Court of Appeal for Ontario

Date: 2025-04-22
Docket: COA-24-CR-1154

Before:
Michal Fairburn, David M. Paciocco, Alison Harvison Young

In the Matter of: Iesha Mitchell

An Appeal under Part XX.1 of the Code

Appearances:
Anita Szigeti, for the appellant
Martin Heslop, for the respondent, Attorney General of Ontario
Michele Warner, for the respondent, Person in Charge of Centre for Addiction and Mental Health

Heard: 2025-04-14

On appeal from the disposition of the Ontario Review Board, dated October 23, 2024, with reasons dated November 1, 2024.

Reasons for Decision

Background

[1] This is an appeal from a detention order imposed on October 23, 2024. The order grants certain privileges, including living in the community in accommodation approved by the person in charge of the Centre for Addiction and Mental Health (“CAMH”), as well as passes to travel internationally for up to four weeks, accompanied by an approved person, subject to prior approval from the person in charge.

[2] The appellant has been diagnosed as living with schizophrenia.

[3] In 2021, the appellant came under the jurisdiction of the Review Board (the “Board”) after having been found not criminally responsible on account of mental disorder on charges including assault with a weapon. She was conditionally discharged back to her parents’ home, where she had been living at the time of the index offences.

[4] In July 2022, the appellant experienced a very subtle, yet very serious decompensation in her mental health that went unnoticed by her family and treating psychiatrist. This resulted in an attempted suicide. She was then admitted to the hospital under the Mental Health Act, RSO 1990, c M.7.

[5] In October 2022, the Board imposed a detention order with privileges up to and including living in the community in Hospital-approved housing. In September 2023, the Hospital approved the appellant’s return to living with her parents. She has continued living with them since that time.

Issues on Appeal

[6] It was agreed at the hearing before the Board that the appellant remained a significant threat to the safety of the public. The sole question was determining what constitutes the necessary and appropriate disposition to manage that safety risk. The appellant suggested that the necessary and appropriate disposition – meaning the least onerous and least restrictive one – was a conditional discharge. The Board rejected that position, finding that a detention order remained appropriate.

[7] This appeal focusses strictly upon whether the Board erred in making a detention order, as opposed to conditionally discharging the appellant. There are two issues that require resolution: (i) whether the Board erred in concluding that the appellant’s housing requires Hospital approval; and (ii) whether the Board erred in concluding that the Mental Health Act would be insufficient in managing the appellant’s risk to safety.

Analysis

[8] Respectfully, we see no error in the Board’s approach to either of these issues.

[9] The Board concluded that approved housing was necessary to manage the appellant’s risk. The appellant maintains that the Board relied upon speculative concerns with respect to housing. In our view, the Board’s reasoning is rooted in the record. Read as a whole, the record supports the Board’s conclusion that the appellant’s treating psychiatrist and treatment team needed the ability to address housing should the appellant’s current housing situation change.

[10] In support of this finding, the Board noted that the attempted suicide and index offences occurred while the appellant was living at home, as reflected in the hospital report. These events suggested that there has historically been a lack of supervision while the appellant lived at home. In the treating psychiatrist’s view, the appellant had only been living with her parents for one year and, while she was doing well, she previously found living with her parents stressful. In these circumstances, the Board reasonably accepted that more time was necessary to monitor the situation.

[11] This is particularly true given the second issue raised, which relates to whether the Board erred by concluding that the Mental Health Act could not adequately address the appellant’s risk to safety in the face of further decompensation.

[12] The Board accepted the “clear and uncontroverted evidence” of the treating psychiatrist that the signs of the appellant’s decompensation can be “subtle”. The Board accepted that the appellant may not recognize those signs. She has limited insight into the symptoms of decompensation and may not disclose stressors or symptoms should she be experiencing them.

[13] As the Board found, the signs of decompensation were subtle enough that a trained psychiatrist did not recognize them prior to the appellant’s 2022 decompensation which had grave consequences. The Board accepted, though, that the “treatment team is better able to identify those signs of decompensation now.” In our view, when the record is read in context, the conclusion that was reached by the Board was rooted in the evidence. It is not for this court to interfere.

Conclusion

[14] In the end, the Board’s decision is a reasonable one. The Board found that the family would be unable to reliably recognize the signs of decompensation. In the event that such signs emerged, prompt action would be necessary to intervene and bring the appellant to the hospital to be assessed. This could only be achieved through a detention order.

[15] The appeal dismissed.

“Michal Fairburn”
“David M. Paciocco”
“Alison Harvison Young”