Help at-risk women

Six years after teenager Ashley Smith choked herself to death in a Kitchener prison while guards looked on, Canada’s prison system still remains “ill-equipped” to cope with women inmates who chronically hurt themselves. That chilling indictment comes in a report from Howard Sapers, the federal corrections ombudsman.

And the problem appears to be getting worse, even as a coroner’s inquest probes Smith’s death.

Sapers’ report, Risky Business, found that the number of recorded incidents of self-harm in federal prisons rose past 900 in the past year, more than tripling since 2007, the year she died. Of the 264 inmates who injured themselves this past year, a disproportionate number were aboriginal and female. And a handful of 17 chronic self-injurers including nine women stood out, like Smith, as the most deeply troubled of all.

As the Star’s Tonda MacCharles writes, Sapers’ findings amount to a plea for compassion and help for those who, like Smith, are most at risk. That the correctional investigator should have to flag this issue, at this late date, is disconcerting. Ultimately Smith was failed by a system that criminalizes the mentally ill and those with cognitive difficulties and then fails to deal with their problems. Have we learned so little from her death?

Granted, the Correctional Service of Canada has spent $90 million to boost mental health care in prisons. But Sapers reports “little substantive progress” since Smith’s death in treating and managing self-injurious women. That’s got to change. And fast.

Prison staff who are tasked with preventing inmates from biting, cutting, head-banging or suffocating themselves commonly rely on disciplinary measures, physical restraints, segregation, pepper spray and other tools to control and deter dangerous behaviour. But all too often, as in Smith’s case, this escalates tension, makes inmates more rebellious and combative and increases the frequency and severity of self-harm. Moreover it deters prisoners from acknowledging that they have impulses to harm themselves, for fear of being isolated or even punished.

Bottom line? “The most prolific self-injurious offenders simply do not belong in a federal penitentiary,” Sapers concludes. “These offenders should be transferred to external psychiatric facilities that are better-equipped to accommodate and care for acute and complex mental health needs underlying their self-injurious behaviours.” It’s past time Ottawa drew the lesson from Smith’s death and got self-hurting inmates the help they need.

Sapers urges that, within the prison system, chronic self-injury be managed “first and foremost” as a mental health issue, not a security, behavioural or control issue. He also calls for better staff training and treatment plans, better monitoring on the use of physical restraints, a ban on prolonged isolation or segregation and more patient advocacy. The Canadian Psychiatric Association agrees with the thrust of his report.

Canada’s most vulnerable, troubled offenders deserve more than shackles, pepper spray and forced medication when they cry out for help. Had Sapers’ compassionate approach been taken with Smith, she might have been alive today.