TORONTO - An inquest in Toronto is hearing a teenager who choked herself to death in prison was a textbook case of antisocial personality disorder.
In fact, a psychiatrist testified Ashley Smith met all 10 of the official diagnostic criteria for the illness.
Dr. Jide Adelugba also said Smith was seen by psychiatrists on 117 occasions during her four month stay at the Regional Psychiatric Centre in Saskatoon — more than one visit a day.
He said the 19-year-old did make some progress before she was transferred to a psychiatric hospital in Montreal.
Months after the transfer, Smith hanged herself in her cell at a prison in Kitchener, Ont.
Adelugba was clinical director at RPC, a psychiatric prison operated by Correctional Service Canada and the only one to take females.
While others have described Smith as a unique case given her propensity to self-harm and acting-out behaviours, Adelugba said that was not the case.
"She was a difficult patient but there was no behaviour that she exhibited that I saw for the first time," Adelugba told the five-women inquest jury.
"She was different, she was difficult, she was challenging. But she was not alone."
Smith arrived at RPC from Truro, N.S., in December 2006 because staff at the Nova Institution couldn't cope with her disruptive and self-harming behaviour.
Adelugba was adamant that Smith had been making progress at RPC, "though slowly."
She had been constantly in segregation at Nova but at RPC, she had on occasion been allowed out of isolation, he said.
At Nova, Adelugba said, there had been 51 incidents in 61 days where guards used force on her but only 45 such incidents in four months at RPC, where she also had one on one sessions with clinical staff.
The inquest heard that the "Diagnostic and Statistical Manual of Mental Disorders," the official guide to diagnosing psychiatric illness, lists 10 criteria for antisocial personality disorder. Among them is a disregard for the safety of self and others.
Smith met all 10, Adelugba said.
She also met four of eight criteria for borderline personality disorder, he said.
Adelugba said he believed staff at RPC were forming a therapeutic relationship with Smith. However, he conceded they were at the "early stage" of that relationship.
After almost four months at RPC, she was transferred to Philippe-Pinel Institute, a forensic psychiatric hospital in Montreal, in April 2007, following an incident in which a correctional supervisor was charged with assaulting her.
After a dozen further transfers, she choked to death at Grand Valley Institute in Kitchener, Ont., in October 2007.