On September 8, 1966, whole families sat mesmerized around one television in their homes, silenced by the airing of the first episode of Star Trek. Space, the final frontier. What wonders were spawned from the imagination of Gene Roddenberry! The show featured amazing tech devices and tools for the characters to accomplish their missions. Doors opened in a sliding fashion simply by crew approaching them, communications were possible with a small ear device (not unlike today’s cordless earbuds), and what really inspired the medical world was the tricorder. Doctor McCoy—followed by Doctors Pulaski, Bashir, and Crusher in subsequent series—could use this device to scan, analyze, and instantly diagnose medical conditions.
Imaginary tech devices first seen in shows like Star Trek completely enabled a generation of engineers to create their own devices to assist in all facets of daily life. Because of these vivid imaginations, coupled with ingenuity and engineering, we have been able to create technical advances in many industries, including law enforcement.
It was less than 70 years ago when the first ballistic vest was worn by peace officers and radar became available for traffic enforcement. Portable police radios first appeared with the British police in 1969. These items became basic tools in everyday police activities. But what of our jails? What advances have changed detention settings over the last few decades? Portable radios, card reader electronic doors, and better safety equipment have been integrated into daily life in detention centers. Jail population needs and their medical and mental health issues, versus medical advances in the private sector, show a different story. This article discusses the needs of inmates that are not being met. Unlike advances in other disciplines, tools cannot be developed fast enough for a jail’s medical staff to accomplish their mission efficiently and safely. What we need is a “Star Trek” that sparks the imagination for the next generation of safe, humane, and responsible jails.
Consequences of Future Crime Rebecca Wickes (2020) once said, “Crime is the perennial human virus for which there is no vaccine.” Let’s be honest. Human nature and free will ensure that crime will never disappear. As illegal activity continues into the next century, the responsibility to care for these criminals once they are booked into our jails will remain. Crime—or what is considered a crime—evolves as new technology is developed. Horse thievery used to be a more
prevalent issue, and it was replaced by bicycle and auto theft as these became our main transportation. What we may see in the future is theft of transporters if you allow yourself to imagine a time where there is no longer a need for a personal automobile as a means of transportation.
We have already seen a change in the types of crime throughout our generation in the areas of fraud through the use of the internet. These types of crimes didn’t exist a hundred years ago. The bottom line is that humans are the variable, and what is acceptable behavior will be determined by the majority. What is not acceptable behavior will be illegal, and lawmakers will determine the consequences of those actions. At the crux of that reality is once the police and courts take away someone’s liberty, there is a responsibility to care for that person: mental, medical, shelter, and more while they are in the custody of the state.
For the law enforcement industry—jails in particular—societal demands, funding, and advances in technology create new challenges constantly. It is imperative that the justice system continues to develop better ways to care for its incarcerated population. Jails are micro-cities independently functioning inside larger communities. They have their own governance, healthcare, kitchens, education, and issues with safety like any other city. However, the responsibility falls on the larger community to ensure that medical technologies available outside the jail system are also available inside it.
Working in tandem with healthcare providers to build and use advances in applied medical technology will pay dividends both for the incarcerated population and the society into which they will eventually reenter. The best way forward is to ensure that jails are not the last industry to adapt new medical technology; but be at the forefront of change. With that goal in mind, jail managers need to: • consider wearable technology for health monitoring, • use of artificial intelligence to monitor inmates in those facilities, and • take a serious look at their current facility deficits to create a detention process that is truly 21st century.
To Explore Strange New Technologies So much can go wrong from the onset of arrest to transportation to a county jail. Therefore, our first step is to develop and use new ways to combat our weaknesses and make improvements in these areas. Rather than add more equipment for the officer to maintain, we can integrate technology into tools already in use.
Wearable Devices Wearable technology exists and is readily available in the form of smart watches, like the Apple Watch or Fitbit. Imagine a wearable device that monitors an arrestee’s heart rate and “speaks” to the patrol car through a mobile data terminal interface, communicating to the officer if there is a medical problem or emergency. As the officer transports an arrestee to jail, she is intermittently watching the subject through the rear view mirror for any signs of distress, but she also knows the “smart restraints” are watching the subject’s health for them. Instead of a potential tragedy occurring during transport, the technology integrated into the restraints remove the guesswork that unknown variables can present from substance abuse and mental and medical health problems. This future technology could be a highly effective warning system to rendering aid before ever arriving at the county jail.
