The Future of Custodial Incarceration Facilities Post-COVID

By Joseph Courtemanche and Felipe Rubim

The face of custodial incarceration facilities has gradually and consistently modified over the last two decades. With a shift, in some areas, to commercially operated facilities, and ever more secure long-term units, convicted inmates face a different reality than in decades past. A part of this reality that the public does not often think about is the “graying” of inmates and the need for more medical care in prison settings.

The initial intake process to the system, whether it is municipal jails, county jails, or work farms, has seen a great deal of change, primarily due to an increased intake of violent young offenders. Because of the way Courts handle this group of inmates, low socioeconomic groups spend more time in these units since they can’t make bail. This leads, as in the prison system, to an increased need for medical, dental, and psychiatric care. Young prisoners present one of the highest rates of healthcare conditions that span from psychosis, depression, and conduct disorder to drug abuse and infectious disease (Colins et al., 2010; Fazel & Seewald, 2012). Research conducted by Gonçalves and colleagues (2017) has shown that the need for psychological care for young inmates is in high demand in the first month of incarceration. Most jails are not set up to treat prisoners who are ill in any large number. This is a reality that becomes particularly problematic since, in addition to the constantly changing prison population, it renders prisons vulnerable to the introduction of contagion into the facility.

During the COVID-19 outbreak, decisions were made by governmental leaders based on the fear of an epidemic in our correctional facilities. I am not here to comment on the wisdom of those decisions but to acknowledge that epidemic outbreaks inside prisons have happened in the past, and will likely happen again unless we are prepared and learn from past mistakes.

Such preparedness will only be achieved if we come together to analyze what we are currently lacking. It is incumbent upon any governmental unit possessing the power to deprive citizens of their liberty to immediately evaluate the standards that have been set for keeping people in custody— not just based on the ability to make bail, as it is in many jurisdictions, but based upon the public welfare, including that of inmates.

It is beyond time for a ground-up examination of our rules for incarceration and addresses many questions that, for long, have gone unanswered: Are we jailing the right people? Are we jailing too many people? Are the conditions of our jails putting people at risk that range from illness to predatory inmates? We must face the dilemma of either locking up everyone who commits a certain level of crime or having an actual set of guidelines that dictate who must remain in custody awaiting trial regardless of their financial situation.

As a part of that custodial evaluation, do we want to warehouse people with serious mental health issues in our facilities, mixing them with inmates who do not suffer from mental illnesses, or do we want to establish separate facilities that are designed to treat these inmates? What would such a procedure look like for our county jails? Would it be unique units with a different quality of life with the availability of counselors, mental health professionals, and proper medical treatment above that of truly “criminal” criminals? Would we have the time, and perhaps, more importantly the resources, to properly train our staff? What should be the criteria for housing people in general?

In the last months, we have witnessed jails being cleared out of many of their inmates because of the threat of spreading illness. Many recent governmental decisions regarding the procedure to deal with prison in times of COVID have raised many questions, not to say eyebrows, along the way. If these inmates were simply let go overnight, then why were they there in the first place, if we could release them in the face of a medical threat?

Moving forward, we must begin questioning ourselves about practical matters for our prisons and prisoners. How should our facilities be set up? We couldn’t have foreseen that COVID-19 was coming until it was upon us. Some facilities rapidly shifted their entire system to isolate new intakes until they passed the point where symptoms would develop. Will we need units “timed”, like basic training in the military where everyone who arrives over a six week period would be kept in the unit 8 weeks to see what happens before they are put in general population? How much Personal Protective Equipment should you have set aside for a contagion? Is your hospital unit/medical staff set to deal with extremely ill patients, that will most likely need ventilators and other specific equipment? Do you have a plan to outsource your medical needs to local hospitals? Is it an onsite plan involving tents and stored equipment?

In addition to these practical challenges that raise these, and so many other questions, staffing presents another unique issue. Your people are going to burn out even more quickly during a pandemic than normally. Under normal circumstances, prison staff is already at risk of burnout (Garland et al., 2014). Burnout in prison staff is not only worrisome for the wellbeing of staff members, but also to prisoners since burnout is connected with decreased support of offenders’ treatment (Lambert, Kelley, & Hogan, 2013). Due to the increased stress in times of pandemic, both the cause and effects of burnout will be enhanced during times of emergency, such as this. All this raise the issue of what are the practices that are being put into place for prison staff members to be dealing with stress and burnout? In fact, simple practices such as mindfulness and social support groups have positive effects in dealing with burnout (Moddy et al., 2013; Peterson et al., 2008).

The reality is that little more exists out there in violation of social distancing than a correctional facility. Can you provide accommodations for the staff that volunteers to stay on-site? Do you have a plan to isolate your units, so that staff on the units that are no longer at risk of contagion are able to go home at night? How do you cover the need to expand coverage to a medical facility if you need to move sick prisoners off-campus? Are the simple things like your booking/intake area conducive to controlling illness? Are they easily cleaned? Or do you still have a gigantic holding pen where almost anything can happen while they wait to be processed?

Every one of these concerns needs to be addressed before the next virus outbreak, or similar tragedy. Though an unfortunate fact, there will be a next time. Will you— and your prison— be ready? Yesterday exists no longer, and tomorrow is not but a vision. All that we have is today, hence there is no better time to act than now. No action can be accomplished fully and well without good planning. Thus, it is imperative that leaders get together to answer these questions so that good, effective and durable interventions can be taken to prevent the spread of diseases inside prisons and to be ready not only for COVID but for any other future outbreaks.

References
Colins, O., Vermeiren, R., Vreugdenhil, C., van den Brink, W., Doreleijers, T., & Broekaert, E.
(2010). Psychiatric disorders in detained male adolescents: A systematic literature review. The Canadian Journal of Psychiatry, 55(4), 255–263. doi:10.1177/070674371005500409

Fazel, S., & Seewald, K. (2012). Severe mental illness in 33588 prisoners worldwide: Systematic
review and meta-regression analysis. The British Journal of Psychiatry, 200(5), 364– 373. doi:10.1192/bjp.bp.111.096370

Garland, B., Lambert, E. G., Hogan, N. L., Kim, B., & Kelley, T. (2014). The relationship of
affective and continuance organizational commitment with correctional staff occupational burnout a partial replication and expansion study. Criminal justice and behavior, 41(10), 1161-1177.

Gonçalves, L.C., Dirkzwager, A.J.E., Rossegger, A., Gonçalves, R.A., Martins, C., & Endrass, J.
(2017). Mental and physical healthcare utilization among young prisoners: A longitudinal study. International Journal of Forensic Mental Health 16(2), 139-148. doi:10.1080/14999013.2016.1273980

Lambert, E.G., Kelley, T., & Hogan, N.L. (2013). Hanging on too long: The relationship
between different forms of organizational commitment and emotional burnout among correctional staff. American Journal of Criminal Justice 38(1), 51-66.

Moody, K., Kramer, D., Santizo, R. O., Magro, L., Wyshogrod, D., Ambrosio, J., Castillo, C.,
Lieberman, R., & Stein, J. (2013). Helping the helpers mindfulness training for burnout in pediatric oncology—A pilot program. Journal of Pediatric Oncology Nursing, 30(5), 275-284.

Peterson, U., Bergström, G., Samuelsson, M., Åsberg, M., & Nygren, Å. (2008). Reflecting peer‐
support groups in the prevention of stress and burnout: Randomized controlled trial. Journal of Advanced Nursing, 63(5), 506-516.

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