GUYSBOROUGH, N.S. -- The judge overseeing an inquiry into a triple-murder and suicide carried out by an Afghanistan war veteran says Lionel Desmond faced a large gap in treatment for a severe case of post-traumatic stress disorder.
As testimony drew to a close Thursday, provincial court Judge Warren Zimmer also said Veterans Affairs Canada did not share key information about Desmond's mental illnesses with the last health professional to talk to him before he shot his family and himself on Jan. 3, 2017.
The provincial fatality inquiry, which started last month in Guysborough, N.S., has heard evidence that after Desmond was discharged from a treatment facility in Quebec in August 2016, he received no therapeutic treatment before the killings four months later.
"From August to December (2016), I haven't seen anything to suggest there had been a real therapy session anywhere, any time," Zimmer told the inquiry.
"That's a big gap."
The inquiry has heard that Desmond sought help through a Nova Scotia hospital's emergency room on two occasions before he managed to meet in December 2016 with a community-based psychotherapist in Antigonish, N.S., contracted by Veterans Affairs.
Catherine Chambers, a therapist who specializes in treating PTSD, told the inquiry she had been in touch with Desmond's case manager at Veterans Affairs but never received any medical documents from the department.
Zimmer read from Veterans Affairs reports indicating Desmond had not responded well to the treatment at the Quebec facility. As well, staff at the facility said Desmond could be suffering from cognitive impairments that required a sophisticated neuropsychological assessment.
"I want you to have an appreciation for what was known at the time that he was discharged and was coming to you," Zimmer told Chambers.
"It's important to appreciate that all of this information was sitting there, and you had none of it."
Zimmer then cited testimony from a psychiatrist in Antigonish who said in a Dec. 2, 2016, report that it appeared Desmond was "falling through the cracks in terms of follow-up by military and veterans programs."
"This information would have been valuable for you to know," Zimmer said to Chambers, "that the person who's coming to see you had, by the view of Dr. Slayter, 'fallen through the cracks?"'
Chambers agreed, saying the recommendation that Desmond receive a neuropsychological assessment for cognitive problems meant he wasn't a good fit for community-based psychotherapy like she provided.
She admitted she did not ask Desmond's case worker at Veterans Affairs to send her any documents, though there was evidence the department was in the process of sending consent forms for Desmond to sign that would allow for the release of health records.
"Since the events of Jan. 3, 2017, my experience has been that information has been provided more regularly," Chambers testified, adding that she now makes a point of requesting health records before she agrees to see any veterans.
Earlier in the hearing, Zimmer read aloud from a Veterans Affairs letter, dated Dec. 15, 2015 after Desmond had been discharged from the military, recommending him for treatment at Ste Anne's Hospital in Montreal, which has an operational stress injury clinic.
At that point, Veterans Affairs was already aware Desmond's PTSD symptoms were severe and that he suffered from a major depressive disorder.
Desmond received treatment in a residential unit between May 30, 2016 and Aug. 15, 2016, when he left the program early, complaining about excessive noise and lack of trust with staff.
On Aug. 9, 2016, Desmond's Veterans Affairs case worker reported he had experienced minor progress at the facility and, more importantly, staff had observed "what appears to be cognitive limitations." That's when Veterans Affairs recommended a neuropsychological assessment, Zimmer told the inquiry.
"We know that he left that clinic in August, and I don't think we can point to any kind of therapeutic intervention up to and including Jan. 3, 2017," Zimmer said.
On Wednesday, Chambers testified that Desmond called her only a few hours before the killings to schedule an appointment, but he also told her his wife Shanna had recently asked for a divorce -- a key piece of evidence that had not been revealed to the inquiry until this week.
On Thursday, Chambers said Desmond's phone call indicated to her he was in a state of crisis, mainly because of the news of the divorce and the fact that the couple had argued about a minor vehicle accident on New Year's Eve -- and Desmond was asked to leave the family home.
Chambers, who had met twice with Desmond in December, said she succeeded in getting him to agree to a "safety plan," which required him to stay away from his home and to go to the hospital if his PTSD symptoms flared or if he started having thoughts of harming himself or others.
"He said he did not have plans to hurt himself or anyone else," she told the inquiry.
About three hours later, Desmond legally purchased a SKS 7.62 Soviet-era semi-automatic carbine, which he later used to kill his 31-year-old wife, their 10-year-old daughter Aaliyah and his 52-year-old mother Brenda inside the family's home in Big Tracadie, N.S.
This report by The Canadian Press was first published Feb. 13, 2020.
-- By Michael MacDonald in Halifax.
