GUYSBOROUGH, N.S. -- A psychiatrist who saw Lionel Desmond twice before he killed his family and himself in 2017 told an inquiry Monday the former soldier displayed symptoms of post-traumatic stress disorder, but his mental health issues were far more complex than the one diagnosis.

Dr. Ian Slayter, who assessed Desmond during two meetings in the fall of 2016, told the fatality inquiry that the Afghanistan war veteran from rural Nova Scotia also suffered from major depression, a probable traumatic brain injury, possible attention deficit disorder and borderline delusions about his wife's fidelity.

"He was complex in terms of having several diagnoses going on at the same time," Slayter told the inquiry, which has held eight days of hearings.

The psychiatrist, who works at the out-patient clinic at St. Martha's Regional Hospital in Antigonish, N.S., said Desmond told him his PTSD symptoms had been subsiding but he said his jealousy toward his wife Shanna and nightmares about infidelity had been getting worse.

"Clearly, jealousy was one of the problems," Slayter said. "I didn't spend a lot of time going into that .... They seemed irritated with each other."

Slayter said when he first met Desmond during an emergency room visit on Oct. 24, 2016, Shanna was with him and did most of the talking, saying at one point she was not afraid of him, though she confirmed there had been a great deal of marital conflict.

"It's clear there had been a lot of arguing," Slayter testified. "They were talking about years of that going on .... He would get angry, pound on tables and throw things."

Desmond, who at the time mainly complained about nightmares and lack of sleep, insisted he had never physically abused his wife.

During a follow-up psychiatric assessment on Dec. 2, 2016, Slayter concluded Desmond's jealousy seemed "over-emphasized" and "bordering on delusional," he said.

Slayter said Desmond, 33, also had problems processing information and complained about having difficulty following instructions or long conversations. Those symptoms could have been linked to a possible traumatic brain injury caused by one of three serious falls he had while serving in Afghanistan in 2007, he said.

On Jan. 3, 2017, Desmond used a Soviet-era SKS 7.62 semi-automatic carbine to kill his 52-year-old mother Brenda, his 31-year-old wife and their 10-year-old daughter Aaliya inside the family's mobile home in Upper Big Tracadie, N.S.

Slayter told the inquiry he was worried Desmond was "falling through the cracks" because he had been receiving care through the federal Veterans Affairs Department when he was living in New Brunswick, but those services stopped when he moved to Nova Scotia.

"I thought it could be organized better," he said. "He deserved it."

Melissa Grant, a lawyer representing the attorney general of Canada, told Slayter that Desmond had a case manager within Veterans Affairs who was working on finding him the services he needed, but there was some dispute over where he would have to go -- Halifax or Cape Breton.

The inquiry has heard that Desmond failed to show up for an appointment with Slayter on Dec. 21, 2016, but on Jan. 3, 2017 -- the same day as the killings -- he booked another appointment for later in the month.

Slayter was the third medical professional to testify that Desmond was articulate, calm, coherent and showed no signs of psychosis or thoughts of suicide or homicide, which is why he was considered a low risk for violence in late 2016 and early 2017.

"There were no red flags," Slayter said.

However, he said he was not told about an incident a year earlier in New Brunswick when Desmond threatened suicide and the police were called in.

Slayter said he wanted Desmond to get help from an occupational stress injury clinic and to undergo a specialized neuropsychological assessment, which would examine the extent of his possible brain injury.

But before those services could be arranged, he asked Desmond to obtain his medical records from the Canadian Armed Forces and Veterans Affairs, something Slayter admitted would be difficult for Desmond to accomplish.

Desmond told the psychiatrist he had an upcoming appointment with a Veterans Affairs therapist, but Slayter confirmed he did not exchange information with her.

Tara Miller, who represents Desmond's sister, Chantel, suggested the lack of communication could have been a barrier to Desmond's care.

"You're both essentially working in the same direction but you're in silos .... So we have all of these folks who are trying to help Cpl. Desmond ... and nobody's able to share the information," Miller said.

Slayter agreed.

This report by The Canadian Press was first published Feb. 10, 2020.

-- By Michael MacDonald in Halifax