Ontario Review Board
Re: Aedyn James Mark Pickering
ORB File No: 8622
Hearing held on: Tuesday, September 2, 2025
Place of hearing: St. Joseph's Healthcare Hamilton (Via Zoom Video Conference)
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M.D. Segal Members: Dr. K. Hand Dr. T. Stirpe Ms. N. Nathanson Mr. K. Brisson
Parties Appearing:
Accused: Aedyn J.M. Pickering Counsel: Ms. A. Szigeti Mr. M. Schloss
The person in charge of hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. K. Malkovich
REASONS FOR DECISION
(Dated October 1, 2025)
Introduction
Aedyn J. Pickering, age 21, was on September 11, 2024, found not criminally responsible on account of mental disorder on a charge of second-degree murder, contrary to the Criminal Code. Mr. Pickering appeared before the Ontario Review Board (the “Board”) from St. Joseph's Healthcare Hamilton (the “hospital”) for his initial hearing. In a Disposition dated October 28, 2024, Mr. Pickering was ordered detained with privileges up to and including to enter the community of Hamilton accompanied by staff.
On June 23, 2025, the hospital notified the Board that on June 12, 2025, Mr. Pickering's privileges were cancelled due to significant incidents of agitation, aggression, and threatening while on the public side of the hospital. A variety of his privileges were cancelled that had previously permitted Mr. Pickering to access the public part of the hospital. The hospital requested a Restriction of Liberty hearing which was acknowledged by the Board on June 23, 2025. Unfortunately, following the curbing of virtually all his hospital privileges, things went from bad to worse. On August 6, 2025, Mr. Pickering was placed in seclusion. On August 12, the seclusion room was replaced by placement in a locked room, subject to a locked-room protocol, which persisted until the date of the hearing.
On September 2, 2025, Mr. Pickering appeared before the Board regarding the Restriction of Liberty by audio visual means. At the hearing, Mr. Pickering’s grandmother attended.
The Board had before it as Exhibit 1 a Restriction of Liberty Report dated August 26, 2025, and the Restriction of Liberty correspondence as Exhibit 2. The Board also had before it the most recent Disposition, the most recent Reasons for Disposition, a transcript of the Superior Court proceedings and Re Warner provided by the patient’s counsel, a leading case on restriction of liberty and seclusion.
The Board was apprised through the Restriction of Liberty Report that on June 10, Mr. Pickering was exercising liberal privileges involving access to the public side of the hospital. He had had a romantic relationship with a woman who attended the Cleghorn Outpatient Clinic at the hospital. Without prior notice, that person had stopped communicating with Mr. Pickering. On June 10, 2025, Mr. Pickering approached her at the Cleghorn Clinic. Mr. Pickering observed her with a person he said was her ex-partner. Mr. Pickering was noticed by staff and asked to leave. He then became extremely agitated and threatening. Extra staff members were called to escort Mr. Pickering back to the unit. He made several threats about wanting to kill the ex-partner and the Cleghorn staff. Mr. Pickering motioned that he was not returning to his unit, but, with support and redirection, he eventually complied. Due to his agitated and threatening behaviour, on June 12 the forensic team assessed Mr. Pickering as an acute risk of harm to others and his privileges were cancelled to mitigate the risk.
As summarized in the Restriction of Liberty Report, following Mr. Pickering’s return to the unit with no off-ward privileges, a Restriction of Liberty hearing was triggered and scheduled. Following that, Mr. Pickering exhibited challenges with behavioural control, substance relapse, and threats and violence necessitating further restrictions and control. On July 7, 2025, he punched the glass at the nursing station and threatened to punch a nurse. The incident had been precipitated by limits being set on accessing hobby materials. Mr. Pickering enjoys making and painting small scale models. On July 15, 2025, Mr. Pickering tested positive for cocaine. Mr. Pickering admitted to snorting cocaine. Presumably, the cocaine came from another patient. Mr. Pickering had limited insight into the acute safety risks of substance relapse for him. Mr. Pickering also admitted to diverting and snorting his oral medication. On August 6, 2025, Mr. Pickering struck another patient in the tv lounge when he became upset that that patient was disparaging his hobbies. The patient was struck in the jaw, went down to the floor and suffered bruising. No charges resulted. As a result, Mr. Pickering was placed in seclusion. He did not show further aggression while in seclusion and was placed in a locked room on August 12, 2025. He remains under the locked-room protocol. He is eligible for courtyard privileges, and meals in the dining room. As of the date of the hearing, Mr. Pickering had not yet received courtyard privileges as the first such use was scheduled for the date of the hearing. There had been a few uses of the dining room.
