Re: Lee-Ann Ronna Perrault, 2025 CanLII 132790

Ontario Review Board

Re: Lee-Ann Ronna Perrault

ORB File No: 6217

Hearing held on: Thursday, October 30, 2025

Place of Hearing: North Bay Regional Health Centre-North Bay Site

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

Before:

Alternate Chairperson: Mr. C. Flanagan

Members: Dr. K. Hand

Dr. S. Wiseman

Ms. N. Nathanson

Ms. R. Chopra

Parties Appearing:

Accused: Lee-Ann Ronna Perrault

Counsel: Mr. C. Bracken

Person in charge of hospital: Counsel: Mr. T. Trenker

Attorney General of Ontario: Counsel: Ms. D. McCaig

REASONS FOR DISPOSITION

(Dated November 18, 2025)

Introduction

1. On October 15, 2012, Lee-Ann Ronna Perrault was found not criminally responsible on account of mental disorder (“NCR”) on a charge of aggravated assault and three charges of breach of probation, all contrary to the Criminal Code of Canada (“Criminal Code”).

2. Ms. Perrault is currently subject to an Ontario Review Board (“the Board”) disposition dated November 4, 2024, which detains her at the Forensic Programs of the North Bay Regional Health Centre – North Bay Site (“NBRHC” or the “Hospital”), with the outer limit privilege to live in the community of North Bay, in accommodation approved by the person in charge.

3. On October 30, 2025, a panel of the Board convened to review the Disposition in accordance with the requirements of s. 672.81(1) of the Criminal Code. Ms. Perrault attended the hearing. This Board granted Mr. C. Bracken’s request to be assigned to act for Ms. Perrault at the hearing, pursuant s. 672.5(8)(b) of the Criminal Code. A Hospital Report dated September 14, 2025, was filed as Exhibit 1 at the hearing.

4. The issue to be determined is whether Ms. Perrault continues to represent a significant threat to the safety of the public, as defined in section 672.5401 of the Criminal Code, and if so, the necessary and appropriate Disposition to manage that risk, having regard to the criteria set out in s. 672.54 of the Criminal Code.

Initial Position of the Parties

5. At the outset of the hearing, the parties were canvassed as to their initial recommendations to the Board.

6. Mr. Trenker, on behalf of the Hospital, recommended the continuation of the existing Disposition.

7. Ms. McCaig, on behalf of the Attorney General of Ontario, supported the Hospital’s recommendation.

8. Mr. Bracken, on behalf of Ms. Perrault, conceded significant threat and supported the Hospital’s recommendation.

9. All parties maintained their initial recommendation in closing submissions.

Index Offences

10. The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:

On April 18, 2012, Ms. Perrault left her residence at approximately 0300 hours that day armed with a knife. At approximately 0400 hours, she entered the residence of a former partner, Timothy Mitchell, who is the father and custodial parent of her two youngest children (boys aged 9 and 10 years), through an unlocked door. Once inside, Ms. Perrault attacked Mr. Mitchell, who was sleeping on his back on the living room floor, by straddling him and attempting to stab him in the throat. The synopsis indicates that Mr. Mitchell awoke and observed Ms. Perrault holding the knife in her right hand with the blade pointing down and plunging it towards his throat. Having blocked the knife with his left arm to protect his throat, Mr. Mitchell sustained a 3” laceration where the blade struck him in the left shoulder. Mr. Mitchell subsequently grabbed Ms. Perrault’s right wrist to control the attack and tried to disarm her by grabbing the blade of the knife with his left hand. He thereby sustained a 4” laceration that extended from the palm to the back of his left hand between his thumb and index finger. Having subsequently bit Ms. Perrault’s hand and thereby causing her to release her knife, Mr. Mitchell took it and ran to the kitchen to call 911 and to ensure that she could not re-arm herself with one of his own knives. According to the Case File Synopsis, Mr. Mitchell believed that Ms. Perrault was trying to kill him.

Personal Background/Psychiatric History

11. Ms. Perrault’s personal background and psychiatric history are detailed in the Hospital Report filed as an exhibit at the hearing and need not be repeated here.

12. Briefly, Ms. Perrault is a 46-year-old, single indigenous woman from Sault Ste. Marie Ontario. She was raised on the Garden River Reserve and has an older brother and two younger sisters. According to her mother, Ms. Perrault was an active child who was very determined, motivated to work hard for what she wanted, and skilled in sports.

