Re: Wilfred C. Bilow
ORB File No: 8090
Hearing held on: Friday, September 12, 2025
Place of hearing: Providence Care Hospital
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. G. Beasley Members: Dr. S. Lessard Dr. W. Loza Ms. K. Weisbaum Ms. K. Brisson
Parties Appearing:
Accused: Wilfred C. Bilow Amicus Curiae: Mr. M. Davies The person in charge of hospital: Counsel: Ms. T. Tom Attorney General of Ontario: Counsel: Ms. J. Ferguson
REASONS FOR DISPOSITION
(Dated October 2, 2025)
Introduction
[1]. On August 1st, 2008, the accused, Wilfred Bilow, was found not criminally responsible on account of mental disorder on account of mental disorder, on a charge of failing to comply with condition of an undertaking or recognizance, contrary to the Criminal Code of Canada.
[2]. By reason of a Disposition of the Ontario Review Board (“ORB”) dated October 21, 2024, Mr. Bilow was ordered to be detained at the Secure Forensic Unit of the Providence Care Hospital, (“Providence”), Kingston, Ontario. The Disposition provided for privileges up to and including residing in the community in accommodation approved by the person in charge.
[3]. On September 12, 2025, the ORB convened a hearing at Providence for the purpose of conducting the annual review of Mr. Bilow’s Disposition. At Mr. Bilow’s request, the hearing was being conducted a month earlier than the scheduled date. Mr. Bilow was in attendance and indicated that he intended to represent himself at the hearing. As a result of an earlier request of the ORB, Mr. Michael Davies was in attendance as Amicus. Ms. Tom appeared as counsel for Providence and Ms. Ferguson as counsel for the Attorney- General of Ontario.
Index Offence
[4]. The circumstances of the index offence are as follows:
“On the 16th of April 2008, the accused, Wilfred Christian Bilow was arrested by the Gananoque Police Service for charges of criminal harassment and assaulting police. He was conveyed to Brockville Court and released on a recognizance of bail with one condition that he reside at 5 Hamilton Street in the City of Brockville.
“On the 10th of June 2008, Brockville Police Service received a call from Bilow's court diversion worker indicating that she has not seen Will Bilow, nor has he been at 5 Hamilton Street since approximately the 28th of May 2008.
“On the 17th of June 2008, information was received that Bilow had been residing in a tent in the Seeley's Bay area and his father was on route to pick him up. Bilow was eventually apprehended in the Cobourg area by Brighton OPP and placed under arrest for breach of his recognizance.”
Criminal History
[5]. Mr. Bilow’s criminal record as taken from the hospital report is as follows:
Date & Location Charge Disposition
1994-11-15 Poss of Prohibited Weapon probation 1yrs, 25 hrs comm. Gananoque, Ont Sec. 90(1) CC serv work & firearms proh. 3 yrs (Youth Court)
1995-01-24 Mischief Under $1,000 Probation 12 mos. Gananoque, Ont (Youth Court)
1995-12-05 Assault Sec. 266 CC $300 – 10 days & Brockville, Ont firearms prohibition – 3yrs (Youth Court)
1996-03-13 Poss of narcotic $100 Brockville, Ont S. 3(1) MC ACT
1998-11-17 Assault – Sec 266 CC $500 and firearms Brockville, Ont proh. 3 yrs
2004-10-25 (1) Uttering Threats (1-2) 30 days intermittent Brockville, Ont s. 264.1(A) CC & probation 2 hrs on each (2) Assault Sec. 266 CC chg conc & mandatory or Discretionary prohibition Order Sec 109-110 CC
2005- 04-11 (1) Assault with intent to resist (1-5) 1 day & (5 days pre- Brockville, Ont arrest – Sec, 2760(1)(B) CC sentence custody) & (2) Fail to comply with probation on each charge Recognizance Sec 145(3) conc. CC (3 charges (3) Assault Sec 266 CC (4) Mischief Under $5,000 Sec. 430(4) CC (5) Assault Sec 266 CC (5) 1 day & (5 days pre- Sentence custody) & Probation 2 yrs
2007-06-08 Fail to Comply with Probation $300 (Gananoque, Ont) Order Sec. 733.1(1) CC
2008-07-28 Assault a Peace officer 1 day (42 days pre-sentence Brockville Ont Sec 270(1)(A) CC custody) & discretionary Prohibition order sec. 110 CC for 10 years
Current Diagnoses
[6]. The current diagnosis as taken from the hospital report is Schizophrenia.
