Second paragraph reads: "Bull, a former amphetamine addict, had been given the wrong "psych medication", an antidepressant called Luvox, and was unbalanced. When he was put in solitary, he set fire to the cell.,20867,20270071-28737,00.html

Jailed in body and mind

Mentally ill prisoners are routinely locked in isolation, writes Elisabeth Wynhausen

August 28, 2006

Dragged away: Tony Bull says he was in solitary confinement at Hobart's Risdon Prison for 40 days. Picture: Manabu Kondo

TONY Bull has lost count of the number of times he went to prison. What he hasn't forgotten is the times he was locked up in solitary confinement in Hobart's Risdon Prison. On one occasion following what he calls a set-to with an officer, Bull barricaded himself in his cell. He was gassed and dragged away. "I got put in solitary in Division 8 for 40 days," he says.

Bull, a former amphetamine addict, had been given the wrong "psych medication", an antidepressant called Luvox, and was unbalanced. When he was put in solitary, he set fire to the cell.

"The officers don't recognise mental illness," he says. "They see you as being a troublemaker and put you in solitary. I'm not the only one it's happened to. It can send you mad if you aren't to start with."

Risdon is due to close later this year, but many other prisons lock up mentally ill inmates in solitary confinement, or what's called segregation, for 22 or 23 hours a day. If prisons are in lockdown, inmates stay in their cells around the clock.

There are more than 25,000 people in prisons in Australia. Many have been affected by the critical shortage of in-patient and community-based mental health services across the nation. Mental illness is so prevalent in the general prison population that a large-scale study in NSW in 2003 found the rate of psychosis was 12 per cent, 30 times the rate in the general population. Since the study was carried out there has been an explosion of drug-induced psychosis.

Estimates of the number of mentally ill inmates in the general prison population range from about one-third to more than two-thirds, says Helen Connor, executive director of the Australian Mental Health Consumer Network.

In 2003, NSW's Corrections Health Service (now Justice Health) found that "almost half of reception inmates and more than one-third of sentenced inmates ... had suffered a mental disorder in the previous 12 months".

A study of all female prisoners in Victoria by psychiatrists Christine Tye and Paul Mullen published this year in the Australian and New Zealand Journal of Psychiatry indicated that if drug-related disorders were excluded, 66 per cent of the women met the criteria for a mental disorder. Victorian Supreme Court Chief Justice Marilyn Warren has condemned the lack of access to psychiatric care for women in Victoria's prison system in two judgments in recent months.

Barrister Greg Barns, legal adviser to Tasmania's Prison Action Reform group, says: "Solitary confinement is routinely used for prisoners who have mental illness. Hundreds of prisoners around Australia are in solitary confinement."

Last month at the inquest into the death of Scott Simpson, the NSW State Coroner recommended that prison inmates who were mentally ill should be put into solitary confinement only as a last resort. Simpson, a paranoid schizophrenic, committed suicide in 2004 in his cell after being locked up 22 hours a day for 26 months. Nurses testifying at the inquest said his medicines were pushed through a slot in the door of his segregated cell in the multi-purpose unit at Goulburn prison. He was then transferred to the High-Risk Management Unit at Goulburn, a prison within a prison known as the supermax.

NSW Corrective Services Commissioner Ron Woodham has the power to have any inmate designated "extreme high risk" held there. When Simpson's mother, Terri, wrote to the commissioner about the effects of the intense isolation in the supermax, Woodham wrote back: "I can advise that Scott's placement at the HRMU is considered to be beneficial to him and his future management."

Found not guilty of murdering a cellmate by reason of mental illness, Simpson was in isolation on the day he died. The Human Rights and Equal Opportunity Commission has stated that the conditions of his imprisonment constituted cruel, inhumane and degrading treatment under the UN's International Covenant on Civil and Political Rights.

Forensic psychiatrists at the inquest testified that mentally ill inmates were likely to deteriorate if held in solitary confinement for extended periods.

"If you put someone who is paranoid and agitated and greatly distressed in a solitary confinement setting for 23 hours a day, you cannot expect that to have a calming effect," said Robert Lewin, a forensic psychiatrist for 20 years. He told Deputy Coroner Dorelle Pinch that being in solitary confinement was bound to have made Simpson worse. "There is no circumstance in which that is appropriate in the care of a mentally ill person," Lewin said. "That it is used in the prison system in my opinion is an absolute abomination."

