Ontario Review Board
Re: Milton Britton
ORB File No: 7885
Hearing held on: Monday, October 6, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks Members: Dr. L.E. Cappe Dr. C. Rose Hon. C. Nelson Mr. J. Cyr
Parties Appearing:
Accused: Milton Britton Counsel: Mr. J. Berman
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. A. Stanford
REASONS FOR DISPOSITION
(Dated October 29, 2025)
Introduction:
On May 4, 2021, Mr. Milton Britton was found not criminally responsible on account of mental disorder (“NCR”), on charges of assault (x2), assault with a weapon (x2), assault causing bodily harm, assault police officer, mischief under, and aggravated assault, all contrary to the Criminal Code of Canada ("Criminal Code").
Mr. Britton is currently subject to a Disposition of the Ontario Review Board (the “ORB” or “Board”) dated October 2, 2024, which detains him at the General Forensic Unit of the Centre for Addiction and Mental Health, Toronto (“CAMH” or the “Hospital”), with privileges up to and including to live in the community of the Greater Toronto Area in accommodation approved by the person in charge.
On October 6, 2025, a hearing was convened at CAMH to review that Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Britton was in attendance at his hearing and was represented by counsel, Mr. Berman.
The issue for consideration at the hearing was whether or not Mr. Britton is a significant threat to public safety as defined in s. 672.54 of the Criminal Code; and if so, a determination of the necessary and appropriate Disposition in the circumstances, bearing in mind the factors identified in s. 672.54 of the Criminal Code.
For the reasons that follow, the Board finds that Mr. Britton continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition is a continuation of his existing Detention Order subject to the removal of paragraph 4(a) thereof relating to the testing of Mr. Britton’s urine and/or breath for the presence of alcohol, drugs or any other intoxicant.
Initial Position of the Parties:
At the outset of the hearing, the parties were canvassed as to their initial recommendations to the Board.
Counsel for the hospital recommended that Mr. Britton continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition was a continuation of his existing Detention Order.
Counsel for the Attorney General was in support of the hospital’s recommendations.
Counsel for Mr. Britton conceded the issue of significant threat for the purpose of the hearing and supported the present current Detention Disposition with no changes.
All parties maintained their joint recommendation in closing submissions.
Current Psychiatric Diagnoses:
- Mr. Britton’s current diagnoses are Schizophrenia and Autism Spectrum Disorder.
Index Offences:
- The circumstances giving rise to the index offences are abstracted from last year's Board Reasons dated October 21, 2024, as follows:
“Mr. Britton was residing with is parents at the time of the index offences. He was noted to have a history of schizophrenia, and was on medications, though he had not been doing well over the past few days. His parents were concerned and decided to bring him to hospital. They informed Mr. Britton of this decision, and he became upset, kicking his father in the leg. His father told him not to hit him, and Mr. Britton began punching his father in the face and head. They moved to the living room, and Mr. Britton continued to assault his father. His mother was pushed to the ground and called 911 as this was happening. Mr. Britton and his father’s struggle continued into the kitchen, where Mr. Britton picked up a glass coffee pot and hurled it at his father. The coffee pot broke. Mr. Britton then obtained a knife from the kitchen drawer. His father attempted to disarm him and was cut across the right forearm. He began to bleed and fled. Mr. Britton’s mother was lying on the ground, calling 911. Mr. Britton grabbed the phone from her and smashed it. He then punched and kicked his mother, who was lying on the ground. His father returned and did what he could to stop Mr. Britton, who continued to assault his mother. He assisted Mr. Britton’s mother to her feet and they went to the hallway, where security was present due to a noise complaint. Mr. Britton followed his parents out of the apartment, still punching his mother in the face and the head. When he saw the security guard, he smiled and returned to the apartment. Officers arrived, and arrested Mr. Britton, who stated, “God made me do this… my parents are possessed.”
