A report from the Correctional Investigator of Canada calls on the federal prison service to treat chronic self-injury first and foremost as a mental health concern, not a security or control issue.
There were 901 incidents of recorded prison self-injury involving 264 offenders in 2012-13, said investigator Howard Sapers.
Self-injury, including cutting, head-banging and self-strangulation, involves inordinate numbers of aboriginal women inmates, the study released Monday found. Aboriginal women accounted for nearly 45 per cent of all self-injury incidents involving female prisoners.
Since 2005, the Correctional Service of Canada has spent approximately $90 million in new funding to strengthen mental health services, implement computerized mental health screening at admission, train front-line staff and improve community partnerships, the report notes.
"Nevertheless, these initiatives have resulted in little substantive progress since the death of Ashley Smith in October 2007 with respect to the management and treatment of chronic self-injurious women in federal custody.
"A number of key policy, capacity, operational and infrastructure challenges remain."
Pepper spray, physical handling and restraints are commonly used in an attempt to interrupt or prevent prison self-injury, the study found.
However, these approaches often simply contain or reduce the immediate risk of harm, it says. They do not — nor are they intended to — deal with the underlying symptoms of mental illness apparent in many cases.
In addition, such offenders are frequently removed from the main prison population, even though isolating an inmate can accelerate the harmful behaviour, the study says.
"Self-injurious offenders are hesitant to disclose thoughts of self-harm for fear of punishment or placement in segregation."
The report concludes prisons are ill-equipped to safely manage the complex mental health needs of federally sentenced women who chronically self-injure.
"Staff admitted that they were often too busy completing paperwork and addressing crises to engage in therapeutic counselling sessions with inmates," says the report.
"Three women identified their psychologist as someone they could go to for support, but they noted that when they engaged in self-injury, it was security, not clinical staff, who responded."
Still the Correctional Service makes limited use of transfer of complex-needs cases to external psychiatric facilities.
The report recommends the prison system end the practice of putting at-risk inmates in solitary confinement and transfer the most troubled cases to community psychiatric facilities.
It says that in cases of self-injury in federal prison, physical restraints should be applied as a last resort and for the shortest time necessary to manage the risk of self-harm. This should be controlled and overseen by health-care professionals, not security personnel, the report adds.
Correctional Service spokeswoman Sara Parkes said Monday the agency was reviewing the findings and recommendations.
NDP public safety critic Randall Garrison said the ombudsman's prescription for change has a ring of familiarity.
"So my question for the government is, when are they going to get serious about these recommendations?"
Liberal critic Wayne Easter pointed out that last March, then-public safety minister Vic Toews acknowledged there are people in prison who do not belong there because of their mental state.
"While the government's own rhetoric shows it has grasped the root of the issue, it has also deliberately failed to take measures to address the growing problem," Easter said in a statement.
Public Safety Minister Steven Blaney reiterated Toews' remarks Monday, but was not available to discuss specific recommendations in Sapers' report.
"We believe that prisons are not the appropriate place to treat those with serious mental illness," Blaney said in a statement, adding the federal government would continue to work with the provinces and territories.