At the end of a first week of public inquiry, coroner Géhane Kamel spoke of the redundancy of the events which followed one another and which led to the death of Sergeant Maureen Breau.
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Fifteen witnesses were heard during the first four days of the public inquiry. (Photo: March 28, 2023)
“Everyone saw something, but it’s no one’s responsibility,” the coroner said to the special educator who was the first at the front in the Isaac Brouillard Lessard case. “At any time during that year, a trigger could have caused you to be Maureen… and that bothers me,” said coroner Géhane Kamel.
Mylène Piché was the primary caseworker, the point of contact in the field, during the psychosocial follow-up of Mr. Brouillard as part of the SIM program, intensive follow-up in the environment. This type of follow-up is offered to adults who have serious mental disorders and whose condition is unstable.
When the service request landed on the SIM desk at the turn of the New Year 2022, I offered myself, relates the specialized educator who describes having understood, from the first meeting with her new user, that she was dealing with a very responsive individual who wanted to be obeyed at the drop of a hat. Find me a place to stay. […] It's your job, ordered Isaac Brouillard Lessard who wanted to control everything. And nothing was happening fast enough. Mylène Piché redoubled her efforts to establish a therapeutic alliance, but we were walking on eggshells, she explains. The setbacks he was experiencing were everyone's fault, sighs Mylène Piché, who works for the Integrated University Health and Social Services Center of Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ ).
The intervener testified Thursday morning, on the fourth day of the hearing ;coroner's public inquest into the death of Maureen Breau.
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End of January 2022. Isaac Brouillard Lessard is strongly agitated during a telephone call with his psychiatrist at the time, Dr. Marc Tannous, who then informed him of what he intended to recommend to the Administrative Tribunal of Quebec (TAQ), the body responsible for 'evaluate one's conditions of retention in society.
The specialized educator is at the side of the angry individual. The call made in hands-free mode goes poorly. Mylène Piché then notes clear signs of decompensation.
Isaac Brouillard Lessard becomes disorganized. His psychiatrist is also concerned, to the point of asking the police to intervene, with the aim of making a request for temporary custody. Once there, the police consider that he is not dangerous and leave the scene.
February 2022 Isaac Brouillard Lessard is summoned to a hearing before the TAQ.
Considering the unpredictable nature of the individual, it was agreed to meet by videoconference from the Saint-Joseph Multiservice Health and Social Services Center in Trois-Rivières, relates Mylène Piché.
Dr. Tannous refuses to allow him to travel to Saint-Jérôme for the hearing because he is worried about the safety of the taxi driver who would have led him there. Isaac Brouillard Lessard knows that the news will not be in his favor and his doctor fears that he will explode.
The coroner is surprised and asks: If it is unpredictable for the taxi driver, it is not unpredictable for you? Mylène Piché replies that a security guard was outside the room. Sometimes, did you have the feeling that things could go wrong?, insists Géhane Kamel. Yes, agrees the educator.
As anticipated, Isaac Brouillard Lessard shouts and protests. He is black mad. The level of crisis is so extreme that the TAQ threatened to end the hearing, remembers Mylène Piché.
The coroner notes that the events which took place that year were the construction of a drama. The same pattern repeats itself, constantly.
On multiple occasions, the speakers who testified before the coroner during the week recounted explosive, highly unpredictable behavior. After which, Isaac Brouillard Lessard regained his calm. Psychiatrist Marie-Frédérique Allard, who has seen others, indicated earlier this week that it was striking in this patient.
Isaac Brouillard Lessard's file at the SIM was closed in December 2022, which coincided with a new call for help from the father, three months before the tragedy. This situation upsets the coroner. Several times during the week, she raises the place left to the voice of parents in clinical decision-making.
Isaac Brouillard Lessard's treating psychiatrist, Dr. Poirier, had given her seal of approval for the psychosocial file to be closed. He didn’t want to know anything about the rest of us, explains Mylène Piché. We're used to dealing with refractory users, but it still has its limits.
All these testimonies feed the reflection of the coroner, who will be responsible for delivering recommendations.
There is something about the term "dangerousness” that we will have to modulate, Géhane Kamel thinks out loud. We'll see that in March. Experts will then be called to testify.
Fifteen witnesses were heard during these first four days of&# x27;public inquiry. In all, there will be around sixty people who took part in the exercise at the end of the hearings which are due to end on March 21, at the dawn of the tragic first anniversary.
Maureen Breau lost her life on March 27, 2023. Her parents, who appeared dignified and united, have not missed anything from the hearings to date.< /p>
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