A look at a similar device proves the technology exists but hasn’t yet been developed as a means to better care for inmates. For example the Continuous Glucose Monitor, or CMG, has the ability to not only continually monitor the glucose level in the blood of a diabetic patient, but also to send a text to a designated cell phone or monitoring device with warnings when the patient’s glucose is low or high. In addition, these monitors can inject necessary insulin at the time of need. How does this
work and not be turned into contraband? When the device is tampered with or not in contact with the patient, it can send an alarm. The needle in these devices is even smaller than a thumb tac and the entire device is smaller than a watch face. To make a weapon out of that would be difficult and the benefit outweighs any danger.
Just for a moment imagine the use of CMGs in a county jail population. Gone would be the multiple nurse visits with carts carrying medications and sharps to housing each day. Instead, a diabetic inmate would wear a CMG that can inject medicine and capture needed data. It would also send this data electronically to medical personnel who could quickly approve the administration of necessary medicines. Diabetes is just one common illness or disease. What if inmates with other illnesses could wear a similar device capable of scanning and delivering necessary medication for many other common illnesses, such as asthma, high blood pressure, or MAT (medication assistant treatments like Suboxone or Methadone)?
Artificial Intelligence Artificial intelligence (AI) is already being employed in custody settings abroad. China and Hong Kong recently announced that their governments are introducing new AI technology to monitor inmates every minute of every day in some prisons. In Hong Kong, the government is testing Fitbit-like devices to monitor individual’s locations and activities, including their heart rates, at all times (Bala & Trautman, 2019). One prison in mainland China is using such devices to monitor and track the movement of inmates in real-time, which then shares the data with software that can analyze behavior and send an alert when abnormalities are discovered.
Following a similar AI model, correctional facilities in the United States could result in a more rapid response to inmates in distress, whether it is through self-harm, assault, or a natural crisis. Comparable monitoring devices have been in use
the 1960s with NASA, which was looking into and developing better ways to remote monitor. In the 1970s, The Kaiser Foundation International partnered with Lockheed Missiles and Space Company to create a remote monitoring system capable of providing healthcare delivery that integrated into a rural location limited medical services (Gruessner, 2015).
On a smaller scale, heart monitoring is commonly used and available to the public in watch technology (Grothous, 2020). The merging of these technologies into handcuffs, or even wristbands, could save lives. But why stop at wristbands? This technology could possibly be integrated into jail cells by way of bedding, the bed itself, or the jail clothing.
Although there will be a cost to develop smart-jail technology, it will ease burdens on staff and increase their ability to provide better care to the inmate population. In turn, this could save counties from having to pay out large sums of money from wrongful death suits. Although AI can be a critical part of enhancing inmate safety, there is another issue of even more importance.
To Seek Out and Avoid the Perils of Facility Deficits We would be remiss if we didn’t also look at the elephant in the room: deaths in custody due to a mental health crisis. How costly are wrongful deaths for jails? In 2019 Mendocino County settled a wrongful death suit for $5 million. According to the coroner’s report, the decedent died from methamphetamine toxicity associated with violent struggle. In 2018, a case that involved the Monterey County Jail cost $825,000 for that county and the California Forensic Medical Group.
A case in Lake County settled for more than $2 million, and a more recent case from Huntington Beach was filed in 2019 by the family of a woman who claimed officers should have provided her with psychiatric help during her time in custody. She died shortly after release. Although these figures are staggering, the cost of human life should not be determined by our inability to care for those whom we incarcerate due to lack of proper medical and mental healthcare.
