Supermax: Hell on earth or . . . not as bad as we thought?

I thought everyone knew that being locked up alone in a tiny cell -- sometimes for years at a stretch -- is bad for one's psyche.

But I was wrong. Based on a one-year project with the Colorado Department of Corrections, a group of researchers says there is a dearth of evidence to support the popular notion that solitary confinement exacerbates psychiatric symptoms among mentally ill prisoners. Although the prisoners they studied did manifest problems, these were preexisting and so could not be attributed to the effects of administrative segregation confinement, the researchers contend.

I was dubious when I heard the researchers present their study, "One-Year Longitudinal Study of the Psychological Effects of Administrative Segregation," at the APA's annual convention last year. Having worked in a Segregated Housing Unit ("SHU") for mentally ill prisoners, I saw with my own eyes the rapid and profound mental deterioration of mentally ill prisoners assigned to the SHU.

Even prisoners who had no preexisting mental disorders fell apart when subjected to prolonged isolation. I will never forget one youngster, a first-timer incarcerated for violating probation in a minor stolen property case, who was sent to the SHU for protection after he reported being raped by his cellmate. They ended up taking him out on a stretcher following a serious suicide attempt. The last time I saw him, when I visited him on the medical ward of a maximum-security prison, he was completely changed from the happy-go-lucky kid I had known.

But he started out healthy. Maybe, contrary to popular wisdom, the mentally ill -- at least those in Colorado -- have more robust psyches than everyone else. Or maybe they are asocial or masochistic. Anyway, I'm just telling you my own personal anecdotes. That's not science.

Study under fire

The report just came out, and already it is generating a lot of heat from those who fear it will be used to legitimize continued warehousing of mentally ill prisoners in SHU's. The ACLU has issued a statement pointing out that the Colorado findings contradict a sizeable body of research, not to mention common sense.

Two leading experts on prison conditions, psychiatrists Terry Kupers and Stuart Grassian, are publicly assailing the study as fatally flawed. They criticize the researchers for not conducting interviews with the prisoners who were the subjects of the year-long study.

"The methodology of the study is so deeply flawed that I would consider the conclusions almost entirely erroneous," said Kupers, author of Prison Madness: The Mental Health Crisis Behind Bars. "And far from finding 'no harm,' there were many episodes of psychosis and suicidal behavior during the course of the study -- the researchers merely minimize the emotional pain and suffering because they judge the prisoners to have been already damaged before they arrived at supermax."

Grassian, the former Harvard professor who coined the term segregation psychosis and who has done research with hundreds of prisoners in solitary confinement, said he notified the researchers of several severe methodological flaws, including a failure to analyze contradictory data, but the flaws were not addressed.

Grassian said the prison's own records document almost two incidents of suicidal or self-destructive behavior for every three prisoners in solitary confinement (63%), compared with less than one incident for every ten prisoners (9%) in the general population.

Since the supermax craze took off in the early 1990s, almost every U.S. state has signed on to the dubious concept, and an estimated 25,000 American prisoners are now locked 24/7 in these tiny, antiseptic cubicles. Although SHU housing was originally intended for relatively short terms of confinement, nowadays prisoners may remain in these constantly lit and electronically surveilled sensory deprivation holes for years -- or even decades. A federal court recently agreed to hear a challenge brought by a man named Tommy Silverstein who has spent a whopping 27 years in solitary confinement.

If they had just talked with the prisoners …

While the Colorado correctional researchers were busy tabulating survey data instead of talking with the prisoners themselves about their subjective experiences, a graduate student at the University of California at Berkeley took the exact opposite approach, and -- not surprisingly -- came to diametrically opposed conclusions.

Keramet Reiter's series of in-depth interviews with former SHU prisoners in California, far and away the world's leader with about 3,330 SHU prisoners, was part of her research into the rise of supermaximum confinement in America.

The settings that the men chose was telling in and of itself: After years in tiny, concrete-filled boxes, almost all asked to meet her either outdoors of close to a window.

Reiter told UC reporter Cathy Cockrell that she was moved by the former prisoners' tragic accounts of the effects of sensory deprivation.

"People spoke of having no clocks, daylight, or seasons to mark the passage of time; growing pale from lack of sunlight; and being amazed at the sight of a single bird, insect, or even the moon, after months or years of virtually no exposure to the natural world."

But, hey, maybe if they had been mentally ill to start with, they wouldn't have minded ad-seg so much. Just a serene vacation, away from the hubbub and stress of general population housing.

