We return to our series pegged around the topic of torture, which made British news headlines in early Spring 2021 when Ghislaine Maxwell’s brother, Ian, spoke out against what he felt were torturous conditions in her New York jail. She is apparently being continually observed in a 6x9ft (1.8x2.7m) cell with no natural light and terrible food & water rations.

Previously: What’s diet got to do with it?

After exploring the questions of ‘What is torture?’ and ‘How small is too small?’ for a jail cell, we discussed ‘What’s diet got to with it?’. The UN’s Standard Minimum Rules for the Treatment of Prisoners (the Nelson Mandela Rules) stipulate food must be nutritious and a detainee must have ready access to drinking water. However, whether or not allegedly inedible food could be considered ill-treatment amounting to torture as defined by the UN’s Convention Against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment (CAT) is doubtful. Either way though, it’s neither necessary nor proportionate punishment for detainees to be without access to nutritious food and reasonable quality water.

Now: sleep deprivation

More recent news reports have shone light on new bruising around Ghislaine’s eyes, suggesting she is now suffering from sleep deprivation as a result of being woken by torchlight repeatedly throughout the night as part of her suicide watch.

The suicide prevention in jails and prisons guidance written by the World Health Organisation (WHO) recognises that adequate monitoring of suicidal prisoners is important to prevent deaths, especially during the night:-

Adequate monitoring of suicidal inmates is crucial, particularly during the night shift (when staffing is low) and in facilities where staff may not be permanently assigned to an area (such as police lockups).

The guidance also understands that the ‘level of monitoring should match the level of risk’. If Ghislaine’s New York jailors have conducted risk assessments that clearly identify her being high risk of suicide, then constant surveillance may be necessary for her own safety. However, if Ian Maxwell’s claims are true and her jailors are acting purely out of an excessive fear for their own reputation, then her level of monitoring is truly excessive and could even be counter-productive. And, as the Judge presiding over Ms Maxwell’s case has already suggested, she could have an eye covering to help her sleep despite frequent nightly checks. So why didn’t someone think of it before?

The Nelson Mandela Rules, which are designed to maintain a prisoner’s human rights and dignity, include guidance on sleeping arrangements:-

All accommodation provided for the use of prisoners and in particular all sleeping accommodation shall meet all requirements of health, due regard being paid to climatic conditions and particularly to cubic content of air, minimum floor space, lighting, heating and ventilation.

Darkness is essential for good quality sleep. As levels of light decrease at the end of the day our body produces the hormone melatonin, which causes muscle relaxation and the feeling of tiredness, which in turn initiates sleep. Light exposure during the night may impede this natural rhythm, provoking periods of wakefulness. Therefore, appropriate lighting, or lack of it, at night time is an important right for prisoners.

Sleep deprivation and interrogation

Historically, the technique of depriving a prisoner of sleep has been used for the for purpose of obtaining a confession or other information. Sleep deprivation was one of five techniques employed by the British Military as an interrogation method during the 1970s. In the European Court of Human Right’s trial Ireland v. the United Kingdom, it was concluded:-

... Although the five techniques, as applied in combination, undoubtedly amounted to inhuman and degrading treatment, although their object was the extraction of confessions, the naming of others and/or information and although they were used systematically, they did not occasion suffering of the particular intensity and cruelty implied by the word torture as so understood. ...
The Court concludes that recourse to the five techniques amounted to a practice of inhuman and degrading treatment, which practice was in breach of [the European Convention on Human Rights] Article 3.

Whether sleep deprivation is inflicted for the purposes of interrogation or it is a result of other biopsychosocial factors, what might be the health consequences?

The importance of sleep

It is common knowledge that a lack of sleep can impact health and wellbeing. In the short term, it reduces concentration and increases irritability. Ongoing sleep deprivation decrease the immune system’s defence against infectious diseases - not a welcome thought during a worldwide pandemic! It also increases the risk of heart disease and diabetes with serious consequences for life quality and expectancy.

How can prisoners achieve better sleep?

Achieving good sleep in prison is a challenge. The stress and chaos of prison life, sometimes compounded by drug and alcohol use, or a mental health problem, often lead to sleepless nights.

Many of the environmental factors in prison cannot be changed, but it is both easy and important to empower prisoners to choose small things that can have a positive impact on their quality of sleep. This is called ‘sleep hygiene’. Making these small changes also increases their sense of control, which is a rare and precious sensation for most of the world’s detainees.

PILs

Our picture-heavy, word-light Insomnia Patient Information Leaflet (PIL) has been designed especially to help prisoners with sleep hygiene. We are in the early stages of an ongoing project to translate our detainee-friendly PILs into multiple languages and make them freely available on our website. This will make them readily accessible to individuals and organisations involved in supporting many of the world’s 11 million detainees. If you have a heart for helping detainees improve their own health and wellbeing, you could donate to our work or (if you’re suitably skilled) join us as a translator.