Ontario Review Board
Re: Travis M. Smithers
ORB File No: 7386
Hearing held on: Thursday, October 9, 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. S. Doherty
Parties Appearing: Accused: Travis M. Smithers Counsel: Mr. A. Confente
The Person in charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. A. Lepchuk
REASONS FOR DISPOSITION
(Dated November 28, 2025)
Introduction
On June 22, 2018, Mr. Travis M. Smithers was found not criminally responsible on account of mental disorder on a charge of assault with a weapon, contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Smithers is currently subject to a Disposition of the Ontario Review Board (the "Board") dated October 23, 2024, detaining him at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“St. Joseph's”). His privilege levels culminate with the ability to enter the community of Southern Ontario, indirectly supervised.
On October 9, 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. Smithers was in attendance and was represented by his counsel, Mr. Confente.
The Hospital Report dated September 3, 2025 was marked as Exhibit 1. The panel heard oral evidence from Dr. A. Courtright and Mr. Smithers.
Without Prejudice Position of the Parties
Mr. O'Brien advised that the hospital’s recommendation as set out at page 92 of the Hospital Report includes two additions:
to live in the community of Hamilton in a supervised accommodation approved by the person in charge;
passes for up to 7 days to enter the community of Hamilton, indirectly supervised, for discharge planning.
The addition of a reporting requirement of not less than once per week, which is not reflected in the Hospital Report is also recommended.
Ms. Lepchuk advised that she agreed with the hospital recommendation but questioned the requirement to include a prohibition vis-à-vis incendiary device.
Mr. Confente advised that an absolute discharge was being requested on behalf of his client.
Background and Index Offences
Mr. Smithers is a 49-year-old unmarried man originally from Guelph. His one sibling, a sister now lives in the United States. His educational background includes completing most of his high school program although he did not graduate. His employment history has been limited, with minimal work experience over the years. He mostly resided with his parents in Guelph, except for brief periods living with a girlfriend and then in subsidized housing. Financial support has come mainly from ODSP for many years.
From adolescence, Mr. Smithers began withdrawing socially and experimenting with substances. From ages 15 to 17, he used LSD daily, as well as mushrooms, cocaine, and marijuana regularly. His substance use history includes crystal methamphetamine. He has reported incidents of animal cruelty and property damage during his youth. Both of his parents have mental health diagnoses: his mother has been diagnosed with bipolar disorder, and his father has a diagnosis of schizoaffective disorder.
Mr. Smithers has an extensive psychiatric history spanning multiple decades. He has received inpatient treatment at several facilities, including Homewood Health Centre, Regional Mental Health Centre in London, and Grand River Hospital. His initial hospital admission occurred in 1995 at age 18. Hospital Records indicate that during his time in Guelph, he was subject to a Community Treatment Order (“CTO”). His admissions have included both voluntary and involuntary stays.
Mr. Smithers has a notable criminal history. He has faced charges for assault as well as threatening to cause death or bodily harm. Court documents indicate that in 1999, as an adult he twice physically assaulted his father. Medical records reveal that in 2012, he struck a psychiatrist from the ACT team during a home visit, though no formal charges were filed.
Mr. Smithers has been found incapable of consenting to his own psychiatric treatment. As a result, his father has served as his substitute decision-maker for treatment matters.
The circumstances of the index offence are taken from last year’s Reasons for Disposition as follows:
“Charge: Assault with a Weapon
The accused, Travis Smithers, currently resides with his parents, Fred Smithers and Wanda Smithers, at [street address] in the City of Guelph. The accused is diagnosed with schizoaffective disorder and has been apprehended under the Mental Health Act numerous times. He is prescribed medications to treat his symptoms, which he has not been taking regularly, and [he has been] becoming more aggressive and delusional as a result.
Synopsis:
On Friday, April 6, 2018, the accused, Travis Smithers was at his residence of [street address] in the City of Guelph. The victim, Fred Smithers, and Wanda Smithers were also at home in the residence.
At approximately 4:42 p.m., the victim was sitting in the living room watching television, while Wanda Smithers was in the kitchen cutting vegetables with a kitchen knife. The accused came up from the basement and then went into the kitchen. It was at this time he grabbed the kitchen knife and then approached the victim in the living room.
