Re: Timothy Firman, 2025 CanLII 10468

Re: Timothy Firman

ORB File No: 4767 Hearing Held On: Tuesday, January 7, 2025 Place of Hearing: Centre for Addiction and Mental Health Pursuant To: Section 672.81(1) and 672.81(2.1) of the Criminal Code

Before: Alternate Chairperson: Mr. C. Fraser Members: Dr. B. Sheppard Dr. T. Stirpe Ms. A. La Viola Ms. R. Chopra

Parties Appearing: Accused: Timothy Firman Counsel: Ms. M. Perez Person in charge of Hospital: Representative: Ms. L. Senko Attorney-General of Ontario: Counsel: Ms. V. Culp

REASONS FOR DECISION AND DISPOSITION

(Dated February 14, 2025)

OVERVIEW

1On June April 24, 2007, Timothy Firman was found not criminally responsible due to mental disorder for an assault causing bodily harm, contrary to the Criminal Code. Mr. Firman’s last review hearing was conducted on October 25, 2024. He is currently subject to a disposition of the Ontario Review Board dated November 6, 2024, detaining him at the Centre for Addiction and Mental Health – Forensic Service, with privileges permitting him to live supervised in the community within the Greater Toronto Area, in accommodation approved by the person in charge.

ISSUES

2On January 7, 2025, the Board convened at CAMH for a mandatory review of the current disposition further to s. 672.81(1) of the Criminal Code. The first issue before the Board was to determine whether Mr. Firman 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. Firman did not attend the hearing, but he was represented by Counsel Ms. Perez. An order was issued under s. 672.5(10)(a) of the Criminal Code permitting Mr. Firman to be absent from the hearing.

3The second issue was to review the two ‘restriction of liberty’ periods that had triggered the notice provisions under s. 672.56(2) of the Criminal Code. The Board received notice indicating that Mr. Firman had been detained in hospital from living in approved accommodation in the community commencing on October 24 and ending on November 11, 2024. There had been a restriction of Mr. Firman’s liberty interests for a period greater than seven days as a result. The Board also received notice indicating that Mr. Firman had again been detained in hospital commencing on November 22, 2024. At the time of the review hearing, Mr. Firman had not yet been returned to his apartment, and the restrictions were ongoing. The Board was to determine whether the restrictions had been necessary and appropriate to protect the safety of the public, according to s. 672.81(2.1) of the Criminal Code. It should also be noted that the Board had just recently conducted a ‘restriction of liberty’ hearing because Mr. Firman had been detained in hospital from September 5 to September 18, 2024.

POSITIONS

4At the outset of the hearing, the Hospital asked the Board to conclude that Mr. Firman continues to represent a significant threat to the safety of the public, and a Detention Order is still necessary and appropriate at this time, with no change. Counsel for the Attorney General, and Counsel for Mr. Firman had no concerns with this position and agreed with the Hospital’s recommendation. A joint position on this issue was put forward for the Board’s consideration.

5On the second issue, the Hospital and Counsel for the Attorney General submitted that both periods resulting in a ‘restriction of liberty’ were necessary and appropriate in the circumstances and remained so throughout the duration of the respective periods, and in the case of the ongoing restriction period, both parties submitted that it continued to be necessary and appropriate. Counsel Ms. Perez stated that she took no position with the first restriction period, however the second restriction period may have been necessary when it was first initiated but its continuation was no longer warranted in the circumstances.

FINDINGS

6The Board’s detailed reasons for the findings and conclusions are set out in the analysis section below. Briefly summarized here, Mr. Firman continues to represent a significant threat to the safety of the public. His response to treatment has been suboptimal, and his mental illness is characterized as unstable because he has spent more time detained in hospital than residing in the community, most recently due to his continuous relapse into cannabis and crack cocaine use. He refuses to participate in any activities or programs offered to him. All of these factors contribute to his overall instability. Mr. Firman’s current risk of reoffending is assessed as high, and a Detention Order remains necessary and appropriate having regard to all the factors considered. In addition, Mr. Firman has required three periods of readmission to hospital under formal orders in just under four months. These were initiated because of Mr. Firman’s continuous relapse into cannabis and crack cocaine use. Both recent decisions to increase restrictions on Mr. Firman’s liberty status and readmission to hospital under review are deemed reasonable as the restrictive periods were both necessary and appropriate to ensure public safety – in the first when it was initiated, during and until it was ended, and in the second, it continued to be so at the time of the hearing. All of which is set out in more detail below.

