Mental health history of shooting victim detailed at coroners inquest

The medical history of a Windsor man killed in a violent confrontation with police was discussed heavily during testimony at Day 5 of a coroner's inquest examining the case.

The inquest heard from Dr. Arielle Salama, an assistant professor in adult psychiatry at the University of Toronto and the Mental Health Emergency Services Director at St. Michael's Hospital in Toronto.

Dr. Salama reviewed over 5,000 documents related to the inquest, dating back to Matthew Mahoney's earliest interactions with the mental healthcare system to the moment he was shot and killed in March of 2018.

The inquest heard about early indications in 2002 of Mahoney suffering from some mental health issues. However, between 2002 and 2009, he was trying to attend college, trying to work and did not require the services of law enforcement or a psychiatrist.

Dr. Salama, who never interviewed or treated Mahoney, described his journey with psychiatric services and the legal system beginning in 2009 as his diagnosed symptoms escalated. Those symptoms included delusions, paranoia and obsession with the police as part of his schizophrenia. A personality disorder was also identified but never clearly assessed.

Between 2013 to 2015, he took part in a program and a comprehensive treatment plan was established that included a social worker, assisting him with various aspects of his life including applying for a job, an apartment and keeping his finances in order. He didn't require any hospital admissions and had no contact with the legal system during this time as he was focused on functional improvements in his life.

Dr. Salama highlighted the importance of a social worker and the trust that needs to be established when dealing with someone suffering from schizophrenia and issues of paranoia. She called it a long, slow process to establish that trust, given people in Mahoney's case can feel a distrust of healthcare professional and police.

According to the documents, she says Mahoney was telling the social worker about his struggles and goals, viewing the social worker as someone who could help him.  

After two years, the social worker was no longer made available. While an exact reason was not given, Dr. Salama says it's usually because of program funding or budget issues, or that the patient has been doing well for awhile. According to the inquest notes, Mahoney stated he didn't want to be discharged and felt it was necessary to maintain the program. 

Dr. Salama told the inquest that schizophrenia is a lifetime illness and even in a patient with treatment, they could become ill again. She said "they may not need intensive treatment the whole time, but they need to have accessibility" because having to restart that process all the time is not good for the patient with paranoia and trust issues.

Windsor Police Service return to the scene of last week's shooting in the McDonald's parking lot on Wyandotte St. W. at Goyeau St. on Sunday March 25, 2018. Police say its part of a parallel investigation into the death of Matthew Mahoney. (Photo by AM800's Gord Bacon)

When the support ended, the documents reviewed by Dr. Salama indicate Mahoney became more vocal about his difficulties with the side effects of his medications. He was considered capable in a legal standpoint to stop the medication and there was a change in his condition.

In late 2016, the inquest was told there was a rapid decline in his condition as he became more delusional and paranoid, believing he was being hurt.

He was admitted to the hospital in Aug. 2017 following a Form 2 request under the Mental Health Act, sought by his family over concerns about his condition and that he could do harm to himself or others. 

He did have a few brief admissions to the hospital in the months prior to his death due to increasingly agitated behaviour, but Mahoney wasn't deemed incapable of making decisions about his medications.

He was also increasing his calls to police, calling dispatch 40 to 50 times, and posting on social media implying he wasn't doing well and was being harassed.

Dr. Salama noted that police are a frequent target of those suffering from paranoia and the more you have to interact with them, the more it amplifies the symptoms.

The inquest was also told of Mahoney's use of cannabis and how it would have a negative impact on his symptoms.

Although there was a statement earlier in the inquest that Mahoney was possibly using crystal meth, Dr. Salama testified there was was no diagnoses or indications of a positive urine drug screening test contained in the notes. Also, the pathology report found no evidence of meth use around the time of his death.

On March 21, 2018, Matthew Mahoney was shot and killed following a confrontation with police in the Dufferin Place alley, behind the McDonalds at Goyeau Street and Wyandotte Street.

Officers had been called for a report of a man carrying a butcher block with knives. Police asked him to stop but he attacked the officers instead. Police tasered the man, but it didn't stop him and then shots were fired.

One officer was stabbed during the altercation.

Ontario's Special Investigations Unit cleared police of any wrongdoing in the case, concluding the shots fired by the officers, which struck and killed Mahoney, 'were justified'.

The inquest is scheduled to hear from 18 witnesses over 10 days.

Once all parties with standing have the opportunity to present their information and ask questions of the witnesses, the jury may make recommendations aimed at preventing future deaths from occurring in similar circumstances.