PORT HAWKEBSURY: The Desmond Fatality Inquiry heard from its final witnesses last week, including a psychiatrist who claimed Ret. Cpl. Lionel Desmond had an inadequate discharge plan when he left Ste. Anne’s Hospital in August 2016.
Scott Theriault, who is employed at the East Coast Forensic Hospital in Dartmouth as a forensic psychiatrist, and has 30 years of clinical practice, told the inquiry on Nov. 1, that he performed a psychological autopsy on Desmond at their request.
Following his review of how the former infantryman’s mental illness affected his decision-making at the time of his death, Theriault concluded Desmond didn’t “fully stabilize” while attending the psychiatric hospital in Montreal.
He explained he most likely would have experienced a decline, highlighting the fact he didn’t receive any therapeutic treatment following his discharge.
“Given that a lot of those discharge planning pieces were left hanging, that would suggest a downward trajectory for him,” Theriault said. “In the absence of all those elements being addressed prior to his discharge; that would increase the probability that Mr. Desmond would not be successful in re-integrating into his community.”
The inquiry, which has seen testimony over the past 21 months, is investigating why Desmond, who was a former soldier, killed his mother Brenda, his wife Shanna and their 10-year-old daughter Aaliyah, before turning the gun on himself on Jan. 3, 2017.
The inquiry’s mandate is to see whether there are any potential changes that could be made to government departments and public institutions that may prevent deaths like the this to occur again in the future.
Theriault also told the inquiry in the years prior to the triple murder-suicide in Upper Big Tracadie, Desmond’s aggressive and constant nightmares about his wife revealed that he was on “the severe end of the spectrum,” when it came to persistent homicidal thoughts.
“I’ve seen cases of a similar nature over the years, where it’s been a case of domestic violence and that includes murder, but the intensity and frequency of those thoughts; wouldn’t be as intense as the information I have about Mr. Desmond,” he testified. “It’s part of sort of a dynamic risk assessment that you would want to take into account, and it’s concerning because as much as it plays into his PTSD, the issues are co-related and it’s difficult to disentangle one from another.”
Theriault suggested when Desmond left Ste. Anne’s Hospital, his follow-up care became problematic following his decision to move back to Nova Scotia and a handover should have occurred between his team in New Brunswick and the Operational Stress Injury Clinic in Halifax.
“Given the information available at the time, that sort of warm transfer process would have allowed the incoming clinicians who were taking on the case to be more fully informed about the issues they might be expected to deal with,” he said. “He still wasn’t sure where he was going to live, or where he was going to get follow-up services. I don’t get any sense that he was in the know about who he was going to see.”
Continuing his testimony on Nov. 2, Theriault testified Desmond was aware of what he was doing and would have been considered criminally responsible for his actions, had he survived.
He highlighted that the veteran’s chronic post-traumatic stress disorder (PTSD) symptoms did not prevent him from knowing that his actions were both “morally wrong and would have been fatal.”
Theriault told the inquiry Desmond was not suffering from delusions or a brief flashback when he fatally shot his mother, wife and 10-year-old daughter. He also stated the Afghanistan veteran wasn’t suffering from a dissociative episode, which comprises of prolonged breaks from reality.
While the fact of the matter remains that Desmond purchased a knife used to slash his wife’s tires and a rifle that was used in the killings, shows that he displayed the capacity to plan the killings, he doesn’t feel Desmond planned to kill either his mother or daughter before stepping foot inside the home.
“Then, with the presence of his mother there and his daughter; he just felt overwhelmed in the situation and he felt that there was another final solution awaiting there for him,” he said. “Sometimes people theorize that killing a family member is a misguided way of saving them from future harm; that they’d be better off dead than living in a world where they didn’t have any parents.”
While the inquiry had previously heard testimony from another psychiatrist who confirmed Desmond had been suffering from dissociative episodes, Theriault testified there was no “real evidence” that Desmond had experience real delusions, which involve a total break from reality.
