Forensic psychiatry

The appellant appealed the Ontario Review Board's disposition finding that she continued to pose a significant threat to public safety and refusing an absolute discharge.

The appellant was found not criminally responsible on account of mental disorder in 2004 for theft of a motor vehicle and assault on police officers.

After 15 years in psychiatric care, the Board considered two incidents—a May 2018 threat to kill a co-resident and an October 2018 assault on a bus passenger—in concluding she remained a significant threat.

The appellant argued the Board improperly relied on unproven allegations based on hearsay evidence.

The Court of Appeal dismissed the appeal, finding the Board properly applied the legal test and appropriately considered hearsay evidence in its inquisitorial proceedings.

An NCR accused appealed the Ontario Review Board's disposition ordering his detention at the General Forensic Unit of the Centre for Addiction and Mental Health with discretionary community living privileges.

The appellant argued he posed no significant risk to public safety, citing 15 years without violent behaviour, and sought an absolute discharge or conditional discharge.

The Court of Appeal upheld the Board's decision, finding that the Board properly considered all relevant factors under section 672.54 of the Criminal Code and reasonably concluded the appellant continues to pose a significant threat to public safety based on his mental illness, lack of insight, substance abuse issues, and criminal history.

The court emphasized that absence of violent behaviour does not eliminate risk of serious psychological harm, and that Part XX.1 is designed to protect public safety before violence occurs.

The appellant appealed a disposition of the Ontario Review Board that ordered his continued detention at Waypoint Centre for Mental Health Care but failed to specify the terms and conditions for an independent psychiatric assessment at Royal Ottawa Mental Health Centre.

The Board had improperly delegated to the parties the responsibility to work out the details of the assessment.

The Court of Appeal found this constituted an error justifying intervention.

The court set aside the deficient disposition and replaced it with detailed terms for an in-patient assessment at ROH, including security measures, duration, and cost allocation to the Ontario Review Board.

An appeal from an Ontario Review Board disposition finding that an NCR accused with schizophrenia and substance use disorders constituted a significant threat to public safety and ordering continued detention.

The appellant challenged the Board's application of the legal test for "significant threat" under the Criminal Code.

The Court of Appeal found the Board failed to properly apply the Winko standard by relying on speculative harm ("could" result) rather than assessing the real likelihood and seriousness of harm together.

The court allowed the appeal and returned the matter to the Board for a new hearing with proper legal analysis.

An appellant who was found not criminally responsible appealed the Ontario Review Board's disposition continuing his detention in a forensic hospital.

The appellant sought a conditional discharge but the primary issue was whether the Board should exercise its inquisitorial powers to investigate alternative community residential arrangements.

The Court of Appeal found that while a conditional discharge was not available due to the appellant's significant risk to public safety, the Board had erred in failing to properly exercise its inquisitorial duties to break the residential impasse.

The Court allowed the appeal and ordered a new hearing.

An appeal under Part XX.1 of the Criminal Code from a disposition of the Ontario Review Board dated April 10, 2018.

The appellant, found not criminally responsible on account of mental disorder for possession of weapons dangerous, sought a conditional discharge or alternatively a new hearing.

The Board maintained a detention order in the general forensic unit at the Centre for Addiction and Mental Health with relaxed reporting requirements.

The Court of Appeal found the Board's decision unreasonable due to inadequate reasons regarding whether the appellant's risk to the public could be managed under a conditional discharge.

The court directed the Board to reconsider the disposition at its next hearing with proper consideration of relevant factors, including mechanisms for securing attendance at hospital and the timing of any intervention.

An appeal of an Ontario Review Board disposition concerning a Not Criminally Responsible (NCR) offender with a long history of serious psychiatric illness, including sexual sadism and pedophilia.

The appellant sought transfer from Waypoint Centre for Mental Health Care to a less secure all-male facility at either the Centre for Addiction and Mental Health (CAMH) or Brockville Mental Health Centre to access escorted community privileges.

The Review Board majority refused the transfer, citing concerns about diminished quality of life.

