Literature Review

Caring for prisoners with mental illness, especially among Black male offenders in

Louisiana, represents a leading difficulty for the criminal justice system. This review evaluates

the evidence by presenting findings about the widespread effects of solitary confinement on

mental illness connected through the extent to which solitary confinement causes anxiety and

depression and develops psychosis sel, self-harming behaviour and suicidal thoughts. The system

demonstrates multiple barriers to proper mental health care delivery in Louisiana prisons by

examining three levels of barriers: policies at the institution and personnel and broader societal

factors. The analysis contains significant sections that present an overview of Louisiana prison

mental health crises for potential reform solutions.

The Pervasive Impact of Solitary Confinement on Mental Health

The isolation practices of solitary confinement, along with reduced contact with others,

lead to disastrous health outcomes for the mind. Siennick et al. (2022) continue to prove that

solitary confinement directly causes the emergence of multiple severe mental illnesses. The

standard psychological results from solitary confinement are anxiety combined with depression

along with psychotic breakdowns that trigger fear-based delusions and despair. The removal of

social exchange with others and environmental stimulation affects typical brain functions, which

causes cognitive problems, prevents people from concentrating, and interferes with their ability

to remember things. Simes et al. (2022) note that the severe pressure created by imprisonment

isolation increases both existing mental illnesses and produces new mental health conditions.

Prisoners isolated in cells exhibit two of the most dangerous conditions, which are self-

injury and suicidal thoughts. The severe emotional distress from helplessness, along with

hopelessness, might drive inmates to destructive behaviors that help them survive. Psychological
indicators of solitary confinement become evident through the interview results of prisoners in

Louisiana prisons, as documented by Frischling (2021). These indicators include suicidal

thoughts and self-inflicted injuries. Frischling (2021) demonstrated through their work that the

situation requires interventions to resolve this fatal matter.

Brandt et al. (2022) showed how loneliness bothers mental health is something complex.

The study by Hennig-Thurau et al. (2023) also revealed that human beings require both social

interaction and social relationships by nature. When individuals undergo solitary confinement,

they lose their natural social connection, disrupting their connection with others and themselves.

The Bible says “The Spirit of the Lord GOD is upon me; because the LORD hath anointed me to

preach good tidings unto the meek; he hath sent me to bind up the brokenhearted, to proclaim

liberty to the captives, and the opening of the prison to them that are bound” (Isaiah 61:1, KJV),

which is a clear depiction of Gods view towards human bondage. Social detachment combined

with unproductive behavior causes damage to cognitive abilities together with emotional

instability.

Prison officials detect the destructive effects of seclusion throughout the entire period of

incarceration. Following time spent in isolation, many inmates face enduring mental disorders

which affect their ability to rejoin society find work, and maintain personal relationships

(Western, 2021). The experience of isolation creates lasting damage, especially due to the

traumatic impact, which makes criminals more likely to repeat offenses, thus returning to the

criminal justice system. Shalev and Dagan (2024) focus on assessing solitary confinement's

immediate and long-term impacts to detect effective strategies for eliminating negative effects.

Systemic Barriers to Mental Health Care in Louisiana Prisons

face endless obstacles which block their access to proper treatment. The problem worsens due to

rules and regulations that function as major hindrances. Wardrop et al. (2021) state that prison

mental health treatment faces resource limitations through its configuration. People with less

devastating but disabling mental disorders will receive no mental health treatment because of

strict treatment qualification standards. Security measures, along with punishing tactics, combine

to generate unfavorable mental health conditions.

At the personnel level, barriers exist to access necessary medical services. Wennerstrom

et al. (2022) suggest that insufficient numbers of mental health specialists, such as psychiatrists,

psychologists, and counselors, create dangerous conditions that result in inadequate treatment in

prisons throughout Louisiana. The existing staff members often experience excessive workloads,

and patients must wait long while receiving minimal individual support. The insufficient mental

health training received by correctional officers creates misinterpretations of symptoms, which

results in improper responses to mental health crises.

