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Solitary confinement carries 'serious risks'

When a boy, aged 15, now known as ‘AB’, called an advice line run by the Howard League for Penal Reform, the adviser who answered could tell he was miserable and fed up.

He had attention deficit hyperactivity disorder and had been locked, alone, in a cell at HM Prison Feltham, for 23 hours a day, weeks on end, allowed outside only to shower and exercise. Understandably, he wanted to end his solitary confinement and was appealing for help.

His situation is far from unique, according to guidance published by the BMA last week about the role of medicine in solitary confinement, the official designation for keeping children alone and under lock and key for 22 hours in a day. Four in 10 boys in detention spend some time in such isolation, say studies it cites.

The case of ‘AB’ was raised at a debate in Parliament, organised by the BMA and hosted by MP for Feltham Seema Malhotra, for senior doctors, MPs, peers, and charities, such as the Howard League, to discuss the report and a joint statement calling for solitary confinement to be banned in the UK for children.


Suicide risk

The medical evidence against isolating children and young people is ‘unequivocal’, according to that statement, which is signed by the RCPCH (Royal College of Paediatrics and Child Health) and the RCPsych (Royal College of Psychiatrists), as well as the BMA. Isolating them heightens their risk of suicide and self-harm. It carries ‘serious risks’ of long-term psychiatric and developmental harm to people. Call them prisoners or patients, they’re still in a crucial stage of development, socially and neurologically. Solitary confinement should be abolished and prohibited and until it is, the health needs of those subject to it should be met, the statement says.

The Howard League’s efforts to end the misery of AB’s solitary fell on ‘deaf ears’ in Feltham, said the charity’s legal director Laura Janes.

‘We had no option to go for judicial review,’ she told the debate. His case was heard last year at the Royal Courts of Justice in London.  The Court found his treatment was unlawful but stopped short of finding it ‘inhuman or degrading’.

The charity hopes to overturn that part of judgment in the Court of Appeal.

The Howard League received more than 40 calls last year from or about children in prison who are isolated.

Politicians at the debate who supported calls for a ban included Labour MP for Liverpool and Wavertree Luciana Berger and Labour MP for Brentford and Isleworth Ruth Cadbury.


Ban prison

Ms Cadbury, who was previously responsible for children’s services as a local authority councillor, said the ban did not go far enough.

‘In my view, we should not only end solitary confinement in the secure estate, children shouldn’t be in prison at all. If they end up in prison, their lives have almost certainly been damaged.’

Doctors at the debate pointed out that children entering prison already had poorer health than their peers and more abused alcohol and drugs.

Imprisonment meant health professionals had much less access to them, said RCPCH child protection officer Alison Steele. ‘We believe that solitary confinement is cruel and degrading treatment,’ she added.

RCPsych adolescent forensic psychiatry special interest group chair Heidi Hales said imprisoned children already had a ‘pretty harsh’ view of the world.

‘They are at the point where the world is being formed by their experiences,’ she added. ‘Putting them in prison can make that view of the world even harsher.’


TV trouble

Children who had difficulties communicating will ‘act not speak’, Dr Hales said.

‘They are not going to be thinking things through when you take their TVs away.'

She called for a ‘pro-social’ alternative to punishing children by locking them up in a cell, as previously endorsed in her blog.

As the Howard League prepares to return to court for ‘AB’, the BMA is preparing a number of ways to investigate and end solitary confinement for children and young people.

The joint call for a ban and evidence for it will be presented to ministers in a letter later this year. Doctors are also calling for a Parliamentary select committee inquiry into solitary confinement – a move much supported during the debate.

‘Solitary confinement has no place in the youth security estate,’ is how BMA medical ethics committee chair John Chisholm summed it up. ‘As a concept, it is simply just wrong.’

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