Psychiatrists Support Correctional Investigator

OTTAWA, Oct. 1, 2013 (GLOBE NEWSWIRE) -- The Canadian Psychiatric Association (CPA), the national voice for Canada's 4,500 psychiatrists, supports the recommendations of the Correctional Investigator that Correctional Services of Canada (CSC) transform its approach to managing chronic and complex self injury cases. Howard Saper's report, released yesterday, Risky Business: An Investigation of the Treatment and Management of Chronic Self Injury among Federally Sentenced Women calls for effective, evidence-based management and treatment strategies for chronic self injuring populations taking precedence over perceived security concerns.  The CPA is particularly concerned that almost half of reported incidents of self-injury occur among federally incarcerated Aboriginal women with little evidence or awareness of culturally appropriate treatments by CSC.

For the report, the Correctional Investigator reviewed the case records, files and reports for eight chronically self-injurious women offenders over a 30 month period.  Between them, they had a total of 802 institutional security incidents.  More than half were self-injury or suicidal events. Seven of the women were Aboriginal.  In total, the eight women were involved in 22 transfers between the regional women's facilities, the Regional Psychiatric Centre (RPC Prairies, Saskatoon) and/or provincial psychiatric hospitals, prompted by the continuous escalation of mental health problems.  Based on these findings, as well as visits and interviews at external psychiatric facilities, the Correctional Investigator made a number of key recommendations. 

One of Mr. Saper's recommendations is that CSC staff receive enhanced training.  "The CPA has a long standing recommendation that CSC staff need more training to help them work with self injurious offenders.   In light of the revelations arising from the inquest into the tragic death of Ashley Smith in a federal women's correctional facility in 2007, and the findings in Mr. Saper's report, it is essential that CSC take notice and provide additional training for their staff and the CPA is ready and willing to help," says Dr. Michael Teehan, President of the Canadian Psychiatric Association.

The CPA concurs with the Correctional Investigator that self-injurious offenders should not be held in conditions of prolonged clinical seclusion or segregation because these measures can exacerbate the frequency and severity of self-injury in some women.  The CPA supports more rigorous monitoring of the use of physical restraints through strengthened reporting of their use.

There are a relatively small number of offenders who account for a large proportion of self injury incidents; 14 per cent of individuals account for just over 35 per cent of all incidents. Given this, the CPA supports the Investigator's recommendation that the most chronic and complex cases of self-injury be transferred to external community psychiatric facilities, provided these facilities are consulted to ensure that the transfer is clinically appropriate and the necessary resources are available at the receiving facility to provide the needed intervention.

For some women – those like Ashley Smith, and the women profiled by the Correctional Investigator - the evidence suggests that treatment in external facilities could lead to a dramatic reduction in the urge, frequency and severity of self-harm.

"Implementing the recommendations of this report could lead to dramatic improvements in outcomes for complex chronic self injurious offenders in the correctional system," concludes Dr. Paul Fedoroff, member of the CPA Board and President of the Canadian Academy of Psychiatry and the Law.

CPA looks forward to contributing to the efforts of CSC and the federal government to develop effective, evidence-based management and treatment strategies for their populations.

The Canadian Psychiatric Association is the national voice for Canada's 4,500 psychiatrists and more than 600 psychiatric residents. Founded in 1951, the CPA is dedicated to promoting an environment that fosters excellence in the provision of clinical care, education and research.