Re: B. (D.)
ORB File No: 8465
Hearing held on: Thursday, April 3, 2025
Place of hearing: Brockville Mental Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. T. Mann
Members: Dr. R. Kunjukrishnan Dr. A. Gibas Ms. M. den Haan Mr. M. Hajek
Parties Appearing:
Accused: B. (D.) Counsel: Ms. E. Warren
The person in charge of hospital: Representative: Dr. A. Adiele
Attorney General of Ontario: Counsel: Mr. K. Schultz
REASONS FOR DISPOSITION
(Dated May 27, 2025)
Introduction:
On January 12, 2024, the accused, B. (D.), was found not criminally responsible (“NCR”) on account of mental disorder, on charges of sexual assault and commit an indecent act, both contrary to the Criminal Code of Canada. B. (D.) is currently subject to a disposition of the Ontario Review Board dated April 23, 2024 which detains him at the secure forensic unit of the Brockville Mental Health Centre (the “Hospital”) with privileges up to and including to live in the community of Eastern Ontario in accommodation approved by the person in charge.
On April 3, 2025, the Board convened a hearing at the Brockville Mental Health Centre to conduct B. (D.)’s annual review hearing pursuant to section 672.81(1) of the Criminal Code. B. (D.) was present at the hearing and represented by counsel, Ms. E. Warren.
The issues to be determined at the hearing were whether B. (D.) continues to represent a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, the necessary and appropriate Disposition which is also the least restrictive and least onerous taking into account the factors set out in section 672.54 of the Criminal Code. B. (D.) also requested a transfer to the Royal Ottawa Mental Health Centre (the “Royal Ottawa”) pursuant to a Rule 13 Notice.
The following documents were entered as Exhibits at the hearing:
(1) Hospital Report dated March 6, 2025
(2) CPIC Report dated March 17, 2025
(3) Rule 13 Request to the Royal Ottawa dated March 28, 2025
(4) Rule 13 Response from the Royal Ottawa dated March 30, 2025
Positions of the Parties:
On behalf of the Hospital, Dr. Adiele recommended a continuation of the existing Detention Disposition with the addition of passes up to seven days into the community, indirectly supervised. Dr. Adiele explained that the reason for the addition is to allow B. (D.) the ability to spend overnight visits with his family in Ottawa if he is clinically stable. The Hospital supported B. (D.)’s request to transfer to the Royal Ottawa to be closer to his family.
Counsel for the Attorney General supported the Hospital’s recommendation of an amendment to the current Disposition but reserved its position on the Rule 13 transfer pending evidence from the Hospital.
Counsel for B. (D.) conceded the issue of significant threat for the purposes of the hearing and supported the position of the Hospital with respect to the Disposition and amendment. She emphasized B. (D.)’s desire to reside closer to his family in Ottawa.
By the conclusion of the hearing, counsel for B. (D.) indicated that they were no longer pursuing the Rule 13 transfer to the Royal Ottawa, and therefore the panel was presented with a joint submission.
For the reasons set out below and based on the expert evidence and opinions before it, the Board concludes independently that B. (D.) presents a significant threat to the safety of the public. The Board finds that his risk can be properly managed with continuation of the existing Detention Order with the addition of seven day passes as set out in our formal Disposition. The Board concluded that the above is the necessary, and appropriate, Disposition in the circumstances.
Index Offences:
- The circumstances giving rise to the Index Offences are extracted from the Hospital Report, as follows:
“September 03, 2022 - Sexual assault
According to the Crown Brief Synopsis, on this date at about 7:30 AM, the victim … was in the Parliament Transit Station looking for maps when B. (D.) tried to speak to her. She could not understand what B. (D.) was saying, and she tried to ignore him. The victim took the Light Rail Transit (LRT) to Tunney’s Pasture, and B. (D.) followed and sat in front of her. B. (D.) continued speaking to her or in her direction, and he was making eye contact. The victim got off the LRT and went into an elevator, and B. (D.) followed suit. An unknown part was in the elevator with them. When the door closed, B. (D.) slapped the victim’s buttocks, which the victim described as “firm and intentional.” She told him “don’t do that.” All parties exited the elevator and walked outside the station while B. (D.) continued saying things to her that she could not decipher. The victim walked to her workplace and noted that B. (D.) was immediately behind her. She entered the building and noticed that he was still outside the building. As such, the victim called police, and officers attended and located him a short distance away. The victim confirmed with officers that they had the correct individual.
