JDAI also mandates that youth who are at risk of harm should be “engage[d] in
appropriate activities and programs that will raise their self-esteem and reduce the risk of further
self-harming behavior,”242 and youth who are at risk for suicide must not be isolated, but rather
engaged in social interactions allowing them to participate in school and other activities.243
Therefore, the conditions self-assessment instrument provided to JDAI sites is a good tool for
jurisdictions that wish to significantly reduce or eliminate the use of isolation, and can help to
improve upon policies and practices for better behavior management.
4. Department of Justice Standards for the Administration of Juvenile Justice
In 1980, the DOJ issued standards related to a broad range of issues in the juvenile justice
system.244 DOJ standards provide that “[j]uveniles should be placed in room confinement only
when no less restrictive measure is sufficient to protect the safety of the facility and the persons
residing or employed therein.”245 The standards restrict room confinement to a maximum of
twenty-four hours, and view isolation as “a severe penalty to impose upon a juvenile, especially
since this sanction is to assist in rehabilitation as well as punish a child . . . . After a period of
time, room confinement begins to damage the juvenile, cause resentment toward the staff, and
serves little useful purpose.”246 The DOJ standards mandate at least daily examination by a
physician, as well as twice-daily examinations by a childcare worker or other treatment staff.247
The standards further require educational materials and other services, in addition to recreation
and outdoor exercise, if the youth is confined in a room for more than twelve hours.248
5. Applicable Federal Health Care Laws and Regulations
Federal laws pertaining to the rights of residents in health care facilities that receive
federal funds also restrict involuntary isolation. The Children’s Health Act of 2000249 limits the
use of isolation by prohibiting punitive practices to be used for the purpose of discipline or
convenience, and allowing isolation only to 1) ensure the physical safety of the resident, staff
member, or others, and 2) with a written order of a physician or licensed practitioner that
“specifies the duration and circumstances under which the restraints are to be used.”250
Similarly, regulations that implement health and safety requirements of the Social
Security Act restrict the use of involuntary isolation in medical facilities.251 Such regulations
prohibit the use of isolation used for coercion, discipline, convenience or retaliation, and allow
such practices only when 1) less restrictive interventions have been determined to be ineffective,
2) to ensure the immediate safety of the patient, staff member or others, and 3) for only so long as
necessary.252 Under this regulation, the limitation on the use of isolation is twenty-four hours,
although individual instances of involuntary isolation for children and adolescents between nine
and seventeen years old may only be renewed at two-hour increments.253 Additionally, a medical
professional must evaluate the individual within one hour of isolation, document the individual’s
behavior and interventions used, examine alternatives and less restrictive interventions, review
242 Id. at 18.
243 Id. at 19.
244 See generally OFFICE OF JUVENILE JUSTICE & DELINQUENCY PREVENTION, supra note 31.
249 Children’s Health Act of 2000, Pub. L. No. 106-310, § 591(a), 114 Stat. 1101.
250 42 U.S.C.A. § 290ii(b) (West 2014).
251 See generally 42 C.F.R. § 482.13 (2014) (implementing 42 U.S.C. §§ 1395x, 1861(e)(9)(A)).
252 Id. § 482.13(e).