Written evidence from Professor Hilary Marland, Director Centre for the History of Medicine, Department of History, University of Warwick (MHP0022)

Theme 7: Segregation/solitary confinement and appropriate use of restraint

Written Evidence submitted by Professor Hilary Marland, Director Centre for the History of Medicine, Department of History, University of Warwick and Co-Principal Investigator Wellcome Trust Investigator Award, ‘Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000’

http://www2.warwick.ac.uk/fac/arts/history/people/staff_index/hmarland/

• This submission provides evidence of the ways in which history can constructively inform policy and enhance debate on mental health in prison.
• It concludes that there has been an enduring relationship between segregation and solitary confinement and high rates of mental illness.

1. Examples are taken from work on our Wellcome Trust funded Senior Investigator Award, ‘Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000’. Our findings show that following the inception of the modern prison system in the mid-nineteenth century the relationship between mental illness and the prison was consistently highlighted and prisons recognised by many observers as institutions likely to produce or exacerbate mental illness: https://histprisonhealth.com/2016/02/03/prisoners-mental-illness/[1]

2. History enables us to connect contemporary debates on segregation with a long perspective on the impact of prison regimes. Additionally, it provides sources of evidence and narratives that highlight the devastating impact of solitary confinement on mental health over the last two hundred years.[2]

3. The roots of solitary confinement can be traced to the rise of the modern penitentiary in the 1840s, when the separate system of prison discipline was imported from the United States to England. It was at Pentonville ‘Model’ Prison in London that separate cellular confinement was introduced in its most extreme form in 1842.  This entailed the confinement of prisoners in their cells alone and in silence for 23 hours out of 24. Prisoners worked, ate and slept in their cells, and their curtailed movements outside the cell – to attend chapel and to take exercise – were rigorously controlled, communication between prisoners forbidden, and outside of their cells they were forced to wear masks or hoods to conceal their identity. Pentonville’s carefully selected prisoners were to be first offenders, in good health and aged between eighteen and thirty-five, fit and able to withstand the force of what was widely recognised to be a ‘testing’ regime and ‘experiment’.[3]

4. Almost without exception, critics of this new system of prison discipline highlighted the close relationship between solitary confinement and mental breakdown. Pentonville was sharply criticised by Charles Dickens, who declared the separate system as ‘cruel and wrong’, ‘this slow and daily tampering with the mysteries of the brain’.[4]  The London Times campaigned against Pentonville and predicted that ‘insanity’ would be a ‘probable’, even ‘inevitable’ outcome of the regime.[5]

5. The prison reformers who introduced the separate system that spread rapidly to other prisons throughout Britain, had an overriding faith in its ability to produce repentance and reform in the quiet of the cell, urged on by the ministrations of the prison chaplains. In practice the introduction of the separate system was marked by high incidences of mental breakdown amongst prisoners. Precise figures are hard to come by in prison regimes that aimed to mask the negative impact of separation, but in 1851 the eminent psychiatrist Dr Forbes Winslow claimed that – despite setting out to exclude mentally ‘weak’ prisoners – 14% of Pentonville’s inmates were suffering some form of mental illness, a figure far in access of that of the general population of around 2.5%.[6] 

6. Striking evidence of high levels of mental breakdown can be found in the journals kept by the institution’s chaplains and prison doctors. While Chaplain Kingsmill at Pentonville was initially a strong supporter of the separate system, within a few years of its introduction he was expressing doubts about the benefits of separate confinement. In February 1849 he described one prisoner as ‘excited, incoherent & strange in his manner. I am of opinion that his mind is likely to be injuriously affected by the discipline’.[7] While official prison reports played down the impact of separate confinement, Peter Laurie, President of Bethlem asylum, described Pentonville as a ‘disgrace’, and complained to the Times that forty prisoners had been sent from Pentonville to Bethlem by 1847: ‘are the public expected to believe that this fearful increase is not the direct result of the separate system’.[8]

7. While mounting concern led to the toning down of the separate system at Pentonville, where by 1853 the period of separate confinement had been reduced from 18 to 9 months, this system of prison discipline endured into the early twentieth century, driven by a desire for uniformity in prison administration and the ambition of making the prison system more deterrent.

Prison regimes continued to be blamed for high rates of mental illness by critical observers or by those working in prisons.

8. In 1894 Reverend William Morrison, chaplain at Wandsworth Prison, argued that the severe and highly deterrent regime operating in prisons by the 1890s was responsible for driving prisoners mad and for further debilitating others who were constitutionally weak. In an article published in The Fortnightly Review under the title ‘Are our Prisons a Failure?’ he asserted that rates of insanity in prisons had doubled between 1875-77 and 1890-92 as penal discipline became harsher, from 113 per 10,000 to 226 per 10,000 compared with 8 per 10,000 in the general population. He acknowledged that many prisoners might be mentally unstable when entering prison, but warned that ‘our discipline may punish them, may shatter their intellect, may drive them mad, but it will never deter them from pursuing a career of crime’. Recidivism, he suggested, might well be associated with this debilitating process, which made many men unfit to earn their daily bread.[9]

9. Prisoners’ writings provide additional and powerful testimony of the ravages of separate confinement and the impact of the separate system on their own mental health and that of other prisoners. During Susan Willis Fletcher’s twelve-month imprisonment in Westminster Prison, she described the full force of the prison’s conditions, the cold and damp, the poor diet and above all the solitude:

Each prisoner is locked in her solitary cell for twenty-three hours out of every twenty-four; which is in itself a very dreadful punishment bad for the health of the body, worse for the health of the mind – abnormal, inhuman, diseasing, demoralizing.[10]

Why the authorities ‘should leave a man alone with his thoughts for eight months I cannot possibly conceive’, reflected prisoner John Lee of his experiences at the start of his sentence in Pentonville in 1885. ‘I can think of nothing more calculated to drive a prisoner mad than eight months of solitude with nothing to think about but his own miseries, with no companion save despair’.[11] Prisoner W.B.N. commented that ‘the system of “separate confinement” is a very bad one’. Some prisoners ‘become little better than half-witted by the time their separate confinement is at an end’.[12] The prison cellular system kept each man ‘in his separate hell’, wrote another prisoner of his confinement in the early 1920s, as in place of the physical torture of days gone by, we find substituted ‘a peculiar form of mental torture… it is not difficult to understand how the minds of many prisoners become warped and contorted from the comparatively healthy state to the imbecile and dangerous’.[13]

10. In their landmark report on English prisons, produced in 1922 following their own experiences of incarceration as conscientious objectors, Stephen Hobhouse and A. Fenner Brockway underlined the ways in which the privations and shock of imprisonment, and the nervous strain it put on prisoners were likely to account for the high rates of insanity in the prison population. The punitive nature of prison regulations, and separate confinement and the rule of silence imposed in prison, was cruel, bad psychology, they concluded, and ‘very often affects the mental powers in a permanent way’. Hobhouse and Brockway suggested that suicides were most likely to occur during the early period of imprisonment when isolation and separate confinement were rigorously enforced. ‘Solitary confinement necessarily fosters the suicidal tendency by depriving the prisoner of the obvious safeguards inherent in useful activities and more particularly in healthy social intercourse.’[14]

11. Whether its imposition was driven by the ideals of early prison reformers or concern to enforce rigorous discipline, historical research reveals that separate confinement was repeatedly deemed responsible for causing mental illness or further deterioration amongst mentally ill people admitted to prison. While statistical information is limited, the testimonies of a range of observers (and only a small selection have been cited here) add significantly to the weight of evidence and force of argument on the destructive impact of isolation in the prison system.

February 2017

References