In preliminary positions, the hospital took the position, supported by Crown counsel, that the Restriction of Liberty was necessary and appropriate, the least onerous and least restrictive course of action that could have been taken, and remained so up to the date of the hearing. Patient’s counsel, Ms. Szigeti, advised that there was no real issue with the curtailing of privileges within the hospital. Ms. Szigeti had serious concerns about the placing of her client in seclusion immediately followed by placing him in a locked room which persisted until the hearing date. She emphasized that the Board was not notified of the further restrictions.
Diagnoses
- Schizophrenia Alcohol Use Disorder – severe Substance Use Disorder (Methamphetamine Type) – severe Opioid Substance Use Disorder - severe
Index Offence
- The circumstances of the index offence are taken from last year’s Reasons for Disposition, as follows:
“On the 29th day of September 2022 at approximately 1900 hours the Accused Aedyn PICKERING was a guest at 156 Henry Street unit D within the city of Brantford along with the Victim Albert HILLIKER. Also at the scene was the girlfriend of the Accused as well as the fiancée of the Victim. The Accused became belligerent towards his girlfriend and subsequently broke her glasses and threw her cell phone across the living room. The Victim’s fiancée and the Accused’s girlfriend then attended the upstairs of the residence while the Victim and the Accused remained in the downstairs.
In an unprovoked fashion, the Accused began strangling the Victim with his hands yelling “die old man” as the victim sat in a kitchen chair. The Victim attempted to resist and was subsequently pushed backwards to the ground. The Accused continued strangling the victim while simultaneously smashing the back of his head onto the kitchen floor. The fiancée and girlfriend attempted to intervene but were pushed away by the Accused. The Accused then drew a knife and began stabbing the Victim in the throat and chest numerous times. As the Accused was stabbing the Victim, he continually stated “repent and die” as he held a rosary to the Victim.
The Accused proceeded to punch the Victim repeatedly in the face for an extended period of time until police attended. After a brief struggle, police were able to restrain the Accused and place him under arrest.
The Victim was transported to the Brantford General Hospital where he succumbed to his injuries.
The Accused stands charged with Murder contrary to section 235(1) of the Criminal Code of Canada.”
Evidence at Hearing
Dr. Aaron Wu, the patient’s psychiatrist since September 2024, testified. Dr. Wu amplified on the Restriction of Liberty Report. Until June 10, 2025, Mr. Pickering was exercising privileges on the public side of the hospital and was not demonstrating overt aggression and had not relapsed into substances. The June 10 incident in the Cleghorn Clinic involved extensive agitation. There were threats to kill others. Staff felt threatened. Mr. Pickering was not an outpatient of that clinic. Following his return to the unit, the forensic team assessed an escalated risk, and on June 11 his off-unit privileges were stopped. The plan was to restrict Mr. Pickering to his unit, engage in conversations including psychoeducation, and developing Mr. Pickering’s insight into risks. Mr. Pickering continued to say he had not done anything wrong. He indicated that if privileges were removed, he felt targeted and he would “lose it”.
In the nursing station incident, on July 7, 2025 he was referred to the nurse in charge. He responded that he would punch that nurse in the face. He also hit the nursing station window with his fist. This incident caused staff to be fearful.
