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The tragic tale of Ashley Smith, the 19-year-old who strangled herself with a strip of cloth while she was under suicide watch in a federal women’s prison, raised profoundly troubling questions over how female inmates who self-injure are treated by the Correctional Service of Canada.Anthony Jenkins/The Globe and Mail

The tragic tale of Ashley Smith, the 19-year-old who strangled herself with a strip of cloth while she was under suicide watch in a federal women's prison, raised profoundly troubling questions over how female inmates who self-injure are treated by the Correctional Service of Canada.

A scathing report by Canada's Correctional Investigator paints a bleak picture of how little has changed since Ms. Smith's 2007 death. It's time to recognize – as does the Investigator, Howard Sapers – that prison might not be the best place for inmates who chronically harm themselves. Such people, where there is compelling evidence of mental illness, should be transferred to external provincial psychiatric-care facilities, which are better equipped to treat these inmates' underlying illnesses.

Who can forget the wrenching video of Ms. Smith being given injections against her will or having her hands duct-taped to the arms of an airplane seat? She was diagnosed as a teenager with mental illnesses – including borderline personality disorder – but as a child, she enjoyed a normal upbringing, raised by adoptive parents in New Brunswick.

That's not typical of other female federal prison inmates who chronically self-harm (mainly by slashing or cutting); they are disproportionately aboriginal. When Mr. Sapers isolated the eight worst cases for his report, he found that seven of them were aboriginal. Most spent their childhoods in group homes or foster care and were estranged from their families. Three had been diagnosed with fetal alcohol syndrome. Three others exhibited cognitive function below average level. All had been diagnosed with mental illness.

Prison remains a place where correctional officers sometimes punish these inmates for harming themselves through the inappropriate use of physical restraints, pepper spray and segregation. Doing so is a breach of prisoners' rights and tends to cause them to do more harm to themselves. Despite pouring $90-million of new funding into strengthening mental-health care in prisons since 2005, there is scant evidence of any meaningful change.

In fact, since 2007, the number of self-injury incidents in federal prisons has more than tripled to 901 in the past year. In Mr. Sapers' report, it is striking that while the number of self-harming incidents has risen, a relatively small number of inmates (17 of 264) disproportionately account for 40 per cent of the incidents. These prisoners should not be punished for suffering from mental illness that is beyond their control. They need effective treatment in specialized facilities beyond the prison walls.

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