Forensic psychiatry

The Crown applied to have the offender, Vezio Cardullo, declared a dangerous offender and sentenced to an indeterminate period of detention following his guilty pleas to sexual assault causing bodily harm, overcoming resistance by choking, and uttering threats.

The defence conceded the dangerous offender designation but opposed an indeterminate sentence, proposing a determinate sentence followed by a long-term supervision order.

The court found the offender to be a dangerous offender under all three pathways of the Criminal Code, citing his extensive criminal history, including prior sexual assaults, and the brutal nature of the predicate offences.

However, based on expert evidence indicating the offender's treatability and motivation for change, the court determined that a determinate sentence of 17 years' imprisonment (9.5 years net from judgment date) followed by a 10-year long-term supervision order would adequately protect the public, rather than an indeterminate sentence.

The applicant, charged with first-degree murder, sought to exclude evidence of his criminal record (including sexual assault and assault causing bodily harm) and to redact references to these convictions from an expert's forensic psychiatry report.

The court denied the application, finding that while the convictions were prejudicial, they formed a vital basis for the expert's opinion, particularly regarding potential antisocial conduct disorder or sexual paraphilia.

The court emphasized that the jury must have access to the full foundation of expert evidence to assess its weight, even considering Gladue principles for Indigenous accused.

The appellant, found not criminally responsible due to mental disorder, appealed a disposition of the Ontario Review Board (ORB) ordering his detention.

He sought an absolute or conditional discharge, arguing the ORB erred in finding he posed a significant public threat and in not adequately applying Gladue principles.

The Court of Appeal granted fresh evidence motions from both parties but dismissed the appeal, finding the ORB's decision reasonable.

The court affirmed that the appellant remained a significant threat due to unstable mental health, risk of medication non-compliance, and substance abuse, which could lead to re-offending.

The refusal of a conditional discharge was also deemed reasonable, as no adequate community treatment plan was in place, despite the consideration of Gladue factors.

The appellant, found not criminally responsible for robbery in 2006, appealed a disposition of the Ontario Review Board.

The Board maintained his detention, removed indirectly supervised community privileges, and denied a transfer to another facility, following his conviction for child pornography.

The Court of Appeal upheld the Board's decision, finding its refusal to transfer and removal of community access reasonable given the appellant's lack of insight and ongoing risk, deferring to the Board's expertise.

The accused, Andy Metatawabin, was charged with attempted murder, aggravated assault, possession of a weapon, and threatening death after stabbing another patient in a hospital.

The trial proceeded in two stages: identity and criminal responsibility.

The court found the accused was the assailant and guilty of aggravated assault and weapon possession, but not guilty of attempted murder or threatening due to reasonable doubt regarding intent and the alleged threat.

In the second stage, the court assessed whether the accused was Not Criminally Responsible by Reason of Mental Disorder (NCRMD) due to schizophrenia.

Weighing expert psychiatric evidence, the court accepted the defence psychiatrist's opinion that the accused was in a psychotic state at the time of the offence, rendering him incapable of knowing his actions were morally or legally wrong.

Consequently, the accused was found NCRMD on the aggravated assault and weapon possession charges and referred to the Ontario Review Board.

During a murder trial, the defence sought to call a forensic psychiatrist to testify that the accused may have been in a cocaine-induced psychosis at the time of the offence, and that the alleged conduct was out of character.

The court ruled that the expert could testify about the potential impact of cocaine consumption and the possibility of psychosis, as this was relevant to the defence of intoxication and the ability to form specific intent.

However, the court excluded the expert's opinion that the offence was out of character for the accused, finding it to be impermissible character evidence and oath-helping.

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 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 from an Ontario Review Board disposition ordering the continued detention of a not criminally responsible accused at Waypoint Mental Health Care.

The appellant sought an absolute discharge, alternatively a transfer to another facility, or in the further alternative, an independent psychiatric assessment.

The Court of Appeal upheld the board's finding that the appellant continues to pose a significant threat to public safety based on his extensive criminal history involving sexual violence, his psychiatric diagnoses including psychopathy, and his lack of engagement with treatment programs.

The court dismissed the appeal but directed the board to reconsider the request for an independent assessment at the next annual review.

Mr. Khan was charged with attempted murder, aggravated assault, and assault with a weapon after stabbing his wife.

The Crown conceded acquittal on attempted murder.

The central issue was whether Mr. Khan was not criminally responsible (NCR) due to a disease of the mind, specifically delirium tremens, at the time of the offences.

The court, accepting expert psychiatric evidence and applying the holistic approach from R. v. Stone and R. v. Bouchard-Lebrun, found that delirium tremens constituted a disease of the mind in this case.

It concluded that Mr. Khan was unable to understand the moral wrongfulness of his acts and was therefore NCR for aggravated assault, with a conditional stay for assault with a weapon.

An appellant found not criminally responsible on account of mental disorder in 2000 for assault and uttering threats appealed his disposition of detention in a general forensic unit with community living privileges at the discretion of the hospital.

The appellant argued the Board's finding that he continues to pose a significant threat to public safety was unreasonable and sought a conditional discharge.

The Court of Appeal upheld the Board's majority decision, finding the disposition reasonable based on the appellant's persistent pattern of threatening behaviour, impulsivity, inability to control anger, and the structured environment's role in preventing escalation to physical violence.

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.

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 appellant appealed two dispositions of the Ontario Review Board following his finding of not criminally responsible on account of mental disorder for offences committed in January 2016.

The Board found the appellant suffered from delusional disorder and posed a significant threat to public safety, ordering his detention on a secure forensic unit.

The appellant sought an absolute discharge or conditional discharge to return to the community.

Amicus curiae argued the hearings were procedurally unfair and the disposition was unreasonable.

The Court of Appeal dismissed the appeal from the Initial Disposition as moot and upheld the Current Disposition, finding the Board conducted a fair inquisitorial hearing and the detention decision was reasonable and 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.

A criminal trial for second-degree murder resulted in a finding of not criminally responsible on account of mental disorder (NCRMD).

The accused, suffering from schizophrenia, committed a fatal stabbing while experiencing severe delusions and hallucinations, believing the victim was possessed by a demon.

Expert psychiatric testimony, accepted by the court, established that the accused was incapable of appreciating the nature and quality of the act or knowing it was morally wrong under s. 16 of the Criminal Code.

The matter was referred to the Ontario Review Board for disposition.

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.

Jordan McPhee pleaded guilty to sexual assault causing bodily harm, unlawful confinement, and robbery.

The Crown applied for a dangerous offender designation.

The court, considering McPhee's criminal record, a subsequent aggravated assault conviction, and a psychiatric risk assessment, found him to be a dangerous offender based on a pattern of repetitive behaviour showing a failure to restrain his behaviour and a likelihood of causing death, injury, or severe psychological damage.

The court imposed a determinate sentence of six years imprisonment (less pre-sentence custody) followed by a ten-year Long Term Supervision Order, with specific recommendations for conditions to the parole board.

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.