The accused said the victim had stolen something from him. The victim observed [that] the accused appeared very angry and his eyes appeared to be bulging. The accused raised the knife in his right hand and got closer to the victim, ready to stab him. The victim grabbed onto the accused's arm, trying to avoid getting stabbed. The victim and the accused wrestled with the knife, when the accused cut the wedding ring finger on the victim's left hand and also cut the victim's right wrist with the knife. Wanda Smithers grabbed onto the accused's arm to help [prevent] the victim from being stabbed. The victim and Wanda Smithers eventually wrestled the knife out of the accused's hands and then the accused ran up to his bedroom.
Wanda Smithers then called for police assistance. Police attended to the residence and, at 4:48 p.m., the accused was arrested and placed in a police cruiser.
At 4:56 p.m., the accused was cautioned on the charge of Assault with a Weapon. When police asked the accused if he understood, he repeatedly said, ''I did not assault anyone with a weapon", and refused to answer if he understood.
At 4:58 p.m., police read the accused his rights to counsel. When police asked if he understood, he replied, "Are you a lawyer? Someone with a 'Ven' in it. Venenheizer. I'd like to talk to a lawyer in the Homewood".
The accused was transported to the Guelph Police Station, where he stated he wished to speak with Duty Counsel. At 5:39 p.m., he spoke with Duty Counsel, I. Dejesus, privately.
The accused was lodged in a cell pending a Bail Hearing.
The victim did not require any medications for the cuts to his hand.
The victim and Wanda Smithers believe the assault was completely unprovoked and are extremely fearful for their safety. The accused is not welcome at their residence until he receives treatment for his mental wellbeing.”
Current Diagnoses
Schizoaffective Disorder
Substance Abuse, in remission in a controlled setting
Antisocial Personality Traits
Evidence at Hearing
Dr. Courtright testified for the hospital. She has been Mr. Smithers’ attending psychiatrist since the fall of 2024 as well as from 2020 to 2023. She testified to having read and adopted the contents of the Hospital Report.
Overall, Mr. Smithers has had a positive year attributable to the successful reintroduction of clozapine in the fall of 2024. That medication was previously discontinued due to medical concerns. Since the re-achievement of therapeutic clozapine levels there have been no seclusions and Mr. Smithers is less preoccupied with chronic delusional beliefs. As a result, he has gained greater privileges up to indirectly supervised hospital grounds access and has also been issued escorted passes enabling him to visit his mother. He has not yet been ready to use indirectly supervised community passes (which are in his current Disposition).
Mr. Smithers has limited insight to his illness. He does not appreciate how dramatically his presentation has changed with the reintroduction of clozapine. His insight is further limited when acutely unwell and he fails to appreciate the factors that compromise his mental wellness. He previously believed that the Hospital Report did not provide an accurate representation of how he was doing.
In August 2025 Mr. Smithers’ mental status was observed to have changed and he subsequently tested positive for methamphetamines. He stated he was given substances on hospital grounds. To his credit there have been no subsequent incidents of this kind. Mr. Smithers advised that he did not want to disappoint his father by using substances again because they have an ongoing relationship and his father regularly visits him in hospital.
Dr. Courtright opined that Mr. Smithers is currently unsuitable for an absolute discharge as he still presents a significant risk to public safety because he suffers from a treatment resistant illness which can only be managed via daily oral medication administered under supervision. Mr. Smithers states his goal is to reduce the dosage of the medications he takes which would worsen his mental status and increase his risk. Dr. Courtright testified she was struck by how easily agitated and how quickly Mr. Smithers resorted to assaultive behaviour when medication non-compliant, even within hospital setting. As a result, an absolute discharge would be premature. The inclusion of community living is recommended so that Mr. Smithers can be placed on a waitlist for supervised residential housing. The treatment team believes he could be managed in the community within a closely supervised setting because he remains compliant with clozapine. The intention is to work with him in hospital so that he can eventually spend more time in the community and increase his independence. If granted an absolute discharge, Mr. Smithers would want to return home to live in Guelph with his father. Dr. Courtright has not spoken to Mr. Smithers’ father about this. This possibility remains inappropriate at present due to Mr. Smithers’ current level of risk.
Mr. Smithers’ symptoms continue to fluctuate with stress. For example, he was distressed and fixated following last year's Ontario Review Board hearing. He would become upset each time he reread the Reasons for Disposition because they contained information from when he was truly unwell.
Mr. Smithers rejects the intervention of an ACT team because he previously worked with one in Guelph and does not wish to do so in the future. Mr. Smithers has a partial grasp of how the ORB system works. He continues to be remorseful for having harmed his father, the victim of the index offence.
