The Tasmanian government must take urgent action to address the overuse of rolling lockdowns and isolation in the state's prison systems, a human rights organisation has said, in the wake of a scathing report from the Custodial Inspector.

The report by the Office of the Custodial Inspector (the Office) found one doctor who defied the Tasmanian Prison Service (TPS) and recommended an inmate spend more time in hospital after swallowing a razor blade, was banned from entering the prison, allegedly for safety reasons.

It comes as First Nations people continue to be significantly overrepresented in the custodial system in Tasmania, at a rate of 872.4 per 100,000 people, compared to the overall rate of 164.7 per 100,000, with the report finding more cultural work was needed to assist inmates.

Custodial Inspector Richard Connock said the mental and physical health impacts of lockdowns across the TPS, as well as the Ashley Youth Detention Centre (AYDC), were a primary concern for the Office.

In a snapshot of a full-day lockdown in Hobart's Risdon Prison in January last year, some units across the facility spent more than half of the month in lockdown — many of the lockdowns were blamed on staff shortages.

Inmates' access to healthcare was severely diminished as a result, with the Office highlighting some had resorted to removing their own teeth.

"Both medical consultants who were involved in the inspections highlighted the significant effects of lockdowns on prisoners' and young peoples' mental and physical health," Mr Connock said.

"These include increased frustration and irritability, anger, depressive symptoms, and a general decline in mental health and wellbeing, as well as social isolation.

"Insufficient TPS correctional staff also reduce the ability to access health care and external medical appointments. Lockdowns also reduce Correctional Primary Health Service (CPHS) staff access into the adult custodial facilities."

In response to the incident where Dr Edward Petch was forbidden to enter the prison – which caused significant embarrassment for the doctor and caused some staff to say they were "ashamed to be wearing their uniform" that day - Mr Connock recommended that the Corrections Act be amended to ensure senior staff are consulted before removing access to prison facilities — for health staff and state servants.

Whilst this was supported by the Department of Health, it was not by the Department of Justice.

Debbie Kilroy from the National Network of Incarcerated and Formerly Incarcerated Women and Girls said this was a "stark reminder of the TPS's disregard for human life and professional medical advice".

"This deliberate ignorance jeopardises the health and well-being of prisoners and underscores the system's view of prisoners as disposable," Ms Kilroy said.

In a letter to Premier Jeremy Rockliff in June 2023, a young inmate at AYDC described their time in lockdowns as being "like dogs at the dog home".

"We get excited when people come to our doors, just like the dogs get excited when someone goes to their cage just because we have someone to talk to," they said.

"Even the cows in the paddocks next to Ashley have more freedom than us."

Justice Reform Initiative executive director Mindy Sotiri said the conditions inside Tasmanian prisons increased the risk of reoffending, noting these concerns had been stated before.

"The Custodial Inspector's findings reaffirm what we know is an incredibly distressing situation for adults and children." Dr Sotiri said.

"We are funnelling far too many people into harmful prison settings when all of the evidence shows us that prisons fail to address the social drivers of incarceration."

Mr Connock made a total of 117 recommendations to improve inmates' mental and physical health but noted only 12 out of the 46 recommendations from the 2017 report had been successfully implemented.

"Disappointingly, my team found the level of mental health support services provided to young people at AYDC to be largely unchanged since the last inspection in 2017," he said.

"Dedicated psychology and psychiatry time for young people has not been increased and AYDC staff highlighted to my inspection team that the current psychology and psychiatry services are not sufficient to meet the needs of the young people at AYDC."