Social barriers create challenges through the prejudiced views that exist against mental

illnesses. Patients avoid getting assistance even when therapy options exist because of the

stigma. McKendy and Ricciardelli (2021) note that prison subculture within its culture base

applies judgments that prioritize punishment over treatment programs. The triple threat of

criminalization combined with race and poverty causes enormous complexity to this issue

because these groups suffer most from mental illness yet lack access to treatment. Moreover, the

multidimensional characteristics of such barriers prevent the necessary evolution of policies and

staff practices and wider societal modifications, as McKendy and Ricciardelli (2021) explain.

The information from Louisiana is detailed by Cloud et al. (2023) to show how these barriers
operate in the mental health treatment of prison inmates. Atkinson (2022) note that the correction

of these system defects stands essential for Louisiana prisoners to achieve proper mental health

services.

The Inadequacy of Mental Health Screening and Assessment in Prisons

Prison mental health treatment needs effective screening and assessment procedures,

which should occur at the proper times to succeed. Galletta et al. (2021) suggest that the

identification of candidates for additional assessment starts at the screening stage, which

functions as a base. These activities continuously face the risk of being abolished. Most of the

prevalent mental health evaluation tools prevent effective assessment of all psychiatric disorders

existing in prison institutions, thus resulting in symptom detection deficiencies. The large

number of inmates requiring screening, as well as rushed procedures, contributes to missing

latent mental illnesses during screenings.

The selected individuals receive an added evaluation, but the quality assessment during

these procedures can be distorted. Young and Pearlman (2022) note that minimal funding and

inadequate veteran mental health worker numbers result in examinations that may be rushed or

insufficient. A heightened reliance on self-reported symptoms represents a problem for

professionals because inmates would potentially conceal symptoms intentionally in their

statements due to the unique prison setting that fosters fear of disclosure. Additionally, it is

particularly worrisome that racial inequalities, together with gender or other inequalities, exist in

mental health assessment accessibility. Cloud et al. (2023) show that implicit bias influences the

clinical approach and treatment plans of medical professionals, which leads to errors in

diagnosing mental illness among certain groups. Misra et al. (2022) show that black males

typically receive psychotic disorder diagnoses, whereas depression along with anxiety usually
leads to diagnoses among females. Studies need to be conducted to fully understand how

population disparities affect the prison system of Louisiana.

The absence of screening procedures and assessment methods results in broad-ranging

negative effects. Failed mental illness treatment leads to progressively worse symptoms, together

with self-endangering conduct and suicide attempts, while making it impossible for inmates to

handle daily prison realities. Stein et al. (2022) note that when mental illness receives incorrect

diagnoses, it results in the delivery of ineffective treatments and improper treatment methods that

make the mental condition more severe. Prisoners who lack mental illness treatment experience

disciplinary issues at prison as well as increased chances of returning to jail and facing

challenges when reintegrating into society (Testoni et al., 2021). Prison mental health protocols

should become stricter to enable proper care delivery to incarcerated individuals.

The Relationship Between Solitary Confinement and Self-Harm/Suicide

Self-injury and acts of suicide among inmates are most closely associated with the

prolonged isolation practice known as solitary confinement. Western (2021) suggests that social

isolation during intense sensory deprivation creates optimal conditions where extreme

psychological pain develops in individuals in solitary confinement. People who experience this

practice consistently express feelings of intense loneliness, together with detachment and lack of

purpose. Massive desperation develops, leaving the subject unable to picture better prospects and

believing in trapping in present conditions. Despair follows as a result, which means complete

hopelessness and total helplessness. Moreover, the findings published in Cloud et al. (2023)

show that solitary confinement in Louisiana prisons produces the desired outcome even with

present circumstances. The interviewed prisoners showed various emotions from solitary

confinement, which led to feelings of complete worthlessness and abandonment and a total loss
of personal control over their existence. When people encounter such experiences, their inner

sense of value shrinks until they develop a circular pattern of negative emotions.

The main reason behind self-injury during solitary confinement arises from emotional

dysregulation, which represents a person's inability to experience and manage emotions. Tadros

et al. (2023) state that standard emotional processing becomes impaired when people experience

social isolation and inactivity, so they lose the ability to manage their emotions properly.

Emotional sensitivity escalates while impulsive behavior grows then prisoners become more

prone to turn toward damaging coping methods because hopeless feelings develop.