PERSONAL BACKGROUND

7The Hospital Report and the Restriction of Liberty Report, both dated December 5, 2024, were entered as one exhibit at the hearing. The following background information, including the events surrounding the 2006 index offence, has been taken from the Hospital Report, summarized here as follows.

8Mr. Firman was in a relationship with a social worker in a shelter where he sometimes stayed, and on January 19, 2006, he spent the night at her apartment. After an argument, Mr. Firman assaulted her, resulting in police charges. He was released on bail with a condition to avoid contact with her. On March 19, while on bail, he visited her (at her invitation), where he assaulted her again, causing significant injuries. It is also reported that he was charged with breaking and entering after stealing from his parents' home while they were on vacation in February 2006.

9Mr. Firman is 47 years old. He is a single man born in Toronto and has no dependents. He resides in mental health supportive housing. Mr. Firman was adopted in his infancy and is one of two boys with no biological relation to his adoptive parents. Throughout his childhood, he was largely a loner and was diagnosed with ADHD, for which he took Ritalin with little success. He experienced feelings of boredom and frustration, which led to destructive behaviour and frequent arguments with his parents, especially during his teenage years. Despite their efforts to provide additional educational support and establish behavioural guidelines, Mr. Firman found their actions odd, and he felt misunderstood.

10At 19 years old, after finishing school, Mr. Firman was asked to leave the family home, resulting in a strained relationship with his parents that lasted until 2008. Between these years, he faced numerous challenges, including arguments, substance abuse, and theft, while his parents tried to help him find work. His mother expressed fear regarding his behaviour. He spent much of his adult life homeless or in shelters and was evicted from one shelter in late 2005.

11An updated check of the Canadian Police Information Centre database showed that since 2003, Mr. Firman has faced multiple arrests, though he has no recorded convictions. One notable arrest occurred on February 24, 2006, following his earlier charge for assault in January. During this incident, he was accused of operating a stolen vehicle recklessly, exceeding the speed limit, and crashing into a parked car with such force that it moved the vehicle into the roadway. The collision caused a chain reaction, resulting in the parked car being hit by another vehicle. After the crash, Mr. Firman fled the scene in the damaged car and later abandoned it on a nearby street.

12Mr. Firman has had a sporadic employment history. Initially, he worked as a lifeguard after leaving home but was dismissed due to lack of attention. His father later secured him a position as a gas station attendant, but he was let go again for causing damage to the property, stemming from his frustration with the job's demands. Although he took on some construction and painting jobs, by age 22, he was deeply involved in street life and regularly consuming alcohol and illegal drugs.

13Mr. Firman has a lengthy history of substance abuse, beginning with alcohol and marijuana in his teens, subsequently increasing to include the regular use of crack cocaine, and some use of PCP, LSD, and ecstasy.

PSYCHIATRIC BACKGROUND

14The psychiatric background information before and after Mr. Firman committed the index offence is contained in the Hospital Report, and it is extensive. The following highlights some of the information.

15Throughout his childhood, Mr. Firman exhibited signs of mental health issues, including behavioural problems in school and substance abuse during his teenage years. Despite concerns, he was reluctant to seek help from a psychiatrist. His first interaction with adult mental health services occurred in 1998 while he was living in a shelter. In 2000, he received his first diagnosis of a major mental illness. Over the years, he displayed severe psychotic symptoms, including auditory hallucinations urging him to commit suicide, and he often acted inappropriately with unpredictable mood swings.

16In March 2001, Mr. Firman was admitted to Scarborough Centenary Health Centre after exhibiting severely psychotic behaviour, including delusions of being God and making threats against his mother. His condition included fluctuating moods and aggressive outbursts. Following his discharge, he continued to struggle with treatment compliance. He attended a drug and alcohol program in August 2001 but left shortly after due to feeling overwhelmed. Attempts to secure stable housing were unsuccessful, primarily due to his inability to manage rent payments and his inappropriate behaviour.