October 25, 2023 - Commit an indecent act with intent or insult or offend another (two counts)
According to the Crown Brief Synopsis, on this date at about 7:45 AM, B. (D.) was in the Starbucks located in Orleans. He initially followed a female to her place of work, a dental clinic, as he made moaning and groaning sounds behind her. A witness heard B. (D.) mumbling, and also observed him with his hand in a blue bag down the front of his pants. B. (D.) followed the woman into the dental clinic, and he continued to mumble to himself and also hit himself in the head. As he exited the clinic, the witness observed him to have his right hand down the front of his pants in the groin region, where his hand was moving up and down in a stroking motion. B. (D.) returned to the Starbucks location and sat down at a table, where another witness observed him pleasuring himself in a sexual manner. The witness observed B. (D.) to have his hand in a blue transparent bag down the front of his pants while appearing to grip his penis. His hand was vigorously moving up and down for about eight full motions while his eyes were closed and he was moaning and grunting with pleasure.”
Background Information:
B. (D.)’s background information, psychiatric history, substance abuse history and legal history are set out in detail in the Hospital Report and do not have to be repeated in detail. Briefly, B. (D.) is 22 years old. He is unmarried and has no children. He is the eldest of four children (two sisters aged 18 and 13, and a half-brother aged six).
B. (D.) was born in the Democratic Republic of Congo. After living for three years in Uganda, B. (D.) moved to Winnipeg with his mother and siblings. His father remained in Africa. The family suffered racial abuse in Winnipeg and B. (D.) got most of the abuse, where children used to punch him. This resulted in his mother keeping the children inside to prevent harassment. B. (D.) reported that the family lived in a “rough neighbourhood” in Winnipeg, with “drug needles on the street” and there was “always fighting.” The family then moved to Ottawa in 2017, which B. (D.) did not like due to leaving his friends behind. They initially lived in the shelter housing system in Ottawa until they could find proper accommodations in February 2018.
B. (D.) reported physical and emotional abuse by his mother. B. (D.) was removed from the mother’s home when he was placed in the youth Detention Centre on two instances in 2019 as well as 2021 as discussed below.
B. (D.) moved back home in between the two incarcerations, but his mother reported that he continued to engage in a number of behavioural difficulties while there. Due to the behavioural and ongoing legal issues, B. (D.) was housed at A Different Street through the John Howard Society in 2022 and 2023. B. (D.) stated that he did not like the program and that the other tenants were using drugs, which made it difficult for him to avoid cannabis. He also recalled being asked to leave the program in May 2023 due to not attending the meetings.
Cognitive assessments showed that B. (D.)’s overall cognitive functioning was in the low-average range. The Hospital Report notes that:
“A letter from St. Matthew’s High School dated February 01, 2019, for the purposes of Dr. Adiele’s Section 34 YCJA assessment, outlined B. (D.)’s struggles with peer relationships, response to authority, general behaviour, parental involvement, and school supports. It indicated that B. (D.) often gravitated towards negative peer influences, and that he had “a tendency to find trouble whether it be at school or off-school property.”
In May 2020, B. (D.) was brought to the Children’s Hospital of Eastern Ontario (“CHEO”) by police after experiencing psychotic symptoms, including paranoid and grandiose delusions as well as thought disorganization. In August 2021 B. (D.) was brought to the Ottawa Hospital by police and briefly admitted on a Form 1 due to aggressive behaviour against his family.
On August 15, 2021, B. (D.) was brought to the Ottawa Hospital from the youth Detention Centre:
due to “bizarre behaviour.” It was noted that he had been in custody for about four days, but he could not explain why aside from repeatedly saying his mother was “crazy, bro.” He was also unsure why he was brought to hospital aside from the staff wanting “an easy day of work not having to do much.” Staff informed the psychiatrist that B. (D.) was having a conversation on a phone for about thirty minutes before they noticed there was no one on the other line. The staff were familiar with B. (D.) from when he was previously in custody at the facility two years beforehand, and it was felt that he was “markedly different” from his baseline from his previous presentation. The staff also observed him attending to auditory hallucinations, sleeping no more than two hours each night, and being really energetic.
