In February 2015, a Georgia prison inmate mailed a handwritten complaint to the federal court in Macon, saying he’d been held in a windowless cell for nearly 24 hours a day for five years.

The inmate, a convicted rapist named Timothy Gumm, said he’d been put there after a failed escape attempt in January 2010 and was told he’d remain there indefinitely, even after the escape charge was wiped from his disciplinary record. He lost contact with loved ones, dropped 50 pounds and was “deprived of almost any environmental and sensory stimuli and of almost all human contact,” he wrote. He saw no way out.

“I hate that I even have to trouble you and the court with this matter,” Gumm wrote in a cover letter to the court clerk.

That longshot filing, written on 11 pages of loose-leaf paper without a lawyer’s help, persuaded a skeptical judge to listen, and to eventually force Georgia to open up its isolation unit to outsiders. A social psychologist who’d studied prison conditions for 40 years was shocked at what he saw: metal cells without openings, including one smeared with blood; mentally ill prisoners screaming in anguish; and a crudely drawn sign that said, “HELP.”

A "HELP" sign on a cell in E-Wing. Craig Haney

The psychologist’s report, released publicly last year, led to a settlement in which the state agreed in January to curtail its use of solitary confinement — a small step in America’s slow-moving shift away from a practice that human rights advocates call torture.

“It’s no longer a conversation about is this something we should be doing,” said Sara Sullivan, who leads the nonprofit Vera Institute’s work with state prison systems to curtail solitary confinement. “There’s a lot of momentum for this. But we still have a long way to go.”

A turning tide on solitary confinement

Solitary confinement has flourished in American jails and prisons since the 1980s and ʼ90s as a way of controlling dangerous inmates, punishing a misdeed or protecting vulnerable prisoners from the general population. Dozens of states, as well as the Federal Bureau of Prisons, have built “supermax” facilities where solitary confinement is standard. An estimated 61,000 people ─ including juveniles, pregnant women and the mentally ill ─ were held in solitary confinement in 2017, according to the most recent comprehensive count by the Association of State Correctional Administrators and the Arthur Liman Center for Public Interest Law at Yale Law School.

The numbers were once even higher, but have declined as more elected leaders and corrections officials have acknowledged that solitary confinement is overused and misused, with many inmates being sent back into society when their sentences end. Some researchers say the practice causes permanent psychological damage, while others say it makes inmates more likely to get into trouble after their release.

Around the country, from Maine to Colorado to Virginia and in Congress and the U.S. Supreme Court, authorities are reconsidering solitary confinement through new laws, policies, court opinions and legal settlements. Many are influenced by harrowing recollections of life in solitary confinement — like the tale of Anthony Gay, who was locked up as a teen for allegedly stealing a dollar bill and ended up spending 22 years in solitary confinement in Illinois. Others react to a streak of inmate suicides, as in Alabama recently.

An inmate in a Special Management Unit recreation cage. Craig Haney

Critics of solitary confinement include Rick Raemisch, director of the Colorado Department of Corrections, whose predecessor, Tom Clements, was murdered in 2013 by a man who’d just been released after seven years in solitary confinement.

In the wake of Clements’ death, Raemisch worked to reduce solitary confinement, and Colorado eventually enacted the country’s strictest limit, 15 days at a time, which meets the United Nations’ “Mandela Rules” for treatment of prisoners. (The United States is not bound by those standards.)

“When did it ever become OK to lock someone in a cell the size of a parking space 23 hours a day for years?” Raemisch says in a video tweeted last month by the American Civil Liberties Union.

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In 2015, several Supreme Court justices condemned solitary confinement in written opinions. In 2016, President Barack Obama moved to curtail solitary confinement in federal prisons and cited Kalief Browder, who spent years in solitary confinement on New York’s Rikers Island while awaiting trial and killed himself after being released from prison. The same year, the American Correctional Association, which recommends standards for prisons, called for restrictions on solitary confinement, particularly for the mentally ill. In December, Congress passed, and President Donald Trump signed, the First Step Act, a criminal justice reform bill that includes a ban on solitary confinement for juveniles in federal lockups.

In several states, lawsuits by or on behalf of inmates have led to settlements that forced prison officials to ease up on the use of solitary confinement.

“We are really reaching a tipping point both in terms of corrections culture and the recognition that solitary confinement makes us worse off and doesn’t lead to safe and effective prisons,” said Amy Fettig, deputy director of the ACLU’s National Prison Project. “The public is also becoming more conscious about what people are subjected to behind bars in this country.”

In Georgia, Fettig said, Gumm’s lawsuit revealed an “extreme use of solitary confinement,” described in such detail that it “sounded like a medieval dungeon.”

