Ontario Review Board

Re: Marissa Brown

ORB File No: 8628

Hearing held on: Monday November 3, 2025

Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas, Ontario

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

Before:

Alternate Chairperson: Mr. G. Beasley

Members: Dr. J. Ferencz

Dr. G. Stone

Mr. D. Sandor

Ms. M. McKinnon

Parties Appearing:

Accused: Marissa Brown

Counsel: Mr. P. de Jong

The Person in charge of Hospital: Counsel: Ms. J. Zamprogna

Attorney General of Ontario: Counsel: Mr. D. Rows

REASONS FOR DISPOSITION

(Dated December 3, 2025)

Introduction:

1. On September 18, 2024, Marissa Brown was found not criminally responsible on account of mental disorder on a charge of arson – disregard for human life, contrary to s. 433(a) of the Criminal Code of Canada. Ms. Brown is currently subject to a disposition of the Ontario Review Board, dated October 24, 2024, that detains her at the Southwest Centre for Forensic Mental Health Care, St. Joseph’s Health Care London (hereinafter referred to as “the Hospital”). That disposition includes privileges up to and including that of entering the community of Southern Ontario, indirectly supervised.

2. On November 3, 2025, a panel of the Ontario Review Board convened a hearing to conduct an annual review of that disposition pursuant to the provisions of section 672.81(1) of the Criminal Code. Ms. Brown was present, represented by her lawyer Mr. de Jong.

3. The record for the hearing included the Notice of Hearing, the most recent Disposition and the Reasons for that Disposition. On the consent of all parties, a Hospital Report, dated August 26, 2025, was entered into evidence as an exhibit.

4. The parties were canvassed for initial positions. Counsel for the Hospital, Ms. Zamprogna, expressed the position that Ms. Brown continued to represent a significant threat to the safety of the public as that term is defined in section 672.5401 of the Criminal Code and as it has been explained by the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. She further expressed the position that it was necessary and appropriate, having regard to the objectives set out in section 672.54 of the Criminal Code, for Ms. Brown to continue to be the subject of a detention disposition, with some changes to the current conditions. Specifically, she sought an expansion of Ms. Brown’s hospital and grounds privileges and clarification on the disposition that Ms. Brown be able to enter the community of “Southwestern Ontario”, subject to the same terms and conditions as ordered under the current disposition.

5. The representative of the Attorney General joined the Hospital on all issues.

6. Counsel for Ms. Brown, Mr. de Jong, indicated that the threshold issue of significant threat to the safety of the public was not conceded. He explained that if the threshold was met, his client would agree that a continued detention disposition was necessary and appropriate and minimally intrusive, having regard to the objectives set out in section 672.54 of the Criminal Code, the primary of which is the assurance of the safety of the public. He indicated that his client was seeking a transfer to St. Joseph’s Healthcare Hamilton though no Rule 13 request had been forwarded to the Board or served on the parties or St. Joseph’s.

7. For the reasons that follow, the Board has determined that Ms. Brown continues to represent a significant threat to the safety of the public. This finding is driven by the seriousness of the index offence, Ms. Brown’s major mental illness and the stage she is at in terms of psychotherapy that her current treating psychiatrist, Dr. Malka, is uniquely positioned to provide. The finding also considers Ms. Brown’s conduct over the course of this past period of review.

8. The Board has also concluded that a detention disposition, as outlined on page 82 of the Hospital Report, is necessary and appropriate to control the risk Ms. Brown continues to pose to the safety of the public. The Board has considered in this regard the seriousness of the index offence and the role Ms. Brown’s major mental illness played in the commission of that offence, as well as the current progress she has made in engaging with treatment providers to address her mental health and other needs, including the ultimate objective of reintegration into the community.

Evidence at the hearing

9. The evidence for the hearing came from the Hospital Report mentioned and from the live evidence offered by Dr. Malka and Ms. Brown herself.