He had three further psychiatric admissions between September 2021 and late August 2022 after concerning behaviour in public. B. (D.) was homeless for a few months prior to the index offences after his mother evicted him from her home due to his “laziness.”
His current diagnoses are:
Other specified schizophrenia and other psychotic disorder
Cannabis use disorder, moderate, in early remission
Antisocial personality disorder
Substance Use History
B. (D.) reported that he smoked cannabis on a daily basis, estimating about an ounce every two weeks when he was residing at his mother’s home and then his friend’s home. He reported that he rarely smoked cannabis when he was homeless (less than half a gram every few days), spending most of his income on a fitness membership, a basketball, and alcohol. B. (D.) stated that he was consuming “quite a bit” of alcohol but could not quantify this.
B. (D.) said he consumed cocaine perhaps up to once per year. The last time he used was about three weeks before the index offences, where he used four lines. He added that he occasionally consumed mushrooms, and had used 7 grams on two occasions, perhaps a few days before the index offences. He found little effect “aside from making him feel uncomfortable in his own skin” and only used if his friends were influencing him.
Legal History
B. (D.) confirmed that he had two court-ordered mental health assessments pertaining to offences he accrued as an adolescent. He advised that he completed his probation following the youth offences, and that he did not have any subsequent breaches. He felt that his alcohol and drug use at the time were the major causes of his behaviours at that point.
A review of B. (D.)’s CPIC showed that prior to the index offences, his previous offences were as a young offender, and he had no adult offences listed.
Collateral legal history Dr. Adiele’s April 29, 2019 YCJA Section 34 assessment:
- It was reported that B. (D.) was facing the following charges that occurred on September 7 and November 28, 2018:
Robbery/theft with violence or threats of violence (three counts)
Assault with weapon or imitation weapon (three counts)
Possess weapon, etc./for committing an offence (one count)
Carry concealed weapon, etc. (one count)
Uttering threats/death or bodily harm (one count)
Possess/use credit card obtained by offence (one count)
Possess proceeds of property or thing obtained by crime/not exceeding $5000 (one count)
Assault (one count)
Theft not exceeding $5000/General (one count) • Fail to comply with condition of judicial release (one count).
Evidence at the Hearing:
The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. A. Adiele.
Dr. Adiele has known B. (D.) since he was a youth. Dr. Adiele noted that B. (D.) has done very well this reporting year compared to expectations and appears to be motivated to work very hard. Over the past reporting year, B. (D.) has been stable at the Hospital. He asks the doctor what it is that he needs to do in order to progress and accepts any program that is offered. Dr. Adiele noted that B. (D.) has completed more groups since the Hospital Report was written, and B. (D.) attended the Board hearing with laminated certificates of all of the programs that he has completed. He informed the Board that he completed high school the day before the hearing. B. (D.) has expressed interest in attending Algonquin College for post-secondary education in an HVAC program.
Dr. Adiele is of the opinion that B. (D.) is very keen and motivated to progress through the forensic system. Dr. Adiele noted that there have been some inappropriate peer interactions and that there are some individuals at the Hospital who are negative peer influences. There was suspicion that B. (D.) had diverted medications in late 2024, but he said that he did not do so.
Dr. Adiele indicated that there have been no issues of disruptive conduct while in hospital in Brockville when B. (D.) has been well and off substances. In terms of incidents of note during the reporting year, on December 19, 2024, B. (D.) admitted to the treatment team that he had used cannabis although his urine drug screen was negative for cannabis use. Dr. Adiele was pleased that B. (D.) reported using the drug to the team.
On January 13, 2025 B. (D.) tested positive for methamphetamines. There have been no incidents since that time. Prior to the January incident, methamphetamine was not a problem substance for B. (D.). No decompensation in his mental state was noticed, but the urine drug screen was positive for the substance. When asked about it by the treatment team, B. (D.) stated that the drugs were given to him, and he didn't know what the substance was. He said he carried it for a while before he tried it.