The Court of Appeal allowed the appeal, finding the Board erred in law by failing to meaningfully consider the appellant's reintegration into society and by failing to assign appropriate weight to the appellant's reasonable preferences and the objective benefits of transfer.

The appellant appealed a disposition order from the Ontario Review Board that imposed a hybrid detention order requiring detention at the Secure Forensic Unit of the Centre for Addiction and Mental Health with discretion to transfer to the General Forensic Unit or allow community residence in approved accommodation.

The appellant, found not criminally responsible for threatening others with a knife in 2011, had been living in the community under conditional discharge but experienced significant deterioration in 2017 due to medication non-compliance and substance use.

The Court of Appeal dismissed the appeal, finding the Board's findings of significant threat and the necessity of the detention order were amply supported by evidence.

An appeal from an Ontario Review Board disposition that detained an NCR accused who had been under the Board's jurisdiction for over a decade following a finding of not criminally responsible for criminal harassment and failing to comply with a recognizance.

The Board determined the appellant posed a significant threat to public safety despite fresh evidence from a clinical forensic psychologist indicating low risk on stalking-specific assessment tools.

The Court of Appeal found the Board's decision unreasonable, holding that the evidence fell short of establishing a significant threat to public safety and that the Board had effectively reversed the burden of proof by relying solely on a moderate-risk HCR-20 V3 assessment without proper expert contextualization.

The appellant appealed the Ontario Review Board's disposition finding him to constitute a significant threat to public safety and ordering his continued detention at a forensic psychiatric hospital.

The appellant sought an absolute discharge.

The Court of Appeal upheld the Board's decision, finding it reasonable based on the appellant's mental health condition (Bipolar Affective Disorder with psychotic symptoms), history of violent offences involving weapons, documented noncompliance with medication, substance abuse issues, and concerning conduct while detained including the discovery of "to do" lists containing weapons.

The court rejected arguments that a conditional discharge should have been considered, noting the appellant had only recently begun substance abuse programming.

An appeal under Part XX.1 of the Criminal Code against the disposition of the Ontario Review Board dated May 25, 2017.

The appellant challenged the Board's removal of the possibility of community living from her disposition conditions.

The Board had acted on a joint position to detain the appellant in the secure unit with potential transfer to the general forensic unit but not to the community.

The appellant's treating physician testified that community living was not a realistic goal given the appellant's recent incidents of unauthorized absence and violence towards hospital staff, and that the frustration of an unattainable condition had contributed to the appellant's anger and violent behavior.

The Court of Appeal upheld the Board's decision, finding it entirely reasonable to remove the community living condition based on the evidence.

An appeal from an Ontario Review Board decision concerning whether the Royal Ottawa Mental Health Centre was required to notify the Board of a significant increase in restrictions on the appellant's liberty when she was transferred from the Secure Forensic Rehabilitation Unit (FRU) to the Secure Forensic Assessment Unit (FAU).

The appellant, found not criminally responsible in 2004, had been abusing substances while on the FRU, leading to the transfer.

The Board was divided on whether notice was required under s. 672.56(2) of the Criminal Code, but unanimously concluded that the transfer constituted the least onerous and least restrictive measure available.

The Court of Appeal dismissed the appeal, establishing a framework for determining when notice of significant increases in restrictions on liberty is required.

The accused was charged with aggravated assault for stabbing the victim in the neck on August 14, 2017.

The accused pleaded not guilty and raised the defence of not criminally responsible on account of mental disorder under section 16 of the Criminal Code.

The Crown and defence agreed on the facts of the assault.

The defence called expert psychiatric evidence from Dr. Beth Eayrs, a forensic psychiatrist, who opined that the accused was suffering from schizophrenia and was psychotic at the time of the offence, acting under command hallucinations.

The court found that while the accused may have been experiencing auditory hallucinations, the evidence demonstrated that he had the capacity to know his conduct was morally wrong.

The court rejected the defence and found the accused criminally responsible for aggravated assault.