The RAND Corporation, a think tank initially created to assist the U.S. military, held its own expert panel on jail and prison deaths in 2017, concluding “most forms of deaths in correctional facilities are preventable with proper interventions” (Brannon, 2020). The majority of California jails were not built to contain inmates for long periods of time, especially those who need substantial mental health services. In June 2021, the California Department of State Hospitals reported that between January 2021 and May 2021 there were up to 1,687 county jail inmates statewide waiting for a state hospital bed. By May of 2021, there were 1,497 inmates still waiting. At its worst, the wait can be over six months to obtain a spot for a severely mentally ill inmate in an appropriate custodial care facility.
These kinds of inmates present unique needs that are not necessarily within the county jails ability to properly monitor and keep safe. They present a situation where 253873 jail managers must identify these inmates early in order to develop security and treatment plans in collaboration with jail nursing, mental health, and deputy staff.
The barriers of an aging facility must be addressed head on, and each inmate’s special situation planned until transportation to a more appropriate facility can be made. Until more space is available for the mentally ill in hospitals and care facilities, we will continue to see our local jails providing basic healthcare for people who need much more services than what a county jail can provide on a daily basis. Therefore, utilizing better technology to monitor inmates during their incarceration is a first important step to preventing many useless deaths, emergencies, and lawsuits.
Imagine how many county jail inmates with these special issues could be better monitored, cared for, and managed by using better surveillance and monitoring capabilities. The use of more modern technology would, in essence, create a way to preventively monitor inmates before they attempt suicide by tracking heart rate spikes or drops, and monitoring episodes. This gives staff the ability to respond before a crisis situation presents or gets completely out of control necessitating a cell extraction.
Take, for example, a suicide attempt by hanging. County jails are required to monitor inmates visually a number of times throughout the night while inmates sleep. A determined inmate could wait for a deputy to do a night round visual check and be fairly confident the next check won’t occur for at least an hour.
By the time the next check happens, the inmate, determined on a course of self-harm, could be beyond help when found. It is precisely a situation like this where a heart rate monitoring device would be invaluable.
To Go Where No Jail Has Gone Before Captain’s Log, star date-301404.43182394735. Part of the solution was to create forward-thinking law enforcement leaders and partners who could continually scan and identify technology in other fields to adapt it for use in the corrections field. Agencies wishing to develop better solutions assessed their current facilities and determined needed upgrades. Once that work was done, they transformed vision into reality.
The next generation jail was built by solution seekers. Old facilities were upgraded; new facilities drew in partnerships with healthcare providers who were essential to determining what advanced technologies could be used for inmate and public safety. In the words of Captain James T. Kirk, “You know the greatest danger facing us is ourselves, an irrational fear of the unknown. But there’s no such thing as the unknown—only things temporarily hidden, temporarily not understood.”
References
Bala, N., & Trautman, L. (2019, April 30). ‘Smart’ technology is coming for prisons, too. R Street. Retrieved from www.rstreet.org/2019/04/30/smart-technology-is-coming-for-prisons-too/
Brannon, M.(2020, October 7). With jail deaths on the rise, California counties look to improve. Center for Health Journalism. Retrieved from centerforhealthjournalism.org/fellowships/projects/jail-deaths-rise-california-counties-look-improve
Grothous, M. (2020, December 22). A brief history of the Apple Watch: How it became the world’s #1 wearable...” Know Your Mobile, Kinsta.com. Retrieved from www.knowyourmobile.com/wearable-technology/a-brief-history-of-the-apple-watch/
Gruessner, V. (2015, November 6). The history of remote monitoring, telemedicine technology.” MHealthIntelligence. Retrieved from mhealthintelligence.com/news/the-history-of-remote-monitoring-telemedicine-technology
Wickes, R. (2020, April 15). Coronavirus: How COVID-19 is changing the world. Lens.monash.edu. Retrieved from lens.monash.edu/@politics-society/2020/04/15/1380013/how-covid-19-is-changing-the-world.
Nina Snyder is a lieutenant with the Marin County Sheriff’s Office in California and has served over 27 years in a number of positions to include assignments in Custody Division, Patrol Division, & Investigations. She is currently the Marin County Jail Admin Lieutenant and is a CA POST Command College Graduate: a 14-month program designed to prepare law enforcement leaders of today for the challenges of the future. She can be contacted at NinaMSnyder@gmail.com.