Disciplinary infractions and restricted housing
Misbehavior occurs within jails and prisons. It is generally handled by a formal disciplinary process. Symptoms and impairments associated with mental illness may play a role in such misbehaviour. One of the many concerns in correctional settings is the use of restricted housing units. Segregation units function as the prison within a prison. Designed for the dangerous and violent offender who cannot be managed safely within the general prison environment, segregation is characterized by single-cell confinement, with minimum time out of cell for showers and exercise (e.g., 5 hours per week). Other features include highly restricted movement, limited contact with others, and few privileges and services. Segregation has been criticized as an inhumane practice due to the degree of social isolation. Specifically, the lack of treatment, programs, and activities to engage the mind; restricted personal contact; lack of control over light and sound; lack of windows; and little or no access to the outdoors are considered to be more extreme than is required for the safe operation of prisons. The most significant issue is whether prisoners are able to psychologically adapt to the austere conditions for long periods, particularly those with mental illness. Because mentally ill inmates may be more prone to rule infractions due to manifestation of their illness, they are more likely to be segregated unless specific rules prohibit their placement. This chapter reviews segregation practices, the data on the potential impact of segregated housing on mental illness, and the role of psychiatry in the disciplinary process.