10. Turning first to the Hospital Report, it is cumulative in nature and outlines Ms. Brown’s history, her struggles with severe forms of trauma historically, and her course while under the jurisdiction of the Ontario Review Board. Ms. Brown has a significant history of hospitalizations and multiple diagnoses rendered over the course of several years, though he has no criminal record. She has repeatedly been hospitalized with symptoms of suicidal ideation, self-harm, aggression towards others, hallucinations, depression and psychosis that has been secondary to use of substances. She has a lengthy and upsetting history of childhood trauma that featured extreme forms of abuse and betrayal by parents and caregivers. The extreme and intimate form of these betrayals need not be published here. It is sufficient to indicate that Ms. Brown now presents to the Board as a deeply troubled individual that is in the initial and hopeful phases of psychotherapy aimed at addressing such deep-rooted difficulties.

The Index Offence

11. These difficulties all informed Ms. Brown’s commission of the index offence. On December 13, 2023 police responded to a fire originating from a second-floor room in a rear apartment at “OneRoof” in Hamilton, Ontario. When they arrived, they learned from Ms. Brown that she had lit the fire. Ms. Brown expressed psychotic delusions, saying that she had lit her bed on fire in an attempt to kill herself. She said that she was being stalked by an individual that she named and claimed that individual was stealing her body parts and using them to assault people. She said that someone had stolen her brain as well and that she had lit her mattress on fire to get away from the person that was attacking her. When Ms. Brown was found she was partially clothed, lying on the floor next to the burning mattress laughing and saying, “I told you guys.”

12. The major mental health issues apparent in the index offence are similar to those experienced by Ms. Brown from as early as 2017 to the date of the index offence. Ms. Brown has been repeatedly hospitalized as a result of psychotic delusions that include themes of her being attacked by others. According to the Hospital Report, in the year preceding the index offence, there were multiple occasions where Ms. Brown complained of individuals “switching her brain” and attacking her. She claimed that she was the victim of a sexual assault perpetrated by a female apparition and maintained grandiose delusions. Substance use continued to be a concern through to the commission of the index offence. Her hallucinations were both visual, tactile and auditory.

13. The Hospital Report describes Ms. Brown’s course while under the jurisdiction of the Ontario Review Board, beginning at page 48. It details Ms. Brown’s continued struggles with auditory and tactile hallucinations, including periods when she has expressed distress over feeling that someone was touching her sexually. The severity of these auditory, visual and tactile hallucinations has led to her crying and yelling to nursing staff. It has led her to indicating intention to murder staff that she has alleged were making and selling child pornography. She has struggled with hallucinations that have caused her to scream “get the fuck out…. I’m actually going to murder you,” while banging on the wall. At times she has presented as tearful and terrified that “he’s here.” At other times she has acted in inappropriate sexual manners to male patients. She has periodically struggled with attempting to obtain contraband directly in front of staff as if they were not present. The theme of auditory, visual and tactile hallucinations is pervasive through the entire Hospital Report.

Historic Diagnosis

14. According to the Hospital Report, Ms. Brown has had a number of diagnoses. When initially coming under the Board’s jurisdiction, she was diagnosed with:

• Schizophrenia

• Polysubstance Use Disorder (Cannabis, Stimulants, Alcohol, Nicotine)

• Rule-out prior diagnoses: Posttraumatic Stress Disorder and Borderline Personality Disorder.

As was pointed out in the most recent Reasons for Disposition, Ms. Brown has a long history of childhood trauma, substance abuse, unpredictability and impulsivity. She has had limited insight into her mental health and the impact of substance use on her major mental illness. Even when on medication and under strict supervision that at one point included a Community Treatment Order, Ms. Brown struggled with breakthrough symptoms. It is notable that the themes that Ms. Brown expressed at the time of the commission of the index offence had been expressed by her for some time leading up to the arson that endangered many lives.

