KITCHENER, Ont. - Inquest jurors paced the beige-painted segregation cell on Thursday where a deeply disturbed teen choked to death five years ago as security guards stood watching her.
The tour of the Grand Valley Institution, one of five federal prisons for women in Canada, aimed to offer the jury better insight into the place where Ashley Smith, 19, spent the last weeks of her life.
"This was Ashley's cell," declared assistant warden Tony Simoes who led the group tour.
A key difference between how the cell was when Smith died in it and how it is now are the two large windows in the heavy grey door that would have given guards a better view of the interior.
The old-style doors, still on the three adjacent cells, have only a small viewing window at about eye level and a "cuff port" or food slot closer to knee level.
Evidence about what guards could see of the cell interior is expected to play a role given that Smith frequently covered the interior surveillance camera and viewing window with toilet paper.
Bits of toilet paper are still visible on some of the cameras.
Dr. John Carlisle, presiding coroner, urged jurors to examine what would be visible if guards could only look through the food slot — about the size of a large mail slot.
"Just make observations," Carlisle advised the jurors.
Trailed by the coroner and more than a dozen lawyers, jurors walked the hallway of the facility — resembling a high school with its notice boards, lockers and windows — through the "sally port" into the four-cell segregation unit.
They peered through the doors and wandered the confined interiors — little more than three metres by two metres — making notes of the cot, sink, toilet and privacy screen.
It was here Smith, of Moncton, N.B., spent much of her time, locked up almost round-the-clock, increasingly showing serious self-harming behaviour. Some days, she apparently never left her cell at all.
Jurors, knelt at the cuff port. They asked questions: "Do they get sheets?" "How often are the cells cleaned?" "Can you close the door so I can get a sense of how it feels?" "Are there cameras in the showers?"
Just outside the unit is the high-walled, narrow concrete exercise yard where segregation inmates are supposed to get at least one hour of fresh air a day.
On one side of the yard, scratched crudely on the sheet metal were the dates September 25 and October 29, 2007 along with a heart. Smith died Oct. 19, 2007.
There was one moment of hilarity when Julian Falconer, the Smith family lawyer, went inside one of the segregation cells and door clanged shut behind him, requiring a guard to come and let him out.
Most inmates of Grand Valley live communally in cottage-style homes on the grounds. The segregation cells are reserved for those deemed to pose a high risk to others or themselves.
Others are housed in the secure unit, with a communal living and eating area, solitary exercise machine, and controlled access to a more pleasant courtyard sporting some grass, a picnic table and basketball hoop.
When she wasn't in isolation, Smith spent time in Cell 11 on Pod 3 of the secure unit, with its table, hutch and closet — not unlike a small dorm room. There are no cameras in the pod cells.
On the wall of the eating space, supper menus promise among other things a chicken burger, bun and mayo for supper one evening; salami and mushroom-topped pizza with fries and mixed vegetables on another.
Smith spent much of her last year alive in solitary confinement, transferred back and forth between the country's prisons. The inquest is exploring the circumstances of her videotaped death. Guard were under orders not to intervene as long as she was breathing.
Carlisle has said the inquest will examine the way the prison system treats the mentally ill.
Following the tour, he adjourned the session until Monday, when a guard is due to testify.
<br>One way to sabotage yourself is to take a single event and treat it as an ongoing source of negativity. "People who are unemployed do this a lot," says Rego. "They've lost their job because of the economy and they personalize it." <br><br> It's also unhealthy to catastrophize--focus on the worst imagined outcome, even if it's irrational. For example, don't let concerns about money escalate into the conviction you'll soon be homeless.<br><br> Instead of thinking, "I'll never get another job," try to say to yourself: "I will get another job. It just may take some time."<br><br> <strong>More From Health:</strong> <br> <br><a href="http://www.health.com/health/gallery/0,,20515167,00.html" target="_hplink">12 Surprising Causes of Depression</a><br> <a href="http://www.health.com/health/gallery/0,,20581256,00.html" target="_hplink">Dos and Don'ts for Dealing with Anger</a><br> <a href="http://www.health.com/health/gallery/0,,20526304,00.html" target="_hplink">20 Celebrities Who Battled Depression</a><br>
Ever clash with a colleague or fight with a friend and then keep obsessively thinking about it, amplifying the anger, stress, and anxiety associated with the memory? Known as rumination, this type of thinking is linked to a greater risk of becoming or staying depressed. <br><br> While reflection is a good thing, and may help you solve problems, rumination does the opposite. <br><br> If you catch yourself ruminating, studies suggest it may help if you try to distract yourself, meditate, or redirect your thoughts. Cognitive behavioral therapy often targets rumination because it can be so damaging to mental health.
Retire Your Crystal Ball
Very few (if any) of us are blessed with the ability to predict the future. But depressed people will often convince themselves they know what will happen a day, a month, or a year down the line. And it's usually bad, if not downright catastrophic. <br><br> Fortunately, our dire predictions rarely come true. <br><br> Try to stay in the present. It's much more manageable and you're less likely to blow things out of proportion.
