Supermax prisons, which are designed to hold prisoners in prolonged and strict solitary confinement, are ineffective, expensive, and detrimental to mental health, surgeon and journalist Atul Gawande said during a speech at Harvard Law School yesterday.

Gawande, who is also a professor at the Medical School and the School of Public Health, questioned whether solitary confinement is equivalent to torture, citing apathy among the public as the reason that solitary confinement is so pervasive in the United States.

“The public is outraged at some level, but not deeply enough...The prisoners are not connected to our society due to racial, socioeconomic, and educational disparities,” Gawande said. “The average inmate is not a person you would run into in daily life. I think it would disturb us or be difficult to stomach putting people we grew up with in solitary isolation.”

There are currently at least 25,000 prisoners in solitary confinement in the United States, according to Gawande.

He cited a study by Craig W. Haney, a psychology professor at the University of California, Santa Cruz, that found that after months or years of complete isolation, many prisoners “begin to lose the ability to initiate behavior of any kind—to organize their own lives around activity and purpose.”

Gawande said the study found that solitary confinement often leads to chronic apathy, lethargy, depression, and despair among prisoners, and that once released they are more likely to commit crimes than they were before being put in solitary confinement.

Supermax prisoners are typically confined to their cell for at least 23 hours a day and permitted to leave only to shower or exercise in an outdoor cage. These prisoners receive their meals through slots in their doors and are shackled whenever they leave their cells.

According to Gawande, one of the paradoxes of solitary confinement is that, as starved as people become for companionship, the experience typically leaves them unfit for future social interactions.

Gawande cited the case of Bobby Dellelo, who was held in isolation for more than five years of a 40-year prison term.

After months without human contact, when Dellelo had an in-person meeting with his lawyer, he had trouble following the lawyer’s words and hand gestures and had difficulty speaking, ultimately leading him to have a panic attack.

“When we consider legalized torture, we consider Guantanamo and Abu Ghraib,” Gawande said.

“But solitary confinement in our state prisons is the legalized torture of our own people within our own communities.”