Troy Anderson is a mentally ill inmate in isolation at the Colorado State Penitentiary, deemed for more than a decade too dangerous to be among other offenders.
His lawyers argue, however, that prolonged solitary confinement is contributing to a vicious cycle, making his psychiatric conditions worse and resulting in misbehavior that warrants further punishment.
Prison officials defend the practice, saying administrative segregation, which can include up to 23 hours a day alone in a concrete cell, is a fundamental part of security.
Art Leonardo, executive director of the North American Association of Wardens and Superintendents, says keeping prisoners away from the general population is a way to "keep them from being harmed."
But prisoners' rights advocates around the nation say putting mentally ill inmates in long-term solitary confinement amounts to cruel and unusual punishment. In some states, activists are pushing court challenges to get convicts, such as Anderson, out of isolation.
"People with mental illness suffer horribly in solitary confinement," said David Fathi, director of the American Civil Liberties Union's National Prison Project.
Anderson, represented by University of Denver law students, last week appeared before a federal judge in Denver to ask for better medication for conditions said to lead to panic attacks. He's also asking to be let outside three times a week.
Colorado Department of Corrections spokeswoman Katherine Sanguinetti says prison officials use isolation "to maintain offender and staff safety."
Inmates' rights activists might concede that temporary isolation has its place, but Anderson's lawyers say he has been in solitary for 12 years, and it's not helping.
Long-term isolation has "become an integral part of how we manage prisons in this country," Fathi said.
The National Prison Project has handled about 10 cases in the last dozen years dealing with mentally ill inmates indefinitely kept in isolation, Fathi said.
There are no statistics detailing how many of the more than 218,000 federal prison inmates are considered mentally ill. Similarly, there is no official estimate as to how many inmates are placed in solitary confinement.
U.S. Bureau of Justice statistics show that in 2010 there were more than 1.4 million inmates in state prisons. However, there are no official estimates for how many state prisoners are mentally ill or in isolation.
Cases involving inmates such as Anderson, convicted of attempted murder in 2000, are coming with increasing regularity, inmates' rights advocates say. The outcomes have been varied.
Lawyers on behalf of a North Carolina inmate with severe paranoid schizophrenia, depression and borderline personality disorder argued last year that a decade of solitary confinement, which sometimes included being shackled inside his cell, worsened his conditions considerably.
But a judge ruled against them, and Michael A. Williams remains in isolation.
A federal jury in January awarded $22 million to a New Mexico inmate who extracted a tooth by hand, rocking it back and forth in the socket for hours, after going without medical or dental care while in solitary confinement for two years.
Stephen Slevin had been isolated because he was depressed and someone checked a box on a form indicating he was suicidal, according to his attorney.
A pending class action lawsuit headed by a South Carolina advocacy group says the state has been punishing mentally ill inmates without giving them enough access to psychiatric care.
One of the four prisoners represented in the suit spent nearly 24 hours a day in his cell for 16 years and saw a counselor only once a month, according to court documents.
Defense lawyers, in closing arguments in March, said South Carolina prison officials are doing their best to treat mentally ill inmates with the limited money they receive from the state.
A judge is considering the case.
Psychiatrist Stuart Grassian says that long-term isolation for prisoners who need psychiatric help is counterproductive. He says the typical approach from prison officials _ "if you punish bad behavior, it'll eventually get better" _ does not work for mentally ill inmates without proper medical treatment.
Leonardo, head of the prison officials group, says that while isolation is not ideal, administrative segregation is the best way to manage inmates who pose a threat and need special care.
"A number of years ago, we began in this country to stop institutionalizing people who had mental illnesses. We just put them in jail. Jails really are not prepared or staffed in most cases to deal with them."
Laura Rovner, a law professor at the University of Denver whose students helped represent Anderson, says part of the reason behind the push for more lawsuits are mental health advocates proclaiming that isolation practices do not work.
"Being put in isolation," Rovner said, "is likely going to make you worse."