Former prisoners and families of those inside jail say the trauma of solitary confinement will haunt them for life.
A recent report from the independent Office of the Inspectorate found between 2020 and 2021, 5665 prisoners spent extensive time in segregation.
The findings shed light on long-lasting consequences faced by at-risk prisoners who spend months, or even years, by themselves.
Cosmo Jeffery, 77, remembered his five-day experience in solitary confinement 20 years ago.
He spent two years at Christchurch Men's Prison after being charged with class A and B drug importation and possession.
In a protest against being transferred to a facility far from home he went on a hunger strike, and he was put in segregation for observation. He was shut in a small cell with the lights on all day, Jeffery remembered.
"In my time, they gave you a horse blanket which was impossible to rip or in any way use in case you wanted to take your life.
"And that got taken away about eight o'clock in the morning... and you are inside that cell all day and, if you are lucky, you went out for an hour or so."
Years after his segregation experience, Jeffery said the memories took a toll on his mental health.
"The feelings of that whole era... I find it quite hard to cope.
"My view is that, if you broke the law - which I did - the punishment is going to prison. But to further punish people by taking normal human needs away from someone is adding punishment on top."
'He said it sucked' - prisoner's whānau
Martha* saw her 26-year-old grandson, diagnosed with foetal alcohol spectrum disorder, in and out of prison since he was teenager.
Locked at Hawke's Bay Regional Prison since May for assault and burglary, she said her grandson spent 10 days in segregation following a conflict with an officer.
He was not allowed to speak with anyone else, he was only allowed out for one hour a day, she said.
"He felt like killing himself, he felt like hurting himself.
"It was a pretty difficult time for him, he said it sucked in the last call we had. Imagine if you were locked up for 23 hours without human contact - it would do your head in, wouldn't it?"
The report by the prison watchdog showed some vulnerable prisoners spent months or even years without any contact with fellow inmates, making them susceptible to long-lasting psychological effects like depression and paranoia.
University of Auckland Associate professor in criminology Alice Mills said long-term segregation could also take a toll on prisoners' physical health.
"There's some evidence from the US that suggests that they can suffer from high blood pressure, arthritis, sometimes diabetes, heart failure, stroke and lung disease."
'The roughest time of my life' - prisoner
Bryan* spent several months on remand at Rimutaka Prison in Upper Hutt in 2021. He was facing multiple serious charges, including assault and rape - charges he disputed.
Afraid for his wellbeing in prison, he chose to go to the segregation unit, fearing violence and gang members.
"Most of the people that I knew that weren't gang members, they chose to be segregated. It's a tough decision, because otherwise we will be put with gang members, they can be violent to you."
He said his recollections of segregation were traumatising.
"I feel like it was the roughest period of my life. It was extremely isolated, extremely lonely and it's so oppressive, it's very claustrophobic."
New Zealand had a high incarceration rate in the developed world, with a 70 percent reconviction rate within two years of release.
Human Rights Commissioner Saunoamaali'i Karanina Sumeo believed while segregation units may be necessary, they should be reviewed.
"If a prisoner is self-harming or behaving in a way that might be harmful to others, probably one of the ways to manage the situation is a period of separation.
"But when you are isolated from other prisoners, from social contact, like proper meaningful contact - I'm not talking about a knock on the door, 'Are you okay?' That's not a meaningful human contact, that would severely impact anybody's spiritual wellbeing as well as mental wellbeing."
More prisoners will have mental health issues - Corrections
Corrections chief custodial officer Neil Beales acknowledged the recommendations, but said the meaning of "meaningful contact" could vary from prisoner to prisoner, and it was not defined in legislation.
"I acknowledge that the levels of interaction would vary from prisoner to prisoner and some of that, it would be for good reasons.
"Unfortunately, we have some people who whilst having a crisis, they would be throwing faeces out of their cell [and that] creates a health and safety risk for our staff, or they maybe would be quite violent."
Beales said some prisoners only wanted to engage with certain parts of the system.
"Some [prisoners] may not wish to engage with custodial staff, but they are quite happy to engage with someone from the health department or the mental health services.
"Prisons are very complex, very dynamic places and we are seeing more and more people coming into Corrections custody that have got quite severe mental health issues, which makes a challenging environment even more challenging."
Corrections accepted all recommendations made and work had already started, he said.
"This report is a call to the department to go 'yes, we recognise your challenge', as the inspectorate quite rightly does.
"But [the report] is asking us to not forget the person behind the door and work to improve the situation for those around segregation to only be in segregation for the time necessary."
* Not their real names.