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Surviving Russian Prison: Evan Gershkovich's Health After Incarceration

— We wish him the best support in reintegrating back home

MedpageToday
A photo of Evan Gershkovich at Andrews Airforce Base after he was released from Russian prison.
Alexandrova is an expert in Russian history and culture. Parker is a licensed professional counselor.

On August 1, 2024, , an American journalist covering Russia for the Wall Street Journal, was released as a result of the between the U.S. and Russia since the Cold War. Others released included former U.S. marine Paul Whelan, incarcerated since 2018, and Alsu Kurmasheva, a fellow journalist with dual Russia-U.S. citizenship.

Gershkovich was arrested and detained for alleged espionage while working on an assignment in Yekaterinburg, Russia in March 2023. After spending approximately 16 months in a pre-trial detention facility, Gershkovich received a in a high-security penal colony for his alleged unlawful activities. According to the on the same day, Gershkovich "was targeted by the Russian government because he is a journalist and an American."

In recent years, it has been a common practice by Russia's Federal Security Service to in order to use them for prisoner exchanges, as happened to basketball player Brittney Griner, who was exchanged for a , Viktor Bout. However, Gershkovich's story was quite different from Griner's, Whelan's, and other fellow Americans detained by Moscow, since he endured 16 long months of pre-trial detention in one of the , and spent at least part of that time .

Gershkovich in Russia

Unlike Griner and some other Americans in the Russian penitentiary system, Gershkovich, to our knowledge, did not perform hard labor in frigid temperatures, and his knowledge of the Russian language likely helped him navigate the Russian penal system. However, solitary confinement is considered to be one of the most difficult punishments.

Gershkovich spent 16 months in the notorious Lefortovo prison in Moscow, a pre-trial detention center (SIZO) famous for its psychologically difficult conditions due to isolation and information vacuum. In recent years, further restrictions were placed on the detained, such as a ban on sleeping during the day (previously unregulated) and restrictions on the use of potable water during walks.

As to Gazeta.ru, "For Lefortovo in general, the problem of prisoners' isolation from the outside world has a much more serious and threatening dimension. In the first 2 or 3 weeks, the defendant finds himself [in this detention center] in a complete information vacuum, without access to visits or even the possibility of any other contact with the outside world."

Lefortovo is different from other SIZOs because in others the incarcerated can still use their cell phones, can see their lawyers, and meet with relatives. Not so in Lefortovo, where the detainees often don't speak to anyone for weeks at a time.

A Closer Look at Solitary Confinement Globally

Throughout history, solitary confinement has been used as the harshest form of punishment for a criminal, detainee, or prisoner of war (POW). It has been highly criticized in all settings due to its detrimental effects across the lifespan. This knowledge is nothing new: have found that "solitary confinement was the 'most psychologically devastating treatment' the prisoners endured."

This type of placement is typically defined by as much as 23-24 hours per day with no contact with other individuals. Many facilities have strict security procedures (which often involve restraints), and the incarcerated typically don't have access to any prison programs (this includes education, vocational activities, or stimuli), often having no outdoor time.

Those in solitary confinement typically have little to no access to mental health treatment, and are often denied medical treatment. There appears to be a against prisoners in these conditions that further exacerbates the outcomes. This practice has been identified by some as a and is often challenged, especially since its long-term effects vary based upon the individual, the length of the isolation, and the exact conditions the prisoner faces.

In to 1983, Stuart Grassian, MD, found that prisoners who experienced solitary confinement were more likely to develop "perceptual changes, affective disturbances, cognitive difficulties, disturbed thought content, and impulse-control problems." Further research found that those who experienced solitary confinement also experienced physical symptoms like anxiety attacks and headaches, along with long-term psychological issues involving rumination, social withdrawal, and anger. This cluster of symptoms has been called .

The Mental Health Consequences of Captivity

Without having met or spoken with Gershkovich, we can only imagine what he may experience now that he is home. What we can offer is an overview of the possible mental and physical health implications that individuals held in solitary confinement or captivity for a prolonged period of time may face.

A person imprisoned under the same conditions as Gershkovich could experience challenges in integrating back into society, which is common for those who have been in solitary confinement. Symptoms of post-traumatic stress disorder -- which often appear after imprisonment -- can hinder the ability to fully integrate without significant support from family, friends, and medical providers.

Many POWs and others held captive report behavioral effects, such as higher levels of paranoia, anxiety, and anger. Others in captivity report physical health consequences; these can result if the person lacks access to their normal medications or if some sort of treatment becomes necessary but isn't provided. Physical symptoms that can result from traumatic situations include heart palpitations, headaches, stomachaches, and difficulty focusing, but these are widely variable depending on the unique circumstances. Finally, those held in solitary confinement and deprived of stimuli for an extended period of time can also struggle with severe anxiety in social situations.

Right after his release, Gershkovich spoke to his boss, the Wall Street Journal's editor, Emma Tucker, and he was making jokes and appeared normal. Given that we don't know the exact circumstances Gershkovich faced during his 16-month-long incarceration, it's hard to predict the particular consequences he may face. We can only wish him the best support and well-being in reintegrating back home.

is an associate professor of instruction at the University of Texas at Austin's Department of Slavic and Eurasian Studies. She teaches courses in Russian history and culture, and is currently involved in student well-being initiatives at UT-Austin. is clinical director of , and president of TX C.U.R.E. She is a licensed professional counselor and a certified integrative mental health professional.