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Research ArticleRegular Article

Hunger Strikes After Restricted Housing Reform

Anthony Tamburello, Kerri Edelman and Rusty Reeves
Journal of the American Academy of Psychiatry and the Law Online March 2025, 53 (1) 45-54; DOI: https://doi.org/10.29158/JAAPL.240088-24
Anthony Tamburello
Dr. Tamburello is Associate Director of Psychiatry and Dr. Reeves is Director of Psychiatry, University Correctional Health Care, Trenton, NJ. Dr. Tamburello is a Clinical Professor of Psychiatry and Dr. Reeves is a Clinical Professor of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ. Dr. Edelman is a staff psychologist, Garden State Youth Correctional Facility, University Correctional Health Care, Yardville, NJ.
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Kerri Edelman
Dr. Tamburello is Associate Director of Psychiatry and Dr. Reeves is Director of Psychiatry, University Correctional Health Care, Trenton, NJ. Dr. Tamburello is a Clinical Professor of Psychiatry and Dr. Reeves is a Clinical Professor of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ. Dr. Edelman is a staff psychologist, Garden State Youth Correctional Facility, University Correctional Health Care, Yardville, NJ.
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Rusty Reeves
Dr. Tamburello is Associate Director of Psychiatry and Dr. Reeves is Director of Psychiatry, University Correctional Health Care, Trenton, NJ. Dr. Tamburello is a Clinical Professor of Psychiatry and Dr. Reeves is a Clinical Professor of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway, NJ. Dr. Edelman is a staff psychologist, Garden State Youth Correctional Facility, University Correctional Health Care, Yardville, NJ.
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    Figure 1. NJDOC hunger strikes over time. Controlled for year-end census; linear regression: R2 = 0.07, F = 0.46, p = .53.

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    Table 1

    Summary Statistics of NJDOC Hunger Strikes Before and After Reform (2015–2022)

    Pre-ICRAPost-ICRAAllp
    Strikes15162213.93
    Unique strikers13357190.681
    Strikes annually (prorated)27.025.726.6.939
    Unique strikers annually (prorated)23.823.623.8.681
    Mean hunger strike duration (days)28.99.723.034a
    Median hunger strike duration (days)434—
    Percent strikes >3 days60.3%45.2%55.9%.049a
    Max duration (days)888222888—
    Mean weight change (pounds)−6.9−5.5−6.4.587
    Weight loss >10% (when known)11.1%8.7%10.3%1
    Percent unknown weight change70.2%62.9%68.1%.331
    • ICRA = Isolated Confinement Restriction Act; NJDOC = New Jersey Department of Corrections.

    • ↵a p < .05.

    • View popup
    Table 2

    Demographics and Housing Locations of NJDOC Hunger Strikers Before and After Reform (2015–2022)

    Pre-ICRAPost-ICRAAllp
    Average age36.937.136.9.895
    Median age353635—
    Men92.5%98.4%93.9%.114
    Women6.0%1.6%4.8%—
    TG-F2.0%0%1.4%—
    TG-M00%0%—
    African American56.3%53.2355.4%.245
    White27.8%37.1%30.5%—
    Hispanic11.3%6.5%9.9%—
    Asian2.7%0%1.9%—
    Other0.7%0%0.5%—
    Unknown1.3%3.2%1.9%—
    Disciplinary housing72.2%74.2%72.8%.866
    PHD, PHDH, or Detention27.2%29.0%27.7%.866
    Ad Seg (Pre-ICRA)43.7%——1
    RHU (Post-ICRA)—43.6%——
    • Ad Seg = administrative segregation; ICRA = Isolated Confinement Restriction Act; NJDOC = New Jersey Department of Corrections; PHD = prehearing detention (pre-ICRA); PHDH = prehearing detention housing (post-ICRA); RHU = restorative housing unit; TG-F = transgender female; TG-M = transgender male.

