Mary E. Buser worked in the mental health field on Rikers Island from 1995 to 2000.. She co-founded the Samaritans of New York suicide prevention hotline, which she directed from 1984 to 1990.

New York state recently announced reforms to the practice of solitary confinement in its jails and prisons. The changes include a ban on this extreme punishment for adolescents, pregnant women and the developmentally disabled.

During my tenure as an assistant chief of mental health on New York City’s Rikers Island from 1998 to 2000, I worked in the punitive segregation unit, which is known as “the Bing.” Even if inmates had no psychiatric issues before they entered solitary, the strain of confinement to an 8-by-9-foot cell — with a daily shackled walk to spend one hour in an outdoor cage — makes mental decompensation swift. Our team was a constant presence in the 500-cell unit — doling out antidepressants, antipsychotics and mountains of sleeping pills. When medication wasn’t enough to hold a person’s psyche together — when human behavior deteriorated into frantic scenes of self-mutilation, as often happened — we were called to cell doors.

While the terms “solitary” and “lockdown” are often bandied about in the media, most people have no idea what they really mean. I often wished the public could have accompanied me to these cells — to see blood-smeared walls, makeshift nooses and agonized, shell-shocked faces. Some inmates were unable to speak, cowering in a corner, often naked and smeared in feces. I imagine that citizens, steeped in the belief that the incarcerated are treated humanely, would be horrified. I was.

But I had little time to think about it. Decisions had to be made. The question we had to ask ourselves was whether the breaking point had been reached — if death or severe injury was likely. If so, the inmate would be bused to a smaller, more specialized unit in another jail. The bus ride alone seemed to offer the isolation-weary inmate enormous relief. We called it “bus therapy.” Once he was a little better, though, he’d be shipped right back to complete his sentence. Like a weary swimmer treading water but starting to go under, he’d be pulled out to catch his breath, then thrown back in. Time and again, I felt that this had all the earmarks of torture. But I brushed the word from my mind, reminding myself that I lived in a civilized country that prohibits such things. Besides, the occupants of these cells had done something to warrant this punishment — perhaps hurt another inmate or an officer.

Yet no matter how hard I tried to rationalize it, I knew in my heart that something was very wrong. A nation that prides itself as progressive on human rights had lost its way.

I often thought of Sen. John McCain, who was famously held prisoner during the Vietnam War. Of his five-plus-year captivity, more than two years were spent in solitary. McCain was cruelly starved and viciously beaten — but he found solitary confinement to be worse. “It crushes your spirit and weakens your resistance more effectively than any other form of mistreatment,” he has written. While our country decries the abuse that McCain endured, somehow Americans don’t equate it with the same treatment that is meted out every day in jails and prisons throughout the United States.

Lately, however, there are hopeful signs. Growing media attention toward our criminal justice system and its myriad problems is casting a spotlight on the deepest recesses of a cutoff world, where human beings in isolation endure untold suffering. New York’s reforms are the stirrings of real change.

Having worked “behind bars” for five years in various capacities, I understand the rationale for solitary — the need to safeguard correctional staff, maintain jailhouse order and manage “high risk” inmates. If, however, the United States is truly to be the champion of human rights that Americans say we are, then surely we can find more humane methods of achieving these goals.