Course following transfer to the Southwest Centre

15. On May 5, 2025, Ms. Brown was transferred to the Hospital in St. Thomas, Ontario and came under the psychiatric care of Dr. Ashley Malka. The Hospital Report from that point begins to question the appropriateness, respectfully, of Ms. Brown’s previous diagnoses. It indicates that Ms. Brown from the point of admission underwent ongoing assessment to clarify the diagnosis and support stabilization. No new medications were trialed, and her antipsychotic medications were slowly tapered to a lower dose. The Hospital engaged in trauma-informed approaches that focused on minimization of re-traumatization and the building of Ms. Brown’s sense of safety and trust.

16. The Hospital Report explains that, at the time of admission into the Hospital in St. Thomas, Ms. Brown described herself as having “10 brains,” each with its own name, history and feelings, but none of which felt like her own. She explained that at times she experienced memory gaps and felt as though the other “brains” were taking over her body. She described experiences that were consistent with depersonalization and derealization. She reported longstanding anxiety, panic attacks and triggers associated with the childhood trauma she experienced. She described somatic flashbacks that included physical pain and symbolic experiences of sexual violation. For the first month on the unit in St. Thomas, she demonstrated many of the behaviours described above.

17. By Ms. Brown’s second month on the Hospital’s Assessment Unit, Dr. Malka and the treatment team were considering a potential alternative explanation for her psychotic symptoms – Dissociative Identity Disorder. Ms. Brown has been somewhat receptive to this possibility and has communicated that the concept of dissociation resonated with her experience. Even so, the Hospital Report describes periods when Ms. Brown has had shifting insight into her mental illness. She has continued to experience symptoms of major mental illness including aggressivity, inappropriate sexualized behaviours, and periods when she did not feel in control of her own body. She has described tactile hallucinations that were sexually invasive and alarming in nature. She expressed some delusional beliefs associated with these hallucinations that incorporated other patients into her subjective experience. While she engaged in grounding exercises and psychoeducation, she continued to struggle with a full range of symptoms that were similar to those experienced at the time of the commission of the index offence. She has had frequent nightmares and has experienced dissociative switches. She has described disturbing sexually invasive auditory hallucinations and multiple self-states with differing personality structures and characteristics.

18. The Hospital Report provides further evidence going to the threshold issue of significant threat and Ms. Brown’s need to be subject to a disposition of the Ontario Review Board. It has been noted that Ms. Brown has a history of substance use that aggravates the symptoms of her major mental illness. On July 30, 2025, Ms. Brown experienced significant hallucinations that a 14-year-old pedophile and rapist were in her room telling her to kill herself. She was convinced that she was being raped. Medication was minimally effective. It was determined the following day that Ms. Brown had used crystal methamphetamine while on the unit. Ms. Brown’s symptoms were particularly concerning following this use and persisted through to August 25, 2025 when she was heard screaming in her room that the rapist was in her closet, her mother had brought him there, and that he was watching her all the time.

19. Ms. Brown’s insight is also of concern as it pertains to the threshold issue placed before this panel. The Hospital Report indicates that Ms. Brown has demonstrated partial and evolving awareness of her mental illness. Her understanding however is complicated by phenomena such as delusional separateness and trance logic. At times her insight fluctuates depending on which self-state she is expressing at the time. She does however generally indicate that the current understanding of her symptoms – Dissociative Identity Disorder – “makes sense” to her and aligns with her experience, particularly as driven by her traumatic history of child abuse. Ms. Brown is medication adherent in a supervised environment and is progressing in her capacity to employ grounding strategies before resorting to pharmacological support.

20. The Hospital Report indicates some positive progress in terms of Ms. Brown’s insight into her own violence risk, saying that, globally, when grounded and supported in a highly supervised and supportive environment such as that offered by the Hospital, she has an appreciation of the risk her major mental illness poses to the public. Those caveats however are further complicated by the fact that Ms. Brown will often disown unsafe behaviours, attributing them to other self-states. This leads to struggles on her part to consistently recognize her own role in incidents that are similar to those that preceded the commission of the index offence.

