Many female inmates need intensive psychiatric therapy but treatment facilities are in short supply, an inquest into a teen's prison death heard Monday.
In his testimony, Dr. Olajide (Jide) Adelugba said the country's lone psychiatric prison that takes female offenders — the Regional Psychiatric Centre in Saskatoon — has only 12 beds for women.
"There are so many women who are in prison and there are so many of them who could benefit from the services we provide at RPC," Adelugba said.
"We don't have the capacity for that, so we always get the worst of the worst."
Adelugba was clinical director at RPC — the psychiatric prison operated by Correctional Service Canada — when Ashley Smith arrived in December 2006 from Nova Institution in Truro, N.S. Staff there had been unable to cope with her disruptive, self-harming behaviour.
The internationally trained psychiatrist said the teen had a severe personality disorder that left her unable to interact normally with others.
"I would say she had a serious mental illness," Adelugba testified. "While she was with us, she was perpetually in crisis."
As a result, he said, Smith "very rarely" spent time with other inmates, remaining in segregation as she had for so much of her four years in youth and adult custody.
Her disruptive, self-harming behaviour also made therapy difficult to administer, he said.
Adelugba, one of seven psychiatrists at RPC, was Smith's primary doctor. On the day she arrived on Dec. 20, 2006, he noted she wasn't suicidal, but enjoyed self-harming:
"Denies intention to hurt self," he wrote on her chart. "Says it makes her feel better."
Smith began acting out within hours of admission to the facility, where she had agreed to be treated.
A doctor soon described her as "severely depressed (and) threatening to kill herself."
On Dec. 26, 2006, a doctor wrote: "Patient attempted to kill herself three times a few days ago. Refuses to take regular medication."
As a result, Adelugba certified her under the provincial health act, meaning they could treat her involuntarily.
Adelugba said he didn't give Smith much psychotherapy himself because that was the role of psychologists at the prison. He did, however, talk to her at times when she was suicidal.
The inquest has previously heard that Smith made some progress at RPC until an issue arose with a supervising guard, who was charged with assaulting her. Barely four months after arriving at RPC, Smith was put on a plane out.
After more than a dozen further transfers, she ended up at a prison in Kitchener, Ont., where she choked herself to death in her segregation cell in October 2007. She was 19.
Adelugba is expected to testify for at least two or three days.