On one side of a tall, chain-link fence topped with razor wire is the area of the prison known as “low side,” housing prisoners who don’t pose a serious threat to each other or prison staff. On the other side of that fence is “high side.” That’s where the more dangerous or unruly inmates are kept under more restrictive custody.

When the average person hears the term “solitary confinement,” an image of something not unlike the hole at the old Montana State Prison jumps to mind. It’s the stuff of Hollywood movies, but those images are rooted in reality.

After all, it wasn’t all that long ago that especially unmanageable or violent prisoners at the old prison were stripped naked and handcuffed to metal rails in “slide rail cells” or locked in pitch-black, soundproof metal boxes and left alone for weeks or months. Right up until the old state prison closed in 1979, some of those seemingly medieval techniques were still in practice, according to Sanchez.

Today’s corrections officials, such as Montana State Prison Warden Leroy Kirkegard, say the corrections community has moved beyond such inhumane treatment of prisoners. “From my perspective, solitary confinement is something you’ll see at the old prison: the old, dank, dark dungeons with the hole in the floor …it has no place in modern correctional philosophy,” Kirkegard says during a recent visit to the “new” 68-acre Montana State Prison compound, which opened a few years before the old prison officially closed for good, and houses some 1,440 inmates.

Warden Kirkegard, 56, is a barrel-chested, imposing figure with a neatly groomed silver beard and balding, closed-cropped hair to match. He’s a Montana native who spent nearly 20 years of his professional life working as a correctional officer in Las Vegas before returning to his home state in 2011 as warden of the state-run men’s prison. In his beige suit and opened-collared white dress shirt, Kirkegard’s hard gaze and thin-lipped expression give the appearance of a man with little patience for bullshit.

However, Kirkegard’s imposing physical presence is offset by a grandfatherly affectation and friendly sincerity. He says he’s a nice guy whose tendency is to trust people, but his eyes tell you not to betray that trust.

Kirkegard walks us through the Montana State Prison grounds with the air of a tour guide. Our small party includes Kirkegard, a Montana Department of Corrections attorney, and a public relations official. As we walk, unguarded, from the prison administration building to the maximum-security unit where offenders are held in “administrative segregation,” the warden explains the layout of the facility as guards “keep an eye on us” from the towers above.

On one side of a tall, chain-link fence topped with razor wire is the area of the prison known as “low side,” housing prisoners who don’t pose a serious threat to each other or prison staff. On the other side of that fence is “high side.” That’s where the more dangerous or unruly inmates are kept under more restrictive custody.

We’re heading to the far end of the facility and its two “locked housing” units, maximum-security areas where prisoners are mostly isolated from each other in individual cells. The unit we’re about to tour on a late-September afternoon is Locked Housing Unit 2, which on this day has 52 inmates confined within six separate cell blocks.

“We try everything we can to keep them out of there. But some people have been there a long time and they’re going to be there a long time.” – Warden Kirkegard

Locked Housing Unit 2 is where Montana’s two death row inmates, William Jay Gollehon and Ronald Allen Smith, count their remaining days on earth. Gollehon was sentenced to death in 1992 for the beating death of a fellow inmate in 1990. Smith, the only Canadian on death row in the U.S., earned a trip to the execution chamber in 1983 for murdering Harvey Mad Man and Thomas Running Rabbit, cousins from the nearby Blackfeet Indian Reservation, after they picked him up while he was hitchhiking.

According to MSP policy, locked housing “is the primary resource for housing inmates who are unmanageable, present a threat to others or themselves, or who for other reasons require removal from the general inmate population.” Kirkegard says this unit of six custody blocks is used for “administrative segregation,” and “prehearing confinement,” two forms of isolated housing he says are necessary, but a far cry from the hole.

Administrative segregation is partly used as punishment, and partly as a safety precaution. Prisoners start their stint in administrative segregation, or “ad seg,” with little more than the clothes on their backs. Over time good behavior can earn back basic privileges, such as time out of the cell in the “day room,” phone calls, and possession of books or magazines.

