Re: Paul P. Todorov
ORB File No: 5728
Hearing Held On: Wednesday, January 8, 2025
Place of Hearing: Centre for Addiction and Mental Health
Pursuant To: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Fraser
Members: Dr. W. Johnston Dr. T. Stirpe Ms. A. La Viola Ms. R. Chopra
Parties Appearing:
Accused: Paul P. Todorov Counsel: Ms. J. Chan
Person in charge of Hospital: Representative: Ms. L. Senko
Attorney-General of Ontario: Counsel: Mr. M. Feindel (via Zoom)
REASONS FOR DISPOSITION
(Dated February 14, 2025)
OVERVIEW
- On October 28, 2010, Paul P. Todorov was found not criminally responsible on account of mental disorder of an indecent act, failure to comply with a probation order, and failure to comply with a recognizance, contrary to the Criminal Code. Mr. Todorov’s last annual review was conducted on January 11, 2024. He is currently subject to a disposition of the Ontario Review Board dated January 16, 2024, detaining him at the Centre for Addiction and Mental Health (CAMH). The disposition permits Mr. Todorov community living in the Greater Toronto Area in supervised accommodations approved by the person in charge.
ISSUES
On January 8, 2025, the Board convened at CAMH for a mandatory review of the disposition further to s. 672.81(1) of the Criminal Code. The issue before the Board was to determine whether Mr. Todorov continues to pose a significant threat to the safety of the public and, if so, to determine the necessary and appropriate disposition for him consistent with the factors set out in s. 672.54 of the Criminal Code. Mr. Todorov attended the hearing in person, along with his Counsel, Ms. Chan.
The Hospital asked the Board to conclude that Mr. Todorov continues to represent a significant threat to the safety of the public, and a Detention Order remains necessary, as already set out in his current disposition, with no proposed changes. Counsel for the Attorney General agreed with the Hospital’s recommendation. Counsel, Ms. Chan, did not contest that the test for ‘significant threat’ had been met, however a Conditional Discharge would be appropriate, along with the removal of some of the restrictions in his current disposition – namely, that Mr. Todorov be allowed access to the community, unsupervised, and that he be allowed communication with persons under the age of 16 years.
FINDINGS
- After reviewing the evidence, the Board concluded that Mr. Todorov continues to represent a significant threat to the safety of the public. Mr. Todorov continues to display significant risk factors, such as poor insight, inadequate coping skills, and a concerning history of paraphilic disorders. He has expressed intentions and desires to form friendships with children, even seeking to have the prohibition against such interactions removed. These factors highlight the ongoing risks associated with Mr. Todorov's case, necessitating close monitoring and intervention to address his treatment needs. His lack of insight and potential for non-compliance remain critical concerns for his safety and the safety of others and requires the conditions as set out in his current disposition, with no change at this time.
PERSONAL BACKGROUND
The Hospital Report dated November 25, 2024, was entered as an exhibit at the hearing. The following background information, including the events surrounding the 2010 index offences, has been taken from the Report, summarized here as follows.
On August 27, 2010, Mr. Todorov attended at a local community centre. The playground was being enjoyed by several children who were supervised by their parents. He attended the playground area and attempted to conceal himself behind a tree. He then proceeded to insert both hands down his pants and masturbate. He continued to masturbate while he watched the children play on the playground. Parents became aware of his presence and actions, and they flagged down a passing police car. He was still on scene fiddling with his pants when police arrived, and he was placed under arrest. At the time, Mr. Todorov was subject to a court order prohibiting him from attending a playground, school, or a place where children are known to be found.
Mr. Todorov is 61 years old, born in Toronto, Ontario and is the oldest of two children. He has not had contact with his younger brother since 2009. Mr. Todorov lived with his parents until they passed away – mother in 2002, and father in 2003. Mr. Todorov continued to live in the family home as his father died. He does not have any other family supports in the community. Due to his developmental delay, Mr. Todorov was placed in special education classes. There were numerous assessments for behavioural and cognitive problems but no hospital admissions until he became aggressive in adulthood. Mr. Todorov reported never having had friendships and preferred to be on his own starting in childhood. He has no history of relationships or marriage.