The Crown sought a dangerous offender designation for the accused following his conviction for sexual assault and two counts of threatening death.

The accused, aged 48 with over 50 prior convictions and a history as a long-term offender, committed a sexual assault on an elderly shelter resident and made death threats to police officers.

A forensic psychiatrist assessed the accused as presenting high to very high risk for violent and sexual recidivism with intractable mental disorders including anti-social personality disorder, schizoaffective disorder, and substance abuse disorder.

The accused consented to the dangerous offender designation and an indeterminate sentence.

The court accepted the consent and imposed detention in a penitentiary for an indefinite period.

The appellant appealed a disposition order from the Ontario Review Board dated January 5, 2017, which ordered his detention at Waypoint Centre for Mental Health Care – Provincial Forensic Division.

The appellant did not challenge the Board's finding that he posed a significant threat to public safety but argued that his transfer from CAMH to Waypoint was not necessary and appropriate for managing that risk.

He contended that the Board failed to consider the context of his behaviour and that the announcement of his transfer triggered his deterioration.

He also argued the Board did not give sufficient weight to the disruption of his therapeutic and familial relationships.

The Court of Appeal dismissed the appeal, finding the Board's decision was reasonable and amply supported by evidence.

An appeal against an Ontario Review Board disposition denying expanded privileges and absolute discharge for an individual found not criminally responsible on a charge of criminal harassment.

The appellant argued the Board failed to conduct a separate and specific analysis of whether his conduct would constitute a serious criminal offence with real risk of physical or psychological harm.

The Court of Appeal dismissed the appeal, finding the Board's reasons demonstrated proper consideration of the seriousness of the offence and the risk to the community.

An appellant found not criminally responsible on account of mental disorder for criminal harassment appealed the Ontario Review Board's disposition that he constituted a significant threat to public safety and should be transferred between secure forensic units.

The appellant had been detained in the mental health system for over ten years.

Fresh evidence from the appellant's treating psychiatrist and a clinical forensic psychologist using a stalking-specific risk assessment tool concluded the appellant no longer posed a significant threat and was entitled to an absolute discharge.

The majority allowed the appeal and remitted the matter to the Board for fresh determination.

The dissenting judge would have granted an absolute discharge directly, finding the fresh evidence uncontradicted and unequivocal.

The appellant appealed a disposition of the Ontario Review Board ordering his continued detention at Waypoint Centre for Mental Health Care.

The appellant, found not criminally responsible on account of mental disorder for assault, argued that he had reached a treatment impasse at Waypoint and sought an independent assessment and transfer to a less secure facility.

The Court of Appeal dismissed the appeal, finding that the evidence did not substantiate the existence of a treatment impasse and that the Board's decision to maintain detention at Waypoint was well-supported by evidence regarding the appellant's risk to public safety, including his history of water intoxication, threats to staff, and previous elopement from other facilities.

The Crown brought a dangerous offender application against the accused following his guilty plea to possession of weapons dangerous to the public peace and three counts of uttering threats.

The accused initially opposed the application but changed his position mid-hearing and consented to being declared a dangerous offender.

The court found that the accused's conduct, which began as an apparent suicide attempt but escalated into threatening behaviour toward police officers, constituted a predicate offence under the Criminal Code.

The court considered the accused's extensive criminal history including 34 prior convictions, pattern of threats, and psychiatric assessments indicating high risk of future offending.

The court declared the accused a dangerous offender and imposed a 6-year determinate sentence plus a 10-year long-term supervision order.

The accused pleaded guilty to possessing child pornography.

The Crown sought a sentence of 6-9 months imprisonment followed by 3 years probation.

The defence sought an intermittent sentence.

The court imposed a 90-day intermittent sentence followed by 3 years probation with ancillary orders.

The court balanced the serious nature of the offence and the need for denunciation and deterrence against significant mitigating factors including the accused's early guilty plea, genuine remorse, commitment to counselling, family support, and low risk to re-offend as assessed by a forensic psychiatrist.