A ‘man made Hell’

Gumm’s handwritten lawsuit made it to U.S. Magistrate Judge Charles H. Weigle, who acknowledged having “serious reservations as to the ultimate validity” of Gumm’s claims. Laws aimed at curtailing frivolous lawsuits make it hard for inmates to protest prison conditions, and judges set a high bar for hearing such complaints. But Weigle noticed that several other of the 180 or so inmates in the Special Management Unit at Georgia Diagnostic and Classification Prison were making similar claims. He eventually let Gumm’s complaint go forward, and assigned lawyers from the Southern Center for Human Rights to represent him free of charge.

Once the nonprofit civil rights firm got involved, the lawsuit picked up speed. Other inmates joined. And Weigle allowed the center’s two lawyers, Sarah Geraghty and Ryan Primerano, to hire University of California, Santa Cruz social psychologist Craig Haney, one of the country’s top experts in solitary confinement conditions, to tour the unit and talk to inmates there.

“I saw things there I’d never seen before,” Haney told NBC News.

Visiting in October 2017, Haney said he was struck in particular by cells, about 7 by 13-and-a-half feet, with solid metal doors and metal shields over windows, that he said “hermetically sealed” inmates inside. Brief recreation time was confined to outdoor metal cages.

He noted a disturbingly high number of mentally ill inmates ─ about 70 out of 180. He also observed many who had not been diagnosed but seemed to be unraveling psychologically ─ cutting themselves, smearing their cells with blood, eating their feces, swallowing batteries and razors in an attempting to kill themselves. In his report, Haney described one wing of the unit as “bedlam-like,” filled with the “cacophony of prisoner screams and cries for help.”

Timothy Gumm mailed a complaint to federal court saying he'd been held in a windowless cell for nearly 24 hours a day for five years in a Georgia prison. Georgia Department of Corrections

Inmates told Haney they had no sense of when, or whether, they’d ever return to the general population. Most only left the unit when they had completed their sentences.

Haney examined recent suicides on the unit, including the death of Jamie Green, 45, who hanged himself after two years in solitary.

Green, serving a 50-year sentence for child molestation, had been sent to the Special Management Unit in his third month in prison after a fight with an officer. He had attempted suicide in 2013, before his prison sentence, and had received mental health treatment. A counselor said he needed monitoring. But he was not put on the prison’s mental health caseload, where he could have received more care.

As his time in solitary stretched on, Green grew despondent.

On Nov. 7, 2017, not long after losing an appeal of his conviction, Green wrote his sister, Kim Knott, one of dozens of letters he sent from solitary. He called his cell a “man made Hell.”

Jamie Green hanged himself in solitary confinement in 2017. Courtesy of Kim Knott

Knott received the letter two days later, and thought he was planning to take his life. She planned to call the prison the next morning, but that night the prison called to say he was dead.

"Our hearts are crushed,” she said. “It's a big empty hole in your heart that will never be filled. He didn't deserve what he got."

Haney concluded in his report that the unit was “one of the harshest and most draconian such facilities I have seen in operation anywhere in the country,” housing some of the “most psychologically traumatized persons I have ever assessed in this context.” He also noted that the unit was operating “in clear violation of a widespread and growing national and international professional, legal, and correctional consensus” about the harms of solitary confinement.

A step toward reform in Georgia

A few months after Haney’s report became public, Georgia’s Department of Corrections agreed in December to limit solitary confinement to two years. The agency also allowed prisoners in the Special Management Unit more time out of their cells and required more education and mental health treatment. Advocates said the settlement isn’t as far-reaching as they’d like to see ─ Georgia still releases people straight from solitary to the street at the end of their sentences, Geraghty said ─ but it’s a significant step.

An inmate shows self-inflicted lacerations inside his solitary confinement cell in E-Wing. The inmate's face was redacted by Haney in his report. Craig Haney

The Georgia Department of Corrections said in statement that it “recognizes the national reforms surrounding restrictive housing, and we are actively engaged in moving forward with internal procedures that address these trends.” The number of people put in solitary confinement has already been reduced by 40 percent since 2017, the agency said.

That decline includes Gumm, who is serving a life sentence. He was transferred out of solitary confinement in July 2017 after more than seven years there, Geraghty said.

She credits his “exceptionally thoughtful, detailed and well-written” complaint for prompting Georgia’s reforms. He has since written lawsuits on behalf of other inmates and writes creatively as well, Geraghty said. He wants to study law, and has applied to help teach fellow prisoners.

But a settlement does not guarantee change. California agreed three years ago to curtail its use of solitary confinement, but a judge recently found that the state had violated the settlement’s terms.

“Prisons are by definition closed institutions,” Geraghty said. “And sunshine can only help.”

CORRECTION (Feb. 19, 2019, 10:04 a.m. ET): An earlier version of this article misidentified the sister of Jamie Green, a prisoner who died by suicide in solitary confinement. She is Kim Knott, not Jamie Knott.