Tobin (Re), 2025 CanLII 122696

Ontario Review Board

Re: Joseph R. Tobin

ORB File No: 3694

Hearing held on: Tuesday, October 7, 2025

Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street

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

Before:

Alternate Chairperson: Ms. S. Clapp Members: Dr. H. Bloom Dr. A. Kerry Mr. P. Capelle Mr. B. Apted

Parties Appearing:

Accused: Joseph R. Tobin Counsel: Mr. A. Rai

The Person in charge of Hospital: Counsel: Mr. S. O’Brien

Attorney General of Ontario: Counsel: Mr. S. Kim

REASONS FOR DISPOSITION

(Dated November 28, 2025)

Introduction

On December 23, 2002, Mr. Joseph R. Tobin was found not criminally responsible on account of mental disorder on a charge of second-degree murder, contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Tobin is currently subject to a Decision and Disposition of the Ontario Review Board (the "Board") dated October 18, 2024 (as amended by Order dated July 11, 2025), detaining him at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“St. Joseph's”), with privileges up to living in the community in accommodation approved by the person in charge.

On October 7, 2025, a panel of the Ontario Review Board (the "ORB" or the "Board") convened a hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Tobin was not in attendance but was represented by his counsel, Mr. Rai.

The Hospital Report dated September 26, 2025 was marked as Exhibit 1. Dr. K. Shariati, Mr. Tobin’s attending psychiatrist, gave oral evidence.

Preliminary Issue

Mr. Rai stated that he had instructions to proceed in his client's absence. An order excusing Mr. Tobin's presence therefore followed per s. 672.5(10) of the Criminal Code.

Without Prejudice Position of the Parties

Hospital counsel, Mr. O’Brien, advised that an increase in the reporting requirement from not less than twice monthly to not less than once per week was recommended. Additionally, further to a direction contained within the Ontario Court of Appeal’s 2025.07.09 Reasons for Decision in Tobin (Re), 2025 ONCA 489, the following term was added “the hospital will exercise all due diligence in pursuing community housing for Mr. Tobin”.

Both Mr. Kim, on behalf of the Attorney General, and Mr. Rai, on behalf of Mr. Tobin, joined in the hospital’s recommendation. The hearing thereby proceeded by way of a joint position.

Index Offence and Background

The circumstances of the index offence are taken from last year’s Reasons for Decision and Disposition as follows:

“On September 5th at 3:30 p.m., the accused returned home with his mother from McMaster University Medical Centre. Later that evening his mother, Arlene Tobin, left Joseph alone at home to drop off a prescription at the drug store and to visit her sister who lived about a two minute drive away. She was fearful of being alone in the house with Joseph and spoke to her husband, who was at work, on the telephone and said, “I can’t take this; he’s threatening again. He just got home from the hospital and he has started already.” Apparently the accused had been screaming upstairs about his clothes being stolen.

The accused’s sister, Tamara, returned home about 7:30 p.m. to get ready for work. She found the accused mopping the basement floors. She also “... left the house early just to be away from him.”

Joseph [the accused] telephoned his cousin at 7:08 pm. and spoke for approximately 35 minutes. The cousin described the accused as “there one minute and gone the next....” “I had to tell him to slow down.” “He was trying to use big words and breathing heavily....” The cousin noted the arrival of Joseph’s Dad. Joseph indicated he would call back but did not. The cousin could hear Joseph’s Dad ask, “What are you talking about” and Joseph said, “Mind your own business; I am on the phone”.

The father called his mother-in-law, Mrs. Coffell, to see if his wife was at her home. Mrs. Coffell could hear Joseph in the background saying, “Dad, Dad” and heard Ron Tobin ask Joseph “to wait just a minute, Joey”. Mrs. Coffell explained that his wife was dropping off a prescription at the pharmacy and was on her way to work. At approximately the same time, Mrs. Tobin tried to call home but the line was busy. On a subsequent attempt, Joseph picked up and she asked him, “Joey where is your Dad? Is he there? He said yeah – I could tell something was wrong. He said he doesn’t look too good. I didn’t know what he meant and I said what happened Joey, and he started to cry and said Mom I stabbed Dad, I stabbed Dad, I stabbed him with a screwdriver.” Mrs. Tobin was at her sister’s and they called the police while her brother-in-law rushed to the Tobin residence. Upon his arrival, he instructed a neighbour to call 911.