Mr. Britton was transported to 53 Division. There, he kicked at the officers while handcuffed. An officer attempted to calm him down and stood in front of him. Mr. Britton kicked at him twice, hitting him in the shin.
Mr. Britton’s father suffered a 5-inch cut to his right forearm and a separated tendon, requiring surgery and causing substantial blood loss. He also suffered an orbital bone fracture, needed 3 stitches in his left eye and had a swollen left eye, a cut to his right eye, and a swollen mouth and lip. His mother had a swollen right eye, a bruised left forehead, an intracranial bleed, and right arm pain. The officer had swelling and bruising to his left shin."
Background Information:
The Hospital Report dated September 12, 2025 (the “Hospital Report”) provides a detailed account of Mr. Britton’s history and background and need not be repeated here as it was entered as an Exhibit at the hearing. We note the following material highlights: Mr. Britton is a 52-year-old man whose family originated from Guyana. He immigrated to Canada with his parents at the age of two. He did not complete high school and qualified for the Ontario Disability Support Program at the age of 16. He has always resided with his parents and younger brother in a Toronto apartment.
Mr. Britton’s first psychiatric admission was to The Hospital for Sick Children in May 1985, at the age of 12. Mr. Britton’s parents reported that the onset of symptoms was quite sudden. He reported auditory hallucinations and was preoccupied with the Bible, reading it daily. The school board had assessed his intelligence and academic abilities, and he was deemed “above average overall intelligence.” At the time of his discharge from hospital in August 1985, his diagnosis was schizophrenia.
Mr. Britton’s parents reported that he was hospitalized for psychiatric reasons three times as an adult. One admission occurred after he discontinued his medications, in favour of natural remedies. He rapidly decompensated, and his parents brought him to hospital. By 2009, Mr. Britton was experiencing worsening psychotic symptoms, including auditory hallucinations, paranoia and religious delusions. At the time, he believed his parents were possessed by evil spirits, and that his mother was the devil.
Mr. Britton had no criminal record and no history of problematic alcohol or substance use.
Following the finding of NCR, Mr. Britton was admitted to CAMH on May 24, 2021 from Toronto South Detention Centre. He consented to a trial of clozapine and was referred for Cognitive Behavioural Therapy (“CBT”) for psychosis. He was compliant with all medications. He disagreed that the medications could resolve his symptoms, but he acknowledged that they helped manage his distress and anxiety over his symptoms.
CBT did not result in any improvement and was discontinued upon the agreement of Mr. Britton and the psychologist. Mr. Britton continued to experience religious delusions and preoccupations and a fear of “going to hell.” He has, however, been able to use passes into the community indirectly supervised and has not presented any management concerns.
Evidence at the Hearing:
The Hospital Report was co-authored by Dr. K. Valoo, Mr. Britton’s attending psychiatrist since May 2025. Dr. Valoo adopted the contents of the Hospital Report and advised there were no material updates thereto.
Mr. Britton has remained detained on the general forensic LGUA over the past reporting year.
Dr. Valoo advised that Mr. Britton is treatment capable and the mainstay of his treatment is the antipsychotic medication, Clozapine. Despite adherence to this treatment within the structured environment of the hospital, Mr. Britton continues to experience residual symptoms of psychosis on an intermittent basis. The Hospital Report indicates that his delusions were of “…religious and persecutory themes, such as that he was condemned, and would be going to hell for his sins, that his mother was the Devil, and that he would spread “demons” to others. These delusional, beliefs, intern resulted in significant anxiety, including panic attacks.”
The Hospital Report indicates that Mr. Britton’s delusions caused him significant distress and anxiety. At times, he would engage in maladaptive coping mechanisms such as seeking reassurance, pouring out salt to ward off demons, preaching to individuals around him, pouring water on himself, repeatedly checking his heart rate, or lying on the floor for long periods of time. Although he intermittently endorsed hearing the voice of God, no command hallucinations were reported. He consistently denied suicidal, violent, or AWOL ideations, intentions, or plans.
