Desmond inquiry: health professionals failed to share information prior to killings

Nov 4, 2021 | 10:41 AM

PORT HAWKESBURY, N.S. — An expert on domestic violence says lack of collaboration among health-care professionals was an “overwhelming theme” in the tragic case of Lionel Desmond, an ex-soldier from Nova Scotia who killed three family members and himself in 2017.

Dr. Peter Jaffe, a psychologist at Western University in London, Ont., told a provincial inquiry today there was evidence showing that psychiatrists, psychologists, social workers and others failed to share critical information about Desmond’s mental decline in 2016.

It’s a theme that has surfaced several times during the inquiry, which started hearings in January 2020 and is expected to draw to a close before the end of this year.

Jaffe says the Afghanistan war veteran had contact with 40 mental health professionals from the time he was diagnosed with post-traumatic stress disorder while still serving in the military in 2011 until his final days in 2017.

The psychologist told the inquiry most of the professionals focused on Desmond’s potential for suicide and overlooked or ignored multiple warning signs indicating he was at high risk of killing his wife and family. 

As well, Jaffe said patient confidentiality should never get in the way of sharing information when there is a risk of harm.

“Throughout the file, I see a theme that we see in our death review cases in Ontario, which is a lack of collaboration — people working in silos, not sharing information, not getting together,” said Jaffe, a co-founder of the Centre for Research and Education on Violence Against Women and Children. 

“And there was a lack of risk assessment and a lack of planning as an overwhelming theme.”

Among his recommendations to the inquiry, Jaffe called for expanded public education on domestic violence and expanded education for front-line professionals to ensure they are up-to-date on the latest information.

As well, Jaffe said the Canadian Armed Forces and Veterans Affairs Canada should ensure that high-risk cases are red-flagged for immediate followup and properly shared with community partners.

Other recommendations include establishing a domestic violence death review committee in Nova Scotia and improving the use of the risk assessment tools used by police.  

In his report to the inquiry, Jaffe noted that Nova Scotia already has a high-risk case co-ordination protocol for police, but there were missed opportunities to use it in the Desmond case.

This report by The Canadian Press was first published Nov. 4, 2021.

The Canadian Press