One of the neighbours had previously witnessed Joseph leaving the house approximately 5 to 10 minutes after Mr. Tobin Sr.’s, arrival home. Upon their arrival, the police arrested the accused as he was coming from the south side of the residence and charged him with aggravated assault. He was also given his rights to counsel and cautioned. The accused stated, “I didn’t mean to do it. I thought I was hurting myself... I thought I was stabbing myself.”

The police observed the accused’s father lying on the floor between the kitchen and the dining room, face up in the doorway, with a wound to the left side of his forehead.

During transportation, the accused was crying out loud and yelling, “I didn’t mean to do that to my Dad; it’s my Dad.” As well, during a videotaped statement, the accused stated he saw himself standing in the doorway and thought it was himself that he was approaching; then his Dad was in front of him. “I don’t remember doing it but I did”. He indicated he remembered his Dad falling down and he ran out of the home because “I wanted to see what happened so I ran around through the alleyway and back to my home because I did not think that, from the doorway where the patio is, that anything had happened to my Dad. I wanted to make sure I didn’t do anything.

Mr. Tobin Sr. succumbed to his injuries and passed away on September 6, 2002.”

Mr. Tobin is now forty-four years old. He has an extensive psychiatric history spanning multiple decades. The index offence occurred when he was in his mid-twenties. Notably, he was discharged from hospital just four hours prior to committing the index offence.

Prior to the index offence Mr. Tobin had accumulated nine criminal convictions dating back to his youth. His childhood was marked by significant behavioral and family difficulties. According to reports from his mother, behavioral problems emerged when Mr. Tobin was approximately 13 years of age, manifesting as:

• Acting out behaviors
• Physical altercations at school
• Substance abuse

His mother reported an inability to manage his escalating behavioral problems. These difficulties resulted in Mr. Tobin leaving school in grade 9. Their relationship ended around 2010 following multiple incidents of domestic violence but has recently been rekindled.

Mr. Tobin has an extensive history of psychiatric hospitalizations dating back to 1997. His clinical presentation over his various admissions was characterized by:

• Psychotic symptoms, including hallucinations and paranoid ideation
• Disorganized thought processes
• Periods of significant agitation
• Threatening and aggressive behavior toward family members and co-patients
• Treatment non-compliance, including medication refusal

His mental health has demonstrated considerable fluctuation over the years. During periods of mental deterioration, he has exhibited:

• Pleasant and subdued demeanour that would rapidly shift
• Sudden onset of agitation and threatening behavior toward co-patients
• Disorganized thinking and paranoid ideation
• Episodes of verbal aggression directed at co-patients

During previous hospitalizations, Mr. Tobin has repeatedly:

• Refused to take prescribed psychotropic medication
• Sold his medication to co-patients (documented on multiple occasions)
• Failed to attend scheduled appointments with treatment staff
• Disregarded hospital rules and treatment team directives

A persistent pattern of treatment non-compliance has been documented throughout his history. Hospital Reports describe his relapses as sudden in onset, accompanied by severe paranoia that creates substantial challenges for staff attempting to redirect his behavior.

Mr. Tobin was transferred from the Waypoint Centre for Mental Health Care to St. Joseph’s in November 2015. He was discharged to live at Emmaus Place in January 2019. Since then, Mr. Tobin was readmitted to hospital on multiple occasions, most recently in July 2024. He has remained an inpatient since then and is not able to return to Emmaus Place as a result of having exceeded the program’s length-of-stay limit.

Current Diagnoses

• Schizophrenia, in partial remission
• Substance Abuse Disorder (alcohol, stimulants, opioid, cannabis), in remission in controlled setting
• Gambling Disorder
• Antisocial Personality Disorder (historical)

Evidence at Hearing

Dr. Shariati was presented as the hospital witness. He has been Mr. Tobin's attending psychiatrist since March, 2025. Dr. Shariati confirmed having read and adopted the contents of the Hospital Report.

