Nova Scotia

Veteran who killed his family, himself sought help from 6 doctors before triple-murder suicide

In the last months of Lionel Desmond's life — and those of his wife, his daughter and his mother — he would visit six doctors near his home in rural Nova Scotia, looking for the same thing: the help for ongoing symptoms of severe post-traumatic stress disorder he'd been told would be waiting.

Lionel Desmond went more than 2 months without follow-up treatment after in-patient psychiatric care

Lionel Desmond, an Afghanistan war veteran, suffered complex post-traumatic stress disorder and sought help from six doctors in rural Nova Scotia before killing his wife, daughter, mother and himself in January 2017. (Dave Irish/CBC)

In the final months of Lionel Desmond's life, he would visit six different doctors near his home in rural Nova Scotia, looking for the same thing: Help for ongoing symptoms of severe post-traumatic stress disorder.

He had been told that follow-up care would be waiting after his release from a psychiatric hospital. It was not.

Desmond sought help at family clinics and the emergency room until Jan. 2, 2017, the day before he fatally shot his wife, Shanna, his daughter, Aaliyah, his mother Brenda, and then himself. 

Each of the doctors who saw him during that search have now testified at the fatality inquiry underway in Port Hawkesbury, N.S., which is charged with making recommendations to prevent future deaths.

Their combined recollection was of a man who fell "through the cracks" as he left the military health-care system and moved to the civilian one. As a psychiatric patient at Ste. Anne's Hospital in Quebec, his days were rigorously scheduled — filled with appointments for counselling, nature therapy, social work and medication consultations — but then he came back to his home community in Guysborough County, N.S., in August 2016 to find no support in place.

Shanna Desmond and her daughter, Aaliyah. (Facebook)

Responsibility for follow-up care

There was still no apparent support when the Afghanistan vet and former infantry soldier went to the first doctor for help in mid-October 2016. 

As Judge Warren Zimmer, who heads the inquiry, said in an earlier session, "He kept getting passed off."

That gap in care begs the question, lawyer Adam Rodgers says, of who is responsible for a patient when they move.

CBC reporter Laura Fraser was live blogging the hearing:

In Desmond's case, he was not only leaving the Quebec hospital, but also moving from the home he'd had in New Brunswick where he'd served at CFB Gagetown to be with his family in Nova Scotia.

"You know that they're moving, so is it your responsibility to know that they've connected with a care team in their new home — or is it the patient's responsibility?" said Rodgers, the lawyer for Lionel Desmond's estate, in an interview.

"In an ordinary case, you may lay more of that responsibility on a patient, but in a case like Cpl. Desmond's, and many other veterans who have mental health issues [and] who have difficulty dealing with crowds and bureaucracy, that responsibility falls back on the care team."

In the week before he left Ste. Anne's, Desmond's team there had a conference call with the doctors Desmond had been seeing at the Occupational Stress Injury Clinic in Fredericton and with his Veterans Affairs case manager, Marie Doucette. 

But it appears that no one spoke with any health-care professional in Nova Scotia until at least October.

Meeting with family doctor

Desmond first visited a doctor two months after leaving Ste. Anne's Hospital, simply to ask a Guysborough physician if he might have any idea about what treatment plan had been set out for him in Quebec. 

That visit was the first time Dr. Luke Harnish met with Desmond and his wife, he testified Wednesday.

Desmond is shown here in a family photo with his mother, Brenda, left, and daughter, Aaliyah, right. (Submitted by Cassandra Desmond)

Harnish hadn't previously been Desmond's doctor. He'd also never heard of Ste. Anne's Hospital when they met and hadn't been contacted by anyone connected to the hospital, the OSI Clinic in New Brunswick or Desmond's Veterans Affairs case manager, he testified.

So, he decided to Google the hospital — and promised the couple his staff would contact the hospital to see about getting the veteran's records. 

It was the only time he would see Desmond, as the veteran never came back. 

Instead, Desmond would later see Dr. Ali Khakpour and Dr. Ranjini Mahendrarajah at the same practice. He would see Dr. Ian Slayter in the emergency room on Oct. 24, 2016, a psychiatrist who told the inquiry at an earlier session that Desmond's PTSD likely worsened due to the months-long treatment gap following his stay at Ste. Anne's.

In that assessment, Slayter noted that Desmond "might be falling through the cracks" as he transitioned from the military health system to the civilian one, which is why he agreed to keep following Desmond.

Rodgers said he expects the judge will address the gap when he makes his final report of recommendations.