Not a vacation I would ever want to take but, hey, that's just me.

Further readings:

• Keramet Reiter: Parole, snitch or die: California’s supermax prisons and prisoners, 1987-2007, July 7, 2010

• Atul Gawande, New Yorker magazine: Hellhole: The United States holds tens of thousands of inmates in long-term solitary confinement. Is this torture? March 30, 2009

• National Public Radio series: "Life in Solitary Confinement"

• Solitary Watch: On Bradley Manning, Solitary Confinement, and Selective Outrage, by Jean Casella and James Ridgeway, Jan. 2, 2011

Drawings: (1) Prisoner sketch by Herman Wallace, Louisiana State Penitentiary, Angola; (2) prisoner sketch, Pelican Bay, California; (3) prisoner sketch, Tommy Silverstein, ADX federal supermax, Florence, Colorado; (4) prisoner sketch, Pelican Bay, California; (5) my (comparatively crude) sketch of a suicidal prisoner whom I observed chained to the floor of a bare concrete "protective" cell.

My Psychology Today post, at my blog Witness, is HERE. For more frequent posts by me on this and other topics, subscribe to my Twitter feed, HERE.

Another Texan joins growing club of exonerees

30 years in prison for rape he did not commit

He could have been free six years ago. But he could not get past even the first of the sex offender treatment program's "four R’s" -- Recognition, Remorse, Restitution and Resolution.

Instead, Cornelius Dupree Jr. continued to stubbornly insist he was innocent of the robbery and rape for which he went to prison 30 years ago.

Today, Dupree finally won back his good name, becoming the latest in a flood of exonerated convicts in Dallas, Texas. District Attorney Craig Watkins, the first African American elected prosecutor of any county in the state, actively supports innocence projects. Like Dupree, the majority of the exonerated men are African American and were convicted of sexual assaults.

By local tradition, many of the other exonerated men attended Dupree's court hearing on Tuesday. Many said they too had been convicted based on eyewitness misidentification, the most common cause of wrongful convictions.

The moral: Do not assume that someone who has been convicted of a crime is lying, just because he or she is denying guilt. Every once in a while, it's true.

An Associated Press article with more case details is HERE.
The Dallas Morning News has an excellent series on the DNA exonerations, HERE.

Prison therapy: It's all in the name

Look at the above picture. What do you see? You should see a monkey in a cage. (More precisely, a capuchin monkey rescued from a laboratory.)


Now look at the second picture. If you again see a cage (or two), your eyes are playing tricks on you. These are not cages. They are "therapeutic modules." It's the California prison system's response to a judicial mandate to provide treatment to mentally ill prisoners.

Using the correct term is important, according to a psychiatric expert quoted by Jack Dolan in today's Los Angeles Times: "If you call them cages, people inside might feel like animals and respond accordingly."

Pictured here is music therapist Daniel Tennenbaum, wearing a flak vest as he strums a sing-along rendition of Otis Redding's "Sitting on the Dock of the Bay":

... I had nothin to live for
And look like nothing's gonna come my way ...
Look like nothing's gonna change
Everything still remains the same ...

I'm just sitting on the dock of the bay
Wasting time

One wonders whether the "therapeutic module" euphemism is truly for the benefit of the prisoners, or more for the psychologists providing window dressing, who want to think that therapeutic healing is possible under such cruel and inhumane conditions.

And if mere renaming can alter reality, then Mina over at Psydoctor8 has a better idea. We could refer to the prisons as "Hawaii." Then, the prisoners might feel like hula dancers instead of caged animals.

Best wishes for the holidays

As you may have noticed, I am taking a holiday break from blogging. Until my return, I want to wish all of you -- and especially my loyal subscribers -- a wonderful holiday season and a new year of peace and happiness.

Juvenile In Justice: An online gallery

Art professor Richard Ross is traveling the United States and photographing juvenile institutions. The project, Juvenile In Justice, is partially funded by the Guggenheim Foundation and the Annie E. Casey Foundation and will be published next year. The 196 photos in the online gallery are well worth checking out. While you are there, visit his related collection, Architecture of Authority. Stunning stuff.

From the top: Los Angeles, California; Cook County, Illinois; Biloxi, Mississippi

Blogger challenges my post on sex offender risk assessment

My report on a promising new method for assessing sex offender recidivism risk prompted a reaction from Robin Wilson over at a new blog by the publishers of Sexual Abuse, the journal of the Association for the Treatment of Sexual Abusers (ATSA).

