Three doctors who assessed a Yellowknife woman later shot and killed by police in an armed standoff testified at an inquest Wednesday that they felt she wasn't a threat to herself.

Karen Lander, 42, was shot and killed in front of her home when she pointed a long-barreled firearm at police during a standoff in March 2012.


Three doctors at Yellowknife's Stanton Territorial Hospital who assessed Karen Lander testified at an inquest Wednesday that they felt she wasn't a threat to herself. (CBC)

Leading up to her death, Lander was taken to hospital several times after threatening suicide, once in April 2011, again in January 2012 a few days after her children were taken into care, and then again in the middle of February — a month before the shooting.

Dr. Alexander Hoechsmann, the former clinical head of Stanton Territorial Hospital’s emergency room, said doctors have to weigh factors to determine what level of risk a person poses.

He said on the one hand, Lander didn't fit the demographic more likely to kill themselves: men, particularly those young or very old. There was also no record of her actually trying to commit suicide.

But on the other hand, she had a history of depression and alcohol abuse, lived alone, had no significant other and had a family history of suicide.

That morning, he decided Lander posed a low risk to herself and didn't need to see a psychiatrist. He made plans for her to meet with her family physician within the week and let her go home.

Another emergency physician, Dr. Dave Pontin, said the N.W.T. Mental Health Act doesn't give emergency room doctors enough leeway to admit patients involuntarily. He said he would like to see that changed.

He also said patients would benefit if they had an easier time appealing a doctor’s decision to admit them.

Pontin's diagnosis of Lander mentioned that she had a personality disorder as well as suicide ideation, but that he had no grounds to admit her to hospital.

In none of the cases the jury heard about did Lander want to be admitted to hospital. The doctors also pointed out that under the N.W.T. Mental Health Act, having a drinking problem isn't reason enough to admit someone involuntarily to the hospital. An addiction issue has to be coupled with mental illness.

Three hours before police opened fire on Lander, psychiatric nurse Lynda Strakowski got a message — a Post-it note saying "call Karen Lander."

Strakowski had been one of Lander's confidants for five years, first as a mental health worker, and later through her work in the psychiatric unit at the hospital.

Strakowski said, in her experience, Lander had only threatened to hurt herself not others, but said Lander consistently struggled with her desire to take care of her family and overcome her addictions.

Strakowski often was a go-to when Lander was in distress. She called back but never reached Lander.

Strakowski told the coroner's jury she wants to see a psychiatric nurse working in Stanton Territorial hospital's emergency room.

At the moment, doctors can call in nurses such as Strakowski to get their specialized opinion, but she said having someone there all the time would provide consistent support to the people who end up in the ER again and again.