Re Justin Myers, 2025 CanLII 129581

Re: Justin Myers

ORB File No: 8479

Hearing held on: Monday, August 25, 2025

Place of hearing: Providence Care Hospital

Pursuant to: Sections 672.81(2) 672.81(2.1) of the Criminal Code

Before:

Alternate Chairperson: Ms. T. Mann

Members: Dr. S. Lessard

Dr. W. Loza

Ms. K. Weisbaum

Ms. K. Brisson

Parties Appearing:

Accused: Justin Myers

Counsel: Mr. C. Carter

Person in Charge of Hospital: Representative: Ms. T. Tom

Attorney General of Ontario: Counsel: Ms. J. Ferguson

REASONS FOR DECISION & DISPOSITION

(Dated December 12, 2025)

Introduction:

1. On January 29, 2024, Justin Myers was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault, mischief under $5,000, and theft under $5,000, all contrary to the Criminal Code of Canada (“Criminal Code”). He is currently subject to a Detention Disposition of the Ontario Review Board (“Board” or “ORB”) dated March 14, 2025. The current Disposition detains him within the Secure Forensic Unit of the Providence Care Hospital (“Providence Care” or “the Hospital”), with a number of conditions and an envelope of privileges, the most liberal of which permits him to enter the community of Kingston within a 20-kilometre radius of Providence Care, indirectly supervised.

2. On July 15, 2025, the Hospital provided notice to the ORB of a decision to significantly increase the restrictions on Mr. Myers’ liberties as of June 30, 2025, when his Exceptional Behavioural Management Plan was fully activated, including placing him in an observation suite, known at Providence Care as a High Intensity Treatment (“HIT”) Room.

3. On July 16, 2025, the Hospital also provided the Board with a Rule 13 notification of its intention to request a Disposition transferring Mr. Myers to Waypoint Centre for Mental Health Care (“Waypoint”).

4. On August 25, 2025, the Board convened a hearing at Providence Care to review the increased restrictions of Mr. Myers’ liberties pursuant to section 672.81(2.1) of the Criminal Code, as well as conduct an early review of the current Disposition pursuant to section 672.81(2) of the Criminal Code.

5. For the reasons set out below, the Board concluded that the significant increase in the restrictions on Mr. Myers’ liberties when he was placed in a HIT room with limited egress was necessary and appropriate, as well as the least onerous and least restrictive intervention in the circumstances, both at the time it was imposed and for its duration. The panel decided it was necessary and appropriate for Mr. Myers to be limited in the HIT room because his threatening behaviour clearly escalated. The ongoing detention was and continued as of the day of the hearing to be necessary to protect the safety of the public. Given the risk he continues to pose, his lack of insight and the treatment impasse reached at Providence Care, a transfer of Mr. Myers to Waypoint was necessary and appropriate.

6. A new Disposition Order was granted following the early review, with limits on Mr. Myers’ egress both inside the Hospital and with respect to community access, consistent with the outer limit of privileges permitted at Waypoint. The terms of the new Disposition Order will continue once Mr. Myers is transferred to Waypoint. The Board added a term requiring Mr. Myers to refrain from use of telephone and internet unless supervised by staff. Additionally, Mr. Myers was enjoined from contact or communication, direct or indirect, with a number of named individuals impacted by his recent behaviour. (A “mirror” term was issued requiring the Hospital to ensure the accused did not have unsupervised access to telephone/internet.) Pending his transfer to Waypoint, the Hospital was granted residual authority to manage Mr. Myers’ custody and rehabilitation upon the terms and conditions set out in the Board’s formal Disposition Order.

Positions of the Parties

7. At the outset of the hearing, the parties were each asked for their respective without prejudice recommendations to the Board. On behalf of the Hospital, Ms. Tom took the position that both the initial restriction of Mr. Myers’ liberty and the ongoing restriction were warranted and the least onerous and least restrictive courses of action in the circumstances. Mr. Myers remains a significant threat to the safety of the public. The Hospital was seeking a transfer to Waypoint and a more restrictive Disposition Order for Mr. Myers with reduced privileges, including the removal of community privileges and indirect access to hospital grounds. Accordingly, Mr. Myers would require staff accompaniment or staff escort. His ability to access the Internet and social media on his phone would also be strictly limited to times when direct staff supervision is available.

8. Ms. Ferguson, on behalf of the Attorney General of Ontario, joined the Hospital’s position and adopted its recommendations as the least restrictive in the circumstances. This included on the issues of significant threat, the restriction of liberty, transfer to Waypoint and the amendments to the Disposition Order.

9. On behalf of Mr. Myers, Mr. Carter stated that his client did not take issue with the restriction of liberty, with the terms of the Disposition proposed by Ms. Tom, or with the finding of significant threat. However, he advised that his client opposed a transfer to Waypoint, adding that Mr. Myers wished to remain in Kingston because of his ties to the community, an item that would be expanded upon later in the hearing.

Index Offences

10. Mr. Myers’ Index Offence is summarized in the Amended Reasons for Disposition dated May 5, 2025, and repeated here, as follows:

The index offences arose from an incident at a convenience store in Brockville at approximately 8:30 p.m. on July 9, 2023. The factual background is outlined in the Transcript of the Reasons for Judgment dated January 29, 2024 (at pages 4-6) and is summarized as follows. Mr. Myers walked quickly towards the clerk of the store with a piece of paper in his hand with a formula on it. He was making comments about the Russians trying to take over and a war, that people were being killed, and that he needed to talk to a higher political power. Mr. Myers was using profanity and speaking in a high-pitched voice. The clerk was very confused and said he could not help Mr. Myers. Mr. Myers then picked up cans of Red Bull and threw them in the direction of the clerk. The computer screen near the clerk was damaged and no longer operable. Mr. Myers then opened cans of Red Bull and started drinking. The clerk tried to calm Mr. Myers down and Mr. Myers started to advance towards him. The clerk told Mr. Myers that he was going to call the police, and Mr. Myers continued to advance. The clerk was afraid and did not know if Mr. Myers had any weapons. Mr. Myers raised his hand toward the clerk and told him to shake it. Mr. Myers then turned away, picked up a lighter, and left the store. There was no physical contact when Mr. Myers advanced upon the clerk, but the clerk was very clear that he felt threatened when this was happening. Mr. Myers went out into the parking lot and was yelling and flailing his arms. He was observed by police to be screaming at a woman who was running to her van. Mr. Myers complied with police but continued to yell about Russia, higher powers, and engineering, such that he was difficult to communicate with.

Evidence at Hearing

11. The panel had before it the following record items, including the Notice of Hearing dated July 28, 2025, a Disposition dated March 14, 2025, and the Amended Reasons for Disposition dated May 5, 2025. The following documents were made exhibits:

• Letter from Providence Care to the Board advising of the restriction of liberty and seeking early review dated July 15, 2025 (Exhibit 1)

• Letter from Providence Care to Waypoint with the Rule 13 request requesting transfer dated July 16, 2025 (Exhibit 2)

• Historical hospital report dated January 28, 2025 (Exhibit 3)

• Progress Note concerning Mr. Myers authored by Dr. Andrew Bickle dated August 20, 2025 (Exhibit 4)

• Letter from Waypoint to Providence Care in response to Rule 13 request dated August 25, 2025 (Exhibit 5)

• Screen shot dated June 26, 2025, of a LinkedIn post by Mr. Myers (date unknown), indicating Mr. Myer’s acknowledgement that he emailed Justice K. Moore (Exhibit 6) the contents of which were read into the record by counsel for Mr. Myers:

“Today I emailed the judge who found me not criminally responsible for the reason that Dr. Bates and my nuclear research for delusions because Providence Care Hospital forensic assessment didn't validate anything which was readily available in my records. I sent the judge my correspondence with Dr. Bates and my five documents with my nuclear research. It doesn't get any more clear to the Crown than this. Direct evidence to the judge that made this mistake because the hospital was negligent. 19 months overtime served due to Providence Care Hospital negligence.”