17Despite multiple psychiatric admissions related to his psychosis and drug use, he consistently refused to acknowledge his mental illness, and he declined treatment, including antipsychotic medication. He was first linked to the Schizophrenia Program at CAMH in 2002.

18Mr. Firman had a brief admission to CAMH in December 2005. After a very severe episode in March 2006, he was again admitted and discharged a few days later. Following his release, his condition worsened – he chose not to take medication or engage in psychiatric follow-up after his discharge. He was ultimately detained at CAMH by disposition of the Board after his initial hearing in 2007.

19After the finding of ‘not criminally responsible’, Mr. Firman was detained at CAMH for approximately 15 years in the ‘medium’ secure units, experiencing many issues in his recovery process. His release to community living, supervised and approved by CAMH, occurred in 2022.

20His current diagnoses are Schizophrenia and Polysubstance Use Disorder (Cannabis and Alcohol – in remission, in a controlled environment), Antisocial Personality Disorder and his intellectual functioning was assessed as being in the ‘Borderline range’. Mr. Firman is currently not capable of making decisions about his psychiatric treatment, but he is capable of managing his finances independently. His substitute decision maker is his mother. He is financially supported by the Ontario Disability Support Program.

EVIDENCE AT THE HEARING

21Mr. Firman’s clinical course for this reviewing year is detailed in the Hospital Report. He is followed by the Expanded Forensic Outpatient Service, under the care of Dr. P. Benassi after he was discharged to supervised community living. The clinical information in the Report is summarized here, along with updated information provided at the hearing.

22It should be noted the Report indicates that on December 5, 2024, a Risk and Recovery Annual Planning Conference took place. The treatment team has proposed that Mr. Firman be held at Forensic Services within CAMH, with privileges that include indirectly supervised community access, and the option to live in supervised accommodations, with a view that Mr. Firman refrain from substance use (excluding cannabis), supply urine samples to verify his abstinence, be prohibited from possessing weapons, and attend mental health appointments as deemed necessary, with a minimum requirement of once a week.

23Dr. Benassi gave evidence at the hearing. He stated that Mr. Firman had again been readmitted to hospital and is now on a waiting list for transfer to a forensic unit. There are significant concerns regarding his behaviour, including Mr. Firman providing diluted urine samples and his involvement in an incident with an unauthorized visitor. Although no contraband was found during a search, Mr. Firman was evasive about this interaction and the identity of his visitor.

24This is Mr. Firman's third re-admission in the past six months, with the initial one after implementing a harm reduction plan focused on his cannabis use. He was informed of the expectations and terms regarding substance use. However, he denied using any substances despite indications to the contrary. Following this, he began providing false urine samples and resumed using crack cocaine shortly after his last discharge. While he has been less engaged with the outpatient team during this admission and expressed frustration at the length of his stay, he has had more productive conversations with the inpatient team.

25The treatment team holds the opinion that Mr. Firman must demonstrate cooperation and engagement in discharge planning to be considered for release. This includes showing commitment to counseling for substance use and participating in structured programming. He has previously declined these recommendations, raising concerns about potential substance use and behaviours that may endanger community safety. Without a change in his outlook and engagement in the rehabilitative process, discharge will not be appropriate. The team hopes Mr. Firman will understand the implications of his situation and the necessity of valid sample monitoring to address substance use.

26This marks the first time that Mr. Firman’s use of crack cocaine has been a significant issue, despite it being a recurring topic over the years. The extent of the substance's impact is difficult to ascertain, however, during that period of use (around the time of the index offence), Mr. Firman experienced multiple psychiatric admissions and was using various illicit substances while not adhering to his medication regimen. This year, a plan was established concerning cannabis use, and at the October ‘restriction of liberty’ hearing, it was noted that Mr. Firman's conditions were under review, with discussions about whether to reinstate cannabis use prohibitions.

27There was considerable debate regarding the potential risk of removing the cannabis condition, especially since Mr. Firman had been living in the community while complying with his medications. Despite using cannabis daily (up to two to three grams) he did not show any significant changes in his mental state, maintained attendance at appointments, and did not experience decompensation or conflicts with his housing. The lack of a direct influence between cannabis use and increasing violence was observed, particularly leading up to his October admission, where he had already chosen to use crack cocaine. This suggests that removing the cannabis restriction may not have been a trigger for other substance use.