Background & Personal History
[7]. Mr. Bilow’s background and personal history are comprehensively reviewed in the hospital report which was filed as an Exhibit at the hearing. For that reason, there will be no extensive reference to the details. Mr. Bilow was 47 years old at the time of the hearing. He has two older sisters and at the time of the commission of the index offence, was residing at home with his parents. According to Mr. Bilow, his relationship with his parents and siblings was not good and if he had his preference, he would choose not to have any interactions with them at all. He stated that he was not particularly fond of school and that he was considered to be a troublemaker, mostly due to boredom and his shyness and small stature. He never failed any grades, nor was he ever expelled from school. With some difficulty, he was able to graduate from Grade 12 which was the completion of his formal education. Although Mr. Bilow states that he worked between seven and ten years at the Gananoque Boat Lines, this information is contradicted by his mother who states that he was only a seasonal employee there. Mr. Bilow’s information with respect to his employment history is somewhat unreliable, at various times stating that he had never been unemployed, but then that he had been collecting social assistance for a number of years. He states that he has no close friends and nobody on which he can depend.
[8]. Mr. Bilow’s first contact with the mental health system was when he was 19 years of age. He was in conflict with his father and was diagnosed as being depressed. His mental health continued to deteriorate in the year leading up to the index offence. As a result of his aggressive behaviour towards his mother, there had been an attempt to admit him to hospital under the Mental Health Act, but he was deemed not to meet the admission criteria.
Position of the Parties
[9]. At the outset of the hearing, Mr. Bilow stated that he was asking the panel to find that he no longer represented a significant threat to the safety of the public and was therefore entitled to an absolute discharge. Ms. Tom stated that the position of the hospital was that Mr. Bilow continued to represent a significant threat to the safety of the public and that the necessary and appropriate disposition was a continuation of the current detention order, with an amendment to the community living clause to specify that any residence should be 24-hour a day, seven days a week supervised. Ms. Ferguson supported the submission of the hospital.
Evidence at the Hearing
[10]. The evidence on behalf of the hospital was presented by Dr. Selhi. She is Mr. Bilow’s attending psychiatrist and the co-author of the hospital report which was filed as an Exhibit at the hearing. Dr. Selhi stated that in her opinion, Mr. Bilow continues to represent a significant risk to the safety of the public as a result of his major mental illness, Schizophrenia. She stated that although his symptoms had improved over the past reporting year, this was in the context of him being detained in the highly structured setting of the secure unit at Providence. Dr. Selhi testified that with his improvement, the treatment team were beginning the process of planning Mr. Bilow’s discharge to supervised community living. She stated that this process had been commenced prior to Mr. Bilow requesting an early hearing so that he could request an absolute discharge. It was put on hold pending the outcome of the Disposition hearing.
[11]. Dr. Selhi attributed Mr. Bilow’s improved mental state to his decision to “work with her” in arranging his medication regimen. Prior to September of 2024, Mr. Bilow’s treatment was given by way of long-acting injection (LAI). Mr. Bilow is considered capable to make his own treatment decisions and frequently declined to accept the medication when scheduled. As a result, his mental status declined, and he exhibited increased paranoia. This would result in irritability and low frustration tolerance during periods of stress and increasing argumentative confrontations, especially with nursing staff. Mr. Bilow opted to be placed in Pod A at the hospital, a more secure unit, in lieu of accepting his long-acting injections. Dr. Selhi stated that Mr. Bilow finally agreed to accept his antipsychotic medications orally. As a result, there was a reduction in his paranoid, somatic, and sexual delusions. Dr. Selhi said that early on in the transition to oral medications there was one incident where Mr. Bilow had to be placed in seclusion after challenging a co-patient to a fight and throwing a punch at him. This resulted from Mr. Bilow’s paranoid beliefs that the patient was talking about him which was a common theme of his delusions. There have been no seclusions since October 2024.