A trial of sertraline to address Mr. Britton’s anxiety yielded some improvements and he remains on this medication.
At his own request, in June 2025, his Clozapine medication was reduced by 25 mg to mitigate possible OCD symptoms, though this did not result in any apparent benefit. Mr. Britton’s anxiety was further assessed, leading to a potential diagnosis of panic disorder. Pregabalin was started to manage his panic attacks and possible OCD symptoms, with good effect. Mr. Britton reported reductions in the frequency and severity of panic attacks over the summer months. As noted in the Hospital Report, it is sometimes difficult to delineate anxiety symptoms from symptoms of psychosis.
In October 2024, Mr. Britton completed an assessment with the Adult Neurodevelopmental Service (“ANS)” and this resulted in a new diagnosis of Autism Spectrum Disorder. Mr. Britton has been referred for Cognitive Behavioural Therapy for OCD through the ANS but he remains on the waitlist for this program. Further, an application for Disability Support Ontario has been submitted to secure Passport Funding for him. The doctor advised that if secured, Passport Funding might be used to hire a Passport worker to provide social supports to Mr. Britton for a wide variety of activities. Dr. Valoo stated that this new diagnosis has not changed the team’s management of his care.
Because of his ongoing residual symptoms and his experience of anxiety, Mr. Britton refused to leave the unit to exercise passes from approximately October to December 2024. He eventually worked with a behavioural support specialist, and with the assistance of high levels of staff support, he began to exercise off-unit privileges. Over the next several months, his pass utilization gradually improved, and as at the hearing date, Mr. Britton is able to exercise independent use of level 8 passes. Over the summer of 2025, he began using accompanied passes to attend church on Sundays and to access local shopping malls independently.
As stated, some of Mr. Britton’s ongoing residual symptoms relate to paranoia about his parents. Despite this, he was successful in maintaining contact with them, and at times would use passes to visit them at their home. He typically saw them every few weeks, and most of these visits were positive and without incident. Dr. Valoo advised that Mr. Britton’s parents are supportive and prosocial influences on Mr. Britton and they remain in contact with the treatment team.
Dr. Valoo advised that Mr. Britton’s insight into his illness, need for treatment, and risk of violence remains quite limited. He is able to acknowledge that his psychiatric medications and professional supports have assisted him.
In terms of his eventual transition to community living, the Hospital Report indicates Mr. Britton was deemed to be at Alternate Level of Care in April 2023. This designation is indicative of his readiness for discharge to community living. The treatment team is of the opinion that Mr. Britton will likely require high support 24/7 community accommodation; however, Dr. Valoo stated that given the paucity of housing vacancies and the prolonged stability of Mr. Britton’s mental status, it may be that the team accepts a somewhat lesser degree of staff oversight but that will be carefully assessed at the appropriate time.
Several applications to high-support community housing providers have been submitted but Mr. Britton has not yet been accepted to any of these facilities. The doctor advised that applications for housing vacancies will continue to be submitted by the team on Mr. Britton’s behalf.
The doctor testified that the team will continue to work with Mr. Britton to assist in his presentation so that he may be considered as a desirable candidate for other housing opportunities. In this regard, they continue to encourage him to attend to his personal adult daily living skills, such as his hygiene and his laundry.
Dr. Valoo testified that a Detention Order Disposition continues to be the necessary and appropriate to Disposition is it affords the hospital with two critical risk management tools. Firstly, the hospital requires the ongoing authority to approve his community housing to ensure that it provides him with the necessary degree of support, structure, monitoring and supervision to address his risk factors. Additionally, when unwell, Mr. Britton’s behaviour can become elevated quickly, and the hospital must retain the authority to rapidly readmit him in that context. In the treatment team’s assessment, his risk of violence could become elevated before he would meet criteria for certification under the Mental Health Act (“MHA”).