28Currently, Mr. Firman's recent behaviour indicates ‘a pushing of boundaries’, despite having adhered to harm reduction strategies for over a year. The treatment team is questioning whether reinstating the cannabis condition would serve as a deterrent for other illicit substances. This situation is complicated by Mr. Firman's history of non-compliance with medication and the potential risks posed by his substance use, which could lead to further complications with housing and overall instability. The treatment team remains concerned about his risk of substance use and its implications on his mental status.

29During this admission, Mr. Firman expressed no intention to use crack cocaine, associating his past substance use with sleep problems. However, he tends to be defensive and minimizes the impact of his actions, believing that the restrictions placed on him are overly conservative. He initially did not plan to use anything beyond cannabis, indicating a lack of insight into how his substance use affects his overall health and treatment outcomes.

30The treatment plan for Mr. Firman upon discharge will continue utilizing a harm reduction approach, whether or not a cannabis condition remains in place. This approach is informed by over two years of observation regarding how cannabis affects his medication compliance and overall wellbeing. Relapses in substance use can be a common part of the recovery process, which necessitates ongoing monitoring through urine testing. Although challenges exist, such as identifying patterns of use amidst diluted samples, the harm reduction model has been effective in fostering a collaborative dialogue regarding Mr. Firman's cannabis use, allowing him to be more open about his substance use.

31Moving forward, the treatment team emphasizes the need for Mr. Firman to re-engage with substance use counseling and establish more structure in his daily routine. His historical resistance to counseling and structured activities has been a barrier to his progress. There is a consensus that he must demonstrate a willingness to participate in these programs and show accountability for his actions to facilitate his discharge. This process requires ongoing collaboration and flexibility, as maintaining open communication about his substance use and treatment goals will be critical for his successful reintegration into the community.

SUBMISSIONS

32The Hospital and Counsel for the Attorney General emphasized that Mr. Firman had made efforts to abstain from substance use during his recent hospitalization, specifically from October 24 to November 11, 2024. Unfortunately, shortly after his discharge, he resumed using substances, which poses a risk to his recovery and to public safety. Dr. Benassi clearly articulated the challenges faced in rebuilding a therapeutic relationship with Mr. Firman, which is crucial for a safe discharge. The Hospital submitted that a period of hospitalization is necessary to establish trust and ensure that any discharge is managed safely and transparently, allowing for a reliable continuation of care in the community.

33Counsel Ms. Perez focussed her submissions on the ongoing restrictions surrounding Mr. Firman’s last readmission to hospital. She noted that there had been several instances of re-hospitalization over the past two years. Despite this, Counsel contended that Mr. Firman is ready to reintegrate back into the community. Mr. Firman's urine samples have been clear for several weeks, which indicates progress. While he has not yet agreed to all of Dr. Benassi’s recommendations for discharge, he is ready for reintegration. Ultimately, Counsel contended that while Mr. Firman will likely continue to face challenges related to cannabis and potentially cocaine use, the question remains about how long he must stay hospitalized before being discharged. She submitted that Mr. Firman has demonstrated enough stability to transition back into the community. Although there may be future issues with substance use, the current treatment plan has been effective, and he can manage his recovery outside of the hospital setting.

ANALYSIS AND CONCLUSION

(a) Significant Threat

34Where 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. Firman continues to pose a significant threat to the safety of the public was not contested at the hearing, and no evidence was presented that would lead to an alternate conclusion. Notwithstanding, we have considered the issue and have made an independent finding.

35Based on the testimony of Dr. Benassi, and the relevant contents of the Hospital Report, we find that Mr. Firman remains a significant threat to the safety of the public, and accordingly, he is not entitled to be discharged absolutely. Mr. Firman has a complex psychiatric profile where his diagnoses indicates concurrent disorders – a history of psychotic symptoms stemming from his primary diagnosis of Schizophrenia are exacerbated by his constant use of illicit substances, together with functional deficits, and anti-social behaviours.

