Inquest into SQ slain officer: Quebec doctors say it's hard to get patients to take meds

Psychiatrists who treated a mentally ill Quebec man who killed a provincial police officer told a coroner's inquest on Tuesday about the challenges in getting patients to follow conditions from the province's mental health board.

The inquest involves the March 27, 2023 killing of Sûreté du Québec Sgt. Maureen Breau, while she and her colleagues attempted to arrest Isaac Brouillard Lessard, in Louiseville, Que., about 100 kilometres northeast of Montreal.

The 35-year-old Brouillard Lessard stabbed Breau with a kitchen knife and seriously injured her colleague before he was shot dead by police moments after in his apartment building.

The inquiry, which began Monday, has heard that Brouillard Lessard had a history of mental illness and despite concerns raised by his parents, he was on his own and in crisis when Breau and her colleagues tried to arrest him for uttering threats and breaking probation.

On Tuesday, Dr. Marc Tannous, who supervised Brouillard Lessard starting in 2019, testified about a November 2021 event when the man's mother told him she was concerned her son was having a psychotic relapse and suspected he wasn't taking his medication. Tannous said he spoke to Brouillard Lessard by phone and determined the man was not an imminent threat.

"Concerns, worries are not facts or elements that can be used before a Quebec court judge to justify hospitalizing someone against their will for a serious, real or immediate danger," Tannous said, repeating several times that Brouillard Lessard's behaviour did not meet the criteria needed to commit him into care.

But days after the doctor made that determination, Brouillard Lessard assaulted the concierge of his apartment building and broke his jaw.

No medication for nearly a year

The inquest heard that Brouillard Lessard hadn't taken his medication for almost a year before he attacked the concierge and he was consuming cannabis, which aggravated his mental health problems.

Tannous testified that Brouillard Lessard had schizoaffective disorder, a mental health condition that includes symptoms of schizophrenia and mood disorders such as mania or depression.

His testimony led coroner Géhane Kamel to say that for a second day in a row, the inquiry has heard that Brouillard Lessard's parents had raised concerns that weren't heeded by authorities.

On Monday, a member of Quebec's independent police watchdog testified that provincial police officers had visited Brouillard Lessard three days before he killed Breau, after his parents had expressed concern about his deteriorating mental state.

The officers decided they did not have reason to arrest him.

Psychiatrist attacked twice

Psychiatrist Dr. Marie-Frédérique Allard testified Tuesday that Brouillard Lessard attacked her twice in 2018. She said she pressed charges, adding that it was the first time she had ever been attacked by a patient.

Allard, who suffered minor injuries, recalled that Brouillard Lessard could be calm and then suddenly explode in anger.

Kamel asked her what good it is for Quebec's mental health board — the Commission d'examen des troubles mentaux — to issue conditions to patients if they aren't respected, in reference to Brouillard Lessard consuming cannabis and not taking his prescribed medication.

It's common for mental health patients to disregard the conditions from the board, Allard said, adding there isn't much that can be done about it.

"It is very problematic." she testified. "I have many patients who break their conditions but who are not necessarily dangerous. Apart from telling the administrative tribunal that the patient used street drugs, there is nothing else I can do."

She said psychiatrists are often put in a position where they are forced to act like probation officers, to make decisions on what to do when a patient breaks the conditions of their release from hospital.

Other than calling the tribunal, Allard said, doctors can contact the province's prosecution service and request that a patient be charged, but she said that has happened only once or twice in her 24-year career.

Dr. David Olivier, another psychiatrist who treated Brouillard Lessard, said the vast majority of patients don't follow the conditions from the mental health board.

"I think there's an ambiguity, many psychiatrists I know are stuck with this," Olivier said. "We know the patient isn't respecting their conditions and at the next hearing, they are told to follow the conditions."

He said there is "no consequence" for breaking the rules, other than not being granted an unconditional release.