Ontario Review Board

Re: Alexander J. King

ORB File No: 7897

Hearing held on: Thursday, September 4, 2025

Place of Hearing: Brockville Mental Health Centre

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. P. Capelle

Members: Dr. R. Kunjukrishnan

Dr. W. Loza

Ms. M. den Haan

Ms. R. MacIntyre

Parties Appearing:

Accused: Alexander J. King Counsel: Mr. M. Bird

Person in charge of the Hospital: Representative Dr. A. Adiele

Attorney-General of Ontario: Counsel: Mr. A. Findlay

REASONS FOR DISPOSITION

(Dated October 14, 2025)

Initial Positions of the Parties

1. On May 25, 2021, the accused, Alexander J. King, was found not criminally responsible on account of mental disorder on two counts of assaulting a peace officer, contrary to the Criminal Code of Canada. Mr. King is currently subject to a disposition of the Ontario Review Board dated September 4, 2024, which detains him at the secure forensic unit of the Brockville Mental Health Centre with privileges up to and including to live in the community in accommodation approved by the person in charge.

2. On September 4th, 2025, the Ontario Review Board convened a hearing at the Brockville Mental Health Centre, hereinafter referred to as “the Hospital” to conduct Mr. King’s annual review hearing.

3. Mr. King attended the hearing and was represented by counsel, Mr. Michael Bird. A Hospital Report dated August 14th, 2025, was filed as Exhibit 1 at the hearing.

Without Prejudice Position of the Parties

4. Dr. Adiele advised that the Hospital was seeking a renewal of the existing detention disposition without changes. Mr. Findlay indicated that he might ask to have subparagraph 2(h), the entitlement to reside in the community removed. Mr. Bird advised that he supported the Hospital recommendation.

Index Offences

5. The circumstances of the index offences can be summarized as follows:

“According to the police report, on 8-September-2019 at approximately 21:35hrs, Mr. Alexander King assaulted Ms. Idile Ibrahim as she was walking away with a punch to the back of her head. Ms. Chantal Marcano confronted Mr. Alexander King regarding the assault and Mr. Alexander King punched Ms. Chantal Marcano in the face as well. The police were contacted, upon their arrival and investigation, Mr. Alexander King was taken into custody at his apartment. During the arrest and transportation to Central Cells, the police noted Mr. Alexander King was calm but became agitated and made statements that did not make sense. He was cooperative, not violent, not prescribed medication and uses marijuana. Mr. Alexander King stated to the police that “he is always depressed and suicidal”.

Once at Central Cells, the during the search process, Mr. Alexander King punched a Special Constable in the face. The police recommended Mr. Alexander King remain in custody.

On 15-November-2019, while in custody at the Ottawa-Carleton Detention Centre, Mr. Alexander King “was showing signs of extreme mental health following an attempted strip search that caused him to be grounded by staff”. Mr. Alexander King was examined by the Registered Nurse and was found to have cuts and scrapes to his forehead and back area. Mr. Alexander King remained uncooperative and refused to be cuffed through the metal hatch. As a result, Mr. Alexander King was removed from his cell where staff attempted to photograph him. Two of the Correctional Officers assisting with the process were punched in the face without provocation by Mr. Alexander King. Mr. Alexander King was grounded and returned to his cell.”

Current Diagnoses

• Schizophrenia

• Cannabis use disorder, Moderate (abstinent while in a restricted environment)

• Borderline personality disorder

Evidence

6. The Board admitted into evidence the Hospital Report dated August 14th, 2025 (Exhibit 1). The document provides a great deal of information concerning Mr. King’s personal history, mental health history as well as his course in Hospital and in the community both prior to and subsequence to the index offences. As the Hospital Report was made an Exhibit, it is unnecessary to reproduce the information contained therein in these Reasons.

7. Mr. King’s medication was changed from haloperidol as he stated that it made him nauseous. Additionally, there were concerns that Mr. King was either cheeking or vomiting following ingestion of Haloperidol tablets. In July of 2025, with the agreement of Mr. King’s SDM (his mother), he is now being treated with 400mgs daily of Seroquel (crushed to ensure compliance) together with Sodium valproate. His mother has been cooperative with the treatment team and easy to reach when requesting medication adjustments. Dr. Adiele noted that Mr. King was unwell during his medication transition.