The Hospital Report states that “… when weighing Mr. Britton’s pertinent risk and protective factors, his risk of any future violence would be Low in the context of a Detention Order with community living. In contrast, should he be granted a Conditional Discharge, his risk of any violence would be Moderate.” The doctor explained that the risk management tools afforded under a Detention Order (being, approval of community housing and rapid readmission under a Warrant of Committal) are the key drivers of the scoring. Dr. Valoo testified that Mr. Britton’s risk is currently well managed through behavioural supports and medication within the structured hospital setting.
In response to a question from a panel member, Dr. Robertson advised that Mr. Britton remains on a waitlist for Cognitive Behavioural Therapy.
No further evidence was called.
Analysis and Conclusions:
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint recommendation that Mr. Britton remains a significant threat to the safety of the public. Moreover, the Board has no difficulty coming to an independent conclusion based on Dr. Valoo’s testimony and documentary evidence available at the hearing that Mr. Britton’s current constellation of symptoms and behaviours support a finding that he continues to pose a significant threat to the safety of the public, as defined by the Supreme Court of Canada in Winko.
Mr. Britton has partial, fluctuating insight into his illness, which is directly related to his risk of violence. He continues to experience residual symptoms of his major mental disorder.
At the time of the index offences, he engaged in serious violence towards his parents and police officers when experiencing symptoms of psychosis. He has continued to experience residual psychotic symptoms despite treatment with antipsychotic medication. We note also that Mr. Britton’s risk is further exacerbated when he experiences increased stress.
In coming to our conclusion, we are also mindful of the Re-offence Scenario set out in the Hospital Report:
“If Mr. Britton is to reoffend, it will likely transpire in the following way: in the context of in adequate supervision and support, Mr. Britton will become compliant with his medications due to either his poor insight or his difficulty with his activities of daily living. He would develop the floor and an enduring symptoms of psychosis, which in case, are largely religious delusions and command hallucinations that he interprets as God’s voice. Under stress, his religious delusions and command hallucinations would lead to increased reactive, hostility, and a proclivity toward violent behavior. He would then be at acute risk of engaging in disorganized violence.”
Having come to a finding of significant threat, we must determine the necessary and appropriate, as well as least onerous, and least restrictive Disposition. It is clear to the panel that Mr. Britton his demonstrated progress over the year in review. He has worked closely with the hospital’s behavioural therapist, occupational therapist and the social work team to incorporate coping strategies to manage his experience of stressors. Additionally, his treatment has been augmented by anti-anxiety medication to assist him.
The goal for the upcoming reporting year is to transition Mr. Britton into an appropriate high-support community residence. For the reasons identified in paragraph 32 above, a Detention Order remains the necessary and appropriate Disposition to address Mr. Britton’s risk profile. The hospital must be in a position to approve his community housing to ensure that he is adequately supported, and closely supervised. Additionally, should Mr. Britton experience any decompensation in his mental state, whether as a result of breakthrough symptoms, medication noncompliance, increased stressors or otherwise, his behaviour would be highly likely to become dysregulated, thereby heightening his risk to the safety of the public. In that context, his risk of violence would become elevated prior to his certifiability under the MHA. For all of these reasons, a less restrictive Conditional Discharge Disposition is premature at this juncture.
For all of these reasons, we concur with the joint recommendation of the parties and find that Mr. Britton’s existing Disposition remains necessary and appropriate with one amendment being the removal of paragraph 4(a) thereof relating to the testing of Mr. Britton’s urine and/or breath for the presence of alcohol, drugs or any other intoxicant. Based on the expert evidence before us, Mr. Britton does not have a history of problematic alcohol or substance use and the doctor opined he was at low risk of future use of such substances. In our assessment, the inclusion of the testing provision is not necessary or appropriate, nor is it least restrictive or least onerous and for that reason it should be removed from his Disposition.
In making our decision, we have carefully considered of all the evidence, the submissions of the parties, and the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Britton, his reintegration into society and his other needs.
DATED this 29th day of October, 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar Ontario Review Board