In response to questions from the panel, Dr. Adiele confirmed that there were two positive tests for methamphetamine in January and B. (D.) acknowledged that he used drugs. In response to questions from counsel for B. (D.), Dr. Adiele stated that B. (D.) has insight into his mental illness and also has insight into the fact that illegal substances contribute to his illness. B. (D.) has demonstrated an ability to abstain from substance use and has good insight into the need to do so. In Dr. Adiele’s opinion, B. (D.) must be carefully monitored over the next few months with respect to drugs.
B. (D.)’s diagnosis remains uncertain. In Dr. Adiele’s opinion there is no clear indication of bipolar illness, which had been the diagnosis when B. (D.) was first admitted to hospital after the index offences. B. (D.) is no longer taking mood stabilizing medication. Since Lithium was discontinued, there has been no change in B. (D.)’s mental status. Many of his medications have been decreased, and he is also now taking fewer medications than previously with no obvious negative effects. In response to questions from the Crown Attorney, Dr. Adiele noted that he will be requesting a psychodiagnostic assessment to clarify B. (D.)'s diagnosis.
Dr. Adiele anticipates making some further changes to medication in the near future including a decrease in dosage of Quetiapine, as it may have negative sedating effects on B. (D.). The injectable antipsychotic medication is working well for B. (D.). In Dr. Adiele’s opinion, B. (D.) is happy to take his medication, and the symptoms of his illness are well controlled under the current treatment regime.
Dr. Adiele noted that B. (D.) has a close relationship with his family. B. (D.)'s mother supports his treatment in hospital in Brockville. His mother and family live in Ottawa. B. (D.)'s mother has visited him in Brockville, but she finds it difficult to travel from Ottawa. His siblings have not been able to visit, and B. (D.) misses them. Dr. Adiele was unaware if financial support is available for the family to assist with travel to Brockville for visits, but this could be explored with the social work department. The Hospital is requesting the addition of seven day passes to this year’s Disposition in order to allow B. (D.) to have overnight visits with his family when he is ready.
The week prior to the hearing, B. (D.) informed the doctor that he wanted to transfer to Ottawa to be closer to his family. The treatment team had no objection, and a Rule 13 request was sent to the Royal Ottawa Mental Health Centre (the “Royal Ottawa”). Currently, B. (D.) is residing in the second least restrictive unit of the Hospital. The least restrictive unit currently has no bed, but B. (D.) is eligible to move there when there is space. It is also possible to discharge B. (D.) directly from his current unit to supervised accommodation in the community.
A functional assessment including B. (D.)’s ability to handle his finances still needs to be completed. However, Dr. Adiele opines that B. (D.) will be eligible for discharge into the community in supervised housing in six to nine months if he maintains abstinence from substances.
B. (D.) is independent and cooks for himself. Dr. Adiele stated that the plan was originally for B. (D.) to transition into the 8-hour supervised Murray Street residence in Brockville and then to Ottawa as an outpatient. After some time in supervised accommodation, Dr. Adiele anticipates that B. (D.) could live independently in an apartment with visits from the treatment team and urine drug screens. B. (D.) and his family expressed a wish for him to move to the family home.
Some concerns remain with B. (D.)'s mother's understanding of B. (D.)'s illness and the need for medication to manage his illness. A home assessment would need to be done prior to B. (D.) spending overnight visits in the home, and his mother has not yet been assessed for suitability as an approved person. Dr. Adiele indicated that it is possible that B. (D.)’s mother has a culturally influenced view of mental illness and medications and may believe that B. (D.) does not require them. B. (D.), however, is happy with the injectable medication that he currently receives. He is not experiencing side effects from the medication, and it effectively controls his positive symptoms. Further education can be provided to B. (D.)’s mother as required.
During the discussion of the transfer request during the hearing, Dr. Adiele provided evidence that there is a very long wait list for admission to the Royal Ottawa, and that there are patients at the detention centre who are waiting for beds. A transfer to Ottawa therefore could take some time. B. (D.) would also lose privileges if he transferred to Ottawa into the forensic assessment unit. In addition, he might remain longer than required in the assessment unit since transfers between the two units at the Royal Ottawa take some time. Furthermore, Dr. Adiele would likely be unable to remain his treating psychiatrist.
