COVID-19 and severe isolation have created a mental health crisis for incarcerated youth

Pandemic precautions have touched off an invisible mental health crisis inside the juvenile detention facilities that house about 44,000 young people nationwide. 

With family visits canceled, rehabilitation programming curtailed and juveniles locked in their rooms for days, young people and their advocates describe an epidemic of despair leading to suicide attempts and violence.

Access to these notoriously secretive facilities is more limited than ever as a result of COVID-19, hiding conditions inside from public view. Interviews by MindSite News along with new reports from state and federal monitors paint a stark picture of the state of mind inside the nation’s sprawling network of youth prisons and detention centers.

“My days are an endless loop,” said A., a 22-year-old being held in a juvenile facility in Washington state for an offense he committed as a teen. When he spoke with a reporter in August, he had just recovered from COVID-19. MindSite News is using only his first initial because he was a juvenile at the time of his offense.

The young man said he has struggled with the overpowering boredom and isolation that have become the hallmark of the pandemic behind bars. After a while, he said, he began experiencing such intense déjà vu that he confided to a friend that everything he felt was uncannily familiar. The friend offered an explanation: Each day was in fact an exact replica of the last. 

With COVID-19 restricting visits nationally, Puerto Rico is among the few places that have received outside scrutiny because of a 1994 court case that mandates quarterly reports on conditions inside the island’s two youth detention facilities. In her most recent report, covering the third quarter of 2020, the monitor, Kim Tandy, identified 32 incidents of “attempted suicides, suicidal gestures or ideation, or self-mutilation”, including 13 instances in which detained youth tried to hang themselves and 23 in which suicidal youth were hospitalized. 

Tandy’s report, filed with the federal court in San Juan in December, describes a series of disturbing events. One young man lacerated his own arm while under “preventative supervision.” Another tried to hang himself from a doorknob using his own sweatshirt. Yet another required removal of his spleen after two young people beat him with a broom handle and a bar of soap inside a sock. 

The situation has been hard on employees as well. With staff members frequently out on quarantine after exposure to coronavirus-positive people, those still on the job had to work 12-hour shifts. In some instances, staff were forced to work double shifts, or 24 hours straight – which “precludes any realistic expectation that staff can be awake and alert,” Tandy wrote, making it impossible for them to ensure that “youth are safe, secure, and protected from harm.”

The despair appeared to worsen over time, according to Tandy’s report. She found a “three-fold increase in the number of youth with suicidal ideation, intent, gestures and self-mutilation” compared with the second quarter and reported that the “volume of serious youth violence, cutting events and assaults reflects institutional environments that are intermittently chaotic and not safe for youth or staff.”

In a written response, the Puerto Rico Department of Corrections and Rehabilitation challenged many of the findings in the monitor’s report, including the determination that the facilities were unsafe.

Alone inside. San Jose Juvenile hall, San Jose, California 1999. Photo: Joseph Rodriguez

“Youth are behaving in the same manner as before the Covid-19 pandemic,” wrote spokesperson Yvonne Guadalupe Negrón, “the difference is the mental health professionals have been trained to identify behavior and report it.”

Suicidal ideation, gestures and attempts are reported as a single number, she wrote, which “creates a false impression that there has been an increase of attempts.” Furthermore, she noted that a three-judge panel created to evaluate mental health services inside the facilities had been disbanded because the Federal Department of Justice was convinced that there was “no emergency that required orders of release due to lack of services.”

“We are constantly reviewing incidents to learn how can services be improved and avoid incidents in the future,” Guadulupe Negrón wrote. “We have to keep in mind that our population has behavior issues and trauma experiences. Our mental health professionals are working together to modify behavior and to help our youth to work to manage their trauma and improve their mental health.”

Pressure builds and ‘bad things happen’

Even in Puerto Rico, COVID-19 concerns have limited access. Tandy, the federal monitor, and her staff instead reviewed internal documents and conducted video interviews with detained young people via Zoom. 

“The youth interviewed named stress over not seeing their family as a major reason for their depression and anxiety,” Tandy’s report said. “Some of the youth that had suicidal ideation or who had attempted suicide named ‘desperation’ at not seeing family or worrying about family as a major stress.”

While the Puerto Rico youth prisons have been troubled and under federal receivership for more than two decades, the pandemic took conditions from bad to horrific, said Gladys Carrión, a research scholar in the Columbia Justice Lab at Columbia University. This suffering isn’t limited to Puerto Rico, she said. 

“I think things are happening and the news doesn’t get out because lawyers aren’t allowed in to see their clients and telephone calls are limited,” said Carrión, a former commissioner for the New York State Office of Children and Family Services. “Kids have breakdowns. They feel isolated. They don’t understand what’s happening. These kids have already experienced trauma upon trauma upon trauma.” 

