TORONTO - Many of Canada's 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.
On the day she arrived on Dec. 20, 2006, Adelugba — one of seven psychiatrists at RPC — 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.
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."
Smith smeared feces on her clothes and windows and seemed to be "enjoying" her behaviour," Adelugba noted.
"She thought it was all a big joke," Adelugba testified.
At times, the teen would act appropriately, but quickly regressed, requiring staff to physically restrain her. She was also put on a cocktail of various anti-psychotic and other medications.
"I may decide to be bad any time," Smith said at one point.
Because they feared she would kill herself or hurt others, RPC psychiatrists felt compelled to certify Smith under the provincial mental 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. He did, however, talk to her at times when she was suicidal.
"Says she likes the feeling she gets from choking herself — the dizziness," Adelugba noted.
Jurors also saw Adelugba's notes related to Smith's allegation a supervising guard had assaulted her in her cell.
"He grabbed me on the hair to lift me up and onto the bed," Smith told Adelugba, adding it was very painful.
"You should behave yourself. I am sick of this," she said the guard, John Tarala, told her.
Adelugba took the complaint seriously, immediately investigating and notifying other senior RPC staff. Tarala would lose his job but was later acquitted of criminal assault.
Adelugba said he initially did not consider transferring Smith, saying there was "no need" to think about that.
He was also adamant any move could only be to a treatment centre, not a prison.
As a result of the incident, and barely four months after arriving at RPC, Smith was put on a plane to a treatment facility in Montreal — apparently a decision made at national headquarters.
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 another day or two.