8. In the hours prior to this hearing, Mr. King was observed by staff laughing to himself. Dr. Adiele opined that it may be indicative that he is responding to unseen stimuli, experiencing psychotic symptoms.

9. Over the past reporting year Mr. King has engaged in minimal programming. Ongoing incidents of verbal aggression are set out at pages 75 and 76 of the Hospital Report. He remains on probation through to the fall of 2028 due to his assault on his previous treating psychiatrist at the ROMHC. At the time of the assault, he was receiving an injectable antipsychotic which he was able to refuse during the six months he spent in jail.

10. Responding to questions from Mr. Findlay, Dr. Adiele advised that Mr. King’s insight remains suboptimal. His recent medication compliance is indicative of a degree of insight. However, in the week preceding this hearing, he requested a dose reduction of his prescribed Seroquel.

11. Since admission Mr. King has kept his word that he would not assault staff. Nevertheless, intimidation incidents continue vis-à-vis female staff. Mr. King remains at a high risk for violence in the community as described in Psychologist Allison Leeming’s July 28, 2025, risk assessment. Further, Mr. King suffers from a personality disorder which also can constitute a risk factor for violence.

12. Mr. Bird inquired whether community placement may be realistic over the next 12 months. Dr. Adiele responded that this is dependent on continued medication compliance, engagement in programming, abstinence from substances and mental stability. Dr. Adiele agreed that some improvement in Mr. King’s mental state has been noted since being provided with an augmented dose of Seroquel in crushed form.

13. Mr. King was able to find and maintain employment at Tim Horton’s for a number of weeks in the first half of this past reporting year. He left that position as he felt threatened by a co-worker. Mr. King very much wants to work but his preference is to work in the community rather than to engage in vocational employment through the Hospital which is not as well paid.

14. Responding to questions from the panel, Dr. Adiele advised that at the time of his admission to the BMHC from jail Mr. King was being treated with risperidone and insisted on changing to haloperidol, which he had received in the past.

15. Dr. Adiele advised that long-term medication compliance in the community will require an augmentation of insight which will drive Mr. King to willingly take his medications. Dr. Adiele added his patient is needle phobic and therefore does not want to receive a long-acting injectable.

16. Reference was made to the fact that three-quarters of the documented violent incidents occurred from May to July of 2025. Dr. Adiele responded that this was during the time that Mr. King’s medications were being changed. He added that his patient has been on the current dosage of Seroquel and Sodium valproate for the past two months which has helped to mitigate the number of incidents. Asked if individual counselling may be available to stimulate his involvement in therapeutic groups, Dr. Adiele responded that Mr. King does not suffer from any intellectual disability that would necessitate individual counselling.

17. Responding to questions from another panellist, Dr. Adiele agreed that subparagraphs 2(e), (f) and (g) should be amended by increasing the radius to 250 kilometres, with a stipulation of “within Ontario”.

18. Mr. King’s treatment capacity was last assessed at the time of his medication transition in June of 2025. It is anticipated that he will be reassessed in this regard when he is more stable.

19. Mr. Findlay clarified that Mr. King’s conditional sentence ended in August 2025 and that it is not anticipated that the terms of Mr. King’s Probation Order, which continues to August 2028, will preclude any type of community living.

Closing Submissions

20. Dr. Adiele advised he had nothing to add but for the possibility to live in the community should remain so as to motivate Mr. King.

21. Mr. Findlay submitted that the evidence heard at this hearing is more optimistic than what is contained in the Hospital report. The greater insight described by Dr. Adiele is quite recent. The contents of the Hospital report contain a number of red flags and concerns. Mr. King has shown a recent history of unpredictable violence, problems with insight as well as verbal aggression in Hospital causing staff to have concerns about their safety. Notwithstanding the recent change of medications, breakthrough symptoms have been seen within the last 24 hours. Mr. Findlay further submitted that employment outside of Hospital is an incentive that can be worked towards this upcoming reporting year. He concluded that community living is unrealistic and unwise in the year ahead.