On July 14, 2025, there was an incident and disquiet about Mr. Pickering’s desire to use the visitation room for his hobbies where he became belligerent and swore at staff when the room was not available to him as another patient had signed up for it. Staff was fearful of his reactions.
On July 15, 2025, Mr. Pickering after a positive screen for cocaine on a urine sample, he indicated as he had not been granted privileges, he had no reason to be sober, he would use cocaine again and he enjoyed it. He also indicated that if he lost privileges he would likely be going to Waypoint. Mr. Pickering did not describe how he got the cocaine. While the hope was to advance Mr. Pickering’s privileges, that incident was a barrier because of his aggressive attitude and poor insight.
On August 2, 2025, a nurse found Epival in his room. It had been prescribed on July 7 as a mood stabilizer to help with emotional dysregulation. Mr. Pickering was diverting and then snorting it. The Epival was stopped. Mr. Pickering indicated that if he did not receive more privileges, he would act out.
On August 6, he punched a co-patient in the tv lounge. There was video but no audio of the incident. The co-patient was disparaging of Mr. Pickering’s hobbies. Mr. Pickering approached the co-patient who was sitting down, and Mr. Pickering made a fist. The co-patient stood up. He had his hands to his side when Mr. Pickering punched him in the jaw. In responding to questions from Crown counsel., Dr. Wu indicated that the co-patient fell to the ground and sustained a bruise to his jaw. Mr. Pickering was escorted to seclusion. He had difficulty accepting any responsibility, blaming the co-patient.
While in seclusion, he was monitored day-to-day. On August 12, the decision was made to place Mr. Pickering in a special locked room that was used for only that purpose. There he would have access to his own clothing, books, a tv and bathroom amenities. The locked room resembled his own room but differed in some respects. One obvious difference was that the door had a lock on it that had been installed or changed prior to his admission. In addition to a port window, it also had a floor-to-ceiling window through which Mr. Pickering could be observed.
Dr. Wu indicated that placement in seclusion was due to escalated violence to others, acute mood dysregulation and the requirement to mitigate the risk to others. When in seclusion, Mr. Pickering would not be allowed out. There were a urinal and a bed pad. In seclusion, meals would be placed in the seclusion room. There was a mattress on the floor. There was no exterior window.
The locked room to which Mr. Pickering moved to was on the same unit as his normal room.
Dr. Wu noted that Mr. Pickering’s behavioural presentation varies daily. Mr. Pickering’s risk factors were routinely and regularly evaluated. Mr. Pickering indicated that he did a favour to the co-patient and other co-patients by punching him. If he saw the co-patient again, he would spit on him and put a cigarette out on him. On August 20, 2025, Mr. Pickering indicated that he was proud to punch the co-patient when speaking to a third co-patient in the dining room.
When Mr. Pickering was placed in the locked room, he was contrary and flipped his food tray over.
On August 25, 2025, Mr. Pickering indicated he was agreeable to trying the liquid form of Epival which was begun. Mr. Pickering is capable of consenting to treatment.
Dr. Wu acknowledged that Mr. Pickering has the capacity to cooperate with staff and manage his emotions. This was demonstrated by his pre-June behaviour when he enjoyed privileges to the public part of the hospital.
The goal of administering Epival is not to sedate but to increase the patient’s capacity to deal with dysregulation.
Staff are afraid of Mr. Pickering. That fear persisted even when Mr. Pickering was in seclusion. On one occasion, on August 21, security was called to attend in the room with staff because Mr. Pickering was making fists at the window saying he would punch staff.
In summary, Dr. Wu is of the view that the actions taken by the hospital were amply justified bearing in mind historical factors in Mr. Pickering’s case, his major mental illness, a history of violence and substance use, and threats of violence, aggression and assault.
In questions by Crown counsel, Dr. Wu acknowledged that Mr. Pickering speaks from a place of not having anything to lose.
No criminal charges flowed from the blow to the co-patient. Dr. Wu stated that usually patients are advised of the ability to pursue charges and it seems that the co-patient did not did.