13. Her parents separated when she was eight years old, and Ms. Perrault and her brother then lived with her father until she was 13. She was sexually abused by her father who was convicted of that offence and sentenced to a period of incarceration.

14. Although Ms. Perrault did very well in elementary school, except for a couple of high school courses that she subsequently completed while in youth custody facilities, grade 8 was her highest level of educational attainment. She has a very limited employment history that includes working in restaurants and once at a call center for about six months, her longest period of employment. Ms. Perrault had two significant relationships. The second, with the victim of the index offence produced two sons.

15. Ms. Perrault began to use alcohol and marijuana when she was 12 or 13. She was using harder drugs such as morphine, OxyContin and cocaine after leaving home at 17. She has a criminal record which includes two assault convictions and breaches of court orders.

16. Ms. Perrault has had numerous mental health contacts that include very brief admissions at the Sault Area Hospital in Sault Ste. Marie, and that she has a history of polysubstance dependence and unreliable adherence to recommended psychiatric follow-up and psychopharmacological treatment in the community

17. Ms. Perrault receives the Ontario Disability Benefit. She is capable of making treatment decisions. At the time of the hearing, Ms. Perrault resided in hospital.

Current Diagnosis

18. Ms. Perrault’s current diagnoses include Schizoaffective Disorder, Substance Use Disorder (alcohol, cannabis, cocaine, methamphetamine) Posttraumatic Stress Disorder, Attention Deficit Hyperactivity Disorder, Provisional Personality Disorder NOS and Eating Disorder.

Evidence at the Hearing

19. The Hospital’s evidence was presented through the oral testimony of Dr. Jean- Guy Gagnon to supplement the evidence contained in the Hospital Report filed as an exhibit at the hearing.

20. Dr. Gagnon has been Ms. Perrault’s treating psychiatrist for approximately five years. On January 29th, 2025, Ms. Perrault was transferred to Owl Lodge due to notable decompensation and increase in her symptoms. In July 2025, as a result of a confrontation with a co-patient, she was placed in Heron Lodge.

21. Dr. Gagnon advised that Ms. Perrault is currently hypo-manic and struggles with symptoms that are challenging at times. Although she has not been a significant management problem, at times, she is more irritable and argumentative with her treatment team, and her judgement remains questionable. She has difficulty maintaining privileges for any length of time.

22. The doctor stated that the emergence of her hypomania seemed to correspond with trauma counseling she was engaged with at the time (since stopped), a large financial settlement she received, and the change in her medication. He advised that Ms. Perrault was on long-acting injectable antipsychotic medication but suffered dyskinesia side effects. As a result, her medication was switched to Clozapine. Although there has been improvement, Ms. Perrault remains a little more acute than expected and continues to suffer breakthrough symptoms. Ms. Perrault’s lithium levels were quite high the week before the hearing which the doctor attributed to dehydration. They returned to normal the morning of the hearing.

23. Dr. Gagnon advised that the treatment team was in the process of stabilizing Ms. Perrault’s mental state and that he expected this to take up to three months. In this regard, the doctor advised that it may require a further increase in Ms. Perrault’s Clozapine medication or a return to long-acting injectable medication.

24. Dr. Gagnon confirmed that Ms. Perrault remained free from substances, with two false positive results during the reporting year. Ms. Perrault is currently engaged with the inpatient Concurrent Disorders Clinician as part of her ongoing treatment. She has been actively participating in both group and individual therapies aimed at addressing her addiction issues.

25. When asked, the doctor agreed that Ms. Perrault has been transparent with the treatment team and had good independent skills. Although Ms. Perrault has good insight into her illness and need for medication, the doctor emphasized that she needs to improve her judgement and at times make better decisions, without ongoing prompting (cues) from the treatment team.

26. With respect to vocational pursuits, Ms. Perrault has remained highly engaged in her placement at the Snack Shack (a patient-operated canteen-type service in a hospital). In July 2025, Ms. Perrault began a volunteer role at Open Arms café (soup kitchen) at a local church. She has also engaged in several Indigenous group activities and has now acquired a membership to the Friendship Centre and goes to Indigenous Cultural Support.