Prehearing confinement is much the same but used to isolate prisoners for a period of time – up to two weeks – prior to in-prison hearings to evaluate their offense then dole out the punishment.

Each bed in these 8-foot by 10-foot cells is a concrete slab with a 3-inch-thick mattress. Another concrete slab serves as a desk; a sink and toilet are in the corner, next to the door. Hooks were once attached to the cinderblock walls, explains unit manager Scott Clark, but prison officials ordered them removed after some inmates tied bedding to the hooks and tried to hang themselves.

Ad seg is a tool the prison must use when dealing with the most violent, most dangerous or otherwise severely out-of-control inmates, according to Kirkegard.

Inmates held in administrative segregation are allowed out of their cells three times a week for showers and five times a week for an hour in the rec yard, according to prison policy. In some less restrictive lockdown units, prisoners can interact with other inmates outside the confines of their cells. Prisoners held in more restrictive lockdown are never free to interact with others, except for whatever communications they can manage through air ducts, or by yelling through the slot of their heavy, steel cell doors.

“People have to earn their way into administrative segregation,” Kirkegard says. “We try everything we can to keep them out of there. But some people have been there a long time and they’re going to be there a long time.”

Ad seg is a tool the prison must use when dealing with the most violent, most dangerous or otherwise severely out-of-control inmates, according to Kirkegard. “If I had perfect inmates here who came in and did their time, we wouldn’t have to have any of this. But unfortunately I don’t,” he says.

This is the area of the Montana State Prison human rights advocates have a problem with. To them, the difference between “solitary confinement” and “administrative segregation,” “supermax,” or “lock-down,” is a matter of semantics. These cells are designed to isolate prisoners from human contact and cut them off from the world. That, the activists say, amounts to torture.

“Human beings require at least some social interaction and productive activities to establish and sustain a sense of identity and to maintain a grasp on reality.”

Dr. Terry Kupers is a psychiatry professor at The Wright Institute, a clinical psychology graduate school in Berkeley, California. Kupers has interviewed thousands of isolated prisoners over the past four decades, and written extensively on the effects solitary confinement has on inmates’ mental health.

Kupers is familiar with the Montana State Prison’s isolation policies in part because he served as an expert witness in a 2009 lawsuit filed by the American Civil Liberties Union of Montana on behalf of a mentally ill teenage boy named Raistlen Katka, who spent more than a year in solitary confinement at MSP. Katka twice attempted suicide in isolation by biting through the skin on his wrist to puncture a vein.

“My thought process was if I don’t die, at least I’ll get out of my cell for 30 seconds,” Katka testified in court, according to a 2010 Billings Gazette newspaper article about the case.

“It is predictable that prisoners’ mental state deteriorates in isolation,” said Kupers in a recent email interview. “Human beings require at least some social interaction and productive activities to establish and sustain a sense of identity and to maintain a grasp on reality. In the absence of social interactions, unrealistic ruminations and beliefs cannot be tested in conversation with others, so they build up inside and are transformed into unfocused and irrational thoughts.”

Kupers says it’s common for disorganized behaviors to soon emerge in isolated prisoners. Their internal impulses tied to anger, fear and other strong emotions grow to “overwhelming proportions.”

Warden Kirkegard denies that prisoners at MSP are ever subjected to total isolation. “We don’t cut people off completely,” Kirkegard says. “They interact daily with staff; they interact with medical; they interact with mental health. They interact with each other.”

Kupers maintains that while the sensory deprivation may not be total, the intermittent slamming of steel doors, yelling, and other noises do not constitute meaningful human communication. “Prisoners in this kind of segregation do what they can to cope,” Kupers says.

Some prisoners relentlessly pace around their cells and do pushups to try to relieve emotional tension. Those who are allowed books, paper and writing utensils read and write letters. Kupers says the tendency to suffer psychiatric breakdown and become suicidal is made even worse by sleep deprivation, which is a frequent occurrence among isolated prisoners.

