GUYSBOROUGH, N.S. -- A psychiatrist who assessed Lionel Desmond two days before he fatally shot his family and himself says the former soldier showed no signs he was planning to hurt anyone when he arrived at the hospital in Antigonish, N.S., on Jan. 1, 2017.

Dr. Faisal Rahman, who has extensive experience treating veterans with post-traumatic stress disorder, told a fatality inquiry Tuesday that Desmond had come to the hospital because he was suffering from symptoms of the disorder after having an argument with his wife Shanna the night before.

"It just kept on escalating until next morning," Rahman recalled Desmond telling him during a 30- to 40-minute interview at St. Martha's Regional Hospital.

Desmond said the dispute was part of a long-standing pattern of conflict with his wife, which had included calls to police in the past, Rahman testified.

He said Desmond admitted to striking a table and startling his 10-year-old daughter, something for which he felt remorseful.

Rahman said Desmond was distressed over what happened, but he was otherwise pleasant, engaging, forthcoming, calm, composed and showed no signs of psychosis or thoughts of suicide or homicide.

The inquiry, which began last month, is investigating why Desmond fatally shot his 31-year-old wife, his 52-year-old mother Brenda and 10-year-old daughter Aaliyah on Jan. 3, 2017 -- a day after he left the hospital. He then shot himself in the head with the same military-style carbine he had legally purchased earlier in the day.

On Tuesday, Rahman told the inquiry he was aware of another psychiatrist's assessment that raised concerns about Desmond's previous treatment for mental illness.

The inquiry has been told that in the fall of 2016, Dr. Ian Slayter -- a colleague of Rahman's -- was worried that Desmond's case wasn't getting the proper attention from military and veterans' programs.

Slayter wrote that normally he would see a patient with PTSD once to confirm the diagnosis and make recommendations. "However, given the complexity of (Desmond's) case, and given that he seems to be falling through the cracks ... I said I would follow him for a short while to help him get connected," he wrote.

The report also stated that Slayter was concerned about Desmond's "borderline delusions" regarding his wife's fidelity -- though he rated Desmond's risk of suicide as low.

Rahman testified he was aware of Slayter's concerns, having skimmed his three-page report the night he met Desmond at the hospital.

However, Rahman said Slayter's note gave him a sense of relief because it was clear Desmond had sought help and was receiving treatment from the hospital's outpatient mental health clinic.

The note also said Desmond was seeing a social worker from the federal Veterans Affairs Department and he had an appointment with a therapist.

"I thought it was a good plan," Rahman said.

During his interview with Desmond, Rahman said he asked the former infantryman if he was thinking of hurting himself or anyone else, or if he had abused his wife.

Desmond denied having suicidal or homicidal thoughts and insisted he had never abused his wife, Rahman said. As well, the 33-year-old veteran told him police had taken away his firearms during an earlier incident, though the details were not disclosed.

Rahman said Desmond admitted that "jealousy used to be a problem" in his relationship with his wife, but he said that problem had abated after he stopped consuming medical marijuana in 2016.

As well, Rahman said Desmond told him about the seven months he served in Afghanistan, where he was involved in intense firefights and was sometimes ordered to place human remains in body bags.

When inquiry counsel Allen Murray asked if Desmond presented any concerning behaviours, Rahman replied: "No."

Rahman said he happened to be at the hospital the next day when Desmond was released and he made a point of asking Desmond if he was having any thoughts of hurting himself or others. Desmond said he wasn't.

Rahman also reminded Desmond to book another appointment with Slayter, which Desmond did the next day -- only hours before the killings.

Rahman described Desmond as "thankful and obliging," adding: "If he wanted to go, I had no grounds to keep him."

Lawyer Thomas Macdonald, who represents Shanna Desmond's family, asked Rahman if he was concerned about Lionel Desmond's military background, PTSD diagnosis, previous borderline delusions, ownership of firearms and rocky marital relationship.

"Wouldn't those be red flags in terms of taking everything he tells you at face value when, the next morning, he says he wants to go home?" Macdonald asked.

Rahman said his decision to release Desmond was based on his clinical assessment.

"That's how psychiatrists assess people ... (but) there's always a risk," he said. "(Desmond) did not meet the criteria to stay in the hospital against his wishes."

This report by The Canadian Press was first published Feb. 4, 2020.

-- By Michael MacDonald in Halifax