Leading doctors call on government to ban solitary confinement of children and young offenders

Leading doctors have called on the government to abolish the solitary confinement of children and young people in the youth justice system, warning that it can have a “profound” impact on their health.

Nearly 40 per cent of boys in British jails are estimated to have spent time in solitary confinement, which is defined under international human rights law as “the confinement of prisoners for 22 hours or more a day without meaningful human contact”.

In an unprecedented move, three major medical organisations have recommended that the practice should be abolished and prohibited, saying it leads to an increased risk of suicide and self-harm.

A joint statement by the British Medical Association (BMA), the Royal College of Psychiatrists and The Royal College of Paediatrics and Child Health said that there is an “unequivocal body of evidence on the profound impact solitary confinement can have on health and wellbeing”.

It reads: “Various studies indicate an increased risk of suicide or self-harm amongst those placed in solitary confinement. As children are still in the crucial stages of developing socially, psychologically and neurologically, there are serious risks of solitary confinement causing long-term psychiatric and developmental harm.”

The groups urged the government to take “immediate action” to ban the policy, adding that until solitary confinement is completely abolished, the youth secure estate must ensure that the health needs of those in solitary confinement are met.

It comes after a report by HM Inspectorate of Prisons in November found many 18-year-olds were being locked in their cells for nearly 24 hours a day, with increasingly poor access to showers and telephones.

This was often a result of widespread staff shortages and increasing levels of violence in institutions, with 40 per cent of inmates reporting that they felt unsafe.

The UN’s special rapporteur on torture has previously stated that “the imposition of solitary confinement, of any duration, on juveniles” contravenes UN rules.

The Ministry of Justice claims there was no such thing as solitary confinement in the prison system, and that “segregation” could be used as a last resort for limited periods of time when no other form of intervention is suitable.

BMA Medical Ethics Committee chair Dr John Chisholm said solitary confinement had “no place” in the youth secure estate and must be “immediately replaced” with alternatives that can better provide for young people’s health needs.

“Until this harmful practice is abolished, there is a duty for authorities to ensure the health needs of those being detained are met and doctors aren’t obstructed in their ethical duty to put their patient’s needs above others,” he said.

“Various studies suggest solitary confinement does little to improve a young person’s behaviour, makes it more difficult for them to reintegrate into communities and is counterproductive. What’s even more concerning is the increased risk of suicide and self-harm in those placed in solitary confinement.

“Doctors working in these institutions are acutely affected by the competing aims of the secure environment and healthcare, and it’s at the heart of the difficulties our members report to us when working in close proximity to solitary confinement.”

Dr Alison Steele, child protection officer for the Royal College of Paediatrics and Child Health (RCPCH), said solitary confinement could lead to underlying issues being left unaddressed, which she warned could have “devastating consequences”.

“Children and young people held in secure settings have three times the prevalence of mental health disorders compared to the general population, with depression and anxiety being the most common,” she added.

“A large number – over 50 per cent – also have learning disabilities. Therefore adults working in these settings must be sensitive to their needs.”

The Howard League for Penal Reform, one of the UK’s leading prison reform charities, which has long campaigned for an end to the practice, welcomed the statement, saying it was “time for change”.

Andrew Neilson, director of campaigns at the charity, said: “It is well established that prolonged solitary confinement can have an extremely damaging effect on adults’ health. The impact on children is even worse, and the problem is widespread.

“The Howard League legal advice line receives calls from prisons across the country, from children who are in almost total isolation. Last year, we went to the High Court to challenge the treatment of a boy who was locked in his cell for more than 22 hours a day, for more than 15 days at a stretch.

“England and Wales are out of step with a growing international consensus that children should never be placed in solitary confinement. It is time for change.”

A Ministry of Justice spokesperson said: “The safety and welfare of young people held in custody is one of our highest priorities.

“When young people in custody are putting themselves or others at risk, segregation can be used as a last resort for limited periods of time when no other form of intervention is suitable.

“We are recruiting more than 100 new frontline [young offenders institution staff] across the estate, to help support the rehabilitation of young offenders.”