A December 2003 Village Voice article entitled "Suicide in the Box" by journalist Jennifer Gonnerman claims that, "On any given day, about 5,000 of New York State's 65,000 inmates are on 23-hour lockdown." Approximately 1,000 or 20 percent of these inmates locked in the box are individuals who are diagnosed with a variety of mental illnesses, including schizophrenia, bipolar disorders, and severe depression.

For the mentally ill, being incarcerated without access to specialized clinical treatment can be dangerous. Placed in solitary confinement or locked in special housing units for 23 hours a day can exacerbate symptoms and in some cases can often prove deadly.

In a recent report entitled "Lockdown New York" published by The Correctional Association, a prison watchdog group, the organization reported that almost a quarter of the inmates placed in solitary confinement within special housing units suffer from mental illness. Furthermore, the report stated that of the 48 state prisoners who killed themselves between 1998 and 2001, more than half died in disciplinary housing. For mental health advocates, this statistic is extremely disturbing given the fact that a significant percentage of these prisoners are individuals with psychiatric disabilities.

Compounding these figures is a recent study by Human Rights Watch that concluded that jails and prisons have become "the nation's default mental health system, as more state psychiatric hospitals have closed and the country's prison system has quadrupled over the past 30 years." Without the necessary clinical and treatment supports in place, prisons are not equipped to rehabilitate persons with serious and persistent mental illnesses. Too often, placement in special housing units or in solitary confinement is used as a means of punishment.

For people suffering from schizophrenia, manic depression, severe thought disorders and other mental illnesses, being placed in special housing units or prolonged solitary confinement can be psychologically devastating and result in a significant increase in symptomatology or in the behaviors that correctional officers and prison officials initially sought to control. It is not surprising that the Village Voice article profiled two cases in which inmates confined to the box committed suicide.

It is unrealistic for our nation's correctional system to treat persons with mental illness by placing them in prolonged isolation in an attempt to control undesirable behaviors. Whether a person is mentally ill or not and commits a crime punishable by incarceration is not the current debate. Prisons and jails must be given the resources to distinguish between a person's behaviors, psychological limitations and their need for clinical treatment while incarcerated. Prisons must not be allowed to replace a need for long-term treatment facilities. Being punished for committing a crime is not the question. Being placed in solitary confinement for being mentally ill is not the answer.

New York's correctional system must work cooperatively with our State mental health system to ensure that clinical treatment is available for inmates diagnosed with psychiatric disabilities. The Office of Mental Health must also re-evaluate the continued closing of state psychiatric beds when a segment of the mentally ill population might benefit from specialized inpatient treatment as opposed to incarceration.

Being placed in a box is not the answer. Thinking outside the box might be.