The jails and prison systems are the de facto mental health institution (Abramsky and Fellner, 2003). There is a prison within the prison, that those with mental health conditions, are subjected to. That is the practice of "solitary confinement". Solitary confinement is defined as, isolation from personal interaction with others, in addition to being locked and confined in cells for 23 to 24 hours a day (Metzner and Fellner, 2010). Additionally, solitary confinement involves being, segregated with little if any educational and vocational activities.
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Prisons and jails have become America's default mental health institutions. More individuals with severe mental illnesses are housed in prisons and jails than in state psychiatric hospitals. Individuals with severe mental illness, while in prisons or jails, lack the proper treatment and care needed for their conditions. Lack of proper treatment, their mental health often worsens, and they often leave prison or jail worse than when they entered prison or jail.