Human Rights Watch urges Governor Spitzer to sign New York State Senate bill S.333-A, which would prohibit the confinement of prisoners with serious mental illness in "Special Housing Units" (SHU). The practice of confining mentally ill prisoners in SHU, which are colloquially known as, "the hole," exacerbates the symptoms and difficulties faced by these inmates and can amount to torture. By signing this bill, Governor Spitzer would be making an important first step toward improving the treatment of mentally ill prisoners in New York State correctional facilities.

SHU rules require prisoners to spend at least 23 hours a day locked in their cells, with the option of an hour of exercise in a barren little cage up to five times a week. Inmates can and do spend years in cramped cells with scant interaction with staff and nothing to do. For the mentally ill, both the isolation and idleness can exacerbate their symptoms. Untreated or under-treated, they may deteriorate. They may rant and rave, babble incoherently, bang their heads against the walls, or huddle silently. They may talk to invisible friends and live in worlds constructed of hallucinations. Many self-mutilate and try suicide; some succeed. Some decompensate to the point of requiring acute care and hospitalization.

The cruelty of SHU confinement for the mentally ill is compounded because mental health services for segregated prisoners typically consist of little more than medication and brief cell-front checks-ins by mental health staff. If prisoners are removed to a mental health hospital, once stabilized they are returned to SHU, where the cycle of deterioration can begin anew.

The mentally ill are disproportionately represented in New York’s SHU units—as in other high security segregation units in state systems across the country. They end up in segregation because their illness makes them less able than other prisoners to cope with prison life. They are more likely to be victimized and more likely to be injured in a fight. They are more likely to break the rules. They are more likely to behave in ways that annoy, disgust and even enrage security staff who have scant training in how to recognize, much less cope with, symptoms of mental illness.

As Human Rights Watch detailed in the enclosed report, Ill-Equipped: US Prisons and Offenders with Mental Illness, it is well established that prisoners with mental illness cannot receive the treatment and rehabilitation measures they need while in SHU. The very architecture of SHU facilities, as well as SHU rules, keep them from receiving group therapy, up therapy, individual therapy, daily living skill training, educational and vocational programs, structured and unstructured group recreation and other activities that can play a crucial role in restoring or improving mental health—or at the very least in preventing further deterioration in the patient’s psychiatric condition.

New York’s prisons were never intended to be facilities for the mentally ill, yet that is one of their primary roles today. Your administration should place a high priority on developing comprehensive policies and programs that address the needless incarceration of the mentally ill. In the meantime, however, you must also use your authority to secure reforms of prison rules that have cruelly unintended consequences when applied to prisoners with mental illness. One such reform is embodied in S.333-A.

Human Rights Watch urges you to sign New York Senate Bill S.333-A and to place the weight of your office behind efforts to bring dramatic improvements to the treatment of prisoners with mental illness in New York. We would be more than willing to meet with you and your staff to discuss this legislation in particular, or the challenges the mentally ill pose for corrections in general.


Jamie Fellner
Director, US Program

Cc: Commissioner Brian Fisher
Department of Correctional Services
1220 Washington Ave, Bldng 2
State Campus
Albany, NY 12226