21. The Hospital Report sets forth evidence that is compelling both on the threshold issue and on issues pertaining to disposition. It notes that, though Ms. Brown is making progress, that progress is still at initial stages. Her medication has not been optimized. She has used, what on the evidence is, for her, a highly decompensating substances (crystal methamphetamine) while in the highly supervised and structured setting offered by the Hospital. She has presented as wanting to progress quickly but is understandably impeded in doing so by the complexity of her major mental illness and the recency of the current explanation and diagnosis associated with her ongoing symptoms. She has not had access to the community in an unsupervised state, has no housing or supports, and comes from a background replete with crippling betrayals that expose her to the most severe forms of victimization. Her intellectual and neurocognitive abilities are depressed and diminished when compared to her peers.

22. The Hospital Report includes a Risk Assessment completed using the HCR-20, Version 3. The adequacy and sufficiency of this module was not questioned over the course of this hearing nor were the methods of its employment. After reviewing historic, clinical and risk management factors, it concludes that Ms. Brown poses a moderate to high risk of violence in the context of a detention disposition. The Hospital Report is clear that, as to the threshold issue of significant threat to the safety of the public, Ms. Brown continues to represent the type and level of risk contemplated in section 672.5401 of the Criminal Code. That evidence was uncontradicted over the course of the entire hearing. The re-offence scenario described in the Hospital Report is realistic. Absent current supports, Ms. Brown would likely fall away from care, return to abusing substances, and experience symptoms similar to those that both preceded and informed the index offence. There is a real likelihood that the public would experience significant psychological or physical harm driven by serious acts of criminality committed in the context of Ms. Brown’s continued difficulties managing interpersonal boundaries, processing and coping with monstrous experiences lived as a child and adolescent, and difficulties misinterpreting neutral stimuli as being threatening. Even if her symptoms are trauma-linked rather than psychotically driven, the risk to the public remains the same. She requires further structure, supervision and programming.

23. In her update and evidence to the Board, Dr. Malka adopted the contents of the Hospital Report and connected the Dissociative Identity Disorder explanation for Ms. Brown’s symptoms to Ms. Brown’s history, particularly that associated with the betrayal trauma occasioned by her as a result of the sexual abuse her parents arranged for her to experience as a child. Dr. Malka explained Ms. Brown’s hallucinations and delusions in this context and highlighted symptoms of amnesia manifest in Ms. Brown that are not a common symptom of schizophrenia.

24. Dr. Malka explained that Ms. Brown is undergoing psychotherapy that will progress in three phases, the first being the longest, and dealing with safety and stabilization to grow Ms. Brown into a position where she is able to be grounded in the present reality and develop safer coping strategies in the context of her historic trauma. In evidence going to both the threshold and dispositional issues before this panel, Dr. Malka explained that Ms. Brown is still at initial stages of this first phase. Second and third phases will deal with trauma processing, reconnection to the community and reintegration. Dr. Malka testified that Ms. Brown is making good progress, but that these are still early stages. She explained that community living in the next twelve months is not viable for Ms. Brown. Generally, phase 1 takes 1-2 years for someone that is fully invested, and Dr. Malka describes Ms. Brown as “ambivalent.” She testified that this makes community living in the next year unlikely.

Current diagnosis

25. Dr. Malka gave evidence that aligned entirely with what is found in the Hospital Report. She described Ms. Brown’s auditory, visual and tactile hallucinations in the context of her current diagnoses:

• Dissociative Identity Disorder

• Polysubstance Use Disorder (Cannabis, Stimulants, Alcohol, Nicotine)

• Posttraumatic Stress Disorder

• Rule out Psychosis, Unspecified.

