A young man spent five days with his hands and legs shackled to an Adelaide hospital bed and denied access to a shower or toilet, a report by the South Australian ombudsman has revealed.

Key points: Prisoner with mental health issues denied access to bathroom

Prisoner with mental health issues denied access to bathroom Ombudsman said treatment of prisoner was unreasonable

Ombudsman said treatment of prisoner was unreasonable Report recommendation include better training for officers, time limit for restraining mental health patients in hospitals

It described how the man - referred to as Prisoner B - was transferred from Adelaide Remand Centre to the Royal Adelaide Hospital's emergency department in October 2014.

The man, who was aged 20 at the time, had mental health issues but was not transferred to a mental health facility for five days.

The Ombudsman's final report was released earlier this week and revealed Prisoner B was repeatedly made to wear nappies while shackled.

According to a submission from the Department of Correctional Services (DCS) chief executive, the man remained in nappies while at the RAH because of his "erratic behaviour and the inability to provide regular access to the toilet due to the risk he posed to himself and staff".

Ombudsman Wayne Lines ruled the DCS acted unreasonably in shackling the prisoner in the manner it did.

He described management of the prisoner at times was "lax" and some paperwork relating to his treatment had not been properly submitted.

Mr Lines' report found a decision to refuse "Hospital Watch Officer assistance [to shower] ... is inexplicable".

"Correctional officers really didn't review the level of restraint required for this prisoner over that period of time and were far too strict," he said.

"More needs to be done to be looking at alternatives and changing that fairly rigid way of thinking about how to secure a prisoner outside of the prison facility."

Latest report gives 'damning' assessment

Mr Lines released a report less than four months ago detailing the "inhumane" shackling of a another prisoner in hospital.

SA Ombudsman Wayne Lines ruled the prisoner was shackled unreasonably. ( ABC News: Nicola Gage )

Doctor Tom Soulsby from the College of Emergency Medicine said it was not uncommon for patients to remain in emergency until a mental health bed became available.

"The Royal Adelaide Hospital and the Queen Elizabeth I think have been struggling," he said.

"This past six months has probably been the worst that I've seen it in 16 years that I've worked in South Australia."

Community Visitors Scheme principal community visitor Maurice Corcoran said the findings were damning.

"It is an absolute breach of human rights when a person is denied access to bathroom, toilet and shower facilities for five days and an insistence on them wearing an adult nappy," he said.

"This is a sad reflection on the way that we're treating people here in South Australia.

Mr Corcoran said he believed another prisoner had been shackled to a bed for up to five days in the same hospital last week.

"The case of Prisoner B was some time ago but the evidence is people are still being restrained for this period of time in our emergency departments."

Mr Lines made nine recommendations and called for better training of officers, and to limit the time mental health prisoners were restrained in hospital.

The Government said it would implement all of the report's recommendations.

Government to undertake 'soft shackle' trial

SA Police Minister Peter Malinauskas said the Department of Correctional Services was looking at undertaking a trial to implement soft shackle restraint technology developed in conjunction with New South Wales.

"We're trying to make sure that we're delivering on the basic human rights of that prisoner by providing them with some of the best available health care anywhere in the world," he said.

"Of course what we have to do is make sure that we balance that with the interest of community safety."

SA's public advocate Anne Gale said the shackling of mental health prisoners in hospitals must be time limited and only used as an absolute last resort.

"We mustn't see this in our state," she said.

"We're a progressive society and this report highlights the need for us to ensure that this isn't happening on an ongoing basis."

Mental Health Minister Leesa Vlahos said the Government had increased the number of mental health beds in the system and reduced mental health waiting times.

"We have an ongoing focus on achieving the most appropriate mix of beds," she said.

The State Government previously set a target that by the start of this year no mental health patient would spend more than 24 hours in an emergency department.

It said it was still committed to meeting that target.