Solitary confinement of mentally ill inmates is archaic, according to Alvin F. Poussaint, professor of psychiatry at Harvard medical school. Poussaint says solitary makes psychotic prisoners "more psychotic" and prisoners who are already depressed likelier to commit suicide.

Australian human rights advocate Charandev Singh has investigated more than 25 deaths in custody and detention, including what he describes as "a disproportionate number of deaths of mentally ill prisoners held in segregation". Though the use of solitary confinement has been widely condemned for 40 years, Singh says, "experts say the mentally ill people least able to handle the isolation are most likely to be locked up in solitary. They are being punished for behaviour that is part of their mental illness."

No one knows for sure the numbers involved because solitary confinement isn't called solitary any more. In NSW, where Simpson died in isolation, it is officially illegal to hold prisoners in solitary confinement.

Solitary doesn't exist in Tasmania either, according to the Tasmanian Yearbook for 2000: "Three solitary confinement cells located in Risdon Prison were in use until the mid-1970s, when the attorney-general ordered that solitary confinement be discontinued."

Bull, 41, now working as a brickie's labourer, was released from Risdon eight months ago. His last time in Division 8 was a few years ago. "Men are still going around there for trivial offences," he says. "Speak out about the system and you're taken from your cell in the nighttime and put in solitary. I know seven were taken out of yard only the other week."

Fellow inmate Mick Marlow spent three years in Risdon's Division 8 in solitary. "He was locked up 23 hours a day. He didn't see sunlight," says a nurse who worked in Risdon. PAR's Caroline Dean says: "He went into solitary on a one-month charge and didn't come out for three years."

One thing has changed in Tasmania since solitary confinement was officially discontinued. Prison authorities talk about segregation in terms that suggest inmates are being managed or protected rather than punished.

A report on women in prison by the Anti-Discrimination Commission of Queensland notes that prison staff "often fail to recognise manifestations of mental disorder and respond with restraint or disciplinary action".

Before being wrongly placed in immigration detention, Australian citizen Cornelia Rau was imprisoned in Queensland. Though seriously mentally ill, she was repeatedly placed in the prison detention units used to "segregate prisoners for breaches of discipline", the report said.

A 2002 survey of female prisoners in Queensland revealed that almost two-thirds reported speaking to a doctor or psychiatrist about mental health issues. Debbie Kilroy of Sisters Inside, which advocates on behalf of women in prison, says in Queensland: "Women with a serious mental illness are held in crisis support units, which means they are locked in isolation 23 hours a day."

The anti-discrimination commissioner's report describes the environment: "The cells contain very little - a bed with a suicide-proof mattress - and no personal property of any kind is allowed. The lights in the cells are on 24 hours a day and while they are in the cells women wear a suicide gown. Suicide gowns are loose cotton garments, similar to the gowns worn in operating theatres. They have fastenings down the back, which routinely gape and provide little allowance for modesty or dignity as no underclothes are allowed to be worn beneath the gowns. Women who are detained in the padded cell in CSU are generally held in a totally naked state ... Each time a woman exits and re-enters her cell, she is strip-searched."

When the report was released, Queensland Police and Corrective Services Minister Judy Spence said the strip-searching "regime ... has cut drug use from almost 20 per cent of prisoners six years ago to now around 5 per cent". The minister said strip-searching in the crisis support unit had been reduced by "50per cent in the last 12 months".

Nevertheless, the anti-discrimination commission report noted that women elsewhere in the prison "related their fear of showing any emotion that may be noticed by prison officers". They were frightened they would be placed in a crisis support unit.

When Queensland doctor and state Liberal leader Bruce Flegg visited the prison a few weeks ago, he was shown the padded cell. It had with nothing in it, not even a mattress, Flegg tells The Australian. Prison staff "admitted to the use of restraints, body belts and so forth", he says.

Susan Hayes, head of the Centre for Behavioural Sciences in Medicine at the University of Sydney, says mentally ill prisoners are often held in conditions of solitary confinement, "because it's easier to lock them in their cells than to deal with them in the general prison population". "The obvious alternative is have them in a forensic hospital, where they're in a clinical rather than a custodial environment and where all the staff are trained to deal with mental illness."

Other experts insist the mentally ill shouldn't be in prison in the first place. "That would mean a much greater investment in community mental health services and sexual assault counselling," Singh says. "There needs to be a total prohibition on solitary confinement for the mentally ill. That's what they're bringing in in New York state.