• Letter from Dr. Julian Gojer letter from the Royal Ottawa Mental Health Centre (“ROMHC”, or “Ottawa Hospital”) and Brockville Mental Health Centre (“BMHC” or “Brockville Hospital”) dated July 9, 2025; distributed in hardcopy to members of the panel towards the end of the hearing. (Exhibit 7)

12. In addition to the documentary evidence, the Board also heard oral evidence from Dr. Andrew Bickle, having been Mr. Myers’ attending forensic psychiatrist since July 3, 2025.

Background

13. The Hospital Report and Progress Notes provide a great deal of information concerning Mr. Myers’ personal history, mental health history and his course in hospital and community subsequent to the date he was found NCR. As these were made exhibits at the hearing, it is not necessary to reproduce the information contained within them fully in these reasons.

14. Briefly and for context in the making of the panel’s decision, the Hospital Report and other information show that Mr. Myers was 39 years old at the time of the hearing.

15. In terms of his personal history, Mr. Myers has a half-sister. His parents divorced and after that he did not keep in close contact with his biological father. He appears to have done well in school and attended McMaster University’s Engineering program for a time but left because he felt his Facebook account had been “hacked” with posts questioning his sexual orientation. He was reportedly married at one point and has a son but is not in contact with either his wife or child at this time. According to the Hospital Report, Mr. Myers currently has limited family supports or friends.

16. His employment history has included short term employment positions mostly in the food service industry but also in construction. It has been reported that some of those positions ended due to his use of substances (alcohol and drugs).

17. Mr. Myers has a history of involvement with the criminal justice system, including having been charged with assault and uttering threats. The Hospital Report also notes Mr. Myers has convictions for mischief and failure to comply. Mr. Myers was previously subject to the jurisdiction of the Board from January 2017 to January 2023. This was the result of a finding on January 19, 2017, that Mr. Myers was found NCR on charges of assault and utter threat to cause death or bodily harm. The circumstances of those index offences involved Mr. Myers punching the victim in the face and threatening to strike the victim with a hockey stick. Mr. Myers was granted an absolute discharge in January 2023. The Hospital Report indicates that since the absolute discharge in 2023, Mr. Myers continued to have numerous contacts with police in the Brockville area due to disturbing behaviours including emailing and mailing the police and vocalizing violent acts that he wished to carry out.

Diagnosis

18. With respect to his psychiatric history, Mr. Myers had contact with the mental health system as of 2007 when he was 22 years old. He has had multiple diagnoses throughout the years including bipolar I disorder, substance use disorder, ADHD, adjustment disorder, and schizoaffective disorder (bipolar type) with mixed personality traits. The Hospital Report dated January 28, 2025, notes his current diagnoses as schizoaffective disorder (bipolar type) and the last Amended Reasons for Disposition also notes substance use disorder (alcohol and cannabis).

Course Under the Jurisdiction of the Board Since the Last Annual Review

19. According to the Progress Notes, Mr. Myers had been in the primary care of Dr. Michael Chan from the time of the last Annual Review in March 2025 until July 3, 2025, when Mr. Myers’ care was taken over by Dr. Bickle.

20. According to Dr. Chan’s portion of the Progress Notes, between March 2025 and July 2025, Mr. Myers’ work with Dr. Chan appeared to go fairly well. Mr. Myers had commenced taking Invega Sustenna injectable antipsychotic medication, receiving the maximum dose of 150mg every three weeks. He did better on Invega Sustenna compared to when he was receiving Clopixol, his previous antipsychotic, and reported that he found the new medication less sedating. Mr. Myers continued on the Invega Sustenna injectable every three weeks through April 2025 into June 2025. Mr. Myers seemed to progress in his treatment. There were many positive indicators of progress, including that he was on a behavioral management plan reviewed weekly by the team and implemented with input of the behavioral therapist at Providence. Mr. Myers also expressed satisfaction with his new treatment regimen.

21. There were some indications for concern, however, in that Mr. Myers had been found treatment incapable. Mr. Myers challenged the incapacity finding in late May and his status as being incapable with respect to treatment was upheld by the Consent and Capacity Board had been upheld. Dr. Chan noted that from his perspective, Mr. Myers’ feelings toward him were adversarial because of his having declared him incapable to consent to treatment and Mr. Myers wanted Dr. Chan to “back off.”

22. On June 30, 2025, Mr. Myers made targeted threats against Dr. Chan, which he expressed to nursing staff. Specifically, he was threatening to assault Dr. Chan at the earliest opportunity. As the threat severity had heightened, a decision was made by the treatment team and the Hospital to transfer Mr. Myers’ psychiatric care to Dr. Bickle. Additionally, Dr. Chan made a report to Kingston Police.

23. On July 3, 2025, Dr. Bickle became Mr. Myers’ most-responsible-physician (“MRP”). Between July 3, 2025, and August 20, 2025, Dr. Bickle conducted a number of interviews with Mr. Myers focusing on his mental state and attitude towards Dr. Chan. This was a concern because the inpatient unit at Providence is relatively small in size and providing the necessary degree of physical separation between Dr. Chan and Mr. Myers during working hours proved challenging.. This limitation of physical space and separation during normal working hours was a major factor in maintaining Mr. Myers in a HIT room and the corresponding restrictions on his liberty at Providence.

24. In addition to the threats to Dr. Chan at the end of June, additional concerns have arisen regarding Mr. Myers’ presentation. These include instances of grandiose thinking that, even accounting for Mr. Myers’ intelligence and knowledge base, seem to not be correct, nor are these accompanied by evidence. For example, Mr. Myers claims he has cracked Einstein’s second theory of relativity and invented a revolutionary new type of nuclear reactor that he has patented. He has also discussed some visual perceptual disturbances such as seeing parts of his book highlighted in gold.

Evidence at the hearing

25. In response to questions from Ms. Tom, Dr. Bickle stated that he has been Mr. Myers’ treating psychiatrist since July 3, 2025. Dr. Bickle is the author of the Progress Notes of August 20, 2025, and adopted its contents.

26. Dr. Bickle stated that the threats to Dr Chan were made by Mr. Myers in the early hours of June 30, 2025, to a member of nursing staff. These included a threat to have Dr. Chan murdered. Mr. Myers made references to knowing people “on the outside” who would facilitate the murder of Dr. Chan. The nursing records include that Mr. Myers said he would be “patient” and “orchestrated” in having Dr. Chan murdered. Later on in the same shift, the threat was repeated and included statements that the next time Mr. Myers saw Dr. Chan, he would assault him. This led to Mr. Myers being put into seclusion in the HIT Room, where he remains with limited egress, including that he may leave the HIT room when Dr. Chan is not expected on the ward, i.e., evenings and weekends. Dr Chan was part of this plan and was supportive of it.