[12]. As a result of the improvement in his symptoms, Mr. Bilow was transferred to Pod C. He now has community privileges which allow him access to the hospital and grounds and to the community. Dr. Selhi stated that he has some insight into his symptoms and realizations that they improve with medication. However, Mr. Bilow is reluctant to engage in any discussions which focus on his illness or his diagnosis. He is also not interested in attending any formal groups which might represent some form of psychoeducation. He does however participate in recreational and social groups both inside and outside the hospital.
[13]. Dr. Selhi stated that the antipsychotic medication is at this time the main risk mitigation factor. Mr. Bilow does not have any substance abuse issues and in her opinion, no personality issues. Dr. Selhi said that if Mr. Bilow continues to be the subject of a detention order at the hospital, then the team will work to find suitable housing for him. In her opinion, Mr. Bilow requires 24-hour a day, seven days a week structured housing in order to manage his risk in the community. In Kingston, this is provided by TRHP structured community residential program. A key feature of this residence will be that the staff will monitor Mr. Bilow’s medication compliance which is essential to his continued stability. Mr. Bilow has previously expressed an interest in TRHP housing. There will be a waitlist for Mr. Bilow to access the housing. As part of the process, the inpatient team intends to invite the outpatient team to their next case conference at the hospital. In addition to providing medication supervision, Dr. Selhi stated that it is important that the hospital have the ability to return Mr. Bilow to the hospital in the event of any decompensation in his mental status. Were he to decompensate as a result of stopping his medication, then he would become more paranoid and would likely engage in violence towards other persons.
[14]. Dr. Selhi was asked if she had had the opportunity to discuss Mr. Bilow’s request for an absolute discharge with him. Dr. Selhi stated that Mr. Bilow had not disclosed any actual plan for his future in the event that he were to receive an absolute discharge. She stated that she did tell him that he would not be eligible for TRHP housing in the event of an absolute discharge and that he would not have the support of the hospital.
[15]. In response to questions from Ms. Ferguson, Dr. Selhi stated that Mr. Bilow’s request for an early review and an absolute discharge was a surprise to her. She said that she advised Mr. Bilow that if he did receive and absolute discharge, he would not be eligible for TRHP housing. Dr. Selhi said that Mr. Bilow began to refuse his LAIs in July 2024. Over the course of the Summer of 2024, he became more adamant about his refusal. However, he does not complain about his current oral medication regimen. Mr. Bilow is not receiving Clozapine but is on a different oral antipsychotic. When asked if his request was “wishful thinking,” Dr. Selhi stated that in her opinion, it was premature. She stated that Mr. Bilow has made progress, and it is certainly his right to ask for an absolute discharge, but it was not supported by the treatment team. Dr. Selhi said that Mr. Bilow needs a slow transition back to the community. She stated that in her opinion, if Mr. Bilow received an absolute discharge, it was quite unlikely that he would continue to take his antipsychotic medication.
[16]. In response to questions from Mr. Bilow, Dr. Selhi agreed that over the course of the past 12 months Mr. Bilow had walked away from a number of confrontational situations on the unit. Dr. Selhi agreed that Mr. Bilow had told her recently that he needed his night medications in particular. She agreed that he had lived successfully independently in the community in the past. When asked if there was an alternative to THRP for him if he received an absolute discharge, Dr. Selhi testified that there was no funding for housing for him if he were absolutely discharged from the hospital. Mr. Bilow asked Dr. Selhi if she was aware of his threatening violence when he was in the community at a cabin. Dr. Selhi said that she was not, only that he had said that he had had a “hard time.”
[17]. Mr. Davies asked a number of questions as Amicus. Dr. Selhi stated that Mr. Bilow does have privileges which permit him indirect access to the community up to 20 kilometres from the hospital. When asked if Mr. Bilow was ready for THRP housing, Dr. Selhi stated “yes, with some qualifications.” She stated that the team had been ready to start the process before the request for an absolute discharge but there was no bed available at that time. Dr. Selhi thought that the wait for an available bed might be somewhere between four and nine months. She stated that there were no other options available than the single TRHP residence in the Kingston area. When asked about the request for a change to the community living Disposition condition, Dr. Selhi stated that this was to make sure that Mr. Bilow goes to the TRHP housing, the only residence which would meet that particular description. Dr. Selhi said that the ideal length of time for residence at TRHP was 18 months, but that it would be a minimum of 12 months if he is successfully transitioned there. Finally, Dr. Selhi agreed that Mr. Bilow has begun to re-engage with his sister.
