- Local, state and federal authorities should ensure that prisons and jails provide adequate physical and mental health care services for inmates, free of charge.
- Health care should accord with professionally recognized standards for services to women and be subject to periodic, external review.
- The federal government should establish an inquiry into mental health services for women in jails and prisons. One element of the study should be the use of psychotropic medication.
- People suffering severe mental illness should be placed and treated in mental health institutions, not in jails and prisons.
WOMEN IN HIGH SECURITY UNITS (SUPERMAX)
In the past few years, many US states have built "super-maximum security" (supermax) facilities designed to house prisoners in long-term isolation in particularly restrictive conditions.(29) Prisoners in these units may be confined for nearly 24 hours a day in sealed, sometimes windowless cells with solid doors, with no work, training or other programs. The facilities are designed to minimize contact between staff and inmates, and prisoners are often subjected to regimes of extreme social isolation and reduced sensory stimulation. The length of time inmates are assigned to such facilities varies, but some prisoners spend years, or even their whole sentence, in isolation.
The large majority of prisoners in supermax units are men. However, several states have similar facilities for women prisoners. As well as harsh physical conditions, the operation of some high security units for women violates standards on privacy and human dignity, as the women are able to be observed at all times by male guards. The isolated nature of these units can increase opportunities for abuse.
Amnesty International believes that conditions in many US supermax facilities violate international standards for the humane treatment of prisoners and exceed what is necessary for security purposes. Studies have shown that prolonged isolation in conditions of reduced sensory stimulation can cause significant mental and physical damage. Both the UN Human Rights Committee and the Special Rapporteur on Torture have expressed concern about conditions in such facilities.(30)
The US authorities have defended the use of supermax facilities as being necessary to control extremely violent or disruptive prisoners. However, many inmates assigned to high security units do not appear to fit these criteria, or to warrant such an extremely punitive environment. For example, some prisoners have been sent to such units for repeated minor rule violations. In many states, mentally ill or disturbed prisoners are held in supermax units, despite evidence that the conditions are likely to exacerbate their illness. According to prison experts, mentally ill prisoners are often more likely than other inmates to end up in such units because of behavioural problems and because prisons lack adequate mental health treatment programs. Women prisoners, especially, rarely fit the criteria commonly given by the authorities as justifying their incarceration in such units (a history of prison gang related activities, escapes or violent assaults).
Although few studies have been undertaken of women in supermax facilities, the evidence in some states bears out the above concerns. A 1996 survey of 14 women held in a special unit in Colorado State Penitentiary (CSP), an otherwise all-male facility, found that 11 of the women were serving sentences for minor, non-violent felonies such as theft, forgery and substance abuse.(31) Many of them had been sent to CSP for relatively minor disciplinary infractions and some were mentally ill. Yet their conditions were extremely punitive and included 23 hour cell confinement, with solitary exercise taken in a small cell equipped, like the men's units, with only a chin-up bar bolted to the wall. No outdoor exercise was provided. The shower unit had glass windows and exposed the women to the view of the predominantly male guards.(32)