The decision to deny Mr. Smithers’ father's application to become an approved person has not been reconsidered because Mr. Smithers continues to attempt to exert pressure on his father to influence treatment decisions. Mr. Smithers’ father is his son’s substitute decision maker.
Dr. Courtright advised that the removal of the incendiary device prohibition is appropriate as Mr. Smithers has no issues with fire setting behaviours and continues to appropriately use a lighter for smoking.
Responding to questions from Mr. Confente, Dr. Courtright advised that her patient was diagnosed with epilepsy in 2023 and placed on medications to address this illness. It is now well controlled although he only has partial insight to his need to take medications to address this physical health issue.
Mr. Smithers has had significant dental issues as well as delusions surrounding the removal of his teeth. Perhaps due to the pain he experiences he has been more cooperative with addressing his dental health this reporting year.
Mr. Smithers’ concerns surrounding his mother's health do not have a significant impact on his mental status. His social worker advises that his mother is not dying although she now resides in a long-term care facility due to a stroke. Her health is otherwise stable.
It is unlikely that a residential bed will become available this reporting year. Even if that happened, Mr. Smithers would have to first successfully exercise community privileges, which has not yet occurred and continue to abstain from substances. A 24/7 supervised residence is unlikely required although oversight for medication supervision and monitoring of mental status is needed. At this time a placement in Hamilton is the only reasonable option for Mr. Smithers given the need for the outpatient team to closely monitor him. Therefore, his preferred placement in Guelph would not be considered appropriate. Dr. Courtright and the treatment team want to see Mr. Smithers succeed when he is placed in the community of Hamilton before consideration of a move to Guelph. It was noted that supervised housing options are even scarcer in Guelph than in Hamilton. If permitted to reside in the community, he will be supported by vocational services and will need to work on employment readiness skills prior to taking on remunerative work.
A conditional discharge is currently inappropriate because given his ongoing symptoms, Mr. Smithers requires proximity to a hospital. If he missed his daily clozapine dose he would need to be quickly returned to hospital and the civil mental health mechanisms would be insufficient to ensure this. The clozapine regime, started in September/October 2024, has now been titrated to therapeutic levels balanced with tolerable side effects.
Mr. Confente called Mr. Smithers to testify. He testified that he no longer uses drugs and does not want to stay in Hamilton. He wants an absolute discharge so he can live with his father and be closer to his mother. He wants to get off disability and find a part-time job in Guelph at Tim Horton's or Walmart.
If granted an absolute discharge, Mr. Smithers testified that he would continue to see a family physician or community psychiatrist. Mr. Smithers would still want to come to hospital every three months to talk to a psychiatrist and wants to “get off the needle”. He will keep taking clozapine although needles caused his epilepsy. He wants a reduced dosage of clozapine because he only needs 200 milligrams daily rather than the current prescribed dosage of 350 milligrams daily.
Closing Observations
Mr. O'Brien submitted there has not been a need to seclude Mr. Smithers since the reintroduction of clozapine. Mr. Smithers’ stability and ultimate recovery still have a long way to go. Mr. Smithers is fortunate that he enjoys the support of his parents. Mr. O’Brien expressed no concerns with the removal of subparagraph 4(d) as suggested by Ms. Lepchuk.
Ms. Lepchuk supported the hospital recommendation and noted that Mr. Smithers’ reintroduction to the community will be gradual. She expressed concern that if Mr. Smithers receives an absolute discharge, he intends to live with his father who was the victim of the index offence.
Mr. Confente confirmed that his client wishes to receive an absolute discharge. In the event a detention disposition is ordered, he would then support the hospital recommendation including the removal of subparagraph 4(d) the incendiary device prohibition.
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. Smithers 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. Smithers continues to pose a significant threat to the safety of the public. In arriving at this determination, this panel of the Board carefully considered the testimony of both Dr. Courtwright and of Mr. Smithers and ultimately preferred the expert evidence of Dr. Courtright that Mr. Smithers continues to pose a significant threat to public safety.
Mr. Smithers stated that if granted an absolute discharge he will move back to Guelph to live with his father and be closer to his mother, get off disability and find a part-time job, continue to see a family physician or community psychiatrist, continue to come to hospital every three months, keep taking clozapine albeit at a lower dose.
Regrettably, Mr. Smithers’ admirable intentions do not allay our concerns about the current state of his treatment resistant psychiatric illness and his markedly limited insight about the illness and treating it. Those limitations, as seen by this panel, will be addressed under the “Disposition” heading which follows.