A panelist inquired why the Hospital Report at page 95 does not address the reasons for Mr. Tobin’s 2024 hospital readmission from Emmaus Place; a 24/7 transitional group home residence where Mr. Tobin lived from January 2019 to July 2024. Dr. Shariati responded that the Hospital Report speaks to ongoing suspicions vis-à-vis substance use and emerging symptoms (some of which may not have been easily detected over the past several years), as well as concerns of increased hostility and “slipping” in his reporting to the outpatient team. Additionally, Mr. Tobin had exceeded the designated duration of stay at Emmaus Place. Dr. Shariati noted that some members of Mr. Tobin’s outpatient team would have supported his return to Emmaus Place had it remained available to him.

Since readmission, Mr. Tobin has done well. Although he is medication compliant, there are nonetheless brief periods of thought and speech disorganization. Mr. Tobin continues to be involved in his treatment plan and now visits his mother at her home. Mr. Tobin is alert and organized during his interactions with Dr. Shariati. There are no issues with his hygiene or participation in programming. His cooperation with the team is very good. Mr. Tobin uses extensive passes into the community for employment, family visits and leisure time and no concerns have been raised.

While Mr. Tobin recognizes disorganization as part of his symptoms, he is not able to make that connection when he is symptomatic. He remains unable to recognize the symptoms of his decompensation in the days prior to receipt of his intramuscular injection.

Asked if CBT for psychosis would be beneficial and whether Mr. Tobin would engage, Dr. Shariati responded that it would and that Mr. Tobin is currently waitlisted for that programming.

Dr. Shariati opined that depending on the setting, Mr. Tobin is now ready for discharge to the community notwithstanding concerns vis-à-vis his ability to manage his activities of daily living in a less structured environment. However, if discharged on the date of this hearing, Mr. Tobin’s housing would again need to be 24/7 supervised. Bed availability within another supervised group home could become available in a couple of months of today's hearing date.

Dr. Shariati opined that on balance, a group home would be safer for Mr. Tobin. However, Mr. Tobin feels he can demonstrate that he has what it takes to live in a less supervised setting. This contrasts with Dr. Shariati’s view that at present, community housing in unsupervised accommodation is inappropriate. The doctor added that if and when a less supervised setting is deemed appropriate there would likely be a lower threshold for readmission.

Mr. Tobin has specified that he wants to live in a more independent community environment, specifically; First Place. The hospital had delayed his community discharge with that placement in mind to enable him to work on substance abuse and gambling issues. Although uncertain, Dr. Shariati presumes Mr. Tobin has started substance abuse programming and that he can continue to attend this type of programming while living in the community.

At present, the inpatient team is aiming for a discharge to First Place by March of 2026. If a bed was to become available prior to March 2026, their staff are unlikely to hold it for more than a couple of weeks. If his discharge readiness to First Place occurs prior to that date, the treatment team will discuss the suitability of discharge at that time. March 2026 is not a hard discharge deadline.

A reference at page 105 of the Hospital Report to possible apartment availability at First Place by the end of 2025 was noted. Dr. Shariati was asked to explain the nature of the conversation that would occur if an apartment became available at First Place at that time. He responded that this is an ongoing conversation to encourage Mr. Tobin to work on identifying areas of concern. If he has made sufficient progress the treatment team would consider the placement, keeping in mind that the determination is milestone-based.

First Place is staffed by personal support workers that have no mental health training and thereby may not be attuned to subtle changes in presentation as compared to staff at Emmaus Place. Nevertheless, they are present twice daily, to assist with medication administration and can report back in the event of noncompliance.

As a discharge date approaches, the doctor will want to look at optimizing the injection dosage/frequency of his patient’s intramuscular psychotropic as well as the prescribed dosage of clozapine. Changes are likely to involve a small increase in the dosage of clozapine in the months leading to discharge. Mr. Tobin is incapable of consenting to treatment and his sister is his substitute decision-maker.

