Degree of miscommunication over Cpl. Desmond’s file affected treatment plans

PORT HAWKESBURY: Rather than immediately being connected by Veterans Affairs with a psychiatrist or psychotherapist in Nova Scotia after his release from Ste. Anne’s Hospital, retired Cpl. Lionel Desmond searched for help on his own.

Desmond would go on to see six different doctors near his home in Upper Big Tracadie.

Approximately six weeks after his discharge from the hospital specializing in serving veterans with post-traumatic stress disorder (PTSD), the Occupational Stress Injury (OSI) Clinic Desmond had been attending in New Brunswick referred him to their sister clinic in Halifax on Sept. 30, 2016, for ongoing treatment.

Natasha Tofflemire, a nurse at the OSI clinic in Halifax, testified at the Desmond Fatality Inquiry on March 9 there had been “some degree of miscommunication” over Desmond’s file and how it should have been handled.

In a document from the Fredericton OSI clinic, Mathieu Murgatroyd indicated in a phone call on Oct. 18, 2016, Tofflemire established Desmond had secured a therapist in his community and he would also be connected with local psychiatric help.

“I think this was a miscommunication between Dr. Murgatroyd and I,” she testified. “It wasn’t overly clear. That was still left open.”

It was Tofflemire’s understanding that Desmond’s case manager, Marie-Paule Doucette, was scheduling arrangements for him to receive local assistance.

She explained Desmond’s Veterans Affairs case manager was trying to locate him a therapist closer to his home community in Upper Big Tracadie; this was being done to save the Afghanistan war veteran hours on the road travelling to and from his appointments.

However, his referral, which was to manage his medication, was put on hold on six days later, as his case manager advised they couldn’t refer him to the Halifax-based OSI clinic without confirming if Desmond had a family doctor.

Dr. Ranjini Mahendrarajah first saw Lionel Desmond in 2015 for treatment on a bee sting. On their second encounter on Nov. 2, 2016, the former infantryman informed her he was still struggling with his PTSD symptoms, particularly in relation to nightmares and flashbacks.

Mahendrarajah testified Desmond’s demeanor was “pleasant, polite and calm” and despite having nightmares and flashbacks, he didn’t show any physical symptoms of depression or mental illness.

“I was a bit concerned that he was on psychiatric medication but not receiving any counselling therapy,” she said.

Mahendrarajah testified while she knew about his emergency room visit at St. Martha’s Regional Hospital with Dr. Ian Slayter, she didn’t know anything about the treatment Desmond received in the military for his PTSD, at the OSI clinic in Fredericton, or about his recent early discharge from in-patient services at Ste. Anne’s.

Had she known Desmond’s prior treatment, she testified she would have requested Slayter and Desmond meet as soon as possible for another assessment to connect him with the counselling therapy he needed.

Dr. Luke Harnish testified on March 10 that two months after returning to Nova Scotia in 2016, Desmond was looking for help in getting psychiatric treatment.

Filling in as a physician at the Guysborough Memorial Hospital, Harnish’s only meeting with Desmond came on Oct. 13, 2016, when he met with the him and his wife to figure out how to help him after Desmond moved back home after a decade away.

“He didn’t know what the plan was and didn’t know where else to turn, I think, at that point, so he came in to see if we could help him,” Harnish said. “I got the impression that he was sort of in a limbo period.”

After searching the internet with Desmond and his wife for contact information for the Ste. Anne’s Hospital to obtain his medical records, as Desmond believed medical officials were supposed to create a follow-up plan for him, he hadn’t received any information.

The emergency room doctor who saw Desmond weeks before the triple murder-suicide suggested the former soldier didn’t present himself as being potentially suicidal or homicidal.

Dr. Ali Khakpour, who has experience treating PTSD amongst soldiers in his native country of Iran, testified Desmond seemed “stable and didn’t appear to be a danger to himself or others.”

“He didn’t have any (suicidal) thoughts, and he looked to me as somebody seeking help,” Khakpour said. “Honestly if he had shown any single point of showing depression that much, there would have been no hesitation, we would have done something different.”