This study sought to evaluate the association of a solitary confinement ban with self-harm among adolescents in New York City's jail system. Data were extracted from medical records on 5,038 adolescent incarcerations from October 1, 2013, through July 12, 2016, and compared incarcerations before the ban (February 20, 2015) with those after the ban. Of the 2,503 adolescent incarcerations pre-ban, there were 171 self-harm gestures among 106 incarcerations (4.2% of incarcerations). Post-ban, there were 2,100 adolescent incarcerations and 105 self-harm gestures among 71 incarcerations (3.4% of incarcerations; p < .01). The post-ban group experienced significantly lower self-harm risk compared with the pre-ban (Crude incident rate ratio, 1.35 vs. 1.81; p < .05). In adjusted analysis, the hazard of self-harm associated with solitary confinement exposure was 1.51 times that of incarcerations with no solitary exposure (p < .05) . This signifies negative health outcomes of adolescent solitary confinement and the need for policy change consideration.
Keywords: adolescents; jails; punitive segregation; self-harm; solitary confinement.