A question of mental health above all

The Chief Coroner of Quebec has made the necessary decision by launching a public inquiry into the triple murder that took place in Montreal and Laval last week.

It is coroner Géhane Kamel, supported by a second coroner, who will shed light on the events that led to the tragic deaths of André Fernand Lemieux, Mohamed Salah Belhaj and Alex Lévis Crevier.

And even though the Office of Independent Investigations conducts its own investigation, Ms.^me Kamel will also examine the police intervention of the SPVM which led to the death of the suspect, Abdulla Shaikh.

Victims’ families and the public need to understand how the suspect, a man charged with serious crimes, and with a diagnosis of schizophrenia and narcissistic and antisocial personality traits, according to court documents, was able to make himself a gun and get ammunition.

The coroner will also be able to examine the follow-up to which Mr. Shaikh has been subjected since his appearance before the Mental Disorders Review Board. This division of the Tribunal administratif du Québec examines the files of persons found not criminally responsible by a criminal court. This was the case of Mr. Shaikh, who represented a “significant risk to the safety of the public”, which enabled the Tribunal to impose several conditions on his release. And who gave the hospital responsible for his follow-up the powers to demand his arrest and forced hospitalization in the event of non-compliance with his conditions.

Psychiatrists tell us that, in general, people who receive mental health care are less likely to reoffend than people who are incarcerated. One can ask whether the follow-up was up to Mr. Shaikh’s problems. The public inquiry will tell us.

The question of access to firearms is far from explaining everything. Driven by a rage to kill, the suspect could just as well have used a knife or a crossbow to commit his murders. This tragedy above all raises questions about available mental health resources.

Did the hospital responsible for Mr. Shaikh’s follow-up have the necessary resources to ensure, on a regular basis, compliance with his conditions, his medication intake and his general state of mind?

Could he not have benefited from specialized accommodation for people with schizophrenia? Such resources – which offer daily medical follow-up and supervision – exist, but they are insufficient, and the waiting lists for access to them are endless.

We also know that there is ongoing pressure from hospital managers to quickly free up psychiatric beds, the number of which has been reduced in recent decades.

We can also wonder whether all the conditions are met at the Mental Disorder Review Board to ensure public safety.

True, zero risk does not exist, but it seems that the process that ensures public safety could be improved.

Experts familiar with this division of the Administrative Court observe that the Attorney General does not systematically attend Commission hearings. Its presence depends a lot on the availability of human resources. However, a representative of the Director of Criminal and Penal Prosecutions could question the arguments of the treating psychiatrist and the defense lawyer. He would advocate exclusively for public safety.

Finally, Coroner Kamel’s inquest will shed light on the quality of the intervention by the Montreal Police Department.

Did the police properly assess the situation? Could they have intervened without killing the suspect? The answers to these questions are eagerly awaited.

There weren’t three victims last week, there were four. And much more if we count the families and loved ones of those who lost their lives.

Certainly, there is no reason to rejoice at the outcome of the events of the last days or to be proud of anything. We must rather ask ourselves what could have been done better to ensure the safety of the population. And to more effectively support people who suffer from mental health problems and their families.