26. Dr. Malka explained that Ms. Brown has had no violent incidents since arriving in St. Thomas in May, 2025. This was attributed to the trauma-based approach actively undertaken by Hospital staff in a highly secure and supportive environment. Dr. Malka highlighted the severe resurgence of symptoms that followed Ms. Brown’s use of substances and expressed concern that any disruption of Ms. Brown’s current disposition would place her in unsafe situations giving rise to the possibility of extreme harm to herself and others. She explained that, at this point, any disposition other than a detention order would be insufficient to ensure the safety of the public. Ms. Brown continues to exhibit symptoms of major mental illness. She has no housing or supports in the community. She is only in the first phase of her treatment plan. Dr. Malka also explained the importance of the disposition being sought in terms of its importance for Ms. Brown.

27. Dr. Malka cited Ms. Brown’s reliance on well-trained and supportive Hospital staff in grounding her in the present reality when delusions or hallucinations occur. Ms. Brown relies on the Hospital for housing and medications – primarily anti-psychotics that help with sleep at night when Ms. Brown is particularly symptomatic. She explained the risks posed by several of Ms. Brown’s self-states, some of which include risks to herself as her self-states exhibit aggressive or provocative behaviours that manifest as coping mechanisms to protect her from harm that she, herself, may be feeling as a product of her past traumas and abuses. Dr. Malka said that it is not a stretch that, if Ms. Brown were in the community, an offence similar to the index offence would happen again, especially if Ms. Brown were in possession of incendiary devices and using substances.

28. Dr. Malka’s evidence rounded out section 672.54 considerations as Dr. Malka explained the treatment plan set forward for Ms. Brown as it will eventually take form under phases 2 and 3 – phases that may well be years down the road but that maintain as their goal Ms. Brown’s reintroduction and reintegration into the community. She explained that Dissociative Identity Disorder is quite treatable and that Ms. Brown has good prognosis if she continues to engage in psychotherapy. Dr. Malka explained that the disorder is an adaptation to extreme situations and that Ms. Brown is incredibly resilient, can adapt to different environments, and, with the support of Hospital staff, is able to step back and look at herself and engage in reflection and insight building. Dr. Malka said that the ambivalence she has observed from Ms. Brown is common for individuals engaging in treatment for this disorder, but that Ms. Brown is engaged and is doing the homework required by the psychotherapy she is receiving. Dr. Malka described Ms. Brown as eager to learn and hopeful as evidenced by the fact that Ms. Brown has not missed any appointments. Dr. Malka said that this was “very hopeful.”

29. Ms. Brown herself testified. She explained that at times she knows she is in the present but that in her head she is somewhere else. She said that she can recognize that she is in a psychotic state when having those experiences and that she needs help in those circumstances. She described some of the several forms of trauma and abuse that she suffered, including abduction and harassment, and how when sleeping she will often go through memories and experience psychosis at night. She described her desire to move to Hamilton at some point for a new start in a new city that may not trigger her memories and psychosis in as acute a fashion as she has experienced elsewhere. She expressed hope in the formation of supportive relationships in the community that would help her. She described her struggle with substances and how she succumbed to peer pressure over the course of this review period to use methamphetamines that she was able to obtain from another patient in the Hospital.

Submissions

30. In their submissions the parties maintained the positions they expressed at the hearing’s outset. Ms. Zamprogna and Mr. Row, the representative of the Attorney General, asserted that the threshold of significant threat to the safety of the public had been met by the evidence. They highlighted Ms. Brown’s ongoing symptomology and the early phases of psychotherapy she was at in response to her current diagnoses. Ms. Zamprogna emphasized that Ms. Brown’s current course involved highly specialized therapy that was not available outside of the Hospital setting. She reminded the Board that Ms. Brown has had historic problems with substance uses that rapidly aggravates ongoing symptoms and that she had engaged in this use of substances by her own admission as a coping mechanism over the course of this reporting period and while at the Hospital in St. Thomas. She highlighted Ms. Brown’s history of violence as associated with her symptoms and with several of her self-states and indicated that while the most physical forms of violence that have taken place over the course of this reporting period happened at her previous hospital, there has been fear among Ms. Brown’s peers on the unit as she, during periods of psychosis, has said that she needed to murder or kill someone. Ms. Brown’s provocative behaviours while on the unit are also an ongoing concern. In the final analysis, counsel representing the Attorney General and the Hospital both argued that while Ms. Brown is engaging with the team and has the inherent capacity needed to progress through psychotherapy, a detention disposition was necessary and appropriate having regard to the factors set out in section 672.54 of the Criminal Code.