27. Dr. Bickle stated that he had a chance to review the threats made with Mr. Myers since becoming Mr. Myers’ MRP. At their first meeting, Mr. Myers acknowledged to Dr. Bickle that he had made threats, but that those threats were different from what was noted in a nursing report of June 30, 2025. Specifically, Mr. Myers said he had not made the threats, but that friends of his had responded to his social media posts and had offered “to do this” and distinguished that from making the threats himself. Subsequently, Mr. Myers said that the statements about his friends were all simulated, that there was no outside input or threat, rather, it was a strategy to have Dr. Chan removed from his case as he had previously requested. In terms of why Mr. Myers chose that strategy, Dr. Bickle stated that Mr. Myers had not made any direct comments about this, but in general was frustrated with Dr. Chan because, fundamentally, Mr. Myers disagrees with Dr Chan’s opinion about Mr. Myers having a psychotic mental illness and the finding of NCR. Mr. Myers has asserted his belief that an understanding of his case requires an understanding of social media, especially his early posts from 2007 when he was at university. Mr. Myers believes that Dr. Chan does not have that understanding, because Dr. Chan is too old to understand social media.

28. With respect to Mr. Myers’ insight, Dr. Bickle stated that Mr. Myers clearly has insight into the consequences of his actions, i.e., obtaining a change in MRP. However, Dr. Bickle has not heard anything from Mr. Myers with respect to having regret about psychological harm caused to Dr. Chan, or any impact on Dr. Chan’s ability to be on the wards.

29. Around the same timeframe of the threats made to Dr. Chan, Dr. Bickle stated he had been told that there were threats of sexual assault made by Mr. Myers to a female staff member, although he was not sure of the exact date of those threats. He had not had a conversation with Mr. Myers about that yet but intended to discuss that with Mr. Myers if Mr. Myers remains at Providence.

30. With respect to threats made to a judge in Brockville, Dr. Bickle stated that when he became Mr. Myers’ MRP, he had been told that Mr. Myers had contacted, or, at least, had attempted to contact the sentencing judge in Brockville, although Dr. Bickle himself has not seen the related email. Dr. Bickle stated that he has seen the screen shot of the post on social media referenced earlier. He does not have any documents about the threat other than what Dr. Gojer reported in his letter of July 9, 2025, regarding the transfer request to Brockville.

31. Dr. Bickle stated that Mr. Myers’ principal diagnosis is schizoaffective disorder. Mr. Myers’ insight about how the diagnosis applies to him is very limited. Mr. Myers is intelligent in relation to many topics and can understand his diagnosis in the abstract, as he can many other topics, however, because of the nature of his disorder, he is unable to appreciate how the diagnosis applies to him.

32. Dr. Bickle stated that Mr. Myers is compliant with his long-acting injectable antipsychotic medication, Invega Sustenna. Supplemental oral medication has been discussed with Mr. Myers, although he is not currently taking it. Dr. Bickle would like to augment Mr. Myers’ current medication regimen with oral medications, as Mr. Myers is not currently optimally treated. Mr. Myers was on his current medication in June when threats were made.

33. Dr. Bickle stated that Mr. Myers is incapable with respect to treatment. He is still a serious risk to the safety of the public. His main risk factors in broad terms include both physical and psychological harm. In the past, he has represented some direct physical harm to others, as was present in the circumstances of the NCR finding and that led to the restriction of liberty. Of concern to Dr. Bickle most recently, Mr. Myers has also posed a risk of psychological harm to people who do not share his view about the nature of his mental illness, whether he has a mental illness, or what the treatment should be, both in the criminal justice system and the health care system.

34. In keeping with the content of the Progress Notes, Dr. Bickle stated that a transfer of Mr. Myers out of Providence is necessary for several reasons. With respect to the current circumstances of Mr. Myers’ detention, the circumstances “are not great” and preclude opportunities for rehabilitation. Realistically speaking, Mr. Myers treatment cannot be managed in the small unit at Providence. Because Providence only has one ward, there is no option for transferring Mr. Myers to another ward, where he might have a new MRP and no contact with Dr. Chan or the nurse whom he threatened. Additionally, Mr. Myers’ treatment has reached a “clinical impasse”, as mentioned in the Progress Notes, in the sense that he cannot take part in any opportunities for rehabilitation.

35. Dr. Bickle stated that he is supportive of the change to Mr. Myers’ Disposition that he only have staff supervised access to a phone and the internet, including social media, the main consideration being that such access is linked to the threat that arose on this occasion and only after a week of having the privilege of internet access. Mr. Myers did in fact contact Dr. Bickle via LinkedIn, not in a threatening manner, but he was reaching out. With the caveat that it was somewhat speculative, Dr. Bickle also expressed concerns about the impact of unsupervised internet access on Mr. Myers’ mental state, given, for example, that social media creates somewhat of a “biased echo-chamber” (which can enhance or more deeply entrench as individual’s beliefs.) Given his mental disorder, his access to social media via the internet needs to be supervised to determine impacts on Mr. Myers’ mental health.

36. In response to questions from Ms. Ferguson, Dr. Bickle indicated that as Mr. Myers’ treating psychiatrist, to date he has had good, albeit somewhat superficial, conversations with Mr. Myers. With respect to conversations about the threats he has made, Mr. Myers’ changes his accounts. Dr. Bickle stated that he and Mr. Myers are working on a therapeutic relationship, however, developing rapport appears conditional on Dr. Bickle agreeing with Mr. Myers about Mr. Myers’ psychiatric history. Dr. Bickle believes that such agreement is unlikely, which presents concerns for their therapeutic relationship in the future.

37. Dr. Bickle’s experience, contact from patients via LinkedIn is not typical. He had seen that Mr. Myers is listed on LinkedIn as a nuclear design engineer, a particle physicist and a power engineer, and that this includes the phrase “mobius sum lambda”, however, Dr. Bickle did not know the meaning of the phrase. (Following consultation with his counsel, Mr. Carter, Mr. Myers then explained that this Latin phrase is the name of a registered business he has with a Dr. Bates at McMaster University graduate school, with whom Mr. Myers has taken courses in the past and collaborated on research. Mr. Myers said that in nuclear physics, the phrase is related to a certain type of mathematical pattern and describes a major part of a “transmutation reactor”.)

38. Dr. Bickle stated that following the first communication from Mr. Myers to Dr. Bickle via LinkedIn, there were a few more contacts made by Mr. Myers, also via LinkedIn, however, this was before Dr. Bickle became Mr. Myers’ psychiatrist. Other than reporting those communications to the program manager, Dr. Bickle did not pay attention to the communications, nor did he take any other action.

39. Dr. Bickle stated that Mr. Myers was not inclined to name any names of the individuals who had offered to help in relation to the threat to Dr. Chan. Mr. Myers conveyed his approval of the suggestions made on social media by the individuals who offered to help and did not indicate any intention to retract. Dr. Bickle had not noted any remorse expressed by Mr. Myers. Dr. Bickle confirmed Dr. Chan’s statement that the threats had been reported to the police.

40. Dr. Bickle stated that he had read in the Hospital Report that Mr. Myers claimed to have resolved the war between Russia and Ukraine by means of a mathematical formula. Dr. Bickle had some related conversations with Mr. Myers, although “not as specific as that”, i.e., not in relation to the mathematical formula. Dr. Bickle noted that Mr. Myers had studied in Russia for a year and may have a child in that country. In their discussions, and as recently as the week before the hearing, Mr. Myers had stated that he transferred his allegiance to Russia and knew that could be regarded as a sensitive issue. Mr. Myers has not talked to Dr. Bickle about the formula specifically, although he has talked about inventing a new generation of nuclear reactor.

