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psychological harm more so to prisoners with mental illnesses, especially when it is used for long period of time of between 23-24 hours per day for some years, the prisons have not stopped the practice. The extended solitary confinement of such prisoners may exacerbate the occurrence of serious mental illnesses, or even provoke their recurrence, where this practice is not addressed in good time. Further isolated confinement of prisoners also restricts the nature of health services that the prisoners can access, thus worsening their conditions even more.

The ethical dilemma faced by prison physicians that include the conflict of loyalties to patients or to the prison as the employer, the poor working conditions, and the conflict that results between the principle of reasonable and meaningful healthcare offering to patients on the one hand and the prison rules and cultures that restrict the health care practice to necessity on the other hand, affects the resolution of the problem of isolated confinement. The prison physicians are restricted access to the segregation units holding the solitary confinement of prisoners. The American Psychiatric Association (APA) has observed that mental health services offered in prison are inadequate, while adding that the mentally ill are more prone to stress and depression that impairs their thinking and judgment. This way, their isolation is causing the mentally ill prisoners even more harm.

While some psychiatrists who work in prisons may concur with the prison argument that it is necessary to confine such prisoners for security reasons, experience has shown that prisons and correctional facilities can operate effectively without necessarily confining the mentally ill prisoners to segregation units.