31. Counsel for Ms. Brown continued to contest the threshold issue of significant threat. He questioned whether Ms. Brown’s risk of instability was sufficiently connected to the type of risk envisioned in section 672.5401 of the Criminal Code, noting that her past instability had only led to one incident of serious criminality as evidenced by the index offence of arson endangering human life. He also questioned whether threats such as those made by Ms. Brown over the course of this reporting period to kill or murder someone while in the midst of a psychotic episode could satisfy the threshold to the standard described by the Supreme Court of Canada in Winko when those threats were not accompanied by actual violent acts. He maintained his position that, if the Board concluded that the threshold had been met, a detention disposition with conditions as sought by the Hospital, would be necessary and appropriate having regard to the objectives set out in section 672.54 of the Criminal Code.

Analysis and conclusion

32. A conclusion that an individual represents a significant threat to the safety of the public is an onerous one that must be carefully considered as a threshold issue whether it is supported by a joint submission or whether it is contested as it was by counsel for Ms. Brown. It goes without saying that persons with major mental illness do not ipso facto represent a threat of significant physical or psychological harm arising from criminal conduct that is serious in its nature. The law is clear that inconvenience, annoyance and even difficulty are insufficient to ground a threshold finding. Nor is there at any time any burden placed upon an individual to establish that they are not a significant threat to the safety of the public. At all times the Board must find that there is a real tie between a series of factors associated with an accused person and the serious type of risk defined in s. 672.5401 of the Criminal Code and described by the Supreme Court of Canada seminally in Winko. If that link cannot be made or is based on speculative considerations, an individual before the Board must be the recipient of an absolute discharge. Considerations of what is in an individual’s best interests do not form part of the Board’s deliberations on the threshold question.

33. In Ms. Brown’s situation, the threshold finding is made in a context of major mental illness that was a contributor to an extremely serious index offence committed in December 2023 in spite of her receipt of supports and treatment in the community outside of the forensic system. At that time Ms. Brown was experiencing significant psychotic symptoms that included visual, auditory and tactile hallucinations. Her symptoms, whatever her diagnosis at the time, were exacerbated by a history of substance use and proved difficult to manage. Those symptoms have persisted over the course of this reporting period. Ms. Brown has engaged in not just provocative sexualized behaviour but in in violently threatening behaviour that has included menacing stares, unfounded accusations directed at others, and threats to murder and kill. These are driven by visual, auditory and tactile hallucinations and paranoid delusions identical in nature to those that persisted over the months preceding the commission of the index offence. When considering whether such conduct, in the context of a recent serious index offence and persistent symptomology associated with a major mental illness can attain to the level of “significant”, the Board must ask itself firstly whether there is a real likelihood that Ms. Brown would continue to act out in such a seriously criminal manner and whether the physical or psychological harm flowing from that conduct would in and of itself be significant.

34. In our opinion both of these questions must be answered in the affirmative. Ms. Brown’s violent conduct while in hospital at St. Joseph’s in Hamilton over the initial portion of this review period was significant and caused other patients to fear her when experiencing what has been regular periods of difficulty whether by way of hallucination or traumatic intrusion. At the Southwest Centre for Forensic Mental Health Care in St. Thomas, Ontario where staff has employed a purposeful trauma-driven approach to services, Ms. Brown has continued to make serious threats in the context of the same ongoing difficulties that, if made in public, would certainly give rise to psychological harm. The Hospital Report notes that the index offences were preceded by a period during which threats to commit arson were to some degree minimized, giving rise to an air of reality to Ms. Brown’s re-offence scenario as described in that same report. Were Ms. Brown not subject to a Board disposition, she would return to the community without supports or housing, would drift away from necessary treatment and the medication that is specifically helping her control the symptoms of her major mental illness particularly at night, would return to the use of substances such as those used while in the extremely secure and supportive environment of the Hospital, and commit serious criminal offences the consequences of which would certainly be significant. Based on the evidence before it, the Board has no option but to conclude that Ms. Brown continues to represent a significant threat to the safety of the public as described by the Supreme Court of Canada in Winko.