41. Ms. Ferguson asked Dr. Bickle if he was able to comment on any indications of personality features and, in particular, any antisocial personality features that Mr. Myers has or has not displayed. Dr. Bickle stated that he had read a document about a previous assessment (an assessment that he had not read himself) and that Mr. Myers was diagnosed in the past with antisocial personality disorder. In the document, psychologist Dr. Douglas reviewed the pros and cons of that diagnosis being made. Dr. Bickle stated that it is certainly true that assessing personality is difficult and raises validity issues if performed when the person is acutely mentally ill, which is what Dr. Bickle understood to be Dr. Douglas’ point in her assessment. Dr. Bickle stated that whilst he regards Mr. Myers as showing some subtle signs of his psychotic mental illness over the last six to seven weeks since becoming Mr. Myers’ psychiatrist, those signs are currently not overwhelming or florid. While his contact with Mr. Myers has taken place over a relatively limited amount of time, Dr. Bickle believes he is bound to consider whether Mr. Myers’ use of threats to achieve an outcome, such as the removal of Dr. Chan as his psychiatrist, and Mr. Myers’ lack of remorse from having done so, may be markers of antisocial personality traits. Dr. Bickle was not, however, aware of a structured assessment of personality having been conducted on Mr. Meyers. While such an assessment might be helpful, it would need to be timed very carefully to be valid.

42. In response to questions from Mr. Carter, Dr. Bickle stated that Mr. Myers’ was put on injectable Invega Sustenna at the time of his last Board hearing and continues on that medication. Last year, Mr. Myers was displaying more florid psychotic symptoms, whereas presently, Dr. Bickle thinks that over the past six to seven weeks there has been a reduction in the range and intensity of those symptoms. Dr. Bickle agreed there were reductions in those symptoms around March, April and June this year as set out in the Hospital Report and that Mr. Myers had been on a behavioural therapy program under a behavioural therapist and made progress in terms of spending time off the unit, such that Dr. Chan was surprised by Mr. Myers' recent behaviour.

43. Dr. Bickle hypothesized that Mr. Myers’ recent behaviour relates to his internet access, and specifically his use of social media. It was Dr. Bickle’s understanding that Mr. Myers access to the internet started when he had access off the ward. He was not sure exactly when Mr. Myers made the sexual assault threat but had been told recently that it was around June 30, 2025. He did not know if there were any consequences as a result of the threats, or if Mr. Myers continues to have any contact with the nurse who was threatened.

44. Dr. Bickle stated that the threat made by Mr. Myers with respect to Dr. Chan had been stated to one of the staff members, who then relayed the message to Dr. Chan. Mr. Myers had described to Dr. Bickle some of the characteristics of the individuals who were allegedly recruited with respect to the threats to Dr. Chan, albeit without stating any names. Dr. Bickle stated that he did not know if those individuals actually existed. Dr. Bickle mentioned that there had been some limited exploration of the identity of any individuals that Mr. Myers may have contacted online, but without, for example, access to Mr. Myers’ social media accounts, it is not possible to be confident that any content would represent his social media activity. Dr. Bickle stated there was to his knowledge no evidence of any interactions between Mr. Myers and any such co-conspirators. He could not say if Mr. Myers behaviour was oriented towards harming Dr. Chan, or obtaining a new psychiatrist. Dr. Bickle was aware of similar past behaviour by Mr. Myers, in particular, threatening his psychiatrists, which was the reason for his transfer to Providence Care from Brockville. Dr. Bickle stated he was also aware that threats had been made by Mr. Myers in the past to Dr. Chan and other staff at Providence, although he did not have a written account of those past incidents, and that Dr. Chan is still averse to interacting with Mr. Myers on the unit.

45. With respect to the hospital seeking a transfer to Waypoint, Dr. Bickle stated that the purpose of seeking a transfer out of Providence Care for Mr. Myers was a combination of increasing Mr. Myers’ treatment opportunities while ensuring protection of staff. With respect to Mr. Myers’ perspective, Dr. Bickle acknowledged that it is Mr. Myers’ preference to stay in Kingston, even with the current level of restrictions in place, however, this is not an option that Dr. Bickle would want for him at all. Dr. Bickle stated that whenever someone detained in the unit is incapable with respect to treatment, as is Mr. Myers, there is always a degree of paternalism in treatment, even when the patient disagrees and insofar as the patient’s best interest is considered. Dr. Bickle stated that he takes that view in Mr. Myers’ case. With respect to the threat to Dr. Chan, Dr. Bickle stated that Mr. Myers had said he was going to be “patient” and “orchestrated”, that he was “going to have him [Dr. Chan] murdered” and that he knew there would be “repercussions” for saying what he said. Dr. Bickle found these statements by Mr. Myers to be, at least, indicative of forethought.

46. Dr. Bickle stated that he agrees that, from Mr. Myers’ perspective, being able to continue his studies is very important to Mr. Myers. Dr. Bickle is aware that Mr. Myers has stated that he is “biding his time” until Medical Assistance in Dying (MAID) is available to him, although he has not discussed MAID with Dr. Bickle. Dr. Bickle stated he is aware that Mr. Myers has a sister (or half-sister) taking courses at a local college and had heard that Mr. Myers’ has a son in the area. As far as Dr. Bickle knows, Mr. Myers is not in contact with his sister or son, but establishing contact is an aspiration.

47. In response to questions from the panel, Dr. Bickle stated that he does not know when Mr. Myers last had contact with his sister or son. Mr. Myers’ privileges allow him to have community access, but do not specify anything related to contact with individuals. When asked how he measures Mr. Myers’ risk of harm to others, such as a treating psychiatrist, with his having access to the community, Dr. Bickle stated that it was evident that having unfettered access to the community or to the hospital, including internet access, increases Mr. Myers’ risk of harm to others.

48. With respect to Dr. Bickle’s comment in the report that a transfer to Waypoint would provide a “fresh start” for Mr. Myers versus protecting individuals at risk of some aggressive behaviours of Mr. Myers, Dr. Bickle stated that both are goals of seeking the transfer.

49. With respect to Mr. Myers’ psychological report of 2024 and as noted from that report at page 16 of the hospital report in which Mr. Myers’ risk had been rated as “moderate” to “high”, Dr. Bickle stated that rating risk in such broad terms “is just that, just a summary.” Dr. Bickle added that if including the capacity for psychological harm or aggression, rating Mr. Myers’ risk as moderate to high is reasonable.

50. Dr. Bickle stated that he did not know if there had been charges laid against Mr. Myers by the police. Mr. Myers has a history of making threats, for example, to a psychiatrist in Brockville, as well as previous threats to Dr. Chan. Dr. Bickle stated that he would take the most recent incident of Mr. Myers threats to murder and use outside agents as “an escalation, or at least something that is very serious.”

51. When asked whether Mr. Myers’ threats will continue or otherwise abate if he goes to Waypoint, or if transfer of Mr. Myers there is more about managing his risk to others, Dr. Bickle stated that Providence Care has tried to refer Mr. Myers to another hospital at the same level of security (i.e., another medium secure setting) and that the opinion of that hospital is that they cannot manage Mr. Myers’ case. As such, it does seem necessary at this point to refer Mr. Myers to Waypoint. However, in addition, Waypoint is a large hospital that can offer greater freedoms within its perimeter and services, so while offering a high level of security, Waypoint might actually offer greater freedoms to Mr. Myers.

52. Dr. Bickle stated that if Mr. Myers continues at Providence, increased privileges, including access to the internet, would come about through gradual exposure with related assessments, in terms of how much individually supervised egress the ward can facilitate. Mr. Myers might have internet access perhaps for an hour, three to four times a week, although Dr. Bickle would defer to the charge nurse on his estimates as to whether staffing levels would permit this. While he could not comment specifically on any comparison of supervised egress time that would be available at Waypoint, Dr. Bickle stated that he had in mind that Mr. Myers would not need to be confined to a security room through the day Monday to Friday, as he is currently. It is desirable for patients to have rehabilitation opportunities, for example, programs, psychosocial groups, and therapists. Mr. Myers may or may not want to participate in those things currently. However, such opportunities are part of any good care plan and should be available to Mr. Myers but are not available at Providence because of his current constraints. Also, the ratio of staff to residents would be a little bit higher at Waypoint compared to Providence Care.