If B. (D.) were to remain in Brockville and be discharged to the Murray Street supervised housing, he would then be eligible to be seen as an outpatient in Ottawa without the need for an inpatient admission to the Royal Ottawa. With this scenario, B. (D.) would avoid being “stuck” at the Royal Ottawa and there is a much higher chance that Dr. Adiele would be able to follow him as his outpatient psychiatrist.
Because B. (D.) is close to exercising the privilege of community living in Brockville, after discussion with his client, counsel for B. (D.) indicated in closing submissions that they would not proceed with the transfer request. In order for B. (D.) to progress through the forensic system, remaining in Brockville is the best option for him in terms of his progress.
In response to a question from the panel, Dr. Adiele stated that if B. (D.) were in Ottawa, there is a sexual behaviours clinic that could perform an assessment. Both the index offence and prior offences had a sexual component. Dr. Adiele stated that there has been no sexually inappropriate behaviour while in Brockville and when B. (D.) is well there is not an issue. In Dr. Adiele’s opinion, the sexual behaviours were a result of substance use or of active psychosis.
No further evidence was called.
Submissions of the Parties
- In closing submissions, the Hospital maintained its initial recommendation of a continuation of the Detention Disposition with an addition of seven-day passes. Counsel for the Attorney General and for B. (D.) were in agreement, and therefore the Board was presented with a joint submission.
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 submissions: B. (D.) remains a significant threat to the safety of the public.
In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, the Board should closely examine a range of evidence including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the accused’s mental condition; the accused's own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by the experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Adiele, in addition to the documentary evidence before us.
In particular, the Board relies on the risk assessment found beginning on page 58 of the Hospital Report. Based on the HCR-20 assessment, B. (D.) presents as a moderate-to-high risk of future violence.
B. (D.) has a history of physical and verbal violence along with sexually inappropriate behaviours when in a decompensated mental state, including violent behaviour for which he was not found to meet the NCR threshold including robbery/theft with violence, assault with a weapon, assault, and uttering threats. He exhibits eight of ten historical (static) risk factors.
B. (D.)’s insight into his illness and medications has improved but, in Dr. Adiele’s opinion, it is still partial. The treatment team is still in the process of finalizing a diagnosis and optimal treatment plan for B. (D.), who is still experiencing negative symptoms of his illness. In terms of future risk factors, Dr. Adiele foresees potential issues with professional services and plans, destabilizers, stress and coping, and personal support.
If B. (D.) were to discontinue his medications after discharge and lapse into substance use, in the Hospital’s opinion it is likely that he would experience a decompensation. This was opined to manifest as manic and psychotic symptoms, leading to an increased risk of violent behaviours similar to the index offences. If B. (D.) were to remain compliant with medications but lapse into substance use, he would likely experience some decompensation in his mental state leading to poor decision-making, rule violations, and possible aggressive or inappropriate sexual behaviours.
To his credit, B. (D.) has been participating well in treatment groups and is compliant with his antipsychotic medication. B. (D.)’s insight into substance use is improving but he is still vulnerable to peer influence and had a recent lapse when he used methamphetamine, a substance which had never been problematic for him in the past. For B. (D.), there is a strong association between substance use and psychiatric decompensation.
Upon consideration of all of the evidence, the joint submission of the parties, and the criteria set forth in s. 672.54 of the Criminal Code, the paramount consideration being the safety of the public, in addition to the mental condition of B. (D.) and his other needs, we conclude that the necessary and appropriate Disposition is a continuation of the existing Detention Order, upon the terms set out in our formal Disposition including the addition of passes for up to seven days.
B. (D.) is proud of his achievements over the reporting year, has laminated his program completion certificates, and was pleased to report to the panel that he just completed his last high school credits. He is performing well at his vocational placement at the River Café in the Hospital and has an interest in completing a post-secondary program for HVAC. The Board commends B. (D.) for his efforts and wishes him well for the upcoming year.
DATED this 27^th^ day of May, 2025, at the City of Toronto, in the Toronto Region.
Ms. M. den Haan Legal Member
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Office of the Registrar Ontario Review Board