There is a shower next to the seclusion room that requires escorted access.
It is still early days in treatment. A true test regarding behavioural improvement would be to see Mr. Pickering interacting with others, encountering stress and being able to navigate without behavioural escalation.
All urine screens after the positive cocaine screen have been negative. There remained various issues regarding Mr. Pickering that need to be explored. They include reviewing his diagnosis for antisocial personality disorder or antisocial personality traits. Mr. Pickering has impulsivity and is quick to anger. In Dr. Wu's view, Mr. Pickering case is complex. There was childhood trauma. There are indications that there may be a mild intellectual disability. Mr. Pickering’s skill sets at interacting with others continues to be an issue.
Counsel for the patient explored the deleterious impacts of both seclusion and the locked room. The doctor acknowledged extended stay in them would result in frustration, have a disorienting impact if prolonged and, in any event, have a potential impact on one's mental health.
St. Joseph's formal policy regarding seclusion was canvassed including staff rounds, 1:1 staff observation and the goal of transitioning out of seclusion as soon as possible. When a patient is in seclusion a physician reviews the file daily and a seven-day review occurs by another psychiatrist. The oversight rigors of the seclusion policy do not apply to the locked room policy. The locked room protocol is an exception to the seclusion policy. Dr. Wu believed but was not sure that the chief of staff reviewed exception plans. Dr. Wu thought, but was not sure, that a review of locked room status occurs every month.
Under the locked-room protocol, staff observe the patient through the window alongside the door. A locked room is the same size as a normal room but has a larger window to allow for observation. And, of course, it is locked.
When Dr. Wu spoke to Mr. Pickering about his impending transfer to a locked room or from seclusion, Dr. Wu told the patient that “it functions like a seclusion room”. That is recorded in the clinical notes. When Mr. Pickering was informed, he was apparently agreeable to the plan to transfer him to a locked room.
There is no one place in the clinical notes that leaving the locked room is noted. The clinical notes do disclose that Mr. Pickering had been in the hallway or dining room area.
A new care plan was created on August 18. It includes a risk assessment each day, outside access to meals and the courtyard access with at least two staff present.
The first time Mr. Pickering came out of the locked room was August 20, but as he was bragging about punching the co-patient, access to the dining room was curtailed temporarily.
When in the locked room staff do enter to provide occupational and recreational therapy in the presence of security staff.
Mr. Pickering receives good support from his grandparents. They have called the hospital. Dr. Wu has spoken to the patient's family.
Dr. Wu acknowledged that the previous romantic interest “ghosted him” which would be upsetting to most young men. He added that it became dangerous when there was a threat to kill.
Dr. Wu acknowledged that prior to June 10, Mr. Pickering was socializing with other patients, using the visitor’s lounge, engaged in his hobbies, and was appropriately using his hospital privileges. Mr. Pickering had shown an ability to work well with staff. Mr. Pickering has shown an ability to be redirected. Dr. Wu was hopeful that the Epival was already having an impact, but the true test would be when Mr. Pickering had to deal with stress. It was hoped that the Epival would reduce the fluctuations in Mr. Pickering’s behaviour.
Mr. Pickering has been receiving assistance from the occupational therapist in 1:1 sessions to assist with coping. A referral has been made to a behavioural therapist which is hoped will start in September. The behavioural therapist would have to assess Mr. Pickering being followed by the development of a plan that would have targeted interventions.
Mr. Pickering’s psychological testing appears to have disclosed some impairment of intellectual functioning, a poor working memory, compounded by impulse issues.
Dr. Wu indicated that Mr. Pickering presents with a constellation of factors. There needs to be a coming to grips with Mr. Pickering’s mental health diagnosis, intellectual testing, substance use relapse treatment and development of a behavioural plan.
No application for DSO funding has been made. Dr. Wu was of the view that Mr. Pickering would not likely meet those criteria, but that possibility would be kept in mind.
