PORT HAWKESBURY: The Canadian Armed Forces arranged for retired Cpl. Lionel Desmond’s treatment to continue following his medical discharge in 2015.
However a psychologist says the “lack of structure” outside the military presented additional strains on the former soldier who was suffering from complex post-traumatic stress disorder (PTSD).
Dr. Mathieu Murgatroyd, the first psychologist who saw Desmond following his discharge from the military, testified at the Desmond Fatality Inquiry on Feb. 25 the two didn’t accomplish much in terms of overall therapy.
“We’re talking about individuals that have several mental health issues and challenges, PTSD, depression,” he said of transitioning from military to civilian life. “Which can lead to poor coping strategies and all of these can interfere with the process.”
The psychologist suggested this came as a result of Desmond finding little purpose outside the military, isolation from his family living in Nova Scotia and ongoing conflicts within his marriage.
Struggling to transition to civilian life, Desmond indicated at times he would consume three 24-packs of beer per week and would eat very little, but the more concerning obstacle that Murgatroyd had right from their first interaction was he wasn’t showing up and would miss appointments.
“In terms of commitment and engagement, it was interfering with the therapy process,” he said. “We were concerned with this inconsistency.”
A structured treatment plan for Desmond was continuously hindered as he split his time between New Brunswick and Nova Scotia, trying to re-establish a relationship with his wife that was in turmoil.
“There were moments when they seemed to be doing better,” Murgatroyd said. “But for the most part, it was strained.”
Under the psychologist’s care for 16 months, Desmond’s treatment plan never progressed as he said they would be putting out fires rather than working on any real intervention.
Murgatroyd suggested the source of Desmond’s psychological distress appeared to be the transition from combat-related PTSD, to a “fixation” with the way his wife was handling their finances, along with concerns of her infidelity.
Desmond’s dreams were impacting his perception of reality, something his psychologist explained helped clarify why he would later rescind his consent allowing the clinic to disclose information to his wife.
Dr. Anthony Njoku, the first psychiatrist to treat Desmond after he was medically discharged, testified on Feb. 26 the veteran experienced dissociative events, sending him back to Afghanistan for minutes at a time.
“I thought he needed a lot of help,” Njoku said.
He explained Desmond would have benefited from in-patient treatment, but first and foremost, he needed to become stabilized by managing his drinking and learning calming techniques.
“He tells me that seeing people in military attire, hearing the sound of gunfire from (the) shooting range, or an overflying aircraft all make him more agitated, aggressive and angry,” Njoku wrote in his initial assessment. “Other triggers included certain smells of food, and together they had caused a heightening of homicidal thoughts towards Arab people within him.”
The fact that Desmond couldn’t self-soothe was a concern for him, given his already three years of psychiatric treatment within the military. Njoku testified that he recommended Desmond be set up with a clinical case manager through Veterans Affairs Canada, but suggested it was unclear on why that was never followed up.
Following a January 2016 appointment that Desmond’s wife and daughter attended, the psychiatrist described them as a “loving family,” and after seeing the level of care Desmond’s wife exhibited, he believed the relationship complaints were those of paranoia and hypervigilance.
“This was a wife who was just as caring, who was just as interested in his well-being and who was wanting to know about his treatment,” Njoku said. “His daughter was there, interactions seemed entirely appropriate, entirely loving. So it’s probably the worst moment of this entire thing.”
He suggested Desmond would become more agitated about his wife, who he claimed was plotting against him; something the psychiatrist deemed “as bordering on delusions.”
Njoku testified he was concerned with Desmond’s use of medical marijuana as it may have augmented his PTSD symptoms, particularly in relation to his paranoia.
He explained he was never able to distinctly figure out whether the former infantryman’s anger in relation to his wife was the result of his PTSD or from the breakdown of a relationship.
“His relationship was quite significantly impacted and he went on at great lengths, complaining about his wife, her family, his distrust of them,” Njoku said. “Multiple incidents (were) triggered by his anger that had contributed to a major strain in his relationships with him.”
The inquiry is now scheduled to hear from the clinicians from Ste. Anne’s Hospital, where Desmond received in-patient treatment in May 2016.