“There are noises at night as other prisoners, for example those suffering from serious mental illness, cry out … officers yell out orders on the unit. Then, the lights are likely on all night,” Kupers says.

That lack of sleep intensifies psychiatric symptoms, according to Kupers, by interfering with the normal diurnal rhythm – the steady alternation of day and night that orients human beings with time – and the resulting sleep loss creates fatigue and magnifies cognitive problems, memory deficits, confusion, anxiety, and sluggishness.

“It is under these extreme conditions that psychiatric symptoms begin to emerge in previously healthy prisoners,” Kupers says. “Of course, in less healthy ones – and a majority of jail inmates suffer from or are prone to mental illness – there is psychosis, mania or compulsive acts of self-abuse or suicide.”

“My thought process was if I don’t die, at least I’ll get out of my cell for 30 seconds…” – Raistlen Katka, Former MSP Inmate

Former Montana State Prison inmate Leroy McKelvey did not cope well during his stint in “ad seg” isolation. McKelvey, 32, was convicted in 2008 of aggravated assault but found by the court to be mentally ill. He was first admitted to the Montana State Hospital in Warm Springs in January 2009 and was eventually released, but a probation violation landed him back in the state’s only psychiatric hospital in May 2012.

McKelvey has myriad mental health diagnoses ranging from schizoaffective disorder, to post-traumatic stress disorder, to antisocial personality disorder. He also suffers from drug and alcohol dependency and a host of other physical ailments and mental health issues. According to his health records, he was hospitalized more than 10 times for psychiatric conditions prior to his readmission to the state hospital in 2012.

At 5-foot 9-inches with buzz-cut hair and a short brown goatee, McKelvey is affable and recalls certain details with amazing clarity, but he’s also jumpy and doesn’t tend to hold eye contact for long. He’s proud that he has a handle on his mental illness, is holding a steady job, and is engaged to his girlfriend, who he met in a mental health group home. On this fall day he’s raising money for a fundraising walk to benefit the Montana chapter of the National Alliance on Mental Illness.

McKelvey talks easily and openly about prison life. Remembering his “house” – or prison cell – on low side, he speaks almost fondly about work activities and prison shenanigans he and other inmates took part in.

But when he describes the July 16, 2012 episode that landed him in pre-hearing confinement, and the events that followed, his mood becomes serious. McKelvey’s gaze hardens, his eye contact more consistent, and he responds to questions with short, direct answers the way a trained soldier might address his commanding officer.

In fact, McKelvey served tours in Iraq and Afghanistan as a U.S. Marine, he says, and according to his own account was dishonorably discharged after assaulting his commanding officer.

McKelvey says while in prison a PTSD flashback from his military days – a painful memory of watching two close buddies die in combat – sent him into a violent rage that July day in MSP. He began beating his mattress, believing it was his former commanding officer, the man he blamed for the death of his comrades.

When prison guards arrived at his cell and ordered him to “cuff up,” McKelvey refused and was physically restrained and extricated from his cell. “You can go peacefully, or you can defy orders and they’ll give you a nice shot of OC [pepper] spray,” McKelvey recalls.

That incident landed McKelvey in pre-hearing confinement, he says, which turned into stints in isolation. Here, McKelvey’s mental state rapidly deteriorated. He threatened to kill the prison psychologist. By Oct. 31, 2012, he was referred back to the Montana State Hospital.

According to his re-admission evaluation at the hospital, “Mr. McKelvey had become unmanageable in the past few months…in the prison setting despite involuntary medication administration and maximum security placement for an assortment of out-of-control behaviors including not eating and losing weight, unable/unwilling to communicate rationally, disrobing, urinating on the floor, smearing feces, crawling in the toilet, angry/belligerent/demanding/entitled/threatening outbursts, and manipulative and drug-seeking behaviors.”