Dr. Wu agreed that Mr. Pickering’s grandparents were prosocial and a stable support and that Mr. Pickering enjoyed seeing them. The relationship added to protective factors.
When questioned about Mr. Pickering’s mental state by a Board member, Dr. Wu advised that Mr. Pickering is compliant with risperidone. In the past Mr. Pickering has presented with hallucinations and false, fixed beliefs. Currently, his thoughts are organized. Regarding questions of paranoia, Mr. Pickering tends to catastrophize. He has voiced that staff are targeting him. His beliefs regarding staff’s intentions are maleable. There are negative symptoms of schizophrenia present such as amotivation. Mr. Pickering expresses that he wants more privileges and enjoys participating in his hobby interests.
In addition to being treated on his own consent, Mr. Pickering can appreciate that he has schizophrenia, can describe its manifestations and what might happen if he stopped his medications.
Dr. Wu plans on speaking with the psychologist about additional psychological testing.
It was clarified that the woman at the Cleghorn Clinic is different from the person who is the subject of a non-communication order.
It was clarified that on August 20, Mr. Pickering made a very brief visit to the dining room, and while his ability to eat in the dining room may have been offered on other occasions, there was no notation in the charts of accessing a dining room in the August 20 to 26 period.
In final submissions hospital counsel, Mr. O'Brien, reviewed the unhappy history starting with the June 10 threats that followed a period when Mr. Pickering had been doing well. There were so many incidents, when laid out together, the totality justified the withdrawal of privileges, followed by seclusion, followed by the locked room. A small ray of light may now be apparent. The hospital had to consider the incident, the patient's mental health, his history of violence, including the significant index offence, substance use, history of aggression and violence, to protect the hospital staff and co-patients. Mr. O'Brien fairly conceded, in response to a Board question, that it would have been preferable had the hospital notified the Board when the restrictions exceeded what was in the original notice to the Board.
Crown counsel agreed with the hospital noting a prior conviction in the patient's history.
Ms. Szigeti expressed her view clearly that the seclusion, albeit a whisker short of the seven-day cut-off for notification, immediately followed by a locked-room treatment, should have triggered a notice to the Board. To patient’s counsel, notification that a client is in seclusion is a very serious basis that prompts responsible counsel to immediately look at addressing the matter. That could include, for example, seeking an expedited Restriction of Liberty hearing. Ms. Szigeti observed that the protocol for seclusion provides more oversight protection than the locked room protocol in relation to mandatory and timely reviews. In her view, the locked room protocol, while somewhat different than seclusion, is a form of seclusion resulting in a withdrawal of socialization with others. Ms. Szigeti and her associate, Mr. Schloss, took no issue with the initial withdrawal of privileges mentioned in the Notice and no opposition to placing the client in seclusion. However, they questioned the ongoing need for the withdrawal of privileges and even more so in relation to placement in the locked room which is ongoing. Ms. Szigeti appreciated Mr. O'Brien’s admission that the hospital could have dealt with the issue of Board notice better.
Analysis
As was conceded by patient’s counsel, the withdrawal of hospital privileges and indeed the placement in seclusion room were warranted. Mr. Pickering, who had used his hospital privileges responsibly up to June 10, 2025, embarked on a downward spiral culminating in assaulting a co-patient as a triggering event that led to seclusion. The hospital was right to notify the Board of the withdrawal of virtually all hospital ground privileges resulting in Mr. Pickering being restricted to his unit. While a stay in seclusion was limited to slightly less than seven days, it immediately was followed by the locked room protocol which continues. The locked room has a great deal in common with a seclusion. The locked room is a special room. It is not the patient’s normal room. It has distinct features that need to be described. It is outfitted with an additional window so the patient can be observed more easily. The door is locked. The only exceptions, apart from necessary medical and compassionate services, relate to the ability to attend meals with other patients while accompanied and the use of the courtyard by themselves, permitted for 30 minutes a day. Therapeutic counseling occurs in the locked room with therapeutic staff accompanied by at least two security staff. Socialization is clearly reduced. Whatever one might say about the locked room, it is a further significant restriction of the patient's liberty well beyond confining him to his own unit.
