Six years after New Brunswick teen Ashley Smith died at her own hands, the federal prison system remains "ill-equipped" to manage female offenders who chronically injure themselves, Canada's correctional investigator says.

In a new report, Howard Sapers said the number of self-injury incidents in federal prisons has more than tripled since Ms. Smith's death in late 2007, raising questions about the government's strategy for managing federal inmates with mental-health problems.

The report found "significant gaps" in the availability of treatment options for offenders who chronically hurt themselves. And despite evidence that punishment and restraint are counterproductive, corrections officers frequently respond to self-injurious behaviour with physical restraints, pepper spray and segregation, the report said.

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Mr. Sapers called for significant changes to the way self-harming inmates are treated, including placing some of the offenders who are at the highest risk in provincial health-care settings instead of prisons. He also recommended independent oversight for inmates at each of the Correctional Service of Canada's five regional treatment centres, which serve as both prisons and mental-health facilities.

An ongoing inquest into Ms. Smith's death continued on Monday, with the acting warden at Grand Valley Institution for Women testifying that she was unaware officials were told not to intervene when Ms. Smith choked herself unless the teen stopped breathing. Cindy Berry said that, in retrospect, she does not believe the institution was prepared to deal with Ms. Smith's behaviour.

Kim Pate, executive director of the Canadian Association of Elizabeth Fry Societies, said Mr. Sapers' report shows that very little has changed since the teen's death. "In fact, things have become far worse for women, particularly for indigenous women, and for women with mental-health issues. We see that the response of corrections to injurious behaviour is now even more restrictive."

About 900 incidents of self-harming were documented in 2012-2013, with aboriginal and female offenders accounting for a disproportionate number, according to the report.

Titled "Risky Business," the report looks at the cases of eight high-risk women who frequently injured themselves in prison, seven of whom were aboriginal. All of the women had been diagnosed with a significant mental disorder, and most had cognitive difficulties.

The report raises concerns about the way the CSC responded to inmates' behaviour, including what Mr. Sapers called an "over-reliance" on use of force and control measures such as physical restraints and segregation.

He said inmates who self-harm often do so to gain a sense of control over their circumstances. "If you respond by trying to take away any of that control that they are trying to achieve, then you get into this very dysfunctional cycle of self-harm, response, more self-harm" which can escalate in severity.

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"Frankly, we found that the corrections service was doing a good job at stopping immediate incidents of self-injury, but they weren't doing a good job of following up and preventing subsequent incidents of self-injury," Mr. Sapers said on Monday.

The Conservative government has made victims' rights a key pillar of its legislative agenda in recent years, and taken a more punitive approach to offenders by increasing mandatory minimum sentences and cutting inmates' pay for some prison jobs.

The CSC spent about $90-million strengthening mental-health care in prisons since 2005, implementing computerized mental-health screening when offenders are admitted to an institution and improving training for front-line staff, the report points out.

"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," it says.

During the year that Ms. Smith was in federal prisons, corrections officers frequently responded to her self-injuring with segregation, forced medical injections, use-of-force interventions and frequent transfers, Mr. Sapers wrote in the report, adding: "CSC's management of Ashley's behaviour served to intensify the frequency and severity of her self-injury."

In an e-mailed statement, Public Safety Minister Steven Blaney said the government does not believe prisons are an appropriate place to treat those with serious mental illness. A spokeswoman for the Correctional Service of Canada said the service is reviewing the report and its recommendations but declined a request for an interview.

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With a report from The Canadian Press