Monday, November 10, 2014

AMA Leaders Debate Benefits, Harm of Solitary Confinement

Solitary confinement of juveniles in correctional settings is severely detrimental to adolescent health, with long-term consequences for development, and should be prohibited.

That’s what psychiatrists told delegates at the 2014 Interim Meeting of the AMA House of Delegates. During reference committee hearings yesterday (where reports and resolutions are discussed before being sent to the House), delegates debated a resolution from the Medical Student Section to oppose the use of solitary confinement in all circumstances. Some emergency and other physicians testified that seclusion of adults is necessary and unavoidable in certain emergency hospital settings, and physicians working in correctional facilities argued the same for adults in jails and prisons.

But representatives from the AMA Section Council on Psychiatry insisted that there should be a separate policy for juveniles, especially in correctional facilities. “The potential psychiatric consequences of prolonged seclusion include depression, anxiety, and psychosis,” said David Fassler, M.D., alternate delegate from the American Academy of Child and Adolescent Psychiatry. “Juveniles in particular are at risk for such consequences. We also know that the majority of suicides in juvenile correctional facilities occur when the person is isolated or in solitary confinement.”

Barry Wall, M.D., delegate from the American Academy of Psychiatry and the Law (pictured above), acknowledged that confinement policies for adults in correctional and other settings are far more complex and offered to work with the Medical Student Section on a separate resolution about adults at next year’s House of Delegates meeting. “If the resolution were to focus on juvenile detention facilities only, we would certainly oppose the use of solitary confinement because of the developmental vulnerability of juveniles.”

The fate of the resolution on solitary confinement will be determined today when the full House of Delegates meets. For more on this subject, see the Psychiatric News article, “Drastic Reform Urged for Solitary Confinement.”

(photo: Mark Moran, Psychiatric News)