Carrión worked until June as a consultant with Tandy’s monitoring team. She said some young prisoners in Puerto Rico who lashed out or committed self-harm told monitors: “I never did this before, but I feel hopeless. I don’t feel like I’m ever going to get out of here. I don’t hear my mother’s voice, or my girlfriend’s voice.” 

The pressure on these kids “just builds,” Carrión said. “And bad things happen.”

Like coronavirus infection rates, visiting restrictions have ebbed and flowed. As the pandemic escalated again in recent months, states including Louisiana and Connecticut reimposed visiting restrictions that had been loosened briefly when cases dropped in the post-vaccine, pre-delta-variant moment in the spring. 

San Jose Juvenile Hall, San Jose, California 1999

The number of kids behind bars is creeping back up as well. According to a monthly survey by the Annie E. Casey Foundation of juvenile detention agencies, their ranks rose by 7% in the first two months of 2021. 

In many facilities, young people “have been totally isolated,” Carrión said. “In some places, kids have been in the room for 24/7, or 23/7. They have been deprived of any kind of stimulus. Under that rubric of keeping kids safe, you’ve really exacerbated the mental health challenges that young people have experienced.” 

‘The whole time, he’s crying, going crazy. He started punching a wall, telling me he don’t want to live.’ 

In Louisiana, young people held at the Swanson Center for Youth in Monroe spent weeks in lockdown after limits on solitary confinement were relaxed, allowing them to be isolated for seven days instead of the previous limit of eight hours, according to a report from the Louisiana legislative auditor. 

Family visits were halted entirely, separating juveniles from their closest support networks at a terrifying time. The number of missed counseling sessions rose 187%, and turnover among staff working directly with young people increased by more than 72%.

The deteriorating conditions exacerbated tensions in the facility and led to a yearlong series of melees and escapes, some of which drew local media coverage. In July 2021, advocates and frightened parents held an emergency online town hall meeting.

“We haven’t seen my son for months because of COVID. They stopped letting us come see him in April, maybe March,” one woman said during the meeting. Her son had been diagnosed with bipolar disorder and schizophrenia and was suicidal when he was brought to the detention center in January. She requested that her name and the nature of the charges against her son not be used for fear of influencing her son’s case, which is still pending.

“I know my son is going through it in there,” she said. “I need to get him out to get him some help because they don’t have no help.” 

After the meeting, she told MindSite News that her son’s mental state deteriorated after family visits – which had been allowed several hours a day, Thursday through Sunday – were cut off in March. It was May before she was permitted to speak with him on a Zoom call.

‘The whole time, he’s crying, going crazy” in that Zoom visit, she said. “When he started punching a wall and telling me that he don’t want to live,  that’s when they took him and stripped him and put him in a room.” 

He told her he spent three days on suicide watch, naked in a cold cell with a paper sheet for a blanket.

The Louisiana Office of Juvenile Justice, which operates the Swanson Center, did not respond to emailed requests for comment.

A vulnerable population

Even before the coronavirus, as many as 70% of incarcerated young people suffered from a diagnosable mental health problem, according to the federal Office of Juvenile Justice and Delinquency Prevention. While the pandemic has exacerbated mental health struggles for many Americans, young people behind bars may be the most vulnerable of all.

When the pandemic hit in March 2020, officials began taking steps to protect the safety of residents and staff members, mostly by reducing the number of people locked up. The governors of Colorado and Michigan issued orders to lower the number of incarcerated young people, as did judges and system administrators in multiple states. 

Between March and October of 2020, the number of incarcerated youth in reporting states fell by a quarter, according to the Youth First Initiative. Four states – Maryland, Mississippi, North Dakota and Delaware – cut youth incarceration in half during that period.

For those left inside, conditions deteriorated radically. Almost overnight, art, writing and other workshops provided by outside nonprofits – a lifeline for many young people – were halted. Paper worksheets became substitutes for human interaction with teachers. 

Misinformation about COVID-19 spread rapidly inside the closed institutions, according to several service providers who work with incarcerated youth, and young people feared for their families and themselves. 

Then came the first COVID-19 cases, and with them the first lockdowns. Monitors’ reports describe young people being quarantined in their pods when a case hit their unit. Others were locked in their cells, often around the clock. 

By February 2021, at least 3,753 cases of COVID-19 had been documented inside youth prisons, according to the Washington, D.C.-based Sentencing Project. Each new wave brought another lockdown.

Josh Rovner, a senior advocacy associate at The Sentencing Project, has been tracking the effect of the coronavirus on incarcerated young people and has found no reports of deaths from COVID-19. 