22. Mr. Bird submitted that giving hope could have a rehabilitative impact. He noted Mr. King’s major progress in the past 8 weeks associated with a change in medication and stark decline in reported incidents.

Analysis and Decision

23. Ongoing significant threat to the safety of the public cannot be speculative. It must entail a real risk of serious physical or psychological harm arising from a criminal offence.

24. In determining whether Mr. King represents a significant threat to the safety of the public the Board has carefully analysed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.

25. The ongoing presence of significant threat was not contested. Nevertheless, the panel carefully deliberated the issue prior to arriving at its determination. Information contained under the Conceptualization of Risk heading at pages 87-89 of the Hospital report, authored by Psychologist Allison Leeming, sets out the Hospital’s rationale in this regard. It provides a well-organized account as to why Mr. King’s elevated risk to public safety is ever present. The two paragraph summary. reproduced below for ease of reference encapsulates this patient’s risk as well as protective factors:

In sum, dynamic factors affecting risk in this case are personality structure, positive symptoms of psychosis, substance use (via its destabilization of psychotic symptoms and disinhibiting effects), insight into mental illness and violence risk, treatment non-adherence contributing to mental decompensation (and exacerbated by poor insight into need for treatment), violent ideation including possible violent attitudes against women, and lack of pro-social supports. Warning signs for increased violence risk may include cognitive disorganization, expressions of violent ideation, evidence of active persecutory beliefs, behavioural destabilization and impulsivity, affective lability, and mental decompensation including to responding to internal stimuli.

Protective factors (strengths in this case include a good level of cognitive functioning (especially when not experiencing disorganization secondary to high symptom acuity), a high motivation for employment and vocational skills (in restaurant settings), and parental support from his mother. It would be critical for clinical intervention to target Mr. King's identified dynamic risk factors in order to lower his risk for violence. If placement in the community were to be considered, a high degree of structured support (both personal and professional) including consistent treatment for mental disorder and abstinence from substances would be crucial for preventing recidivism.

26. Given the foregoing, the panel accepts Mr. Findlay’s closing submission that Dr. Adiele’s testimony puts forth a more optimistic perspective than does the Hospital Report, particularly the findings contained within the Conceptualization of Risk heading.

27. By July 2025, precipitated by concerns that Mr. King was cheeking and/or vomiting following ingestion of Haloperidol tablets, his psychotropic medications had been transitioned to a daily 400mg. dose of crushed Seroquel to augment the likelihood of compliance together with Sodium valproate Notwithstanding these changes staff observed Mr. King laughing to himself in the hours preceding this early afternoon hearing. Dr. Adiele described this presentation as indicative of active psychotic symptoms.

28. Dr. Adiele referenced the Hospital Report as corroborative of his statement that three-quarters of documented incidents relating to Mr. King took place from May to July when he was being tapered off Haloperidol and his dosage of Seroquel was titrated to its current dosage. Further, that this change of psychotropic medications has succeeded in reducing the number of documented incidents. The panel notes that the positive tone of Dr. Adiele’s testimony vis-à-vis Mr. King’s recent presentation, does not align with that of Ms. Leeming who states in part at page 88 of the Hospital:

As Mr. King is currently in a period of mental decompensation characterized by acute positive symptoms of schizophrenia, his risk of violent behaviour in the imminent future is likely higher than usual.

29. The panel accepts Mr. Bird’s submission that the possibility of community living is a motivational element that may also serve as a rehabilitative driver. That provision will therefore remain within his disposition for 2025-2026. However, given Mr. King’s presentation to date, if community living is to occur, the Panel foresees that it will only take place towards the end of the reporting year. In the interim, we hope that Mr. King will actively engage in programming and pursue vocational or community employment as he works towards the privilege of again residing in the community.

Conclusion

30. Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. King poses to the safety of the public while still meeting his needs, remains a Detention Disposition with the change as noted in the formal Disposition.

31. In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Adiele and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. King’s mental condition, his reintegration into society and other needs.

DATED this 14th day of October, 2025, at the City of Toronto, in the Toronto Region.

Mr. P. Capelle

Alternate Chairperson

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Office of the Registrar Ontario Review Board