“An unforgettable look at the peculiar horrors and humiliations involved in solitary confinement” from the prisoners who have survived it (New York Review of Books). On any given day, the United States holds more than eighty-thousand people in solitary confinement, a punishment that—beyond fifteen days—has been denounced as a form of cruel and degrading treatment by the UN Special Rapporteur on Torture. Now, in a book that will add a startling new dimension to the debates around human rights and prison reform, former and current prisoners describe the devastating effects of isolation on their minds and bodies, the solidarity expressed between individuals who live side by side for years without ever meeting one another face to face, the ever-present specters of madness and suicide, and the struggle to maintain hope and humanity. As Chelsea Manning wrote from her own solitary confinement cell, “The personal accounts by prisoners are some of the most disturbing that I have ever read.” These firsthand accounts are supplemented by the writing of noted experts, exploring the psychological, legal, ethical, and political dimensions of solitary confinement. “Do we really think it makes sense to lock so many people alone in tiny cells for twenty-three hours a day, for months, sometimes for years at a time? That is not going to make us safer. That’s not going to make us stronger.” —President Barack Obama “Elegant but harrowing.” —San Francisco Chronicle “A potent cry of anguish from men and women buried way down in the hole.” —Kirkus Reviews

Over the past four decades, the rate of incarceration in the United States has skyrocketed to unprecedented heights, both historically and in comparison to that of other developed nations. At far higher rates than the general population, those in or entering U.S. jails and prisons are prone to many health problems. This is a problem not just for them, but also for the communities from which they come and to which, in nearly all cases, they will return. Health and Incarceration is the summary of a workshop jointly sponsored by the National Academy of Sciences(NAS) Committee on Law and Justice and the Institute of Medicine(IOM) Board on Health and Select Populations in December 2012. Academics, practitioners, state officials, and nongovernmental organization representatives from the fields of healthcare, prisoner advocacy, and corrections reviewed what is known about these health issues and what appear to be the best opportunities to improve healthcare for those who are now or will be incarcerated. The workshop was designed as a roundtable with brief presentations from 16 experts and time for group discussion. Health and Incarceration reviews what is known about the health of incarcerated individuals, the healthcare they receive, and effects of incarceration on public health. This report identifies opportunities to improve healthcare for these populations and provides a platform for visions of how the world of incarceration health can be a better place.