Center on Sentencing and Corrections

Locked Up and Locked Down

Segregation of Inmates with Mental Illness

Locked Up and Locked Down

Guy, Anna. Locked Up and Locked Down: Segregation of Inmates with Mental Illness. Amplifying Voices of Inmates with Disabilities (AVID) Prison Project, September 8, 2016.


“Between 80,000 to 100,000 inmates are currently placed in small single person cells for 22 to 24 hours per day, for days, if not months or years at a time. Notably, many of those housed in segregation found their way there due to behaviors associated with a mental illness, or they developed symptoms of mental illness due to their prolonged isolation. Many inmates with mental illness are not only locked up and serving a sentence, they are disproportionately locked down in segregation, where they remain isolated in their cells and experience severely restricted access to programs and activities, including mental health treatment.”

“In recent years, protection and advocacy agencies (P&As), organizations granted with the special federal authority to enter facilities that serve people with disabilities, have been going to the most segregated areas of prisons to identify issues facing people with disabilities. P&As have received countless reports of abuse and neglect of inmates in segregation, including prolonged isolation, deplorable conditions, inadequate care, increased self-harm and suicide attempts, and even death.”

“In September 2014, AVID brought together staff from the P&As in New York, South Carolina, Arizona, Colorado, Louisiana, and Texas, as well as from the National Disability Rights Network, to strategize about ways to increase national attention on the issues faced by inmates with disabilities.”

“This report, which has grown out of that collaborative national effort, examines issues related to the segregation of inmates with mental illness in our state prison systems, including the harmful effects of prolonged isolation on that population, the excessive use of force that often precedes or accompanies placement in segregation, and the restricted access to programs and services in segregation. P&As from across the country provided examples of either past or ongoing advocacy, demonstrating the crucial role that P&As have played in fighting against the excessive use of segregation of people with mental illness in our nation’s prisons. This advocacy is multi-modal, ranging from routine monitoring, to informal and individual advocacy, to systemic litigation.”

“This report begins with a brief overview of the P&A system, explains the different types of advocacy P&As use, describes the effect of segregation on people with mental illness, and outlines legal protections related to segregation of inmates with mental illness. Next, this report details the work P&As across the country have done to advance the rights of inmates with mental illness in segregation, dividing the advocacy into non-litigation and litigation strategies. Finally, the report concludes with a number of federal and state recommendations to build on the momentum gained by the P&As and their partners.”


Click here to view the report, as well as access extensive original interviews with inmates with mental illness and corrections experts.


Keywords: mental health and solitary confinement, disability rights, litigation, lawsuits, advocacy, effects of segregation on mental health