From the ages of 17 to 21, Mr. Todorov operated an ice cream bicycle cart during the summer. In 1992, he was employed as a porter at Toronto General Hospital. From 2013 to 2015, he served as a Canteen Operator in his unit at CAMH. Following this, he took on the role of Canteen Supplier at CAMH before transitioning to community living with VITA Community Living Services in 2016.
The documented sexual history is summarized as Mr. Todorov underwent a sexual behaviours assessment conducted in 2009 wherein, he expressed no interest in children, denying any experience of sexual or physical abuse during his childhood. While hospitalized at CAMH Mr. Todorov admitted to having a sexual attraction to children and showed an interest in exhibitionism. He initially dismissed masturbation but later acknowledged that he occasionally engaged in it. After beginning treatment with leuprolide, a medication to reduce sexual drive, he reported being unable to achieve an erection, despite ongoing sexual thoughts.
A records check of Canadian Police Information Centre database revealed that Mr. Todorov's criminal history includes convictions for assault, indecent acts, exposure to persons under the age of 16, criminal harassment, failure to comply with recognizance, mischief and failure to comply with probation/recognizance, among others.
PSYCHIATRIC BACKGROUND
The psychiatric background information is contained in the Hospital Report, and it is extensive, beginning with the first interaction with psychiatric assessments when Mr. Todorov was 3 years old due to behavioural and cognitive problems. The most consistent diagnoses included Intellectual Developmental Disorder, Exhibitionistic Disorder, and Pedophilic Disorder. While Schizophrenia was considered, this was never clinically diagnosed until later.
Mr. Todorov was evaluated due to significant developmental delays, including encopresis (passage of feces outside of toilet-trained contexts in children) and speech difficulties. Cognitive testing indicated that he had an IQ of approximately 60, consistent with a diagnosis of Mild Intellectual Developmental Disorder. He was attending school for only one hour a day in a special classroom, displaying concrete thinking, poor fine motor skills, and limited social interaction.
In 2006, it was reported that Mr. Todorov's sexual paraphilic interests related to body odour and coprophilia (sexual arousal or pleasure from feces), along with concerns about frotteurism ((interest in rubbing, usually one’s pelvic area or penis, against a non-consenting person for sexual pleasure)). A subsequent psychiatric assessment while incarcerated indicated that he struggled to cope in the general population, displaying strange behaviour that led to his placement in segregation. At that time, he was treated with antipsychotic medication for serious mental health issues.
Mr. Todorov's initial forensic psychiatric hospitalization took place in 2007 after he exhibited aggressive behaviour at his residence. He spent several days in the hospital, where he was treated with olanzapine. In February 2009, he underwent an assessment at the Sexual Behaviors Clinic at CAMH. Later, in September 2009, he was again evaluated following an incident where he assaulted random individuals on the street and allegedly exposed himself to school-aged girls.
In January 2010, Mr. Todorov was assessed for his fitness to stand trial. The evaluating psychiatrist deemed him fit to stand trial and it was advised that he participate in a sexual offender treatment group, which he ultimately did not pursue. Following the ‘not criminally responsible’ finding in October 2010, he was detained in hospital, remaining there until he was transitioned to community living in June 2016 – VITA Community Living Services. This secure residence caters to individuals with a history of sexual offences and intellectual disabilities, providing continuous staffing and supervised medication administration. In April 2018, Mr. Todorov was readmitted to hospital for about a month after expressing intentions to harm children. An adjustment in his medication helped to alleviate these thoughts, allowing him to return to his residence. Since then, Mr. Todorov has maintained relative mental stability, avoiding any significant incidents.
Mr. Todorov’s current psychiatric diagnoses are Pedophilic Disorder, Exhibitionistic Disorder, Mild Intellectual Developmental Disorder and Rule Out Possible Unspecified Schizophrenia Spectrum and Other Psychotic Disorder. Mr. Todorov has been found capable of making decisions about his medical treatment, and he is capable of managing his finances independently. He receives support managing his finances from the VITA accountant and the administrator of his parents’ estate.
EVIDENCE AT THE HEARING
Mr. Todorov’s clinical course for this reviewing year is extensively detailed in the Hospital Report and his attending psychiatrist is Dr. B. M. Khan.