“We certainly should be worried about their lungs,” Rovner said. “But the greatest impact health-wise has been on their mental health.” 

Self-mutilation. San Jose Juvenile hall. San Jose, California 1999. Photo: Joseph Rodriguez

For an incarcerated child put into quarantine, Rovner said, “being in a room by oneself can feel like solitary confinement in all but name.” The United Nations special rapporteur on torture has called for an “absolute prohibition” on the practice of keeping juveniles in solitary confinement, warning that “the severe mental pain or suffering solitary confinement may cause” to adolescents “can amount to torture.”

With guards out sick or quarantining at home amid exposure, chronic staffing shortages have only exacerbated isolation. 

“We always heard, ‘Oh, we don’t have the staff,” one young man said of the months he spent locked up in Washington state, often eating his meals in his room. 

‘An alarming degree of confinement’

At Manson Youth Institution in Cheshire, Connecticut, access to the library was halted, education programming was limited to class packets slid under cell doors, and mental health support consisted of brief visits through cell windows, according to a report from Sarah Eagan, the state’s child advocate. She described “a shutdown of facility programming and a reliance on a prolonged and alarming degree of cell confinement.” 

As part of her research, Eagan reviewed facility incident reports. One showed the lengths some young people took to counter boredom and isolation. She described a young woman at York Correctional Institution telling an officer she felt like hurting herself. When a clinician came to see her, the young woman conceded she wasn’t actually suicidal.

“I told them I want to hurt myself so I could talk to crisis,” the incident report quoted her as saying. “I don’t have a book, I thought [STAFF] would be here so I can get a book.”

Instead of a book, she was given a lecture about “utilizing crisis for serious MH (mental health) matters and not for books” and punished with a stint in the Restrictive Housing Unit for “making suicidal statements for secondary gain.” 

No mention was made of whether she ever received a book.

Eagan said she had long expressed concerns about the overuse of cell confinement, and the pandemic and resulting staff shortages made things worse. 

“The impact on kids’ mental health is significant,” she said.

Connecticut correctional officials took Eagan’s findings to heart “and diligently worked to address the concerns,” Andrius Banevicius, public information officer for the Connecticut Department of Correction, said in an emailed statement. He noted that Eagan credited his agency for its success in limiting coronavirus infections.

“When the pandemic hit, the Agency took the necessary precautions that would help to save lives of the incarcerated population as well as staff members,” Banevicius said. “As soon as it was deemed safe to do so, (corrections) staff worked to increase opportunity for engagement by initiating video visitation, and also increasing access to programming.”

‘Imagine how frantic this parent was’

A few months into the pandemic, Valerie Slater, who heads the Virginia-based advocacy group RISE for Youth, heard from a distraught mother. The mom had just received a letter from her incarcerated son, who has serious mental health struggles. The letter was “saying goodbye to her in case something happened to him and in case he was the one that caused that something negative to happen,” Slater said.

“Imagine how frantic this parent was,” Slater said when she told the story at a webinar convened by the Sentencing Project. 

Young people’s mental health is worsened by anxiety about the safety of family members, many of whom are essential workers unable to shelter in place. Several caseworkers talked about young people who lost family members to COVID-19 and could attend their funerals only virtually, if at all. 

The 22-year-old incarcerated in Washington state said he was terrified when he learned early in the pandemic that his mother, father and three sisters had contracted COVID-19. 

That was “one of my biggest scares,” he said. “Not really knowing what COVID was, I just kept thinking, ‘Man, I hope nothing bad happens to them.’ All I could do was ask my mom to make sure she calls me so I could know how they’re doing.” 

The isolation measures would have been more tolerable, he added, if they had actually protected him from contracting the virus. Instead, he said, he fell ill not long after a young man on another unit tested positive and the young man’s cellmate was transferred to his unit to protect the roommate from infection. 

“This is a really bad idea,” the 22-year-old remembers thinking. He wore his mask religiously and tried to keep to himself, he said, “but it got to the point where everyone started getting COVID because they were moving people around.” 

Soon, he woke up with an intense headache. He said he and much of his unit soon tested positive and were placed on lockdown in their cells before being transferred to a quarantine unit in an empty wing of the building. 

The isolation, the crushing boredom, even COVID itself – none of this was his greatest pandemic-related hardship. The hardest part, he said, was going almost a year and a half without seeing his son. 

As things began to open during the post-vaccine window, he finally got a visit to mark his child’s birthday. When he congratulated his son on turning 5, the child just looked at him. “Dad,” he said finally, “I’m 6.”

Journalist Nell Bernstein is the author of “Burning Down the House: The End of Juvenile Prison.” She is working on a new book about the movement to close youth prisons.