35. Turning then to the issue of disposition, the Board agrees that a detention order as set out in the Hospital Report is both necessary and appropriate. The primary objective of the Board’s disposition is to ensure the safety of the public. Ms. Brown continues to manifest the symptoms of her major mental illness. The ongoing nature of these symptoms is serious. If Ms. Brown were granted any other form of disposition, the Hospital would be unable to respond quickly with the support she requires to mitigate the risk that drives the threshold finding. Furthermore, over the course of the latter portion of this reporting period, Ms. Brown has received an alternative explanation for her psychotic symptoms – Dissociative Identity Disorder – the treatment of which is in early phases. Ms. Brown’s insight is impacted by the characteristics of this disorder and she herself described the benefit that she gains from the supportive assistance of her treatment team over periods when her symptoms manifest.

36. To her credit, Ms. Brown has developed a positive therapeutic alliance with Dr. Malka and the treatment team. She is proactively engaged in her treatment and shows a good measure of resilience. She expresses understanding of the nature and object of the psychotherapeutic course she has undertaken and seeks support at times when her symptoms are of a severity that assistance is required for the purpose of grounding herself in the present. She expresses awareness of past traumas and the way they inform her ongoing symptoms of major mental illness. As a whole, the Board was impressed with the determination expressed by Ms. Brown to increase her level of engagement in the psychotherapeutic process. The Board also notes that Ms. Brown exercises some insight into her need for antipsychotic medications to assist with symptoms, particularly at night. This is promising should her treating psychiatrist and treatment team determine that, even in the context of her primary diagnosis, Ms. Brown’s symptoms are of a nature as to require other forms of medication to treat symptoms of a psychosis non-specified that is being ruled out.

37. All of the foregoing is harmonious with the other objectives set out in section 672.54 of the Criminal Code. It is clear that the Hospital’s treatment plan for the coming period of review and the progression of the three phases of Ms. Brown’s therapy accords with her mental health and other needs. It ensures that she benefits from the safe and supportive environment offered by the Hospital and its attentive staff whose efforts she appreciates. It provides her with a setting that minimises the traumatic intrusions that inform the most troubling of her symptoms. It sets out a course of progress that maintains the importance of section 672.54’s ultimate objective being Ms. Brown’s reintegration into the community. No other disposition so satisfies all of the objectives set out in section 672.54.

38. As a final matter and though there was no formal written request of transfer of Ms. Brown to Hamilton, the Board nonetheless considered this issue raised by her counsel on her behalf. Noting the importance of written notice to all parties and to the proposed receiving hospital, the Board nonetheless would have declined to grant such a transfer at this time. Ms. Brown’s diagnosis is uniquely addressed by Dr. Malka and staff at the Hospital have developed a supportive program that is specifically and acutely responsive to Ms. Brown’s needs. In our view, even if adequate notice had been given, Ms. Brown’s progress at the Hospital needs to continue uninterrupted if the objectives set out in s. 672.54 are to be met.

39. The Board congratulates Ms. Brown on the progress she has made since her transfer to the Hospital and encourages her in her ongoing engagement with Dr. Malka and the treatment team. It wishes her good progress and good courage over the course of the next reporting period. It also thanks all who participated in this hearing for their able assistance.

40. An order will issue accordingly.

DATED this 3^rd day of December 2025, at the City of Toronto, in the Toronto Region.

Mr. D. Sandor

Legal Member

____________________________

Office of the Registrar

Ontario Review Board