Dr. Khan gave evidence at the hearing pertaining to Mr. Todorov’s clinical course this reporting year. She stated that there were notable updates that took place at a Tim Horton’s establishment in December 2024. Mr. Todorov attended a Tim Horton’s birthday party for a co-resident from VITA. Mr. Todorov engaged in a verbal disagreement with the staff after refusing to remain in the van and insisting on entering the establishment. The concern arose because there were preschoolers present, and his current restrictions prohibited contact with children under the age of sixteen.
Mr. Todorov argued that preschoolers were not included in his restricted contact list. Consequently, staff had to call the housing manager to redirect him to stay in the vehicle, highlighting the challenges in managing his behaviour in public settings.
The second incident occurred when Mr. Todorov attended a birthday party for another resident. Upon arrival, he inappropriately asked the birthday individual if they would be interested in starting a relationship and sharing a bed with their parents, which made the birthday person uncomfortable. Both incidents were discussed with Mr. Todorov during a meeting with the housing manager. During this meeting, Mr. Todorov agreed to adhere to the rules of his disposition and to be redirected by staff. He continues to reside at VITA and is interested in transitioning to long-term housing. Given the nature of his recent behaviours, there are ongoing concerns regarding his ability to manage interactions in environments with minors or less supervised settings, as demonstrated in these recent incidents.
After further inquires, Dr. Khan stated that in November 2023, a mental status examination revealed concerning behaviours exhibited by Mr. Todorov, particularly regarding his housing situation. It was noted that he engaged in inappropriate sexual behaviours and displayed emotional dysregulation towards other residents, often fixating on controversial topics. One specific incident involved Mr. Todorov calling a co-resident a "terrorist," which upset the individual and prompted staff to intervene. Over the past year, however, Mr. Todorov has participated in interpersonal skills programming, which has led to improvements in his interactions and a reduction in such incidents since he began this programming in May 2024.
Despite these improvements, there remain concerns about Mr. Todorov's overall insight into his situation and the potential risks associated with his behaviour. He has formed positive relationships with staff at VITA, particularly with the housing manager, who has been effective in redirecting him during incidents. Mr. Todorov is interested in transitioning to long-term housing, but his ongoing need for supervision and monitoring is crucial for managing the risk he poses in the community. The treatment team has been working on developing skills that will support his success in long-term housing, particularly focusing on interpersonal skills. The VITA maintenance home is designed for individuals who reside there for extended periods, and the aim is to ensure that Mr. Todorov can successfully integrate into that environment when a vacancy becomes available. It is clear that while he expresses a desire for relationships and family, he continues to demonstrate a lack of insight into the implications of his past behaviours and his diagnoses, including his interest in children and the potential threat this poses to public safety.
Additionally, Mr. Todorov has also expressed a desire to remain within the VITA organization, as he values the relationships he has built there. He has indicated that if he does not transition to long-term housing, he hopes to find an apartment in the community, although this is currently not feasible under his disposition. The treatment team is actively exploring different housing options, including potential placements in other facilities. It is important to note that any transition will be managed to ensure that Mr. Todorov continues to receive the necessary support and supervision, particularly given the concerns related to his past behaviours and the need for ongoing monitoring.
SUBMISSIONS
- The Hospital stated that it is clear from Dr. Khan's testimony that the concerns outlined last year still resonate today. The Detention Order remains necessary and appropriate, as the hospital requires the ability to ensure suitable accommodations, and 24-hour supervised housing is essential to provide the necessary support. Moreover, the provisions of the Mental Health Act would be insufficient to manage the associated risks within the community. Regarding the terms of the current disposition, these terms are still necessary, as the risks to minors are evident in the record and the respective prohibitions should be maintained. Counsel for the Attorney General emphasized that it is crucial for Mr. Todorov to be monitored closely given the context of his recent incidents. As he prepares for the upcoming year, it is important that the treatment team remains vigilant in ensuring his compliance with the conditions set out in his current disposition. Counsel Ms. Chan submitted that while Mr. Todorov is not directly challenging his inherent risks, he is questioning the necessity of the ongoing order. It is hopeful that with the absence of incidents in recent months, a Conditional Discharge would be appropriate.