McKelvey says he begged mental health staff for anti-psychotic medications to treat his mental illnesses, but former prison staff psychiatrist Peter Edwards – who oversaw McKelvey’s mental health treatment at the time – noted that he believed McKelvey exhibited drug-seeking behavior and was “malingering,” or faking mental illness to get out of isolation.

The former inmate doesn’t recall much about his time in solitary. “I remember there was feces on the floor, toilet paper … supposedly I was eating toilet paper… I guess when I threw out toilet paper and shit, I guess I thought I was creating a new universe, which is weird,” McKelvey says with an embarrassed laugh. “I was always trying to cover my floor with my Barney Rubble suit and call it my carpet. I don’t remember getting any sleep. I thought I seen Hitler in there.”

“Barney Rubble suit” is the name prisoners use to refer to smocks worn by suicidal inmates which resemble the outfit worn by the The Flintstones cartoon character.

McKelvey says since he was on a behavioral management plan, he was fed a “food loaf,” which he described as being made of “raisins, carrots, and nasty-ass bread stuff.” He says he was so constipated from the food loaf and water diet that at one point he tried pulling feces out of his anus with his fingers. “The guards, you know, they just laughed about it,” McKelvey says.

Prison officials declined to discuss McKelvey’s case.

When an average individual is placed in isolated confinement, he will develop massive free-floating anxiety, hyper-responsiveness, paranoid ideas, confusion, perceptual distortions, and psychomotor excitement and become frightened, says Kupers of The Wright Institute.

And those are the widely reported symptoms experienced by relatively stable prisoners in isolation, Kupers says. “Just imagine how difficult it would be for someone who is prone to paranoid psychosis or suicidal despair to remain balanced.”

“Segregation should be utilized relatively rarely, and only when less restrictive and potentially damaging alternatives have been tried and exhausted…” – Dr. Terry Kupers

Disability Rights Montana is a federally mandated civil-rights watchdog and advocacy organization based in Helena, Montana, and is the lead plaintiff in a pair of federal lawsuits against the Montana Department of Corrections and the Department of Public Health and Human Services. The complaints center on a practice of shipping guilty-but-mentally-ill patients from the state mental hospital in Warm Springs to the state prison in Deer Lodge without giving those patients due process.

The lawsuit against the Montana State Prison alleges the prison is guilty of a pattern of withholding medication, misdiagnosing prisoners with long histories of mental illnesses, and punishing mentally ill inmates for behavior caused by their mental illness.

According to DRM’s investigation and lawsuit, prisoners with mental illnesses were routinely subjected to months or years of solitary confinement and “behavior modification plans” that deprived them of clothing, working toilets, bedding and proper food, which only exacerbated their illness and caused needless suffering. “It’s torture. It’s inhumane,” says DRM Executive Director Bernadette Franks-Ongoy.

If Kirkegard is a warden straight out of central casting, then Franks-Ongoy could play a middle school librarian. She has short, salt-and-pepper hair and wears dark, square-rimmed glasses. She smiles easily when she talks, but her friendly demeanor belies a fiery passion fueling her advocacy on behalf of people with disabilities.

Franks-Ongoy says DRM doesn’t typically get involved in prison litigation because such lawsuits tend to diminish an advocacy organization’s financial resources. But DRM made an exception in this case.

“Some of the things we were hearing were really outrageous in terms of prisoners being put in solitary confinement; prisoners not getting their medication, prisoners being identified as malingerers when they have mental illness,” Franks-Ongoy said on September 3, a few hours after a federal judge in Helena dismissed the corrections department from the lawsuit, though DRM is now appealing that decision. Neither side would comment on the lawsuit specifics citing the pending litigation, but Franks-Ongoy spoke openly about her fierce opposition to isolation as a form of punishment.

“Uncategorically, it is absolutely an inappropriate way in which to manage and in which to treat any person with a disability,” she says. “Solitary never works.”