[18]. Dr. Selhi was asked a number of questions by members of the panel. She stated that Mr. Bilow has had a lifelong aversion to participating in psychoeducational groups. However, he does engage with other more recreational or social groups both inside and outside the hospital. He is apparently talented as a guitar player and leads a number of musical groups. Dr. Selhi said that there would be 24-hour a day, seven days a week staff supervision at the TRHP housing. In the event of decompensation due to non-compliance with medication, she estimated it would be “weeks to months before it became evident.” Once admitted to TRHP housing, Mr. Bilow would be seen twice a week by forensic staff and twice a month by Dr. Selhi. Mr. Bilow has not expressed any interest in working but does have an interest in gardening. There are programs available to him at TRHP housing. Dr. Selhi stated that there has been no issue reported from the community since Mr. Bilow began to exercise access.
[19]. Dr. Selhi was asked about the risk assessment contained in the hospital report. She stated that the risk assessment in the report is from 2024 and was completed at a time when Mr. Bilow was not doing well. Dr. Selhi said that with the early review there was insufficient time to complete a new risk assessment. She acknowledged that a more favourable risk assessment from 2023, which was not included in the report, would have been more appropriate. Dr. Selhi stated that she agreed with the portion of the risk assessment report which stated that in the event of an absolute discharge, Mr. Bilow continued to represent a significant or high risk to the safety of the public. She agreed that this risk would flow from the likelihood that he would stop taking his antipsychotic medication, decompensate, and suffer a return of his paranoid delusional symptoms.
[20]. Neither Ms. Ferguson nor Mr. Bilow called any evidence at the hearing.
Submissions of the Parties
[21]. Ms. Tom reiterated the submission made at the outset of the hearing that Mr. Bilow continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition was a continuation of the detention order with one amendment to the residence clause. Ms. Ferguson supported the submissions of the hospital. Mr. Bilow stated that were he to be granted an absolute discharge, that he would continue to take his antipsychotic medication. He said that the TRHP housing was something that he would accept. He concluded by stating that he spends time taking courses and participating in groups in the community and that he has a lot to offer. Mr. Davies’ submission dealt only with the request by the hospital to amend the residence clause. He submitted that this would be unduly restrictive and that there was no real evidence to support making the detention order more onerous than it is at the present time.
Analysis and Disposition
[22]. The threshold issue for the panel to determine is whether or not Mr. Bilow continues to represent a significant threat to the safety of the public. The “significant threat” standard is an onerous one. There must be both a likelihood of a risk materializing and the likelihood that serious harm will occur. An accused is not to be detained based on mere speculation; the Board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the accused to deny them an absolute discharge. As set out in Winko 1999 CanLII 694 (SCC), 2 S.C.R. 625) the threat must be:
(1) More than speculative in nature and must be supported by the evidence; (2) Significant in the sense of there being a real risk of physical or psychological harm to individuals in the community and in the sense that this potential harm must be serious; and (3) The conduct creating the harm must be criminal in nature.
[23]. Mr. Bilow has been under the jurisdiction of the ORB since 2008. While much of that time has been spent detained in a hospital, he has at different times transitioned successfully to the community through both supportive and independent housing.
[24]. Of significance, in 2023, Mr. Bilow was living independently in the community having moved from the hospital through THRP housing to independent living. Having been found capable at that time to consent to his own treatment, Mr. Bilow elected to stop taking his antipsychotic medication. The resulting decompensation in his mental status ultimately resulted in his being returned to the hospital. As a result, he displayed an increase in incidents of aggressive conduct including physical aggression.