The recommended increase in the frequency of reporting represents the minimum safe reporting frequency at present to identify signs of worsening psychosis or clozapine non-compliance.

Responding to questions from Mr. Rai, Dr. Shariati agreed that Mr. Tobin has/is:

• had no indicia of physical aggression,
• remained medication compliant,
• fair understanding of his mental health condition and importance of treatment,
• shown no homicidal or suicidal ideation,
• currently employed part-time,
• shown no indication of substance abuse,
• community passes have gone well,
• independent with activities of daily living.

Financial capacity remains a concern for Mr. Tobin as an outpatient. Dr. Shariati acknowledged that gambling causes financial stress in Mr. Tobin's ability to obtain basic necessities. Mr. Tobin currently limits his gambling to $15 per week. Dr. Shariati testified that Mr. Tobin’s abstinence from gambling would be optimal, but the treatment team is prepared to consider other approaches. A consultation has been requested with Alcohol Drugs Gambling Addiction Services (ADGAS) for their recommendations. The independent housing that Mr. Tobin is seeking will require ongoing engagement in gambling and substance use groups. While Mr. Tobin is financially capable, it was Dr. Shariati’s opinion that consideration of a voluntary trustee for money management could expedite the desired placement.

Mr. Tobin is currently invested in substance and gambling interventions motivated by wanting to be discharged into a more independent setting. Mr. Tobin does not perceive he poses the level of risk that the treatment team does. Mr. Tobin does not acknowledge having a gambling disorder. He does not report cravings for gambling, but these can nevertheless be presumed as he is diagnosed with a gambling disorder. Dr. Shariati undertook to review the propriety of Mr. Tobin's recreational activities of playing cards and bingo.

Dr. Shariati described Mr. Tobin as mostly asymptomatic day-to-day but for brief periods of speech disorganization. Antisocial traits are not apparent as an inpatient, but their emergence must be prepared for on an outpatient basis.

If Mr. Tobin was to receive an absolute discharge at this time his level of significant threat would be significantly and materially higher. Dr. Shariati emphasized that the risks this patient poses requires the need to manage his susceptibility to stress, medication non-adherence, substance use and gambling.

Closing Observations

Mr. O'Brien described Mr. Tobin as a challenging patient. He is currently well managed under a detention disposition, however, absent oversight, this can quickly change. The hospital is attempting to have him discharged in consideration of his wishes as he does not want to return to a group home. With Mr. Tobin’s cooperation, he may be appropriate to live at First Place. The hospital has attempted to advance Mr. Tobin’s community placement as directed by the Ontario Court of Appeal while still protecting public safety. Mr. Kim adopted the hospital’s closing submissions.

Mr. Rai submitted that overall, his client has had a positive year. He referenced the aforementioned Ontario Court of Appeal’s decision vis-à-vis Mr. Tobin’s need for housing and emphasized that the direction contained therein constitutes an obligation, not a suggestion.

Mr. Rai observed that his client is ready to start substance use programming and may already have done so. It is important that the team continues to determine if milestones leading to Mr. Tobin’s desired discharge are met. Mr. Rai added that it is encouraging that if a bed becomes available at First Place prior to March 2026 Mr. Tobin’s suitability for discharge will be considered at that time.

Analysis and Decision

(a) Significant Threat

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 conduct that is both serious and criminal in nature.

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

The Board unanimously finds that Mr. Tobin continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Shariati that Mr. Tobin continues to pose a significant threat. Dr. Shariati’s opinion is buttressed by the following excerpt from page 106 of the Hospital Report:

Risk has increased when external structure decreases. Community periods have shown rapid shifts to disorganization and activation, reduced transparency, suspected diversion, “cheeking,” substance and gambling relapse risk, and functional decline in instrumental activities of daily living (late bills/phone interruptions, food insecurity, and difficulties keeping the apartment clean.) Peer influence and boundary setting have also been recurring stressors.