ANALYSIS AND CONCLUSION
(a) Significant Threat
- Where there is a risk of serious physical or psychological harm to members of the public resulting from conduct that is criminal in nature but not necessarily violent, the Board must find that the threshold for ‘significant threat’ has been met. The issue of whether Mr. Todorov continues to pose a significant threat to the safety of the public was not contested at the hearing, however we have considered the issue, and made an independent finding. Based on the testimony of Dr. Khan and the relevant contents of the Hospital Report, we find that Mr. Todorov remains a significant threat to the safety of the public, and accordingly, he is not entitled to be discharged absolutely. Mr. Todorov has a complex psychiatric profile. His diagnoses include focused sexual behaviours towards children. He requires treatment involving sex drive reducing agents and psychotherapy to change his cognitive patterns. Several factors convince us that the threshold for ‘significant threat’ has been met. The evidence was clear, and we agree that Mr. Todorov continues to exhibit significant risk factors, including poor insight, inadequate coping skills, and a troubling history of paraphilic disorders. Concerns regarding his non-adherence to treatment and supervision persist, alongside negative attitudes towards his mental health needs. His lack of understanding about the implications of his diagnoses, particularly regarding his sexual interests and behaviour, and the importance of ongoing treatment, remains evident. Past reports indicate his eagerness to reduce medication, and his non-compliance is very concerning, as he has historically expressed intentions to engage in harmful behaviours towards children, and he continues to express a desire to form friendships with them, to the degree that he would like the prohibition removed from his disposition.
(b) Necessary and Appropriate
We find that a Conditional Discharge has absolutely no air of reality at this time. The plan of care in place for Mr. Todorov is a tailored one and it addresses his rehabilitation and safe reintegration into society. A Detention Order is necessary and appropriately addresses his continuing level of threat to the safety of others given that he is subject to the level of supervision provided by his treatment teams, including the forensic psychiatry services at CAMH. His psychiatric treatment and care involves the necessary level of supervision, evaluation, and adjustment to manage his risk level. Without the forensic treatment team, and their ability to intervene, his stability would most certainly decline. Independent community living without an effective supervision response is not appropriate for Mr. Todorov at this time because his treatment needs require the that hospital be equipped with the ability to quickly intervene should Mr. Todorov fall away from treatment or engage in inappropriate sexual behaviours towards children. This plan is in place because Mr. Todorov needs a supervised community setting with trained staff capable of addressing any clinical destabilization. He requires ongoing and frequent psychiatric follow-up. Of particular concern is that he wishes to have contact with children and has expressly requested that the prohibition in his disposition be removed, which shows that he has no insight into the risk he poses to vulnerable members of the community. In addition, he has recently experienced a decline in physical health, necessitating treatment for a urinary tract infection and management for an enlarged prostate, alongside musculoskeletal pain. His reluctance to disclose health issues has often required intervention from VITA staff to ensure he receives the necessary medical care. Without such supervision, his health could deteriorate further, potentially worsening his mental state, increasing his risk of reoffending.
We note that the treatment team is actively seeking permanent housing for Mr. Todorov, although he has not yet transitioned to the VITA maintenance home and continues to reside in the treatment facility. During this period, he has worked on improving behavioural regulation, reducing fixations, and enhancing interpersonal skills through structured programming that he finds meaningful, in preparation for his eventual transition. Both the community and the CAMH treatment teams are key in helping Mr. Todorov achieve manage his level of risk, Mr. Todorov is critically dependent on the supervision provided by his Detention Order. Without this oversight, he may find himself in environments conducive to reoffending, such as parks or schools, where he could engage in inappropriate sexual behaviour. His resistance to treatment and lack of insight into his actions further complicate his recovery process, as he has previously blamed external factors for his index offences. Without this level of supervision, the potential for him to act on his harmful impulses increases significantly. We conclude on the evidence before us that the most necessary and appropriate outcome for Mr. Todorov is to continue his recovery process under the supervision and authority of the Ontario Review Board, in accordance with the conditions in his current disposition, with no change at this time.
DATED this 14^th^ day of February, 2025 at the City of Toronto, in the Toronto Region.
Ms. A. La Viola Legal Member
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Office of the Registrar Ontario Review Board