d. Key principles for the use of seclusion and instruments of restraint Drawing on the Mandela Rules and on other international human rights law and professional guidance,17 I would set out the following key principles for assessing the use of solitary confinement: • It must only be used to achieve a specific and well defined purpose; as a last resort when other avenues have been tried and failed; for a short a time as possible, and; in the least restrictive conditions possible. • Where used, minimum requirements must be met and minimum standards adhered to (and preferably exceeded). Minimum entitlements include sufficient food, drinking water and health care,18 and daily access to at least 1 hour of fresh air and exercise, a telephone, and a shower. Material conditions of detention must also meet the minimum standards set in international instruments including those relating to natural and artificial light, ventilation and thermal comfort. • Solitary confinement must not be indefinite or prolonged (longer than 15 days). • Certain categories of people must be excluded from solitary confinement altogether, in particular children and young people, and people with disabilities, including mental health conditions. • Decisions on the regime, material conditions and provisions that segregated people can access should be based on ongoing, individual risk and needs assessments; should ideally involve the individual concerned, and be taken by a multi-disciplinary team, and; be regularly and substantively reviewed by a different person to the one who authorised the initial placement. • The institution’s need to maintain good order or discipline in prison or to prevent patients from acting in a harmful manner in health and disability settings must never be at the expense of the individual’s needs and right to be treated with respect for their inherent human dignity. The individual has a right not to be subjected to inhuman or degrading treatment or punishment. The burden is on the authorities to demonstrate that they have sought alternatives to seclusion/ restraint.19 17 See Appendix 3 for additional human rights texts and A Sourcebook on Solitary Confinement (2008) (cited above) for further discussion and referencing. 18 Due to time constraints, health-care provisions for secluded/segregated individuals were outside the scope of this review, but these should be looked at and assessed. 19 World Health Organisation (2005) Resource on Mental Health and Human Rights. WHO Europe: Copenhagen. 22