36Several factors convince us that Mr. Firman’s risk of reoffending remains high. Mr. Firman’s history of substance use, the violent and harmful acts surrounding the index offence, his history of non-adherence with medications, his limited insight, and the limited recovery progress he has made so far under the oversight of the Board. He has been assessed as a high-risk of relapse into substance use, which increases his risk of committing grave harm to the public. Despite treatment efforts, he remains resistant to improvement, and so there remains a need to continue to develop his treatment and supervision approach.

37Mr. Firman's substance use history, particularly the impact of crack cocaine on his behaviour and the ongoing challenges related to his treatment remain concerning. Since living in the community, he has been returned to hospital multiple times, and this is over a very short period of time. Psychological assessments indicate that Mr. Firman also exhibits characteristics consistent with borderline intellectual functioning, which aligns with his persistent academic difficulties. This condition influences his capacity to handle various challenges successfully. Combined these factors result in his impulsivity, emotional volatility, and limited cognitive control over his immediate reactions, all contributing to his overall mental instability, all of which puts public safety at a considerable risk of harm. On that basis, we conclude that Mr. Firman meets the threshold for a finding of ‘significant threat’.

(b) Significant Increases in Restrictions on Liberty

38The authority to increase the restrictions on the liberty interests of a person found not criminally responsible due to a mental disorder is delegated to the person in charge of the hospital, pursuant to section 672.56(1) of the Criminal Code. This authority is not unrestrained and hospital decisions to increase restrictions on the liberty interests of detained persons under the Board’s authority are subject to review.

39The Ontario Court of Appeal outlined in Campbell (Re), 2018 ONCA 140 that hospitals must make certain to stay within “… an envelope set with the major preoccupation of liberty in mind and the utmost liberty compatible” given all the circumstances. When hospitals decide to restrict the liberty interests or ‘liberty norm’ of an NCR accused, the Board must review that decision and determine whether it was necessary and appropriate. To achieve these ends, there are two steps the Board must keep in mind in its approach. First, the assessment of the liberty status before the increase in restrictions, and second, the liberty status after the restrictions were imposed. The test to be applied to significant increases in the restriction of liberty is the same as that required for dispositions, whether the restriction was necessary and appropriate, considering issues of public safety, while protecting individual liberty rights.

(c) Application of the Test

40In addition to Dr. Benassi’s testimony, we have considered all of the evidence contained in the Restriction of Liberty Report, the detailed notes regarding the readmissions to hospital, and in particular, the summaries of staff who directly engaged in the care of Mr. Firman during the restrictive periods under review.

41Mr. Firman’s privilege level in the community, living at the Dowling Residence (transitional housing), was the highest liberty norm he was able to obtain since the finding of ‘not criminally responsible’. The housing program provided meals and medication monitoring, and he could also access the community for recreational, counselling or educational purposes. When both restrictive periods under review were initiated, and the decision was made to readmit him to hospital, his privilege levels were dropped to the lowest privilege level available to him under his disposition (access to hospital grounds, escorted by staff), so, the decisions to increase restrictions on Mr. Firman’s liberty interests was significant for both periods (initiated respectively on October 24 and subsequently on November 22, 2024) here under review.

42The reason he was readmitted to hospital on October 24 was because he had resumed his cannabis use, which was confirmed by his drug tests. He was readmitted as part of his ‘harm reduction’ strategy. Notably, he displayed no signs of mental deterioration, mood swings, or aggressive behaviour, and he complied fully with the reporting and monitoring protocols, which ended the initial October restrictions on his liberty interests, as it was no longer necessary and accordingly, he was returned to his Dowling Residence apartment. Mr. Firman was made aware of the conditions and expectations set for him, which included a commitment to refrain from using other substances and continue with the ‘harm reduction’ strategy applied to cannabis use.

