Background

Solitary confinement is defined as the placement of an incarcerated individual in a locked room or cell with minimal or no contact with people other than staff of the correctional facility. It is a form of discipline or punishment. The potential psychiatric consequences of prolonged solitary confinement are well recognized and include depression, anxiety, and psychosis. Due to their developmental vulnerability, juvenile offenders are at particular risk of such adverse reactions.

There are multiple other terms used for similar practices, including “restrictive housing” which can apply to a wide range of housing practices including but not limited to solitary confinement. “Isolation” or “segregation” are other means by which youth are kept separate from others in terms of housing, services, and activities such as “medical isolation” to limit spread of disease and “disciplinary segregation” after an aggressive incident. Other terms that should be distinguished from brief interventions include “time out,” which is a brief intervention used as a component of a behavioral treatment program and “seclusion”, which is a short-term emergency procedure.

Several national organizations have released statements opposing solitary confinement including the United Nations, the National Commission on Correctional Health Care, the American Medical Association and the American Psychiatric Association.

To protect incarcerated youth from potential psychiatric consequences of prolonged solitary confinement, the American Academy of Child and Adolescent Psychiatry:

• Opposes the use of solitary confinement of juveniles for disciplinary purposes in correctional facilities;
• Supports legislative efforts to limit or prohibit solitary confinement of juveniles in correctional facilities, and encourages strict enforcement of existing laws pertaining to limiting or prohibiting solitary confinement of juveniles;
• Recommends the implementation of measures to avoid confinement of juveniles, including interventions such as appropriate behavioral plans;
• Recommends that correctional facilities have procedures in place to continuously evaluate the mental health of youth in solitary confinement and procedures to mitigate the negative mental health impact; and
• Recommends that any youth that is confined for more than 24 hours be evaluated by a mental health professional.

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The American Academy of Child and Adolescent Psychiatry promotes the healthy development of children, adolescents, and families through advocacy, education, and research. Child and adolescent psychiatrists are the leading physician authority on children’s mental health.

Approved by Council April 2025