for 22-24 hours a day in severe
physical and social isolation, Amnesty International believes the
conditions described in this report breach international standards for
the humane treatment of prisoners. Many have been held in isolation
for prolonged or indefinite periods - without a means to change their
circumstances – amounting to a violation of the prohibition against
cruel inhuman or degrading treatment or punishment under
international law. The report also details disturbing evidence of
prisoners with serious mental illness being detained in harsh isolated
conditions without adequate screening, treatment or monitoring.

amnesty.org
Index: AMR 51/040/2014
July 2014