53. When asked about the process for reintroducing privileges if Mr. Myers is transferred to Waypoint, Dr. Bickle stated that when someone is transferring to the unit at Providence Care, there is some period of observation with respect to privileges and rates of reinstatement. Dr. Bickle stated that he was perfectly sensible to the fact that moving Mr. Myers to another hospital does not alter the risk related to access to social media. Dr. Bickle hoped that progression in terms of being out of a very secluded room and being able to do other things within the hospital, given Waypoint’s secure perimeter, might progress “pretty quickly.”

54. With respect to how transferring Mr. Myers to another hospital would mitigate the risk of harm he poses to others, Dr. Bickle stated that the issue of managing Mr. Myers’ reaction to people who disagree with him about his psychiatric history, the nature of his psychosis and his treatment will continue to be a challenge wherever he goes, however, transfer out of Providence will be a way of managing Mr. Myers’ risk to those with whom he already has a rift “in a fairly dramatic fashion.”

55. Dr. Bickle stated that he had only recently found out about the threat that Mr. Myers had made to a nursing staff member. He had not had any opportunity to investigate whether the threat had impacted the nurse either psychologically, or in terms of their work assignment. He had been told that around the time the threat was made that Mr. Myers had threatened a specific nurse.

56. At the request of the Alternate Chair, Ms. Tom sought and obtained further information in connection with Mr. Myers’ threat to nursing staff. Ms. Tom advised the panel that she was in receipt of a text from Ms. Chantal Thompson, Review Board Coordinator at the Hospital. Ms. Tom read the text during the hearing: “After that threat, he [Mr. Meyers] was returned to the high intensity treatment room and the nurse who was threatened is not to be assigned to his care and she does not have direct contact with him.” The Alternate Chair stated that everyone would be able to ask questions about the text following the questions from all panel members.

57. Dr. Bickle stated that other than the request to transfer Mr. Myers from Providence Care proposed to the Brockville Hospital and the letter (not yet circulated at that point in the hearing but produced later) from Dr. Gojer of July 9, 2025 (Exhibit 7), no other medium security facilities had been approached to request a transfer. There were some discussions among the team about what to do following the refusal from Brockville Hospital, however, the team believed it was unlikely to be successful in making requests to other medium security facilities, at least not until Mr. Myers was assessed by Waypoint.

58. Dr. Bickle stated that while awaiting the assessment from Waypoint does not preclude a transfer request to Hamilton, this would need to be discussed with staff in Hamilton, given Mr. Myers’ connections to McMaster University and purported relationship with a former professor, although whether contact would be welcomed by his professor is another consideration that would need to be made by the team. Dr. Bickle stated that he did not know if anyone at Providence Care had reached out to McMaster University, the professor, or the hospital in Hamilton. This does not preclude a referral to the hospital in Hamilton; however, these are factors that would need to be considered carefully.

59. Dr. Bickle stated that any personality assessments of Mr. Myers would need to be carefully timed in order to ensure validity. Standard assessments for structured personality contain caveats about use with people with active mental illness. Active symptoms of mental illness could skew the results. Acute changes to someone’s mental state could confound the findings. Dr. Bickle would look to Dr. Douglas, the unit psychologist, to conduct the testing. Providence Care is currently in the process of trying to recruit a second psychologist after another psychologist left. The Hospital’s capacity to perform tests is limited at this time.

60. Dr. Bickle stated that prior to the incident related to Dr. Chan, Mr. Myers was doing behavioural therapy with the behavioural technologist, something that Dr. Bickle was aware of from reviewing Board reports. Mr. Myers later declined to participate in the therapy. Currently, staff are controlling Mr. Myers’ internet access by keeping him in the HIT room most of the time and only permitting supervised leave off the ward.

61. With respect to Mr. Myers taking online courses through Athabasca University, Dr. Bickle stated that he did not think that Mr. Myers was currently taking courses. If Mr. Myers was to take online courses at some point in time, depending on the nature of the courses, Dr. Bickle stated that there could be internet access for the purpose of education, depending on the nature/delivery mode of the course. (Ms. Tom indicated that she would need to obtain direction on this point and subsequently did; see paragraph 74 below.)

62. Dr. Bickle stated that in conducting a risk assessment, an individual’s history of acts of aggression that were not part of a criminal act are considered. Threatening or violent behaviours might not result in conviction but are still part of the overall assessment of risk.

63. Dr. Bickle stated that Waypoint will be the arbiter of whether or not Mr. Myers requires the maximum secure setting of Waypoint to manage his risk of harm to others. While Waypoint’s response to the Hospital’s Rule 13 request indicated that its security level is higher than needed, it was not a “black and white refusal.”

64. Referencing the letter from Dr. Gojer on behalf of BMHC dated July 9, 2025, Dr. Bickle noted that the letter indicated that BMHC would not be able to manage Mr. Myers’ risk.

65. With respect to whether a term of the Disposition Order prohibiting direct or indirect contact with Dr. Chan, Justice Moore and the nurse who was threatened might be appropriate, Dr. Bickle stated that his first impression was that those limits seem to be reasonable measures.

66. Dr. Bickle stated that Mr. Myers’ primary diagnosis is schizoaffective disorder with periods of mania, although of note is that the 2016 NCR finding was in the context of Mr. Myers being depressed. Mr. Myers’ secondary diagnosis is substance abuse disorder for alcohol and cannabis, currently in remission in a controlled setting. Mr. Myers has not had any recent therapy targeting those conditions.

67. With respect to Mr. Myers’ index offences, Dr. Bickle stated that the restrictions on weapons in the current disposition should remain in place.

68. Dr. Bickle stated with respect to the Reasons for Disposition dated May 5, 2025, paragraph 31, which includes an excerpt from the most recent prepared Progress Notes – Psychology, dated February 27, 2025, authored by Dr. Douglas, Clinical and Forensic Psychologist at Providence Care:

“Although he has a lengthy psychiatric history, Mr. Myers does not have a history of criminal conduct outside of his mental health difficulties. His aggressive behaviour has primarily been of verbal threats in the context of disorganized behaviour, positive symptoms of psychosis, and thought disorder.”

69. Dr. Bickle stated that for the most part, the content of the excerpt remains correct, however, he added, “I think that could be qualified a bit more, in that the current threats did not seem to be in the grip of florid positive symptoms of psychosis and thought disorder.” This indicates escalation of Mr. Myers’ risk because of the potential for his risk to occur outside the context of acute psychotic symptoms.

70. There were no further questions from the members of the panel.

71. In response to further questions from Ms. Tom, Dr. Bickle stated that with respect to his earlier evidence regarding the identity of Mr. Myers’ friends in the community who might participate in harming Dr. Chan, Mr. Myers had not revealed the identity of any individuals but had mentioned characteristics of those people. Specifically, Mr. Myers had told Dr. Bickle that the individuals were friends in Hamilton from a long time ago, not exclusively people who he had met just on social media, and that two of those friends had been to jail. Mr. Myers did not give any additional details about these friends, e.g., which jail or for how long.

