Self-harming inmate needs hospital care, advocate says
A mentally ill and brain-damaged woman prisoner at the Regional Psychiatric Centre (RPC), who compulsively bangs her head, has been held in restraints for so long she has lost the ability to walk, a prisoner’s advocate says.
Psychiatrists have said Marlene Carter, 43, should be in a psychiatric hospital, not a federal correctional institution where security measures “trump therapy,” said Kim Pate, executive director of the National Association of Elizabeth Fry Societies.
Pate is dismayed that an apparent funding glitch has stymied a hoped-for transfer to an acclaimed Ontario psychiatric hospital.
“It’s an extremely shortsighted decision ... I would hope that very quickly it would (move) ahead, because it’s outrageous that she is still at the RPC and isn’t in a mental health facility,” Pate said in an interview.
Inmate comparable
to Ashley Smith
Carter’s case sparks comparisons to that of teenager Ashley Smith, who strangled herself to death in 2007 under the watch of prison staff in Kitchener, Ont.
Smith had also spent time at the RPC in Saskatoon, where staff became frustrated and burnt out from responding to her frequent acts of self-harm without the benefit of effective treatment to change the behaviours.
“I WOULD HOPE THAT VERY QUICKLY IT WOULD (MOVE) AHEAD, BECAUSE IT’S OUTRAGEOUS
THAT SHE IS STILL AT THE RPC AND ISN’T IN A MENTAL HEALTH
FACILITY.”
KIM PATE
A correctional supervisor, John Tarala, who was charged with assaulting Smith during a strangling intervention, was found not guilty at trial.
Security efforts to control Smith included uses of force, restraint and extended periods of segregation, as they now do for Carter.
Long periods of restraint common
for Carter
The first time they met, Pate had to squat down and peek through the food slot to talk to Carter, who was restrained on a bed.
“I had to look at her up through her legs. It was a horrible way to meet someone,” Pate said.
At that time, Carter had been in near-constant restraints for six weeks and staff had refused for two weeks to deal with her, Pate said.
Carter’s psychiatrist “was extremely concerned that even though he was making a number of recommendations that she be released out of the restraints and to have some exercise and to have showers, his recommendations about the therapeutic needs of Marlene were trumped by so-called security needs,” Pate said.
Carter has spent months of 23-hour days with her body strapped to a hard board or in a special wheelchair because it is the only way staff at the RPC can prevent her from banging her head or lashing out at others, witnesses said at a hearing at Saskatoon provincial court last fall, where the Crown sought to have Carter declared a dangerous offender.
Carter has suffered mental illness since her first jail terms for relatively non-violent crimes but the severity of the her mental illness has increased with time and she has served longer sentences, which have been further lengthened by charges laid for assaults upon other inmates and staff, witnesses testified.
Carter’s behaviour is so erratic, she was not able to be physically present at her trial or sentencing hearings but participated via closed circuit television, where she could be seen confined in the restraint wheelchair.
Carter was found guilty of assaulting a guard with handcuffs in 2009 and throwing a cup of hot water at a guard in 2011.
RPC staff at her dangerous offender hearing said she hears voices that tell her to bang her head, and that she feels frustrated when she is stopped before she has completed the number of head strikes she intended.
A psychiatrist said he has never seen an adult strike her head with such force or so many times. He said Carter has brain damage caused at least in part by that behaviour.
Judge Sheila Whelan is scheduled to decide on Aug. 20 if Carter is a dangerous offender to serve an indefinite term or if she will be subject to a lesser, defined sentence.
Smith case sparks hope for hospital care
Last December, a coroner’s inquest into Smith’s death recommended female inmates with serious mental-health issues or histories of chronic self-injury serve their terms in treatment facilities, not security-focused penitentiaries.
The jury also recommended abolishing segregation longer than 15 days for female inmates.
The recommendations led in May to federal Public Safety Minister Steven Blaney announcing a pilot project to help female inmates with serious mental illness.
It includes the Royal Ottawa health-care group’s Brockville Mental Health Centre, which will set aside two beds for troubled female offenders.
Dr. Adekunle Ahmed, associate chief of the Integrated Forensic Program at the Royal, assessed Carter at RPC in May and found she would benefit from treatment there, an official from the hospital said.
Nicole Loreto said uncertainty about Carter’s prisoner status after her Aug. 20 sentencing date have stalled plans for her transfer. Carter is currently on remand awaiting sentence and it is not known if she will be sentenced to a federal term or if she will remain under the jurisdiction — and the fiduciary responsibility — of the province, Loreto said.
Pate knows hospital treatment could make all the difference. She points to the successful treatment at Brockville, Ont., of another self-harming woman who had been incarcerated alongside Carter at RPC.
That woman’s story was featured in Corrections Investigator Howard Sapers’ 2013 report, which found the woman’s habitual selfharming behaviours were brought under control at Brockville and she eventually was released to the community, where she has managed to live successfully.
No official response about Carter case
Corrections officials did not provide any information about the intended move or the reasons it hasn’t happened or whether it might still occur.
They cannot comment on the matter because of privacy law and because Carter’s criminal case is still before the courts, said Jeff Campbell, a spokesperson for CSC.
“Within CSC, each region has a Treatment Centre that provides intensive interdisciplinary treatment to federal offenders with mental and physical health care needs in safe and supportive environments,” Campbell wrote in an email.
The CSC response contrasts with the findings of Sapers, who wrote in his September 2013 report on federally sentenced women who self-harm, that prisons are ill-equipped to handle women who hurt themselves.
“Within CSC, the management of self-injury incidents tends to elicit a security or punitive response, namely containment, isolation, seclusion or segregation. Such responses tend to exacerbate the frequency and severity of self-injury or escalate the resort to other resistive or combative behaviours,” Sapers wrote.