Inquest lays bare a sad pattern
Ashley Smith defied all attempts to help
Take all the cultural references you can find that have to do with a repeating loop – whether the brilliant Groundhog Day movie or Yogi Berra’s line that “This is déjà vu all over again” — and you have the Ashley Smith coroner’s inquest.
The inquest is examining the life and death of the 19-yearold teenager who asphyxiated in her isolation cell, trademark ligature around her neck, at the Grand Valley Institute for Women on Oct. 19, 2007.
Now in its fifth month, the probe is looking at each of the federal prisons or institutions where the mentally ill young woman spent time.
Though it has been widely repeated that among the many cruelties inflicted upon Ashley was that she was shifted brutally among 17 different federal prisons and hospitals (in the earliest days of the inquest, before I realized how creative was that counting, I wrote it myself), the truth is she spent significant time only at six places.
And so, in rough chronological order, coroner’s counsel Jocelyn Speyer and Marg Creal have called witnesses from these institutions.
First was Grand Valley, where only those working the morning Ashley died testified; others who worked with her at other times during her two stays there will testify later.
Then came witness clusters from each of the Nova Institution for Women in Truro, N.S., the Regional Psychiatric Centre in Saskatoon and the forensic hospital L’Institute Philippe-Pinel de Montreal (the evidence from the latter was interrupted and will resume Thursday).
This week, it was the turn of the St. Thomas Psychiatric Hospital in St. Thomas, Ont., where Ashley stayed all of eight days in June 2007.
Three witnesses have testified already; a fourth will follow next week.
And this is where the loop kicks in, where it is almost invariably the same story at every place — and each time in contradiction to the accepted, and very dark, public narrative. The most hands- on St. Thomas witness, for instance, was Christine Whalen, a veteran nurse of the old-school sort. She has worked at the hospital’s 16bed forensic assessment unit since 1999.
St. Thomas has a memorandum of agreement with the Correctional Service of Canada to accept mentally ill inmates when it can, which isn’t often. The list for beds is long and growing, with some inmates waiting in jail for months.
Whalen had some dealings with Ashley herself, and as the unit’s team leader, is conversant with those others had.
St. Thomas is a hospital, so it doesn’t have an army of correctional officers or the wherewithal of a prison with staff enough to keep rushing into a cell to stop a patient from hurting herself.
If a patient does that, the hospital’s only real option is to use restraints, and seclusion (the hospital version of segregation) to keep the person safe.
Enter Ashley on June 11, 2007.
Whalen said they knew what to expect, but everyone says that about Ashley: Knowing her on paper, from her file, was not the same thing as experiencing her.
Diagnosed as having a hardto-treat anti-social personality disorder, with borderline traits, Ashley had spent much of her adolescence in isolation in the youth criminal justice system in her home province of New Brunswick.
Transferred to the federal adult system in the fall of 2006, her youth records followed her, and so did her behaviours, and she spent much of her time in this system also in segregation.
She was an inveterate selfharmer (in prisons, she sometimes tied up with her homemade ligatures multiple times a day), both charming and sly, a divide-and-conquer force with staff, often aggressive, prone to luring staff into her cell so she could have the only form of human contact she knew.
She was immediately placed in a seclusion room, because of her frantic self-harming, Whalen said.
“We were concerned about her safety.”
Within hours, Ashley had removed her sleeveless security gown, stuck her head through an armhole, and was twisting it around her neck.
Over the next days, she bit holes in one mattress (and made two strips for future ligature use) and damaged another; banged her head against the door and the wall; tried to block the camera in her cell with toilet paper; stole keys from a nurse; spat, bit, kicked and grabbed at staff, and managed, while under close watch, to switch from appearing to braid her hair to tying a noose around her neck.
“See?” she said, smiling at the nurses who rushed in, “I can choke myself.”
Whalen had to use a “suicide knife” to cut off the noose.
“It was the first time I ever had anyone do that right in front of us,” she said.
As a result, Ashley spent a good part of her eight days at St. Thomas either in restraints, being given antipsychotics (which didn’t work) or on the High Needs Intervention Bed, a bed with magnetized restraints that was used only on doctor’s orders, for only four hours at a stretch, and is supervised both by cell camera and a nurse in the room.
The idea behind the bed is that a patient will be kept safe; as a side benefit, being still may be calming to some people.
In the usual course, Whalen said, she and her staff might use the high-needs bed “once a year, if that.”
Ashley was in it three times in eight days, once for more than 24 consecutive hours.
She behaved only when she wanted something (phone calls home) or after she got her way (she demanded to be returned to Grand Valley, and cooled down once she learned it would happen).
It’s the same old story: Good people meet deeply troubled young woman, try to help her and direct massive institutional resources to her care, to no discernible effect.
It will be Groundhog Day again on Thursday.