The pathways from isolation leading to suicide and self-injury consist of numerous

difficult psychological mechanisms. Hopelessness combined with despair while dealing with

emotions results in dangerous behavior which damages the self. A few individuals employ self-

injury to eliminate briefly the terrible emotional pain they endure or exercise control over

feelings when their world seems empty. However, Magnuson et al. (2024) highlight that the

practice of suicide enables certain inmates to escape from the dehumanizing conditions of

isolation. Research into these paths should proceed to develop appropriate intervention methods

that protect inmates from suicidal actions and self-damage.

The Ethical and Legal Implications of Solitary Confinement for Mentally Ill Prisoners

The practice of solitary confinement constitutes a major ethical and legal issue when

applied to inmates who suffer from mental illnesses. The international framework for human

rights progressively acknowledges the innate abuses in solitary confinement as well as the

discriminatory effects upon inmates with mental illnesses. United Nations Nelson Mandela Rules

(2016) mention solitary confinement has no place when applied against someone for a period

longer than fifteen consecutive days while forbidding its application for inmates with mental
disorders. Under the rules, every person has the human right to respect and dignity, while

authorities bear specific responsibilities to preserve prisoners' mental health.

The Eighth Amendment within the United States Constitution mentions prohibitions

against cruel and unusual punishment making it possible to use it as a legal challenge against

solitary confinement practices. Gordon (2021) explains that constitutional safeguards face

diverse understanding which makes legal defenders experience significant challenges hurdles in

their attempts. Courts normally hesitate to review administrative decisions at prisons because

they recognize that prison officials carry more expertise in these matters. Despite these

outcomes, courts established that lengthy solitary confinement practices and their adverse impact

on individuals with mental health needs are both unconstitutional.

The ethical duties of mental health professionals and corrections administrators are

directly threatened by this situation. Johnston and Ricciardelli (2021) note that all prisoners,

including those who are mentally ill, need to be cared for under the responsibility of corrections

administrators to protect their security and wellbeing. Chakofsky-Lewy (2020) stated that

executive agencies should strictly control solitary confinement usage as a form of punishment,

specifically against arrested individuals who have mental illness. The professional work

environment of prisons creates an extreme ethical challenge for mental health providers (Testoni

et al., 2021). Mental health providers have an ethical responsibility to fulfil their representative

duties for their patients' healthcare decisions while maintaining a possible exclusion from

security prison protocols. The usage of solitary confinement stands against patients' healing

process and may lead to worsening their mental illness symptoms.

Detailed legal and moral proof demonstrates that prisoners with mental instability should

not be isolated. This unethical practice violates fundamental human rights and violates
international standards and sometimes qualifies as cruel and dehumanizing mistreatment. To

solve this issue, the community must join forces with penal policy reform initiatives and

improved supervision alongside responsible mental health specialists and prison personnel who

will defend every inmate's legal and ethical rights.

Alternatives to Solitary Confinement

Extensive criticism exists about solitary confinement because it creates serious mental

problems, mainly among those who are mentally ill. According to the bible, correction should be

done in gentle way, and not trough harsh punishment. It says: 'Brothers and sisters, if someone is

caught in a sin, you who live by the Spirit should restore that person gently. But watch

yourselves, or you also may be tempted.' (Galatians 6:1, NIV). Brenig et al. (2023) note that de-

escalation techniques managed by correctional officers who have received training alongside

experienced mental health counselors help control violent situations and stop such incidents from

growing into disruptive behavior. Active listening, empathy, and communication methods in de-

escalation techniques help professionals determine the nature of behavioral issues while building

a constructive resolution. When solutions and communication are properly focused, de-escalation

effectively stops conflicts through peaceful means without requiring disciplinary enforcement.

Treatment through cognitive behavioral treatment (CBT) along with dialectical behavior

treatment (DBT) provides inmates with skills enabling better emotional self-control and

behavioral management while teaching healthy coping methods. The individual can understand

harmful thinking patterns, develop a skill set to bypass destructive thinking patterns and achieve

healthier stress responses using CBT. Verona et al. (2024) state that working through DBT helps

patients develop improved emotional and social abilities, resulting in stronger interpersonal

relationships and impulsive temptations. Additionally, positive reinforcement programs

approach to creating change. Rewards used throughout these programs include privileges

together with educational and vocational training, as well as social interaction. These programs

use constructive reinforcement to establish a healing setting which promotes better conduct.

