Start at the top to get to the bottom

One concern that came out clearly in the recent provincial election campaign is that Nova Scotians want improvements to health care. That obviously includes ensuring people have treatment available for mental health.

Given that context, it’s bewildering that the public has been denied an in-depth investigation into whether inadequacies in the system contributed to a former soldier killing his wife, mother and child, then himself.

People – including family of the victims and other members of the military – have reacted in disbelief after Nova Scotia’s medical examiner announced this week there would be no fatality inquiry into the shootings. This follows widely publicized reports after the Jan. 3 tragedy in Upper Tracadie that the man at the centre of the incident, Lionel Desmond, a veteran of the Afghanistan war, had been seeking help for his post-traumatic stress disorder – and the help wasn’t available when he needed it.

For many, just for starters, this lack of follow-up will raise the question of how a country can afford to send soldiers off to war but has to scrape together the bare minimum when it comes to addressing the resultant, and quite predictable, mental and physical trauma.

How many times do we need to hear about cases of PTSD among members of the forces and an inadequate response?

But it has implications beyond that for the general public, about an overburdened health system and whether severe cases go unrecognized.

In addition, how does this series of events reflect on what this province and country are doing to address domestic violence in general?

Following this heartbreaking case of murder-suicide, Premier Stephen McNeil said the province would investigate how the health care system dealt with Desmond’s needs regarding his mental health. But, in safeguarding confidentiality, any such probe would not be made public.

In the meantime, in Nova Scotia, we have for example a mental health unit closed nearly two years ago in Pictou County with a roundabout explanation about why that was necessary, including shortage of psychiatric staff. As the province ostensibly worked to fill in the blanks by consolidating services in other centres, mental health advocates, consumers and local politicians asked in vain about long-term plans.

In short, few answers appear forthcoming.

That’s what public inquiries are all about. They don’t aim to necessarily assign blame – although when there are holes in the network of support for people they are bound to make those responsible nervous. An inquiry, rather, is about how can we do things better.

The crux of this is, it’s hard to improve services offered and address gaps unless we have a serious look to identify the shortfalls, something that calls on the testimony of experts, consumers and administrators of the health system.