The hospital should have notified the Board of the change to Mr. Pickering’s status. If it was responsible for the hospital to notify when Mr. Pickering’s privileges to the public side of the hospital were abridged, the further significant restriction of liberty by placing him in seclusion immediately followed by a locked room, more severe restrictions than the withdrawal of hospital privileges, certainly should have caused the hospital to notify the Board. Hospital counsel, to his credit, conceded as much.
The Board has considered Re: Warner, February 25, 2025, in which the Chair of the Board considered the issue of restrictions of liberty in detail. That decision, relying on R. v. Campbell 2018. ONCA 140, set out the range that various forms of restrictions may take and the critical importance of notifying the Board so the Board’s oversight of significant deviations from a patient’s liberty norm may be promptly reviewed as required by the Criminal Code. Restricting our view to the circumstances at St. Joseph’s only and in relation to Mr. Pickering, the patient was subjected to a further restriction after the initial withdrawal of hospital privileges. At the point in time that this patient was placed in the locked room, there was a duty to inform the Board and the parties including patient’s counsel. Patient’s counsel relies on that notice to protect their client’s interests.
Despite the lack of notice regarding the increased restrictions, because of the hearing, the Board became fully apprised of Mr. Pickering’s course in seclusion and in the locked room. That is not an ideal way for the Board to find out these matters. But find out we did and, so, the panel was well placed to determine whether the ongoing restriction of liberty including the restriction of privileges to the public part of the hospital, seclusion and the continuing locked room status, continue to be necessary and appropriate and the least onerous course of action that was open to the hospital on the facts and evidence. The restrictions relating to withdrawal of privileges to the public part of the hospital and in the locked room, continue to be necessary and appropriate and the least restrictive course of action. We see this because Mr. Pickering’s downward spiral was extraordinary, engaged the safety of the public, specifically staff and co-patients. Acts of aggression and multiple threats including of death, occurred despite ongoing psychoeducation. Mr. Pickering’s ability to grasp the severity of his conduct and the risk and safety to others is at present manifestly underdeveloped. A series of acts and words, especially with his history of violence, substance abuse, aggression and impulsivity, left the hospital with no choice. The hospital must be ever cautious as it moves to reintegrate Mr. Pickering into the patient population.
Clearly, the hospital was of the view that seclusion was no longer justified. The follow-up locked room status is being examined by the hospital on a continuing basis as to whether it still is required in Mr. Pickering’s case. Mr. Pickering has been offered meals with other inmates. It appears he does not always desire that. On August 20 his inappropriate bragging about punching a co-patient led to a temporary end to that ability. The patient needs socialization and fresh air. Yard privileges were to start on the day of the hearing.
The hearing was a very full one, far exceeding the time estimate. There were areas explored that while not wholly relevant to the Restriction of Liberties further assist as they may relate to his ongoing treatment and the next annual hearing. That information assisted the panel in understanding how Mr. Pickering is doing and what current areas are required to be addressed. The administration of Epival, now in liquid form, is in early days. The hospital is optimistic that it will take hold and result in a heightened ability to cope with stress. The hospital is looking at other areas including at least:
A more complete evaluation whether there is a mild intellectual disability. If one is identified, it could possibly assist with potential helpful DSO funding.
Work on Mr. Pickering’s history of substance abuse.
Behavioural therapy including addressing coping mechanisms for stress and a possible behavioural plan.
A history of childhood trauma.
There is a sense of optimism that the Epival maybe having desired effects. The days preceding the ROL hearing appear to demonstrate less aggression and more stability.
Bearing in mind the evidence received, and the patient's background, the restrictions of liberty continue to be appropriate. The Board is hopeful that the hospital will continue to regularly review whether relaxation of the restrictions is warranted. We wish Mr. Pickering well.
DATED this 1st day of October 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
Office of the Registrar Ontario Review Board