[25]. Since his return to the hospital in April 2023, Mr. Bilow has had long periods of refusing treatment with antipsychotic medication. It appears from the hospital record that in 2024, he accepted only three doses of his intramuscular long-acting injection. Although Mr. Bilow has some limited insight into his mental illness, he refuses to participate in any form of psychoeducational programming. Dr. Selhi testified that the most important factor in mitigating Mr. Bilow’s risk to the safety of the public is his antipsychotic medication. She further testified that in her opinion, it is quite unlikely that Mr. Bilow would continue to accept the oral antipsychotic medication were he to be granted an absolute discharge. In that event, in her opinion, Mr. Bilow represents a significant threat to the safety of the public. The panel is unanimous in accepting the evidence of Dr. Selhi.
[26]. Once the panel has determined that Mr. Bilow continues to represent a significant threat to the safety of the public, then the next step is to draft the necessary and appropriate Disposition. Section 672.54 of the Criminal Code sets out the criteria to be considered by the panel, of which the safety of the public is the paramount concern followed by the reintegration of the accused into the community and his other needs. The panel is unanimous in accepting the recommendation of the hospital as supported by counsel for the Attorney-General, that the necessary and appropriate disposition is a continuation of the current detention order. It is acknowledged that Mr. Bilow has successfully resided independently in the community in the past. As set out in the hospital report and in the evidence, Mr. Bilow is presently enjoying a privilege level which allows him unsupervised access to the hospital grounds and to the community. He participates in recreational and social programs both inside and outside the hospital. According to the evidence, he is a talented guitarist and participates in a number of different musical programs. The evidence indicates that he is the leader of one of these programs.
[27]. Although he has some limited insight into his mental illness and symptoms, Mr. Bilow has steadfastly refused to participate in any programming of a psychoeducational nature. Dr. Selhi testified that Mr. Bilow will not discuss his illness or treatment to any great extent. In her evidence, Dr. Selhi stated that she did have a conversation with Mr. Bilow about his request for an absolute discharge. He did not indicate to her that he had any kind of plan were he to be released from the hospital. Although there were no submissions with respect to the possibility of a conditional discharge, the panel, as it is obliged to do, considered it in forming the necessary and appropriate disposition. The panel accepts the evidence of Dr. Selhi that Mr. Bilow’s current level of stability is a function of his residing in a highly structured and supportive environment of the hospital. In her opinion, he requires a gradual transition to the community in order to succeed and to protect the safety of the public. Dr. Selhi testified that this can be accomplished by transitioning Mr. Bilow to TRHP housing which will provide 24 hour a day, seven day a week support and medication compliance monitoring. The panel is unanimous in accepting Dr. Selhi’s opinion and the recommendation of the hospital that this represents the necessary and appropriate disposition to protect the safety of the public.
[28]. At the outset of the hearing and in her final submissions, Ms. Tom stated that the recommendation of the hospital was for an amendment to the residential term of the current disposition to require that Mr. Bilow reside in 24-hour a day, seven days a week supervised housing. In her evidence, Dr. Selhi stated that the purpose of this was to ensure that Mr. Bilow went to TRHP housing, the only residence in the Kingston catchment area which would meet this description. As pointed out by Mr. Davies in his helpful submissions, this would represent a more onerous term in the Disposition than that which is presently set out. Mr. Davies submitted that not only was there no evidence to support such a change, but that the evidence of Dr. Selhi was that Mr. Bilow had in fact made progress throughout the past reporting year. The Board is unanimous in agreeing with the submissions of Mr. Davies. It is unnecessary to amend the disposition to achieve the goal articulated by Dr. Selhi because any placement requires the approval of the hospital in any event.
[29]. In her evidence Dr. Selhi acknowledged that the risk analysis in the hospital report was copied from the 2024 report and did not represent an accurate assessment of the risk as of the date of the 2025 report. Although other evidence was presented to provide the panel with a sufficient factual basis to make a determination of significant risk, it is important that when a hospital report is presented and filed as an exhibit that it be an accurate and up to date presentation of assessment results and opinion.
[30]. In summary, the panel finds that Mr. Bilow continues to represent a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order without amendment. The panel wishes Mr. Bilow well and hopes that he continues to work with Dr. Selhi and the treatment team towards his reintegration into the community.
DATED this 2nd day of October 2025, at the City of Toronto, in the Region of Toronto.
Mr. G. Beasley Alternate Chairperson
Office of the Registrar Ontario Review Board