OTTAWA — Canada’s prison watchdog says chronic self-injury among female inmates remains a challenge for corrections workers who continue to turn to pepper spray, segregation, physical restraints, criminal charges and institutional transfers to deal with difficult offenders, despite the controversial death six years ago of Ashley Smith.
The 19-year-old with severe mental health problems asphyxiated herself in a prison cell at Grand Valley Institution for Women in Kitchener, Ont., in 2007 as guards watched. An inquest into her death is ongoing.
In the meantime, correctional investigator Howard Sapers is recommending difficult inmates like her be transferred to provincial health care facilities that are better equipped to deal with behaviour like chronic head banging, cutting and ligature use.
“These women require a disproportionate amount of attention and command a disproportionate amount of resources to deal with them,” he said in an interview Monday, noting it’s hard on both the inmates and the corrections officers.
“At some point we have to recognize that prisons cannot be the kind of therapeutic environments that can safely manage these very high needs women.”
Shipping self-injurious offenders offsite is one of 16 recommendations included in the report that sought to “review and assess how the Correctional Service of Canada responds to incidents of chronic self-injury.”
A number of the recommendations, including prohibiting the use of prolonged segregation for mentally ill inmates, were included in several earlier reports by the prison ombudsman, but have not yet been implemented.
The report also called for enhanced training for staff who work with self-injurious offenders, better monitoring and reporting of the use of physical restraints to deal with self-injury, and a prohibition on forced injections for physically restrained, non-consenting inmates.
It also recommended appointing a patient advocate at each of the five regional treatment centres for mentally ill convicts.
According to the report, since Smith’s death, the number of self-injury incidents in federal penitentiaries have more than tripled to 901 incidents involving 264 offenders. About 45 per cent of all self-injury incidents involve aboriginal offenders.
The study centred on the records of eight self-injurious female offenders which were examined over a 30-month period from January 2010 to June 2012. Officials also visited three women’s institutions including Grand Valley, where Smith died.
It focused on self-injuring women as women are more prone to this type of behaviour, Sapers said, noting all the women examined had a history of psychiatric hospitalization. Several were diagnosed with Fetal Alcohol Syndrome, while others had below average cognitive ability.
All were victims of physical and/or sexual abuse and most spent their childhood in foster care or group homes.
The study found a third of all self-injury incidents were met with use of force, seven of the women faced between 19 and 100 additional disciplinary charges because of their behaviour and six were convicted of other criminal offences, resulting in additional time being added to their sentences.
The latter was a chief concern in the case of Smith who was originally jailed for throwing crab apples at a postman but ended up accumulating additional charges and jail time due to her behaviour while incarcerated.
Sapers said his office considered recommendations to address the use of disciplinary and criminal action against mentally ill offenders but in the end decided to focus on other areas.
He said there is merit in looking into the disciplinary process as it relates to offenders with mental health problems in the future. That said, he hopes that if implemented, recommendations like developing comprehensive treatment plans and moving inmates into hospital settings will reduce the number of use-of-force incidents and therefore render the issue “moot.”
Like Smith, the eight women also faced frequent transfers between institutions, the report found, and most of them faced “considerable” periods of time in seclusion or segregation.
Ultimately their “mental health needs were not being addressed,” Sapers said, adding many of the problems are “systemic.”
“Self harm is often an exercise in control and the more you try to control these individuals, the more they will be inventive in trying to assert themselves and that manifests in more significant self-harm,” he explained.
In a statement Monday, Public Safety Minister Steven Blaney thanked Sapers for the report and agreed prisons are “not the appropriate place to treat those with serious mental illness.”
According to the government, efforts have already been made to improve access to mental health treatment for inmates and training for corrections staff in prisons. Those changes have included faster mental health screening and extended psychological counselling.
NDP public safety critic Randall Garrison said if the government has indeed started implementing the changes, it should make public the results.
“The recommendations put forward by the investigator require careful consideration by the government,” added Liberal public safety critic Wayne Easter.
“The response to mental health problems within federal institutions should not be punitive; they must be restorative and respond to actual problems faced by individuals within our institutions.”
tcohen@postmedia.com
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