By Moya Atkinson, MSW, co-founder of Social Workers Against Solitary Confinement


Darla Spence Coffey, CEO and President of the Council on Social Work Education (CSWE) recently agreed to the request made by Social Workers Against Solitary Confinement (SWASC) to work together to develop instructional modules which will expose the ethical and practice challenges faced by social workers working with prisoners facing solitary confinement. They will be introduced under Competency #3 Human Rights. This is very welcome news for SWASC, whose mission is to help to eliminate the use of solitary confinement.

Thousands of health professionals work with people experiencing solitary confinement –80,000-100,000 on any one day, 400,000 in a year, who are disproportionately poor, minority, mentally ill and disadvantaged.  Solitary confinement is the cruel, inhuman, degrading and torturous treatment of people in jails and prisons within the U.S. according to the United Nations’ Mandela Rules.

NASW’s mission is to “promote, develop and protect the practice of social work and social workers; and seek to enhance the effective functioning and well-being of individuals, families, and communities through its work and through its advocacy.”   And our profession’s Code of Ethics states —Social workers respect the inherent worth and dignity of the person.

But until now, NASW and its related organizations have provided no guidance to social workers dealing with the sharp edge of the ethical challenges they face when working with prisoners in or facing solitary confinement.

Social worker and author Mary Buser described her experience thus: Having worked as acting chief of Mental Health in the 500-cell solitary confinement unit on Rikers Island, I can personally attest to unspeakable suffering – head-bashing, self-mutilation, attempted hangings – that were the direct result of this grueling and inhumane punishment.

Commenting on NASW’s Brief advocacy/2016/03/nasw-social- justice-brief-urges-social- workers-push-to-end-solitary- confinement-offers-guidance- to-help-inmates/  she stated The idea that social workers should provide “effective and quality treatment” to inmates in solitary confinement demonstrates an utter lack of understanding about this punishment. There are no words — and there are no pills that will counteract the effects of prolonged isolation. My job amounted to being sure that no one actually died from their self-injurious behavior. In the end, I felt I was little more than a monitor of human suffering – a far cry from the idealistic social worker I’d once been.

Social worker Mary Gamble resigned from her position in a county jail in Maryland after witnessing a mentally ill nineteen-year-old man being treated inhumanely under “suicide watch” in solitary confinement.  She wrote: “I was not only a witness, but also an accessory to human torture. I was making waves there and was starting to fall out of favor. My presence and input were no longer wanted at meetings. My integrity was questioned. Some staff members even flat out called me a liar, that what I was reporting was simply not happening. Others stated that I was jeopardizing officer safety….

I utilized supervision and sought out support from my profession, but found that little support was available….. In a position statement by the National Commission on Correctional Health Care – “Correctional Health Professionals’ Response to Inmate Abuse,” several guiding principles are listed for reporting the mistreatment of inmates. According to these principles, it is the duty of health staff to report harm to appropriate authorities. The statement lists “unreasonable confinement” and “willful deprivation of services which are necessary to maintain a person’s physical or mental health” as forms of abuse.[1]

The question is, without formal mandated reporting laws, who does a health professional report such abuse to? Who are the appropriate authorities? In order for social workers and other health professionals to practice ethically in the correctional environment, there must be a formal mechanism in place for reporting abuses.”  

In answer to Mary Buser’s and Mary Gamble’s dilemma and that of thousands of health professionals in similar settings, SWASC members have been urging our profession to support the following position by Jeffrey J. Metzner, MD and Jamie Fellner, Esq. 38/1/104.full:

The professional organizations should acknowledge that it is not ethically defensible for health care professionals to acquiesce silently to conditions of confinement that inflict mental harm and violate human rights. They should affirm that practitioners are ethically obligated, not only to treat segregated inmates with mental illness, but also to strive to change harmful segregation policies and practices. Finally, the organizations should not be content with clarifying the ethics-related responsibilities of individual practitioners in these circumstances. They should actively support practitioners who work for changed segregation policies, and they should use their institutional authority to press for a nationwide rethinking of the use of isolation (M.A. BOLD)..

On the contrary, the following NASW-related organizations are among those that have rejected SWASC’s requests and/or have been silent:

  •  the NASW Board members elected between 2016-2019;
  • the NASW Foundation;
  • the NASW Pioneers’ Steering Committee’s Co-Chairs and 12 members;
  • NASW’s 12-member National Ethics Committee, and the co-author and key spokesperson for NASW and the profession’s Code of Ethics;
  • Most Deans, Directors and faculty members of social work programs, including those at Historically Black Colleges and Universities (HBCU);
  • Committee members of the American Academy of Social Work and Social Welfare (AASWSW) who are responsible for including information on solitary confinement in the “Smart Decarceration” and “Social Isolation” Challenges;
  • the Association of Social Work Boards (ASWB), regarding legislationwhich would prohibit the participation of health care professionals in the torture and abusive treatment of prisoners, with sanctions, and require health care professionals to report instances of torture or abusive treatment of prisoners and provide protection for those professionals who refuse to participate in prohibited acts or who investigate them; and
  • the Congressional Research Institute for Social Work Policy (CRISP), which originally provided good information, but has remained silent for over three years.

The most recent example of NASW’s silence is the June 2018 Issue of NASW News’ centerfold feature “Commitment to Social Justice: Social work roles are many in criminal justice system”. One faculty member stated, It can be difficult and emotional to work both with survivors of crime and the perpetrators of it…. And for those (social workers) who work within jails and prisons, the environment can be daunting.… However, there was no mention of the dual loyalty challenges they face in solitary confinement settings – the emphasis was on social workers in the courts.

NASW is represented on the Board of the National Commission on Correctional Health Care (NCCHC), as one of 36 major supporting national organizations in the fields of health, law and corrections. NCCHC, a not-for-profit organization “is committed to improving the quality of health care in jails, prisons and juvenile confinement facilities.”

NCCHC’s  Position Statement on Solitary Confinement, referred to by Mary Gamble, does not specify that its 36 members use their collective authority as national organizations to assume responsibility, as requested in SWASC’s petition below: to set mandatory standards for those assigned to these units and to denounce Solitary Confinement in its current form, as it is in direct violation of our Code of Ethics, which call upon us to uphold the dignity and humanity of all people. compose/1750582738

Without mandatory standards, transparency and independent oversight, health professionals cannot take care of their patients appropriately.

SWASC is committed to doing what our National Association of Social Workers (NASW) and its related institutions are unwilling to do!  We will attempt to fulfill NASW’s mission. We seek your support as we grapple with the problem of working in a retributive environment, and learn from others how to turn it into a restorative environment, true to our values.