    • View popup
    Table 3

    Diagnoses of NJDOC Hunger Strikers Before and After Reform (2015–2022)

    Pre-ICRAPost-ICRAAllp
    Any personality disorder62.9%58.1%61.5%.538
    ASPD39.1%41.9%39.9%.759
    Malingering29.1%9.7%23.5%.002a
    No diagnosis19.9%32.3%23.5%.074
    ICD or ADHD17.2%19.4%17.8%.697
    Anxiety disorder13.3%17.7%14.6%.399
    Psychotic disorder11.9%12.9%12.2%.821
    MDD11.9%6.5%10.3%.323
    BPAD11.3%9.7%10.8%.813
    Adjustment4.0%0.0%2.8%.184
    Placement on the MH Special Needs roster63.4%57.4%61.5%.355
    No diagnosis or any personality disorder82.8%90.3%85.0.%.207
    • ADHD = attention deficit and hyperactivity disorder; ASPD = antisocial personality disorder; BPAD = bipolar affective disorder; ICD = impulse control disorder; ICRA = Isolated Confinement Restriction Act; MDD = major depressive disorder; MH = mental health; NJDOC = New Jersey Department of Corrections.

    • ↵a p < .05.

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    Table 4

    Documented Reasons for Starting a Hunger Strike (2015 – 2022)

    Pre-ICRAPost-ICRAAllp
    Housing change25.8%25.8%25.8%1
    Protest discipline19.9%19.4%19.7%1
    Conflict with custody11.3%3.2%8.9%.108
    Suspected psychiatric symptoms8.6%11.3%9.4%.607
    Unknown8.6%9.7%8.9%.795
    Disagreement with medical treatment8.0%11.3%8.9%.436
    Conditions of confinement6.6%8.1%7.0%.770
    Legal4.0%6.5%4.7%.482
    Parole3.3%0.0%2.4%.325
    Disagreement with mental health treatment2.7%6.5%3.8%.235
    Property2.7%3.2%2.8%1
    Classification2.7%0.0%1.9%.325
    Conflict with peers2.7%0.0%1.9%.325
    Dietary2.0%4.9%2.8%.360
    Lack of family contact1.3%1.6%1.4%1
    Support hunger striking peer1.3%0.0%0.9%1
    • ICRA = Isolated Confinement Restriction Act.

    • View popup
    Table 5

    Reasons Documented for Stopping a Hunger Strike (2015 – 2022)

    Pre-ICRAPost-ICRAAllp
    Unknown43.1%53.2%46.0%.226
    DOC intervention17.9%8.1%15.0%.090
    MH intervention total11.7%11.3%11.3%1
     MH intervention (medication)3.3%3.2%3.3%—
     MH intervention (housing)3.3%1.6%2.9%—
     MH intervention (higher LOC)2.7%3.2%2.9%—
     MH intervention (education)2.0%3.2%2.4%—
     MH intervention (liaison with DOC)0.7%0.0%0.5%—
    Gave up10.6%11.3%10.8%1
    Medical intervention total7.3%3.2%6.1%.355
     Medical intervention (education)5.3%3.2%4.7%—
     Medical intervention (diet)1.3%0.0%0.9%—
     Medical intervention (hospitalization)0.7%0.0%0.5%—
    Wanted off hunger strike protocol3.3%8.1%4.7%.159
    Gave up after medical illness2.7%0.0%1.9%.325
    Moot (released)1.3%1.6%1.4%1
    Denied hunger strike1.3%1.6%1.4%1
    Legal intervention0.7%0.0%0.5%1
    • DOC = Department of Corrections; ICRA = Isolated Confinement Restriction Act; LOC = level of care; MH = mental health.

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Journal of the American Academy of Psychiatry and the Law Online: 53 (1)
Journal of the American Academy of Psychiatry and the Law Online
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1 Mar 2025
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Hunger Strikes After Restricted Housing Reform
Anthony Tamburello, Kerri Edelman, Rusty Reeves
Journal of the American Academy of Psychiatry and the Law Online Mar 2025, 53 (1) 45-54; DOI: 10.29158/JAAPL.240088-24

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Hunger Strikes After Restricted Housing Reform
Anthony Tamburello, Kerri Edelman, Rusty Reeves
Journal of the American Academy of Psychiatry and the Law Online Mar 2025, 53 (1) 45-54; DOI: 10.29158/JAAPL.240088-24
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Keywords

  • prison
  • hunger strike
  • restricted housing
  • isolated confinement
  • reform

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