“The information that we have about any dissociative phenomenon is relatively brief,” he said. “But there’s no evidence that I have that would suggest that a dissociative event would be as protracted as this particular (homicidal) behaviour that he ultimately engaged in.”
Adam Rodgers, the lawyer representing Desmond’s estate, questioned whether Desmond’s decision to purchase a rifle and to then change into camouflaged clothing just prior to the killings could point to a dissociative event.
“We have information that on Jan. 3, (Desmond) had several conversations with several people over a period of time, where he presented as organized, polite and controlled,” Theriault said. “My expectation would be that for an individual in a dissociative state, who is functioning as though they are in a war zone, that level of calm demeanour would not be present.”
Clear red flags of the potential tragedy went unnoticed by doctors, therapists and police officers involved in Desmond’s recovery, as they were focused on his PTSD, a domestic violence expert told the inquiry on Nov. 3.
“There was a great deal of focus on trying to keep him alive and functioning,” Peter Jaffe testified. “And what got lost in that focus was that Shanna and Aaliyah were also in danger and, ultimately, also his mother was, as well.”
Jaffe, who is the former director of the Centre for Research and Education on Violence Against Women & Children, was tasked by the inquiry to review the deaths and to determine whether or not there were any potential risk factors that may have predicted what would occur.
“The mental health problems were so overwhelming,” he said. “That the danger these mental health problems posed were overlooked.”
According to the Ontario Domestic Violence Death Review Committee, in cases of intimate partner homicides, a review found that there were seven or more risk factors present in 70 per cent of the fatalities in Ontario between 2003 and 2018.
Out of the 41 risk factors that can predict an increased risk of intimate partner death, Jaffe indicated he found 20 present in Desmond’s relationship with his wife Shanna.
He distinguished that other health professionals seemed to consider Desmond’s demeanour as symptoms of his PTSD rather than ongoing patterns of domestic violence.
Jaffe told the inquiry there’s evidence that Desmond’s mother Brenda recognized that her granddaughter and daughter-in-law weren’t safe.
“She was there to protect the family and she lost her life protecting the family,” he said.
As a critical piece of the inquiry, Jaffe’s testimony addresses one of the mandate’s core principles; whether or not medical professional who interacted with Desmond and his family were trained to spot warning signs of domestic violence.
“From 2011-2017, no one really addressed the extent of domestic violence and abuse,” Jaffe’s report read. “Most professionals did not explore what was really happening between Cpl. Desmond and his wife; as well as what their daughter was living with in these circumstances.”
Finishing his testimony on Nov. 4 as the inquiry’s final witness, Jaffe explained a lack of collaboration among health care professionals was an “overwhelming theme” as there is evidence showing psychiatrists, psychologists, social workers and others failed to share critical information regarding Desmond’s mental decline.
“Throughout the file, I see a theme that we see in our death review cases in Ontario, which is a lack of collaboration,” he told the inquiry. “People working in silos, not sharing information, not getting together.”
Desmond was in contact with 40 mental-health professionals from the time he was diagnosed with PTSD and major depression while still serving in the military in 2011 until his death in 2017.
“In my view, there’s no reason why prior service providers couldn’t have written a summary and forwarded it and offered their email address and cellphone number for follow-up,” Jaffe testified. “There’s lots of ways information could have been shared.”
In his part, Jaffe submitted eight recommendations to the inquiry, including a call for expanded education on domestic violence for front-line professionals. He also recommended the Canadian Armed Forces and Veterans Affairs Canada should ensure that high-risk cases are flagged for immediate follow-up and properly shared with community partners.
“Had there been earlier risk assessments, earlier interventions, there may have been a different course,” he said. “And the thing in which I’m struck in reading the file was how much Lionel Desmond wanted help; how much he was reaching out.”
On Nov. 29, it’s anticipated that the lawyers involved with the inquiry will begin their submissions for Judge Warren Zimmer to consider in his final report.