While juvenile psychiatric facilities have used isolation for youth who present a danger to
themselves or others, “the research has found seclusion to be harmful to patients and not related
to positive patient outcomes.”40 More than thirty years of evidence regarding the use of isolation
in psychiatric facilities shows that “[t]here is no theoretical foundation for the use of seclusion
with children” and that “the practice of seclusion does not add to therapeutic goals.”41 In short,
the use of isolation lacks any foundation as an evidence-based practice. Indeed, increased
scrutiny of the use of restraint and seclusion in psychiatric facilities has created a “legal and
regulatory environment” in which the practice is discouraged because its use is arbitrary and
More than two-thirds of youth confined in juvenile facilities suffer from one or more
mental illness.43 Common mental illnesses found in youth in juvenile facilities include disruptive
disorders, substance abuse disorders, anxiety disorders, and mood disorders.44 One study
“identified from 19% to 46% of youth in the juvenile justice system as having attention deficit
disorders.”45 Research suggests that adults who struggle with these mental illnesses are more
likely to engage in behaviors that lead facility staff to place them in isolation.46
Youth who are disruptive or violent, in spite of their mental health status, may be placed
in a facility’s disciplinary unit where the focus is on containing and deterring future disruptive
behaviors rather than treatment or psychosocial management of such behaviors.47 These units
isolate youth, often from both sight and sounds of others, as a sanction for rule breaking.48 In
contrast to psychiatric units that may use isolation for brief periods of time and contingent on the
individual’s ability to safely return to a regular unit, disciplinary seclusion in a correctional
context may be longer and pre-determined as a sentence.49
3. Isolating Victims of Trauma Can Further Victimize
The prevalence of exposure to trauma among youth in the juvenile justice system is
significant and profoundly important to treatment efforts. According to a 2010 survey released
by the Office of Juvenile Justice and Delinquency Prevention, seventy percent of youth confined
in correctional facilities revealed that they had personally “seen someone severely injured or
killed,” and seventy-two percent “had had something very bad or terrible happen to [them].”50
40 Linda M. Finke, The Use of Seclusion Is Not Evidence-Based Practice, 14 J. CHILD & ADOLESCENT PSYCHIATRIC NURSING 186,
41 Id. at 189.
42 STEPHAN HAIMOWITZ, ET AL., RESTRAINT AND SECLUSION- A RISK MANAGEMENT GUIDE 1 (2006).
43 JENNIE L. SHUFELT & JOSEPH J. COCOZZA, NAT’L CTR. FOR MENTAL HEALTH & JUVENILE JUSTICE, YOUTH WITH MENTAL HEALTH
DISORDERS IN THE JUVENILE JUSTICE SYSTEM: RESULTS FROM THE MULTI-STATE PREVALENCE STUDY 4 (2006),
44 Id. Of the number of youth in the juvenile justice system, this study suggests that approximately 46.5% have disruptive disorders,
such as conduct disorders, 46.2% have substance abuse disorders, 34.4% have anxiety disorders, and 18.3% have mood disorders
such as depression. Id. at 2. Seventy-nine percent of the youth in this study meet the criteria for more than one diagnoses, and sixty
percent meet the criteria for three of more diagnoses. Id. at 3.
45 ROBERT B. RUTHERFORD JR. ET AL., YOUTH WITH DISABILITIES IN THE CORRECTIONAL SYSTEM: PREVALENCE RATES AND
IDENTIFICA TION ISSUES 18-19 (2002).
46 See HUMAN RIGHTS WATCH, ILL-EQUIPPED: U.S. PRISONS AND OFFENDERS WITH MENTAL ILLNESS 147 (2003), available at
http://www.hrw.org/sites/default/files/reports/usa1003.pdf (“The mentally ill are disproportionately represented among prisoners in
segregation. As discussed earlier in this report, persons with mental illness often have difficulty complying with strict prison rules,
particularly when there is scant assistance to help them manage their disorders. Their rule-breaking can lead to increasing punishment,
particularly if they engage in aggressive or disruptive behavior. Eventually accumulating substantial histories of disciplinary
infractions, they land for prolonged periods in disciplinary or administrative segregation.”).
47 Christopher A. Cowles & Jason J. Washburn, Psychological Consultation on Program Design of Intensive Management Units in
Juvenile Correctional Facilities, 36 PROF. PSYCHOL.: RES. & PRAC. 44, 45 (2005).