Zupanic points out that the vast majority of prisoners who are held in isolation will one day be released back into the public. She says it’s counterproductive to subject inmates to seclusion that could exacerbate their mental health issues or harden antisocial behaviors.

Human rights advocates say there are ways to safely confine dangerous prisoners without violating basic human rights.

“There are little things the prison can do such as increasing out-of-cell time, increasing contact through phone calls, or through letters or through in-person visitation through a barrier … so you’re lessening the negative impacts of someone being completely alone,” says Niki Zupanic, public policy director for the ACLU of Montana.

Zupanic points out that the vast majority of prisoners who are held in isolation will one day be released back into the public. She says it’s counterproductive to subject inmates to seclusion that could exacerbate their mental health issues or harden antisocial behaviors.

The anti-solitary confinement advocates we spoke to for this story say they do not oppose short-term segregation in emergency situations or for safety reasons. But Kupers points out that the Special Rapporteur on Torture for the U.N. has said that solitary confinement for longer than 14 days is a human rights abuse.

“Segregation should be utilized relatively rarely, and only when less restrictive and potentially damaging alternatives have been tried and exhausted,” Kupers says.

For his part, Warden Kirkegard says he’s tuned in to the national focus on administrative segregation and considers himself a part of that conversation. While he says he personally doesn’t believe in administrative segregation, he calls it a “necessary evil.”

“We have offenders here that are violent to the point that they have to be locked up,” Kirkegard says. “I would much rather be sitting here talking to a reporter … or talking to a judge defending my use of administrative segregation, before I’d have to stand in front of anybody and have to defend someone killing one of my staff or killing another inmate.”

Kirkegard says he’s taking steps to reduce the number of inmates housed in segregation. The prison is working on infrastructure upgrades that will eventually turn some lock-down isolation units into less-restrictive housing blocks.

But Kirkegard says he faces significant challenges. While the “new” Montana state prison may be a century advanced from the one built during Montana’s frontier days, it’s now almost 40 years old. The locked housing units were built in 1982 and reflect the predominant correctional philosophies of the time. Kirkegard has to work within the parameters of the facility he manages, he says.

“What you saw today is what I’ve got, and I’ve got a lot of inmates,” Kirkegard says. “So yes, we are well-aware of the national trend, but I have limitations here at the Montana State Prison.”

While they may be in philosophical tug-of-war over the use of segregation, Kirkegard and human rights groups agree that drastically reducing the number of prisoners in segregated housing will require significantly more financial resources from the state.

“My problem with population is managing with the beds that I have,” Kirkegard says.

“Although there is plenty of death within the walls, more men came into the prison, did their time, and were released than died at Deer Lodge,” Felton wrote. “While they were there, the prison took their souls.”

Larry Cheadle died in the cell at the far end of “the hole” in the old Montana State Prison. In some of the hole’s other cells, prisoners used crude tools to carve slashes in the stucco walls marking the days they spent isolated beneath the prison’s administration building.

Bill Felton, a former corrections officer at the new prison, periodically visited the old penitentiary during the late 1980s. According to Ellen Baumler’s book, Dark Spaces: Montana’s Historic Penitentiary at Deer Lodge, Felton wrote eloquently about the way prisoners were treated at the old prison.

“Although there is plenty of death within the walls, more men came into the prison, did their time, and were released than died at Deer Lodge,” Felton wrote. “While they were there, the prison took their souls.”

Five decades after Cheadle’s death in the hole, the debate surrounding the use of solitary confinement has certainly changed, but it’s still a long way from being settled. The controversy over isolation in Montana and throughout the country continues to smolder.

JOHN S. ADAMS is an award- winning investigative journalist and former Capital Bureau Chief for the Great Falls Tribune. When he’s not studying arcane bureaucratic processes, digging around in dark corners of major institutions, or holding elected officials accountable, Adams spends much of his time seeking untracked powder in Montana’s backcountry.