The Board’s finding of significant threat also relies on the Hospital Report, specifically, the concluding paragraph of the current Risk Assessment, found at page 91 of the Hospital Report and reproduced below:
Considering Mr. Smithers’ current level of protective factors, his historical (static) risk factors and his current/dynamic risk factors, his current level of risk for violence remains moderate, reflecting little change in his mental status, behavior, and self-management of risk factors since the previous risk assessment. If Mr. Smithers were to engage in violence it would likely be the result of fluctuations in his mental status secondary to medication nonadherence, substance misuse, acute psychological stress, or physical health issues (e.g. constipation, excessive tobacco use). In such an event, Mr. Smithers would likely experience increased paranoia, disorganization, agitation, and reactivity due to misunderstanding. He may engage in verbal and physical aggression toward patients, staff, strangers, or family members. To his credit, despite situations which he has misconstrued as potentially threatening, Mr. Smithers has refrained from physical violence this year. Without the oversight of the forensic system and detention order, Mr. Smithers’ risk would increase due in large part to medication nonadherence and exacerbation of psychotic symptoms. Due to his poor insight into his illness and symptoms, limited response to medication, and the significant risk-management and benefit he derives from supervision and support, Mr. Smithers is not considered a candidate for a conditional discharge based on his current risk profile.
The Board therefore accepts that absent an ORB Disposition, Mr. Smithers would likely become non-compliant with clozapine which would lead to decompensation very quickly. We rely on Dr. Courtright’s testimony that she was surprised by the rapid onset of agitation and how fast Mr. Smithers became assaultive, even within a hospital setting when his clozapine was stopped. The use of substances and the re-emergence of behaviours similar to those seen at the time of the index offence would follow. We are therefore satisfied that absent an ORB Disposition, it is likely that Mr. Smithers 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. Smithers 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. Smithers’s needs pursuant to s. 672.54 of the Criminal Code.
The necessary and appropriate disposition for Mr. Smithers provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.
In considering Mr. Smithers needs, the Board was attentive to his desire to move back to Guelph to lend support to his family and reintegrate into that community. Regrettably, those plans are premature because of his treatment resistant mental illness that requires oral medication (clozapine), to be administered under supervision.
In addition, Mr. Smithers has limited insight to his illness. In the absence of any specialized psychiatric training Mr. Smithers wants to reduce his daily dosage of clozapine from 350mg to 200mg as well as discontinuing his intra-muscular antipsychotic. The expert evidence of Dr. Courtright is that these steps would cause a rapid decline of his mental state thereby augmenting his risk to public safety. Dr. Courtright also provided expert testimony that stress, for example the stress arising from reading this Board’s 2024 Reasons for Decision issued after Mr. Smithers’ annual hearing, caused a destabilization of his mental state.
Although Mr. Smithers testified that he no longer uses drugs, as recently as August 2025 he tested positive for methamphetamines.
The addition of a community living provision (and the passes required for discharge planning) is the next logical step in working towards Mr. Smithers’ reintegration into the community. Although he is not yet ready for discharge to the community (and has not exercised indirectly supervised passes into the community yet), this will allow Mr. Smithers to be placed on wait lists for appropriate housing if he continues his current positive trajectory. The panel noted that Mr. Smithers was not at all ready for discharge to the community last year, but since the reinitiation of Clozapine he has improved to the point where the treatment team are now comfortable recommending the addition of this provision in Mr. Smithers’ Disposition.
The evidence demonstrated that the incendiary device prohibition was no longer necessary or appropriate.
This panel also considered whether Mr. Smithers could be managed pursuant to the terms of a conditional discharge and determined that he could not. We accept Dr. Courtright’s expert opinion that Mr. Smithers continues to require proximity to a hospital. In the event he missed a daily clozapine dose he would require rapid re-admission to assess his mental state and hopefully restart this oral medication prior to the rapid onset, given his history, of mental decompensation. The hospital also requires the ability to approve Mr. Smithers’ housing to ensure that it has the appropriate level of support and supervision to mitigate his risk to the public.
Conclusion
Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Smithers poses to the safety of the public while still meeting his needs, is a renewal of his current Detention Order amended as described in the Without Prejudice Position of the Parties section of these Reasons for Disposition, and removal of the incendiary device prohibition.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Courtright 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. Smithers’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