72. Ms. Ferguson had no further questions.

73. With respect to the letter dated from Waypoint dated August 25, 2025, at page 2, that Mr. Myers would have limited community access at Waypoint, Mr. Carter asked Dr. Bickle if it was a fair statement that this was a reason for Waypoint’s recommendation to consider transferring Mr. Myers to a secure forensic program at another hospital, granting Mr. Myers the opportunity to work with a new treatment team but without the restrictions of the high security setting at Waypoint. Dr. Bickle agreed that this was a fair statement. Dr. Bickle acknowledged that it is likely Mr. Myers would not be able to come back to Kingston and have access to family, as he might wish, adding that whether the desire for contact is reciprocated by his family is not clear from the information available.

74. Ms. Tom confirmed that the letter of July 9, 2025, from Dr. Gojer at ROMHC had been located and would be provided to the panel. She had no further questions. She stated that there was no objection from her or the other parties regarding entering the letter from Dr. Gojer at ROMHC as Exhibit 7. She also stated that the detail regarding internet access for educational purposes can be subsumed into the conditions of permitting internet and phone access only if supervised by staff and that staff availability is limited and not guaranteed for schooling purposes.

75. Mr. Carter confirmed that Mr. Myers is not currently taking courses at Athabasca; he is registered but does not qualify for OSAP until early 2026.

76. No further documentary or other evidence was called by the parties.

Submissions

77. In her final submissions, Ms. Tom repeated her original position that the restriction of liberty was warranted and the least restrictive option. Given that the facts and situation have not changed since the restriction began, the ongoing restriction of Mr. Myers’ liberty is also warranted and the least restrictive option. It began with an escalated threat to cause harm to Dr. Chan. Consistent with Dr Bickle’s testimony, Mr. Myers’ motivation was to obtain a new treating psychiatrist who would view his situation as he perceives it and not as viewed by his previous treating psychiatrists or within the Board system.

78. Ms. Tom submitted that the hospital is seeking a more restrictive Disposition Order for Mr. Myers with reduced privileges, including removal of community privileges and indirect access to hospital grounds. Accordingly, Mr. Myers would require staff accompaniment or staff escort. His ability to access the Internet and social media on his phone will be strictly limited to times when direct staff supervision is available.

79. With respect to questions at the hearing about whether the transfer request relates to a treatment impasse, or whether it is about security, Ms. Tom submitted that Dr. Bickle’s evidence has been consistent that it is about both. The safety of the public being the primary and paramount concern before the Board, in this instance, the safety of the public related to Mr. Myer’s behaviour towards his treating psychiatrist, Dr. Chan, who has been quite concerned. It is already a pattern for Mr. Myers to threaten others, for example, when he stopped his medication after his past absolute discharge. Dr. Douglas commented in the hospital report about Mr. Myers’ making threats to others when he has been unwell and is experiencing active symptoms of psychosis. As Dr. Bickle stated, the circumstances of the restriction of liberty are different; Mr. Myers has not been experiencing active symptoms of psychosis; he is taking medication and up to the time of the event when the threat occurred, he was doing well. No one knows what caused him to make the threat, but regardless, he made the threats. With respect to whether or not Mr. Myers intended to follow through on the threats of harm, or whether he intended to gather the support of his colleagues in Hamilton, the risk and threat of psychological harm is still significant harm. As noted in the Progress Notes, Dr. Chan continued to work with Mr. Myers when he had made threats in the past, however, the recent incident that led to the restriction of liberty was an escalation. Regardless of whether Mr. Myers intention was to cause physical harm to Dr. Chan, Mr. Myers “put it out there” and said his friends responded. He has no remorse. He was deliberate and manipulative in his intention. He is prepared to use the threat of psychological harm to get his way, which is not the first time this has happened with the treating psychiatrist involved in his care.

80. While there were no concerns about the content of Mr. Myers’ attempts to contact Dr. Bickle, it is clear that Mr. Myers is skilled and comfortable in terms of this use of the Internet and that he wants to determine not only who is his psychiatrist but also that he has a psychiatrist who agrees with how he perceives his condition. Ms. Tom suggested that the Board “send a clear message to Mr. Myers that he crossed the line” and that it is not acceptable to threaten harm to a treating psychiatrist. There is no evidence of any charges being laid by the police following Dr. Chan reporting the threats made to him by Mr. Myers, however, it is clear that Dr. Chan took the threats seriously, as recorded in the Progress Notes.

81. Ms. Tom submitted that Dr. Bickle has clearly stated that continuing at Providence will not be good for Mr. Myers, rather, his rehabilitation requires he have access to therapeutic supports and opportunities, something he cannot have in a HIT room with limited egress. Given the safety concerns to Dr. Chan and to the nurse whom Mr. Myers threatened with sexual assault, as well as the further limitations and restrictions requested by the Hospital at the hearing with respect to a new Disposition Order, the current situation is unworkable. The letter from Waypoint, which does not say “no” to a transfer, takes into consideration Mr. Myers’ existing Disposition, which Waypoint sees as a bit generous in terms of community access and the limits on access at Waypoint. However, Providence now seeks a different Disposition Order that would remove clauses permitting community access and what Waypoint offers is similar to the conditions that Providence would have in place under the requested revisions to Mr. Myers’ Disposition. While is it not clear what other facilities, such as Ontario Shores, or Saint Joseph’s Healthcare Hamilton, with similar levels of security to Providence Care might offer, the Hospital is concerned about how long a transfer could take. Again, given the paramount concern of risk to the safety of the public, transfer to Waypoint is the best option.

82. Ms. Tom submitted that the restriction of liberty was required and was the least intrusive option, given Mr. Myers behavior. The transfer to Waypoint is warranted: it is known that Waypoint will say yes to the transfer request and it is the only disposition transfer disposition that can be made, given the terms being requested by the Hospital. After some time and with some assessment and treatment, a transfer to a medium security institution might be explored.

83. Ms. Ferguson endorsed Ms. Tom’s submissions, adding that if charges are laid because of Mr. Myers’ threats to Dr. Chan and/or the member of the Hospital nursing staff, the release process would likely be accompanied by restrictions, i.e., for Mr. Myers to stay a specified distance away from those persons. A transfer to Waypoint would be the most appropriate, the speediest and the most consistent with all the considerations, including the level of security Waypoint provides. Additionally, it would anticipate the kind of release orders and conditions that may subsequently be placed on Mr. Myers, e.g. to stay at least 100 metres away from Dr. Chan, which would be virtually impossible to enforce at Providence Care.

84. In his submissions, Mr. Carter referred to Ms. Tom’s submission that the most recent threat to Dr. Chan was different from past patterns of threats in two regards: that it was done in a context in which Mr. Myers was better than he has been in the past and that Mr. Myers engaged the services of outside sources. Mr. Carter questioned the idea of outside sources being engaged. He submitted that if the threat, while serious, was of a level of severity as suggested, the police would have been more proactive in tracking down people who Mr. Myers claimed were going to do harm to Dr. Chan. In the two months since the threats were made, there does not appear to be any such movement by the police, raising questions about the truth or credibility of the threat. While the summer may be a “slow” time, that does not relieve the police of any obligation to remove genuine threats. Mr. Carter submitted that Mr. Myers pattern of threatening psychiatrists is more connected to his frustration with the therapeutic relationship, the pattern being that Mr. Myers escalates into threat mode when he feels frustrated that there is no second opinion on his case, or that the psychiatrist does not believe him, a pattern that is likely to continue.