43During that period, he claimed not to have used any additional substances, even though the evidence indicated otherwise. Following that, Mr. Firman began providing false urine samples, which he had not done in a long time, and he resumed using crack cocaine shortly after discharge, resulting in his readmission on November 22. This was Mr. Firman's third admission in the past four months. He submitted urine samples that were notably diluted. He admitted to using cannabis but denied using any other substances. While hospitalized, he ultimately admitted to using crack cocaine while he was living in the community – a decision he made impulsively without considering the impacts. He found it difficult to articulate his reasoning further and expressed a desire to stop using crack cocaine, recognizing its seriousness and negative effects. He continued to test positive for cocaine metabolites until November 29, and his latest sample on December 3, 2024, showed continuous cannabis use (even while detained in hospital). Given these concerns, it has been determined that he is not yet ready for more advanced privilege passes because his engagement with the treatment team regarding programming expectations has been lacking. It is hoped that he will start substance abuse counselling moving forward. Given the circumstances, he is currently detained in the hospital, as it is necessary for him to be there at this time to understand the expectations and to actively engage in the rehabilitation process. His behaviour continues to be a concern as his progress continues to be monitored.

44Overall, Mr. Firman has been unreliable about reporting his substance use and has provided diluted urine samples to avoid detection, complicating addiction counseling efforts. His statements about wanting to abstain from substance use have been inconsistent, sometimes appearing motivated by a desire for freedom.

45Socially, Mr. Firman experiences significant isolation, maintaining only a few close relationships beyond family. He has shown hesitation towards committing to rehabilitative efforts and counseling programs, which further exacerbates his social detachment and lack of stability in life. Moreover, Mr. Firman struggles with a lack of insight regarding his psychotic condition and the importance of medication in managing his symptoms. While he occasionally recognizes the negative effects of cannabis and crack cocaine on his mental health, this awareness is not consistent. Compounding these issues are his longstanding anger management challenges and antisocial tendencies, along with his developmental deficits, ultimately contributing to his current difficulties, overall instability, and declining recovery process.

46We acknowledge that CAMH gave notice of the liberty restrictions to the Board, and in doing so recognized the serious implications its decisions had on Mr. Firman’s liberty interests. Its decision leading to increases in restrictions on Mr. Firman’s liberties was significant, and we acknowledge that it was according to the guiding legal authorities, while following its procedural policies – all of which was done in Mr. Firman’s case. For both restriction periods, we conclude that the Hospital’s decisions were reasonable given all the circumstances, and it was so for the reasons it was initiated, and for its duration, because of Mr. Firman’s relapse into substance use, putting others at risk of serious physical, and psychological harm. Both restrictive periods were necessary and appropriate to ensure public safety, and the ongoing restriction of his liberty interests continues to be necessary until such time that Mr. Firman can be safely reintegrated back to supervised community living.

(d) Necessary and Appropriate

47The plan of care in place for Mr. Firman appears to be a tailored one, but it does not yet fully address his current level of threat to the safety of others, as demonstrated by his continued relapse into cannabis and crack cocaine use, and readmissions to hospital as a result. His psychiatric treatment and care involves constant supervision, evaluation, and adjustment to manage his risk level. Without the forensic treatment team, their interventions and support – Mr. Firman’s recovery path would most certainly decline even further. He continues to require the appropriate level of supervision and treatment at this time, which is not viable in a community living environment, even with the residence supervision at the Dowling Residence.

48Notably, the forensic treatment team is crucial in helping Mr. Firman achieve more stability and progress in his recovery and rehabilitative process, which comes with the continuous challenge of his relapses into consistent cannabis and the recent crack cocaine use. It is very concerning that he has not been honest with his teams about his urine testing and substance use. This attitude continues even though he is continuously offered a variety of alternatives, and activities and programs – he refuses to participate in anything offered to him. He requires constant and regular prompting to attend substance abuse counselling. Without this assistance, given that Mr. Firman has a history of non-adherence with medication and habitual drug use, the treatment teams have had to resort to quick interventions by readmissions to hospital, while trying to help his path to recovery.

49We acknowledge that Mr. Firman requires the supervisory level currently provided by the hospital environment. In all the circumstances we conclude that he could not be safely managed otherwise. Notwithstanding, it remains to be seen if Mr. Firman is able to make some progress moving forward and achieve more stability in the upcoming year. He is currently in the hospital setting, and this placement is necessary and appropriate, considering the extensive range of programs and activities available to him. We conclude on the evidence before us that the most necessary and appropriate disposition for Mr. Firman is to continue his recovery process under the supervision and authority of the Ontario Review Board, in accordance with a Detention Order, at this time.