Solitary Survivor Survey
This survey is for solitary survivors who have experienced segregation, solitary confinement, or being sensory and socially deprived (SSD) in a Michigan prison for an extended period of time (over 15 days.) We define solitary confinement as any setting in which a person is isolated in prison for more than 20 hours a day. (A separate survey is available for family members who have a loved one in solitary.)
Citizens for Prison Reform (CPR), AFSC Michigan Criminal Justice Program, and the ACLU of Michigan plan to use information learned in this survey to inform a policy brief and recommendations as part of the Open MI Door Campaign, a statewide effort to end harmful practices and develop safer, more therapeutic alternatives to solitary confinement. Visit
to learn more.
You can choose whether or not to participate in the survey and can stop at any time. You do not need to answer every question. Your responses will remain anonymous and your name will not be required to complete this survey. Responses to anonymous surveys will not be traced back to the respondent. No personally identifiable information will be captured unless voluntarily offered in any of the comment fields. Our materials will never include any identifiable information for anyone currently in prison or under MDOC supervision. There are no right or wrong answers to the questions.
Trauma disclaimer: We aim to forewarn individuals who would like to complete this survey about potentially traumatizing content. We understand that considering the conditions of confinement in solitary and/or segregation is incredibly traumatizing. If you find yourself unable or unwilling to complete this survey, please discontinue at any time. While we value your input, we do not wish to add any more trauma to an already difficult situation.
Please contact 734-761-9796 for further questions. This number is on the universal pin, meaning you can call this number collect Mon-Fri 8:30-4:30. You may also email questions to
Was your solitary experience in a Michigan prison?
1. How long were you/ have you been in segregation?
2. At which facilities were you in segregation?
3. Please describe your experience when you first entered segregation:
4. Please describe your experience as time went on. How did your activities change? How did your habits change? Anything else like sleep, hunger, ability to concentrate, etc.
5. What are things about isolation that are the most difficult to handle (i.e. the most dreaded part of segregation)?
6. Was/is fear a part of your experience?
7. Did you develop any lasting physical ailments as a result of segregation?
8. Please describe how your relationship with your family has changed during your time in segregation.
9. If you could either change or replace segregation, would you? How would you change it?
10. Anything else you think is important to include?
Would you be interested in doing an interview about the impact of solitary confinement on your life?
Yes, please contact me for an interview about my experience. (Be sure to include your contact information in the fields above.)
No, thank you.
By submitting this questionnaire, I give permission to Citizens for Prison Reform (CPR), AFSC Michigan Criminal Justice Program, and the ACLU of Michigan to use my anonymous responses, all or in part, for written publications and other materials related to the Open MI Door Campaign.
Yes, I give permission to use my anonymous responses in written publications.
No, I do not want my responses included in written publications.
Never submit passwords through Google Forms.
This form was created inside of Michelle Weemhoff.