85. With respect to the submission that Waypoint is the most appropriate transfer destination for Mr. Myers, Mr. Carter submitted that in its letter to Providence, even Waypoint respectfully questioned the decision to send Mr. Myers to Waypoint given some of its limitations. The language of “sending a clear message” is outside the Board’s obligations, which are to examine the facts and apply the law. Following his instructions from Mr. Myers, Mr. Carter requested Mr. Myers be allowed to remain in seclusion until a place is available in Hamilton so that Mr. Myers can be more closely connected with his former professor, who is also in Hamilton. Alternatively, Mr. Myers wants to remain at Providence Care, even with significant restrictions in place, in an effort to develop a relationship with his sister and his son. Ultimately, Mr. Myers’ objective is to achieve MAID. Mr. Myers has been consistent in recent years with respect to his desire for MAID. A further contextual factor is any anticipated discharge of Mr. Myers to the local constabulary prison and how that might unfold if he is unwell.

Analysis—Restriction of Liberty

86. With respect to Mr. Myers’ restriction of liberty, the analytical framework established by Campbell (Re), 2018 ONCA requires the Board to consider the accused’s liberty norm and liberty status at the time of the increase in restrictions. The liberty norm and liberty status for each restriction must be examined to determine the significance of the increase (if any) on the restriction of an accused’s liberty caused by the restriction. In determining the liberty norm of an accused at the outset of each period of restriction, the Board must “take a contextual approach, one that considers the individual’s pattern of liberty in the recent past” ((Re) Campbell, para. 66). The liberty the accused was experiencing (rather than what they were entitled to) at the time of the increase is what the Board is to consider, and that “liberty must be of sufficient duration to have become, objectively speaking, the NCR accused’s norm” ((Re) Campbell, para. 65).

87. Having heard and considered all of the evidence and the submissions of the parties, the Board found that there was a significant increase in the restrictions on Mr. Myers’ liberty from June 30, 2025, and continuing as of the date of the hearing. Further, the Board found that this significant increase in restrictions was warranted when it began and to the hearing day. The Hospital’s decision to move Mr. Myers to a HIT room was eminently reasonable and appropriate in the circumstances, which included an escalation in his threatening behaviour. This represented the least onerous and least restrictive option to manage his risk to public safety, including the safety of Dr. Chan and other staff.

88. As reported by Dr. Chan, Mr. Myers had been doing generally well during March through to June 2025. He had been compliant with his antipsychotic medications. He spoke of particular goals. While the reasons for the change in his demeanor are not completely clear, the escalation of his threats towards Dr. Chan and nursing staff were taken extremely seriously. Providence Care is a small facility with limited alternatives in-house. Confining Mr. Myers to the HIT room and greatly limiting his egress was the only reasonable option.

89. As of the hearing date, the circumstances of Mr. Myers’ restriction of liberty had not resolved. He had not expressed any remorse or acknowledged the impact of his behaviour. Confining Mr. Myers to the HIT room and greatly limiting his egress continued to be the only reasonable option.

90. In coming to its decision, the Board was cognizant of Mr. Myers’ lengthy history of threats and aggression directed at others, which was a fundamental aspect of the Index Offence upon which Mr. Myers was most recently found NCR.

Analysis—Early Review

91. Also before the panel was an early review of Mr. Myers’ Disposition as requested by the hospital. The threshold issue for the panel to determine on the early review was whether or not Mr. Myers continues to represent a significant threat to the safety of the public. The “significant threat” standard is an onerous one. There must be both a likelihood of a risk materializing and the likelihood that serious harm will occur. An accused is not to be detained based on mere speculation; the Board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the accused to deny them an absolute discharge. As set out in Winko v. British Columbia (Forensic Psychiatric Institute) 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625, the threat must be:

(1) More than speculative in nature and must be supported by the evidence;

(2) Significant in the sense of there being a real risk of physical or psychological harm to individuals in the community and in the sense that this potential harm must be serious; and

(3) The conduct creating the harm must be criminal in nature.

92. Taken all together, the evidence shows that Mr. Myers remains a significant threat to public safety.

93. Mr. Myers’ index offence involved unprovoked attacks based on delusional beliefs in the context of being unmedicated for a long period of time. As noted by the panel for Mr. Myers’ annual hearing in 2024, the Transcript of the Reasons for Judgment clearly stated that the victim felt threatened and that this had been a traumatic event for him that he could not forget. The threshold for significant threat was met.

94. Mr. Myers is not currently optimally medicated but was showing improvements between March and June 2025. He acknowledged that he was doing better on Invega Sustenna. He made progress with his privileges and had expressed positive attitudes and outlooks. Given his apparent progress, the threats made on June 30, 2025, that gave rise to the restriction of liberty “came as a complete surprise and shock” to Dr. Chan. The escalation of his threatening behaviour on that occasion, while being something he has been prone to in the past, was not due to being untreated.

95. Despite improvements on his current medication regimen, Mr. Myers’ behaviour is currently less predictable, less tied to symptoms and more difficult to manage. Even when his mental disorder is well controlled, he still presents a risk to the safety of the public and, in particular, a real risk of psychological harm, reflecting a desire to intimidate others when frustrated in order to achieve an end. His recent behaviours did not appear to be part of florid positive symptoms of psychosis and thought disorder. The potential for his risk to occur outside the context of acute psychotic symptoms indicates an escalation of Mr. Myers’ risk.

96. This also raises questions about Mr. Myers’ insight, that is, his ability to appreciate that his behaviours have significant consequences for others. Dr. Chan and the staff nurse have been significantly impacted by Mr. Myers’ threats. As a result, Mr. Myers egress has been completely limited when Dr. Chan is on the wards, and the nurse who was threatened by Mr. Myers is no longer assigned to Mr. Myers’ care. Again, of note is that psychological harm was a key component of the index offence.

97. If Mr. Myers were no longer under the Board’s jurisdiction, it is highly likely he would stop taking his medication, deteriorate, and engage in behaviour that could cause harm—particularly psychological harm—to others. Mr. Myer’s index offence, which caused significant psychological harm, occurred during an active psychotic episode when he had stopped taking antipsychotic medication. The same risk factors remain present. He continues to deny both his diagnosis and NCR finding. His lack of insight is a symptom of his major mental illness. When he does not believe he is ill, he does not believe he needs medication, which makes non-adherence highly probable outside a supervised hospital environment.

98. Individuals who challenge or disagree with Mr. Myers regarding his diagnosis may be exposed to psychological harm, as was the case with Dr. Chan. Even if Mr. Myers were released from the Board’s oversight and initially continued medication, his conduct in the Hospital since the incident—including recent threatening behaviour while doing well on antipsychotic medication—demonstrates that his risk persists even when florid psychotic symptoms are not present. Testimony from Dr. Bickle indicates that these threats occurred in the absence of overt psychosis, making Mr. Myers’ risk profile less predictable and more difficult to manage. Taken together—the seriousness of the past harm, the nature of his illness, his denial around his diagnosis, the probability of medication refusal without supervision, and the emergence of threatening behaviour even while medicated—the evidence supports a finding that Mr. Myers continues to pose a significant threat to the safety of the public.

99. The Board deliberated at length with respect to: the issue of transfer of Mr. Myers from Providence to another hospital and, specifically, the suitability of Waypoint given it is a high security facility; the letter of response dated July 9, 2025, from Dr. Gojer on behalf of the BMHC; and Mr. Myer’s own first choice of remaining at Providence Care and second choice of being transferred to the St. Joseph’s Health Care in Hamilton.

100. The Board decided that, in all of the circumstances, the least restrictive and least onerous Disposition included a transfer of Mr. Myers to Waypoint, for the reasons that follow.