Static risk factors include the serious index offence, chronic psychotic illness, and longstanding antisocial traits. Modifiable risks include stress management, medication adherence outside observed dosing, substance use and gambling issues, instrumental activities of daily living and financial strain (especially near month-end), Forensic Outpatient Program contact reliability, and peer-boundary issues. Protective factors are his engaged family (mother and sister, both Approved Persons; sister is Substitute Decision Maker), consented information-sharing, sustained stability in a structured setting, employment, and willingness to accept enhanced monitoring and Occupational Therapy assessment.

On the ward, where structure, monitoring, and observed medication are present, overall risk is low–moderate. In less structured community conditions, where medication adherence, substances, gambling, instrumental activities of daily living, peer contact, and boundaries are variably controlled, risk rises to at least moderate and has historically escalated quickly.

Given the foregoing and subsequent to our own independent analysis, the Board accepts that absent an ORB Disposition, Mr. Tobin would likely become non-compliant with prescribed medications which would lead to decompensation, use of substances and the re-emergence of behaviours similar to those seen at the time of the index offence. We are satisfied that absent an ORB Disposition, it is likely that Mr. Tobin will cause serious physical or psychological harm to members of the public and such conduct will likely be criminal in nature.

(b) Disposition

Flowing from the Board’s finding that Mr. Tobin continues to pose a significant threat to the safety of the public it must shape a Disposition for the year ahead. Its paramount consideration in doing so must be the safety of the public while also considering Mr. Tobin’s needs pursuant to s. 672.54 of the Criminal Code.

The necessary and appropriate disposition for Mr. Tobin provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.

In considering Mr. Tobin needs, the Board was attentive to his desire to reside in less supportive housing than is being recommended by the hospital, and the hospital’s efforts to provide that opportunity, notwithstanding the need to ensure necessary and appropriate risk management. In light of Mr. Tobin’s recent history of multiple re-admissions, a cautious approach is required. Paragraph 18 of the 2024 Reasons for Decision and Disposition is reproduced below:

18. In the reporting year of 2024, Mr. Tobin was readmitted on 3 occasions. He was again highly disorganized and admitted to misusing his medication. He was described as somewhat irritable and confused.

Mr. Tobin is again ready to be discharged to a highly supportive community residence. However, Mr. Tobin wishes to transition to a less structured environment where he can live in his own apartment. He is therefore waitlisted for a unit within First Place, a multi-unit senior’s apartment building affiliated with the hospital. Personal support workers attend twice daily for medication oversight and can therefore report back instances of treatment non-compliance.

Dr. Shariati and his treatment team are to be commended for their willingness to continue to work with Mr. Tobin towards that objective, notwithstanding a lower readmission threshold in the absence of robust supports. This is why the hospital’s recommendation for an increased reporting frequency to once weekly is both necessary and appropriate.

The panel did have some concern that recreational time spent playing cards and bingo may feed Mr. Tobin’s propensity to gamble thereby jeopardizing his ability to meet his financial needs in the community. The panel also supported the consideration of establishment of a voluntary trusteeship to manage his funds in order to stabilize Mr. Tobin’s spending and advance his goal of living more independently. We share Dr. Shariati’s view that continued participation in gambling programming as well as substance use programming are essential for Mr. Tobin to be placed as well as to remain at First Place. To his credit Mr. Tobin has already expressed a willingness to engage in CBT for psychosis and awaits the start of this programming.

The hospital has, as directed, exercised due diligence in pursing community housing for Mr. Tobin, and is considering Mr. Tobin’s wishes as part of the process. His continued cooperation and engagement with the treatment team will determine whether and when he can be discharged to and remain at First Place.

Conclusion

Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Tobin poses to the safety of the public while still meeting his needs, remains a Detention Disposition as modified within the Without Prejudice Position of the Parties heading of these Reasons.

In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Shariati 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. Tobin’s mental condition, his reintegration into society and other needs.

DATED this 28th day of November 2025, at the City of Toronto, in the Toronto Region.

Mr. P. Capelle Legal Member

Office of the Registrar Ontario Review Board