27. Ms. Perrault is in frequent contact with family, including her sister who resides in the hospital. She also enjoys regular contact with her children. Doctor Gagnon advised, however, that at times family has been a double-edged sword and Ms. Perrault can be manipulated.

28. Asked about next steps, Dr. Gagnon advised that at this point in time, the treatment team remains cautious with a goal of getting Ms. Perrault back into the community. The doctor elaborated that once Ms. Perrault’s mental state has been stabilized and she has made good progress, Ms. Perrault may be able to return to Maplewood House (a community- based supervised and supported residence), where she was a good fit, or to Osprey Lodge, a transitional steppingstone to community living.

29. Should she be discharged, she requires supervised and supported accommodation in the community. Dr. Gagnon confirmed that Ms. Perrault remains a significant threat to the safety of the public. He elaborated that she remains hypomanic and left unchecked and unsupervised, she could stop her medication, return to substance use, and show poor judgment. Dr. Gagnon advised that Ms. Perrault’s risk can be appropriately managed under her current Disposition. In this regard, on September 17, 2025, Dr. Michel A.S. Larivière, Correctional Psychologist, updated the Assessment of Risk of Violent Reoffending which concluded on page 89 of the Hospital Report as follows:

“In considering the factors identified by the HCR-20V3 and PCL-R:2, it is our current opinion that her risk of violent recidivism is moderate (without all the supports in place). With ongoing support and treatment adherence, her risk is likely low (i.e., while under the supervision and care of the NBRHC).”

30. The doctor confirmed that the hospital needs to approve Ms. Perrault’s housing in the community, with the ability to return her quickly to hospital should she begin to decompensate. He elaborated that when Ms. Perrault was previously placed on Conditional Discharge, it took only a few months for her to return to substance use and go missing. He agreed that the MHA, on its own, would not suffice to manage the risk.

31. No further evidence was presented at the hearing.

Conclusion and Disposition

32. Having considered all the evidence presented at the hearing, the Board finds that Ms. Perrault continues to pose a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code. We make this finding based on the evidence of Dr. Gagnon and the evidence contained in the Hospital Report, notwithstanding the joint position on significant threat by the parties.

33. Ms. Perrault’s index offence was a serious attack with a knife on her former partner in his residence. She has multiple diagnoses which include a major mental illness (schizoaffective disorder), substance use disorder and provisional personality disorder. She

has a history of unreliable adherence to treatment and has been known to relapse into substance use while residing in the community.

34. Notwithstanding a switch to Clozapine medication during the reporting year, Ms. Perrault remains hypomanic and continues to experience break through symptoms of her illness. As such, this has presented certain challenges to her treatment team, who will need to stabilize her mental state before she is able to return to supportive housing in the community. Although she has good insight into her illness and need for medication, Ms. Perrault needs to develop better

insight into certain decision making while exercising her community privileges, without the need for ongoing cueing by the treatment team.

35. Should Ms. Perrault become suitable for reintegration into the community, it remains important that she be supported and monitored throughout this transition. In this regard, any future accommodation should be approved by the hospital to support her ongoing rehabilitation and manage the risk in the community. As such, her current Disposition is well suited to this end.

36. On a positive side, Ms. Perrault continues to adhere to her pharmacological treatment, has remained substance free and remains transparent with her treatment team. She continues to participate in vocational activities and enjoys a good relationship with her family, visiting regularly with her children.

37. Although not advanced by the parties, a Conditional Discharge remains unrealistic at this juncture. Ms. Perrault’s accommodation needs to be approved, and the hospital requires the ability to return her quickly to appropriately manage the risk, should her mental state decompensate, or she returns to substance use.

38. Consequently, this Board finds the necessary and appropriate Disposition is the continuation of the existing Detention Disposition with an amendment to clause 4(d) to read “when living in the community, report to the person in charge of the North Bay Regional Health Centre – North Bay Site or his or her designate as required and not less than once per week”.

39. In reaching our decision, this Board has considered the need to protect the public from dangerous persons, Ms. Perrault’s mental condition, her reintegration into society, and her other needs.

DATED this 18th day of November 2025 at the City of Toronto, in the Toronto Region.

Mr. C. Flanagan

Alternate Chairperson

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Office of the Registrar Ontario Review Board