101. The Board agrees with the assessment of Dr. Bickle that going forward, treatment of Mr. Myers will be frustrated at Providence Care. The terms of the new Disposition Order, which are necessary to protect the safety of the public, including Dr. Chan and the nursing staff, will further the impasse. As stated by Dr. Gojer in his letter of July 9, 2025, the features of the BMHC are similar to Providence Care and a transfer of Mr. Myers to BMHC would simply constitute a shift of the same set of challenges at Providence Care to BMHC.

102. In making the decision to transfer Mr. Myers to Waypoint, the panel was mindful of the decision of the Ontario Court of Appeal in in Penetanguishene Mental Health Centre (Person in Charge) v. Magee, 2006 CanLII 16077 (ON CA), 80 O.R. (3d) 436. In that case, the Ontario Court of Appeal set aside an ORB decision that had ordered the transfer of an NCR accused from a maximum-security hospital to a medium-secure unit at CAMH. The Court held that the Board erred in law by treating the issue as whether the respondent’s risk could be “managed” in a medium-security setting, rather than applying all the mandatory factors in section 672.54 of the Criminal Code. By failing to weigh public safety, treatment needs, reintegration prospects, and the accused’s liberty interests together, the Board’s conclusion that its order was the “least onerous and least restrictive” disposition was legally flawed.

103. The Board agrees that a transfer to Waypoint is in keeping with the treatment needs of Mr. Myers. While technically a more secure forensic setting, given Mr. Myers’ current and continuing circumstances at Providence Care, transfer to Waypoint constitutes a less onerous, less restrictive Disposition, is in keeping with the protections outlined in Winko as emphasized in Magee, and will provide circumstances far more conducive to ensuring treatment opportunities for Mr. Myers. For example, Dr. Bickle indicated that there is a better staff to resident ratio at Waypoint than at Providence Care, which will allow for more supervised internet time that Mr. Myers will be able to use for study, connecting with family online (who would also be able to visit Mr. Myers at Waypoint, if they are so inclined), or collaborating with his former professor at McMaster (if that person is so inclined.) Waypoint is also known to offer a number of recreational and vocational facilities within its secure perimeter which will not be available to Mr. Myers if he stays at Providence Care which are not available to Mr. Myers were he to remain at Providence Care in his current restrictive circumstances. All of these activities are important factors related to Mr. Myers’ treatment needs and reintegration prospects, including those described by Mr. Carter as important to Mr. Myers.

104. Mr. Carter submitted that Mr. Myer’s preference is to remain at Providence, that he is contented to spend the majority of his time studying in his room and that remaining in Kingston would allow for possible contact with his half-sister and son, who live in the area. However, following Magee, the Board must take steps to promote the accused’s rehabilitation and reintegration.

105. The Board noted that the letter from Waypoint indicated concerns that some of the terms of Mr. Myers’ previous disposition could not be met there, for example, allowing him community access, and that Waypoint might therefore be a more restrictive option than Providence Care. However, Waypoint’s conjecture was with regard to Mr. Myers’ previous Disposition and the terms that would be limited at Waypoint are not included in his new Disposition.

106. With respect to transfers to other hospitals, there was nothing in the evidence to show that Mr. Myers’ second choice of being transferred to Hamilton was viable within a reasonable timeframe given the circumstances of his current detention at Providence Care. There had been no contact made with Hamilton to explore it as an option. BMHC had concerns about transferring Mr. Myers to Brockville, given the similarity between its facility and Providence Care and there were additional concerns given that the judge who found Mr. Myers NCR is in Brockville. Waypoint was the only live alternative to Providence Care to consider at the time of the hearing but was also found to be the least restrictive and least onerous option compared to keeping Mr. Myers at Providence Care.

107. Mr. Myers has the option of applying to the Board for an early review. Should a place become available for him in Hamiton, or should an assessment completed at Waypoint indicate that he becomes a candidate for transfer to Brockville, Mr. Myers will be able to incorporate a related request(s) into his application.

108. The rationale for transferring Mr. Myers to Waypoint is also consistent with the Ontario Court of Appeal’s decision in MacLean, Re, 2012 ONCA 909, in which the Court found that, paradoxically, a transfer from a general ward to a secure ward could constitute the least restrictive disposition where the more favourable staff-to-patient ratio in the secure setting provides the accused more objective freedom. This will also be the case for Mr. Myers upon transfer to Waypoint, and specifically with respect to internet access. Looking through the combined lenses of Magee and MacLean, a transfer to Waypoint is the least restrictive and least onerous option. Also, everything that Mr. Myers has said he is contented to do at Providence, he will be able to do at Waypoint.

109. The Board notes that Mr. Myers aspires to make connections with family members and with his former professor at McMaster University in Hamilton, however, there was no related evidence presented. For example, there was no evidence of any reciprocal intention to make contact on the part of family members.

110. Mr. Carter emphasized that Mr. Myers has been consistent in his desire for MAID when that becomes available to him and that his desire is part of his overall context and circumstances. Respectfully, and noting that Mr. Myers’ aspiration for MAID is clearly important to him, it was not a factor that the Board was able to account for in making its Disposition.

111. Having considered all of the evidence presented at the hearing and the submissions of the parties, the Board finds that Mr. Myers poses a significant threat to the safety of the public as set out at section 672.5401 of the Criminal Code, and as further defined by the Supreme Court of Canada in Winko. Notwithstanding the recommendations of the parties, the Board finds that the terms requested by counsel for the Hospital and included in these Reasons for Disposition at paragraph 113, constitute a Detention Order that is necessary and appropriate, and the least onerous and least restrictive Disposition in all of the circumstances.

Disposition and Conclusions

112. In summary, Mr. Myers remains a serious risk to the safety of the public. His risk factors in broad terms include both physical and psychological harm. Mr. Myers also poses a risk of psychological harm to people who do not share his view about the nature of his mental illness, whether he has a mental illness, or what the treatment should be, both in the criminal justice system and the health care system. His treatment at Providence Care has reached a “clinical impasse” and precludes opportunities for rehabilitation. The situation would be the same at BMHC. Given his situation at Providence Care, a transfer to Waypoint is necessary. The features of Waypoint, including that it is a larger institution with a better staff to resident ratio, will better facilitate rehabilitation opportunities for Mr. Myers, beyond spending the majority of his time in a locked HIT room without access to the Hospital and grounds.

113. For the reasons cited above, the panel accepted the Disposition terms and conditions as recommended by the Hospital as follows:

• Be detained at the Secure Forensic Unit of Providence Care Hospital until transferred and detained at the High Secure Provincial Forensic Program of the Waypoint Centre for Mental Health Care;

• Attend within or outside of the hospital for necessary medical, dental, legal or compassionate purposes;

• Receive hospital and grounds privileges, beyond the secure perimeter, escorted by staff;

• Abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant;

• Submit samples of urine and/or breath to the person in charge of the Waypoint Centre for Mental Health Care and/or the person in charge of the Secure Forensic Unit at Providence Care Hospital, or their designate for the purpose of analyzing whether the accused has ingested alcohol, drugs or any other intoxicant;

• Refrain from having in their possession any firearm, ammunition or other offensive weapon, or being in the company of any person possessing a firearm other than a peace officer;

• Refrain absolutely from use of internet and telephone unless supervised by staff; and

• Refrain from contact or communication, direct or indirect, with Dr. Chan, the judge named in the Disposition Order, and the nursing staff member named in the Disposition Order.

114. In making this Disposition, the panel reviewed the provisions of section 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Myers’ mental condition, his reintegration into society and his other needs.

DATED this 12th day of December 2025, at the City of Toronto, in the Toronto Region.

Ms. K. Weisbaum

Legal Member

Office of the Registrar

Ontario Review Board