GUYSBOROUGH: Already having heard from three doctors who interacted with Afghanistan war veteran retired Cpl. Lionel Desmond in the months prior to the triple murder-suicide at their Upper Big Tracadie home, on February 11, the inquiry began hearing testimony from the nurses who oversaw him.
Mental health crisis clinician Heather Wheaten, who assessed Cpl. Desmond two months before the 2017 tragedy, says his symptoms of post-traumatic stress disorder (PTSD) appeared to get worse during a period of time in 2016 when he wasn’t receiving any treatment.
A “situational crisis” and “worsening of PTSD symptoms,” she told the inquiry, resulted in Cpl. Desmond and his wife, Shanna, attending the emergency room at St. Martha’s Regional Hospital in Antigonish, on October 24, 2016 as a last-ditch effort to receive therapy.
Wheaten filled out a mental health assessment form, noting at the time the former rifleman was suffering from interrupted sleep, nightmares, loss of appetite, aggression towards objects, conflict with his wife, and increasing anger, depression and anxiety.
In addition, she noted Cpl. Desmond was having paranoid thoughts about his wife, lacked concentration and was “not sure how to live as a civilian.”
“Very brief stability and then problems getting worse since then,” she wrote in her October 24 notes.
Wheaten asked to speak with Cpl. Desmond alone, something both he and his wife declined, preferring both to be in the room.
In notes she took during that assessment, Cpl. Desmond seemed “downcast and unkempt” and was “having trouble navigating the Veterans Affairs system and worried about what they will offer and what they will cover.”
In the hour-long assessment, Wheaten concluded Cpl. Desmond had “frequent, passive suicidal ideations,” but she didn’t believe he had a plan or any real intentions to act on them. Dr. Faisal Rahman, a psychiatrist at St. Martha’s later assessed Cpl. Desmond’s risk of suicide as “low.”
After learning about the tragedy, the mental health crisis clinician testified she decided to change her interview approach.
“I wonder if I had of made sure to have time alone if anything, if either one of them would have disclosed anything differently.”
Every medical professional that has taken the witness stand has been asked what they’ve changed since the 2017 triple murder-suicide, Wheaten was the first to admit a direct change to her practice.
“This one today that nurse Wheaten mentioned that she now speaks to people individually, well that’s a good change,” lawyer Adam Rodgers said. “It’s not a terribly significant change compared to some of the things we’re thinking about – but it’s something at least.”
Speaking with both Cpl. Desmond and Shanna, who was also a psychiatric nurse, Wheaten suggested Shanna appeared to “manage and advocate” her husband’s care.
“I did have to ask her to not answer for her husband that I would look to her to answer if needed,” she said. “She was doing a lot of the presenting of the information.”
Wheaten ultimately helped the struggling couple make a plan to deal with Cpl. Desmond’s “anger issues.”
“I remember Shanna was talking about how there was an incident where Lionel had banged his hand on a table and Aaliyah was in the room,” she said. “Shanna said that ‘I took my daughter aside and I explained to her that daddy wasn’t mad at her, that he was just feeling frustrated and angry and it didn’t have anything to do with her.’”
As Judge Warren Zimmer looks at making recommendations to prevent further deaths, like those at the centre of this fatality inquiry, he’s making sure there aren’t any gaps as someone moves from military care to the civilian health-care system.
Wheaten’s testimony suggested those gaps do exist and were present with Lionel’s case ever since his discharge from the Armed Forces in 2015 – eight-years after serving in Afghanistan.
Cpl. Desmond spent more than two-months without any follow-up treatment as he waited for Veterans Affairs to arrange for it, upon returning back to Nova Scotia after spending time at an in-patient operational stress injury clinic at Ste. Anne’s Hospital in Quebec.
Wheaten told the inquiry Cpl. Desmond and his wife were awaiting correspondence from Veterans Affairs to confirm a new case worker in Nova Scotia and were hoping the department would make arrangements for him to see a private therapist.
“I take from your note that a recurring theme with Lionel Desmond is this concept of trying to get care, but it just seems to be not happening,” inquiry counsel Shane Russell said.
On February 10, a lawyer representing the Attorney General of Canada told the inquiry Cpl. Desmond’s case manager was working on establishing the services he desperately needed in Nova Scotia, but there was some discrepancies on where the location would ultimately be, Halifax or Cape Breton.
The Fatality Inquiry has also been tasked to probe whether the civilian clinicians who interacted with Cpl. Desmond were trained to recognize the symptoms of post-traumatic stress disorder and domestic violence.
Wheaten, a nurse with more than 20-years experience told the inquiry she did not receive any formal training regarding domestic violence.
When asked by Russell if that type of training would have been useful, Wheaten testified she felt capable of making a professional evaluation by using a mental health assessment form.
“I believe that we evaluate the risk,” she said. “If there’s a cue of any kind we would explore that fairly extensively. It’s with an awareness that if a person is going to act out violently towards another person, more often than not that’s going to occur in their intimate relationships.”
Wheaten had trouble remembering details of her interaction with Cpl. Desmond outside of her notes, and lawyers have identified problems with the lack of details in the medical assessment notes, and undecipherable writing.
Cpl. Desmond would visit the emergency room at St. Martha’s on two other occasions; in one instance on December 1, 2016 – he left after several hours without being seen by a medical professional.
On January 1, 2017 he was held for overnight observation following another dispute with his wife, and she asked him to leave following a small car accident the night prior.
Cpl. Desmond was released the following morning after a psychiatrist determined the 33-year-old former sniper was not a threat to himself or anyone else.
Evidence presented to the inquiry already has suggested the attending nurses may have seen a much different version of Cpl. Desmond that night – one who “slept poorly” and was “restless,” which they indicated in his medical chart.
Leanne Watts and Maggie MacDonald oversaw Cpl. Desmond’s emergency room stay two-days before the triple murder-suicide.
MacDonald, who conducted Cpl. Desmond’s discharge after she received the order from Rahman by phone, testified the veteran had a “flattened affect” when she spoke to him, but “otherwise seemed normal.”
“From what I noticed, he was very pleasant and calm,” she said. “He just had an emotionless look to his face.”
Rahman previously testified after assessing Cpl. Desmond on January 1, he didn’t re-read his medical chart before releasing him.
Watts, who observed Cpl. Desmond overnight in the emergency room, indicated she recorded his demeanour as “calm and cooperative,” and her notes also suggested there was “nothing out of the ordinary.”
It was then on January 3, 2017 when Cpl. Desmond purchased a military-style carbine, changed into full camouflage fatigue and killed his 31-year-old wife Shanna, his 52-year-old mother Brenda, and his 10-year-old daughter Aaliyah, before turning the gun on himself.