the conditions or symptoms that warranted the use of isolation, and indicate the individual’s
response, including the rationale for continued isolation.254
6. American Academy of Child and Adolescent Psychiatry
The American Academy of Child and Adolescent Psychiatry (AACAP) issued a policy
statement in 2012 opposing the use of isolation for juveniles and urging that any youth confined
for more than twenty-four hours be evaluated by a mental health professional.255 This statement
recognized the potential psychiatric consequences of prolonged isolation, including depression,
anxiety, and psychosis, and noted particular adverse reactions by youth as a result of their
developmental vulnerability.256
The AACAP created parameters for the use of isolation on youth within psychiatric
institutions. These standards allow for isolation only when “necessary to ensure the safety of the
patient and others, for prevention of significant damage to the program and property, and after
documented failure of less restrictive interventions.”257 A verbal or written order for isolation is
limited to one hour for children under the age of nine, two hours for youth from age nine to
seventeen, and four hours for individuals eighteen and older.258 An in-person reevaluation must
occur every two hours for patients under eighteen and every four hours for those over eighteen.259
The patient’s family must also be promptly notified of the initiation of isolation.260 The youth
should only remain in isolation long enough to regain self-control, once he or she has calmed
down, the isolation should be terminated.261
The AACAP standards also focus on the use of isolation in correlation with psychiatric
treatment and preventative measures, emphasizing that “[d]iagnosing and treating the underlying
psychiatric illness are essential to the management of aggressive behavior.”262 Additionally, after
a youth is removed from isolation, a staff member should review the event with him or her, and
work with the youth to prevent a reoccurrence of the aggressive behavior.263
7. International Conventions on the Rights of Children
Prohibitions on the use of isolation for youth have been addressed at the international
level as well. The United Nations Convention on the Rights of the Child is an international
human rights treaty that seeks to protect the rights of children for those countries in which it is
adopted.264 The United States is one of two members of the United Nations that has not ratified
the treaty.265 The United Nations Committee on the Rights of the Child requires that disciplinary
measures “be consistent with upholding the inherent dignity of the juvenile and the fundamental
objectives of institutional care.”266 Moreover, the United Nations strictly forbids disciplinary
254 Id.
255 Solitary Confinement of Juvenile Offenders , AM. ACAD. OF CHILD & ADOLESCENT PSYCHIATRY,
http://www.aacap.org/AACAP/Policy_Statements/2012/Solitary_Confinement_of_Juvenile_Offenders.aspx (last visited Nov. 22,
2013).
256 Id.
257 Kim J. Masters et al., Practice Parameter for the Prevention and Management of Aggressive Behavior in Child and Adolescent
Psychiatric Institutions, with Special Reference to Seclusion and Restraint, 41 J. AM. ACAD. CHILD & ADOLESCENT PSYCHIATRY 4S,
7S (Supp. 2002).
258 Id. at 15S.
259 Id.
260 Id.
261 Id.
262 Id. at 10S.
263 Id. at 20S.
264 Jenni Gainborough & Elisabeth Lean, Convention on the Rights of the Child and Juvenile Justice, LINK, Summer 2008, at 1, 1.
265 Id. Note that the United States has signed but not ratified this Convention; thus, while it is obligated not to undermine the object
and purpose of the Treaty, it is not specifically bound by its terms. Id. The only other country that has not ratified the Treaty is
Somalia, which is currently operating without a functional central government. Id.
