Psychiatric referral for veteran who killed his own family delayed due to lack of family doctor, investigation finds
By the time Lionel Desmond was referred to the Workplace Stress Injury Clinic in Halifax, the new facility was turning away veterans who did not have a family doctor, an investigation into the death of the Afghan veteran who shot he and his family heard Thursday.
Numerous witnesses testified at the inquest in Port Hawkesbury, Nova Scotia, about the care Desmond received from the time he was released from the military in June 2015 until the evening of January 3, 2017, when he shot his wife, Shanna, his daughter. , Aaliyah, his mother, Brenda, and finally himself at his in-laws’ home in Upper Big Tracadie, NS. The purpose of the investigation is to determine how to avoid future deaths.
After Desmond’s military release, he had been a patient at the Workplace Stress Injury (OSI) Clinic in Fredericton, New Brunswick, an ambulatory care facility funded by the Department of Veterans Affairs that treats former soldiers. who develop a mental illness as a result of their service. Desmond himself had been diagnosed with severe post-traumatic stress disorder.
He was sent to an inpatient psychiatric facility in Ste. Anne’s Hospital in Montreal. When Desmond left this facility in August 2016, he moved home to Nova Scotia to be with his family. His care team, back in New Brunswick, wanted his counterparts in Nova Scotia to follow up. But their dismissal failed.
Derek Leduc, the former director of operations for the Nova Scotia OSI clinic, told the inquest on Thursday that the clinic would only accept referrals from a client’s veterans case manager.
But when Desmond’s case manager logged in to the clinic, a nurse note from October 2016 suggested she was unable to complete the referral. Instead, the note stated that she would follow up with her client to see if he had a family doctor and then send his file for psychiatric services.
The memo also said Desmond would seek therapy in his home community of Guysborough, Nova Scotia, approximately 260 kilometers from the clinic.
Gaps in Desmond’s follow-up care
One of the mandates of the inquiry is whether the veteran had adequate access to mental health care. It should also be a focal point for the judge’s recommendations.
Shane Russell, investigating lawyer, suggested to Leduc that the Nova Scotia OSI Clinic was unfairly admitting patients in 2016.
“It looks like you’ve drawn a very hard line in the sand, closed one of the doors to access OSI services,” Russell said. “Have you thought about what there is on the other side for those who are trying to look for it in the community?”
Leduc said access would have been part of their discussion, but at the time they had a psychiatrist and this person was only working four days a week.
The investigation has already learned from a nurse at the OSI clinic in Nova Scotia that there was a wait of about two months before seeing a psychiatrist.
Leduc said the psychiatrist would primarily do disability assessments and medication management – and relied on a family doctor to provide follow-up care.
However, many former soldiers did not have a civilian family doctor if they had only recently left the military, Leduc admitted.
And it would likely take them a while to get one – in the fall of 2016, about 40,000 people were on a provincial waiting list for a family doctor, according to provincial data.
This prompted the clinic to make a change: Leduc said he asked Veterans Affairs to fund an internist, a recommendation that was approved on December 13, 2016.