Don't Dwell On The Past
It's pretty pointless to tell yourself you<em> should</em> have done this or <em>shouldn't</em> have done that. You can't change the past, but you can live in the present. <br><br> Just accept that you made the best decisions you could have made with the information or resources you had at the time. Hindsight is always 20/20, so best to try to just let it go and don't beat yourself up for perceived missteps. <br><br> And do a rumination check; ruminating about the past can generate anxiety, just as worry about the future.
Reach Out To Others
A hallmark of depression is isolation. It can happen easily if you're not working, or you're avoiding people because you're depressed. But reinvigorating or expanding a social network provides an opportunity to get support, perhaps even from people in the same or a similar situation, says Rego. <br><br> "Once you start reconnecting with people, you get a sense they understand," he says. "You get positive advice and encouragement and it's often done in activities that end up being fun." <br><br> Staying home alone will perpetuate the depression. Getting out with other people--even a little bit--will lift your spirits.
Stick To A Structured Routine
Even if you don't feel like it, make sure you get up at a set time, eat meals at the same hour every day (even if you're not hungry), and avoid lounging on the couch during the day lest it prevent you from sleeping well at night. <br><br> "People who are depressed tend to eat or sleep inconsistently," says Rego. "Even if you're unemployed or feeling down, it's really important to set and establish a daily routine as best you can. This gives you a sense of regularity that can help with a depressed mood." <br><br> If you can incorporate socializing into your routine, all the better.
Avoid Black And White Thinking
Black and white is great for zebras, but not thoughts. Depressed people tend to think in extremes: I'm a loser. No one loves me. I'll never get a job. <br><br> But your thought patterns could put you in a rut or keep you there. "Being depressed or sad is going to color the way you think about yourself in a negative direction," says Rego. <br><br> These thoughts can paralyze you and stop you from doing the very things that will get you out of a lousy situation. Try to think in shades of gray, says David R. Blackburn, PhD,a psychologist with Scott & White Hospital in Temple, Texas. Instead of "no one loves me," try "lots of people (if not everybody) love me."
Reality Check Your Thoughts
If you're depressed, negative thoughts go with the territory. However, they are rarely grounded in reality. <br><br> Once you've identified a negative thought, ask yourself, "Where is the evidence that I'm the most despicable human being on the entire earth?" There probably isn't any. <br><br> "You can't just be rattling these thoughts back and forth and saying they're true," says Blackburn. "You have to come up with some solid evidence." <br><br> And if you're worried about what people are thinking about you, go ahead and ask them.
Choose Smart Goals
Select a few simple, straightforward goals you can easily set and follow, suggests Rego. Those goals should be <em>SMART</em>, which stands for "specific, measurable, attainable, rewarding, and time-limited." <br><br> So for example, deciding you will have a job by the end of the week is unrealistic. <br><br> But deciding to post two resumes online by the end of the week, on the other hand, is <em>SMART</em>. "It's specific. It's attainable. It's not that much effort to do and it could be rewarding," says Rego.
Fake It A Bit
Write down all the things you used to like doing that you've stopped doing because you're sad and depressed, suggests Rego, who is also assistant professor of psychiatry and behavioral sciences at Albert Einstein College of Medicine. <br><br> That could be going to the movies, socializing with friends, or simply going to the corner coffee shop with a newspaper. <br><br> Then, one by one, start reincorporating these activities into your life even if you're feeling unenthusiastic about it. Also, focus on tasks that can give you a sense of mastery or accomplishment, whether it's tidying up the apartment or paying the bills. That can help ease the depression as well. <br> <br><strong>More From Health:</strong> <br> <br><a href="http://www.health.com/health/gallery/0,,20515167,00.html" target="_hplink">12 Surprising Causes of Depression</a><br> <a href="http://www.health.com/health/gallery/0,,20581256,00.html" target="_hplink">Dos and Don'ts for Dealing with Anger</a><br> <a href="http://www.health.com/health/gallery/0,,20526304,00.html" target="_hplink">20 Celebrities Who Battled Depression</a><br>
Don't Deny Depression
If your present situation, well, sucks, denying it will only make things worse. "Some people don't accept they're depressed and instead beat themselves up or think they're crazy or weak," says Rego. <br><br> This may only drive you deeper down, while acceptance can relieve the suffering, he says. <br><br> In general, knowing and accepting that you're depressed can allow you to take steps to make it better or get treatment, rather than pretend that everything's just fine.
Treat Yourself Well
Take a look at the language you use when you think about or talk to yourself and compare it to the way you talk to everyone else. If there's a disconnect, try to treat yourself in a kinder, gentler way. <br><br> "We're often kind to everybody else but we beat ourselves up. That's a double standard," says Blackburn. "It would be preferable to use a single standard: Don't beat everyone else up, but get off your own back, too." <br> <br><strong>More From Health:</strong> <br> <br><a href="http://www.health.com/health/gallery/0,,20515167,00.html" target="_hplink">12 Surprising Causes of Depression</a><br> <a href="http://www.health.com/health/gallery/0,,20581256,00.html" target="_hplink">Dos and Don'ts for Dealing with Anger</a><br> <a href="http://www.health.com/health/gallery/0,,20526304,00.html" target="_hplink">20 Celebrities Who Battled Depression</a><br>