The article written by Motillon-Toudic et al. (2022) demonstrates how solitary

confinement directly opposes both rehabilitation needs and social reintegration requirements.

The authors support strategies that strengthen social behavior and mental wellbeing. The reform

measures described by Mears et al (2021) at state levels work to decrease solitary confinement

through new methods of behavioral control. Their study revealed that states investing in

rehabilitation programs have experienced positive outcomes marked by reduced prison

disciplinary actions and better prison mental health conditions among inmates. Evidence-based

alternatives help create safer and more humane prison environments thatting rehabilitation and

ander recidivism outcomes.

Comparative Analysis of Solitary Confinement Policies Across States: A Literature Review

The divergence of state-by-state solitary confinement policies presents learning

opportunities for achieving better institutional reforms. The restrictions which Louisiana

regulates for solitary confinement have encountered broad-scale criticism because of their

excessive nature. According to Cloud et al. (2023) human rights groups alongside various legal

proceedings have denounced Louisiana's prolonged isolation system that makes prisoner

psychological health deteriorate to worse conditions. Several states implemented major reforms

which both minimize the abuse of solitary confinement cells and enhance mental healthcare for

incarcerated people. Additionally, Karplus (2023) stated that Colorado advanced solitary

confinement reform through the 2014 bill, which restricted segregation for prisoners diagnosed
with serious mental illness. This bill gained support from then-Governor John Hickenlooper. The

purpose of the prison reform was to address both prisoner psychological health deterioration in

solitary cells and rehabilitating approaches. Karplus (2023) suggested that New York passed the

HALT Solitary Confinement Act, which enforces extended solitary confinement to only 15

consecutive days, followed by an obligatory mental health service requirement.

The solitary confinement policies have improved in New Jersey, California, and

Louisiana. Rowe et al. (2023) state that the California reform restricts prisoner isolation periods

and expands their access to mental health support services. New Jersey passed legislation that

controlled solitary confinement use while making conditions better for prisoners subjected to

isolation (Chmiel, 2021). When examining the multiple decentralization strategies, receive

successful practices and experiences from states that achieved reform. This analysis allows for

effective solutions for solitary confinement policy reforms that support prisoners' mental health

while keeping them healthy.

The Role of Race and Ethnicity in Mental Health Disparities within Prisons

The blend of race and ethnicity strongly affects mental illness management in the

criminal justice framework which leads to systematic discrimination through scarce access and

unfavorable results together with harmful forms of punishment like solitary confinement. Shim

(2021) demonstrates that racial and ethnic minorities encounter serious mental health problems

while within the criminal justice system. The high number of people of color, especially Black

prisoners, inside prisons intensifies existing disparities. Canada et al. (2022) recently established

that prisoners of Black and Latinx backgrounds receive fewer diagnoses of mental illness as well

as ineffective treatments compared to their white counterparts.

individuals who are imprisoned. Schouler-Ocak et al. (2021) note that the institution of racial

bias, together with institutional racism, acts as a major reason for missing and inadequate mental

illness diagnosis and treatment in minority prison populations. Eno Louden et al. (2023) suggest

that prison facility mental illness screening tools consistently miss Black and Latinx diagnoses

for such disorders as they demonstrate limited capability to properly identify these patients even

though these individuals have lower rates of detection and referral. Stigma related to mental

illness exists within minority groups, and because of this, members avoid seeking treatment.

Mental health suffers from the way individuals perceive their racial identity. Zajdel et al.

(2024) have shown that prisoners with Latino racial identity perceptions experience better mental

health outcomes during their prison time than those who identify as White due to racial identity

factors. The measurements of race and ethnicity by social systems in prisons strongly influence

how prisoners experience mental health during their incarceration. Moreover, Vinson and Dennis

(2021) highlighted that Ministry of Justice policies and mental healthcare service delivery

mechanisms should specifically address the unique requirements of minority inmates.

Understanding how race and ethnicity create mental health inequalities permits authorities to

develop customized solutions that will enhance mental healthcare delivery for every prisoner,

thereby decreasing cognitive health problems across the criminal justice system.
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