My interest dissolved into disappointment when I realized that the response sidestepped substantive discussion of the new research, a collaborative project by scholars in the United States, New Zealand, and Australia finding that accuracy of risk prediction can be enhanced by using age-stratified tables.

Instead of engaging with the scientific merits of this study, Dr. Wilson focused on the Static-99 actuarial tool, chastising me for being overly critical of that approach:

Dr. Franklin has something of a penchant for the flamboyant. Actually, I often appreciate a bit of bluster, but I think we also need to avoid bias and unnecessary sideswipes at our colleagues. In the spirit of honesty, let me say that I work in a civil commitment center and that I am a certified trainer for the Static-99 group of measures. So, my potential bias is on the table.

Is having an opinion a form of bias?

The term bias refers to a partiality that interferes with the ability to be fair or objective. Expressing a point of view does not make one biased. Rather, the articulation of informed opinion advances professional practice. Indeed, such "expert opinion" is precisely what courts seek from forensic psychologists when they solicit our testimony. An expert witness is expected to have a firm grounding in the applicable science, and to be able to critically analyze its strengths and weaknesses as it applies to a specific issue or case.

It is that process of reflection -- invoking complementary theoretical perspectives from criminology, sociology, anthropology and international studies relevant to forensic psychology -- that germinates many an idea for this blog. I welcome critical engagement with these ideas, but hope that interlocutors can themselves refrain from diversionary ad hominem arguments.

Why pick on the Static-99?

Dr. Wilson's main theme is that I am unduly critical of the Static-99 and its developers.

The Static-99 website promotes the tool as "the most widely used sex offender risk assessment instrument in the world." As Dr. Wilson himself notes in another publication, its "prolific use in sexual offender civil commitment proceedings" is one reason it generates so much debate.

But Dr. Wilson is correct in pointing out that many of the Static-99's flaws apply equally to its cousins. In referencing the Static-99, I in no way intend to exempt other actuarials from critique. Indeed, in previous posts I have discussed problems with the MnSOST-R and have reported the results of studies on the relative accuracy of the Static-2002, Risk Matrix 2000, RRASOR and other actuarial tools.

Dr. Wilson makes an essential point in defense of the Static-99. By encouraging us to anchor our risk estimates in empirical data, he reminds us, actuarials serve as a counterbalance against clinicians' inherent tendency to vastly overestimate sex offender risk:

Maybe, what Dr. Franklin should be highlighting more is the fact that some evaluators are falling prey to partisan concerns. A well done sex offender risk assessment [using an actuarial instrument] should say the same thing, regardless of who you are working for.

In principle, Dr. Wilson is entirely correct. Sadly, from my vantage point as a forensic psychologist working in the courtroom trenches, I see endemic partisan allegiance in this arena. The Static-99 is being systematically deployed to provide a scientific veneer for highly questionable practices in the service of civil commitment.

The problem is not just a handful of rogue evaluators. The latest permutation of the Static-99 fosters such misuse. I am referring to the developers' advice to assign sex offenders to one of four categories with different levels of actuarial risk. As I pointed out in a previous post, this procedure introduces a large element of clinical judgment into a procedure whose very existence is predicated on doing away with such subjectivity. In the polarized Sexually Violent Predator arena, evaluators now have an easy way to elevate their estimate of an offender's risk by comparing the individual to the highest-risk group rather than to the lower recidivism figures for sex offenders overall. This practice reflects a tautology, or logical fallacy. In a civil commitment proceeding the evaluator essentially says: "This offender is high risk. Just look at the recidivism rates for offenders in the high-risk group to which I have assigned him."

The Static-99 developers may be quite well intentioned, as Dr. Wilson says. But subjective intent is far less important than real-life effects. The road to Hell, as they say, is paved with good intentions. I will not be alone in cheering when I hear that the Static-99 developers have stepped up and publicly condemned the systematic misuse of their instruments in courthouses all across the United States.

If Dr. Wilson's point was to chastise me for the use of the term reliability where I meant to say accuracy, I stand corrected. (I have made the correction to the original post.) However, I make no apologies for expressing an informed viewpoint and, indeed, I unflinchingly embrace such a role as part of my professional obligation. The goal of my blog is not to convince people that I have all the answers. Rather, I am happy if I encourage critical reflection and stimulate people to read the original source material. In so doing, I hope I am doing my part to advance science and combat bias.

The award-winning Texas blog Grits for Breakfast has a more favorable reaction, with links to additional topics of interest.