Re Joseph C. Darosa, 2025 CanLII 135638

Ontario Review Board

Re: Joseph C. Darosa

ORB File No: 8433

Hearing held on: Thursday, December 4, 2025

Place of hearing: St. Joseph's Healthcare Hamilton

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

Before:

Alternate Chairperson: Ms. L. Banks

Members: Dr. M. Attia Dr. P. N. Wright Mr. E. Siebenmorgen Mr. A. Mete

Parties Appearing:

Accused: Joseph C. Darosa Counsel: Ms. M. Addie

The person in charge of hospital: Representative: Mr. S. O’Brien

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

REASONS FOR DISPOSITION

(Dated December 31, 2025)

Introduction:

1. On October 16, 2023, Mr. Joseph Darosa was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault and assault by choking, contrary to the Criminal Code of Canada (the “Criminal Code”). Since that time, he has been subject to Dispositions of the Ontario Review Board (“ORB” or the “Board”), most recently a Disposition dated December 13, 2024, detaining him at the Forensic Psychiatry Program at St. Joseph's Healthcare Hamilton (“St. Joseph’s” or the “hospital”) with privileges up to and including living in the community within the catchment area of the hospital in supervised accommodation approved by the person in charge of the hospital. The Disposition contains a number of other terms and conditions, including inter alia, that Mr. Darosa not attend within 100 metres of 100 Lower Ossington Avenue Toronto, Ontario, abstain from the non-medical use of alcohol and drugs or any other intoxicant and submit to testing for same.

2. On December 4, 2025, a panel of the ORB convened a hearing to conduct an annual review of Mr. Darosa’s Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Darosa was present at the hearing and was assisted by his counsel, Ms. Addie.

3. The issues to be considered at this hearing are whether Mr. Darosa remains a significant risk to public safety as now defined in s. 672.5401 of the Criminal Code and, if he is found to be a significant threat to the community, the determination of the necessary and appropriate Disposition in the circumstances bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

4. For the reasons set out below, the Board finds that Mr. Darosa continues to pose a significant threat to the safety of the public and that a continuation of this existing Detention Order is necessary and appropriate subject to the changes noted at the conclusion of these Reasons.

Index Offences:

1. The circumstances giving rise to the index offences are abstracted from last year’s Reasons for Disposition dated December 20, 2024, as follows:

"On Friday, December 18, 2020, at approximately 8:30 PM, the victim in this matter was attempting to exit her [address], when the accused DAROSA entered the building vestibule, and in a completely unprovoked manner grabbed the victim by her neck and began punching her.

The victim managed to get free from the grasp of the accused and called 9-1-1 using her cell phone. The accused fled into an adjacent door that connects to the underground paid

parking garage at this address.

Officers from 14 Division attended the location and spoke with the victim. A check for the accused showed that he had made good his escape. The victim advised that she

recognizes the accused, as he frequently hangs around outside of the apartment building.

The victim believes his name is “Crazy Joe”.

Investigation into the accused identified his as Joseph DAROSA (1959-09-02).

On December 20, 2020 at approximately 9:30 AM, the same victim called in as she

observed the accused acting erratically at the intersection of Queen Street West and

Ossington Avenue. Officers from 14 Division attended the area and were able to locate

the accused. The accused was arrested, read his Rights to Counsel, and transported to 14 Division where he held pending a show cause bail hearing.

INJURIES – No injuries to victim, but extremely shaken and disturbed from an

unprovoked attack and choking.”

Personal Background:

1. The Hospital Report to the ORB dated November 18, 2025 (the “Hospital Report”) sets forth in great detail information concerning Mr. Darosa’s background, criminal history and psychiatric history and accordingly, those details need not be repeated here. Briefly stated, Mr. Darosa is a 66-year-old man who was born in Quebec to parents who immigrated from Portugal.
2. No developmental information was available, although it was reported that Mr. Darosa had experienced a head injury that resulted in a loss of consciousness at the age of seven.
3. His recent history indicates that he resided at Regeneration House in Toronto in 2015 and subsequently in a boarding home from 2016 to 2019. More recently, he was described as being homeless and residing in Toronto's shelter system.
4. Mr. Darosa has some history of employment but since 1986 has been supported by the

Ontario Disability Support Program and Canada Pension Plan.

1. Mr. Darosa has a reported history of regular tobacco use as well as cannabis and crack cocaine. He has been diagnosed with chronic Hepatitis C which was treated but it is unknown whether or not he completed his prescribed course of treatment.

2. Mr. Darosa is currently single. He was previously married and has three adult daughters with whom he has not had contact for several years.

Criminal History:

1. Mr. Darosa has accumulated a significant criminal record starting on January 12, 1997

which documents an extensive history involving theft, break and enters, fraud, numerous fail to comply convictions, arson, mischief, as well as assault (x2) and assault with a weapon. His criminal record appears to end on November 18, 2002.

1. It is documented that Mr. Darosa has been involved in threatening behaviour which has involved weapons and sexually inappropriate behaviour.

Psychiatric History:

1. Mr. Darosa has a lengthy psychiatric history which begins in 1981, and he has been predominantly treated and followed by the mental health professionals at the Centre for Addiction and Mental Health (“CAMH”).

2. Mr. Darosa’s longstanding history of mental illness includes a pattern of medication non-compliance requiring the intensive services of an Assertive Community Treatment team and, at times, a Community Treatment Order.

3. He was homeless and staying in the Toronto shelter system from 2019 until his admission to hospital following the index offence. He has had at least ten previous psychiatric admissions to hospital. He was evicted from Regeneration House in 2015 and from a boarding home in 2016, for not following the rules and smoking cannabis.

4. It is noted that many of the records from that period are no longer available. Over the years he has been treated with various medications. He has a history of noncompliance with treatment.

Current Diagnoses:

1. Mr. Darosa’s current diagnoses are:

Schizoaffective Disorder, Bipolar Type; and

Polysubstance Use Disorder

Positions of the Parties:

1. At the outset of the hearing, the parties were canvassed as to their initial positions. Counsel for the hospital indicated that Mr. Darosa remains a significant threat to public safety and the necessary and appropriate Disposition is that he continue to be subject to his existing Detention Order.

2. Counsel for the Attorney General and counsel for Mr. Darosa indicated their support of the hospital’s recommendations in all respects.

3. In closing submissions, counsel for all parties agreed that the geographical boundary of “within the catchment area of the St. Joseph's Healthcare Hamilton, West 5th Campus” referred to in paragraphs 2(h) and (i) should be amended to read “within the community of Southern Ontario”. In all other respects, all parties maintained their initial joint recommendation in closing submissions.

Evidence at the Hearing:

1. Dr. S. Prat, Mr. Darosa’s attending forensic psychiatrist, testified at the hearing to supplement the documentary evidence available to the Board. Dr. Prat advised he has been involved in Mr. Darosa’s care since his transfer to Mountain 2 in April 2025. The doctor endorsed the contents of the Hospital Report and advised there were no material updates thereto.

2. The Hospital Report indicates that Mr. Darosa remains incapable to consent to treatment and his sister acts as his substitute decision maker (“SDM”). Under his SDM’s consent, he receives treatment with a long-acting injection (“LAI”) of the anti-psychotic medication, Paliperidone Palmate, which he receives by injection every 28 days. He is also treated with oral antipsychotic (Olanzapine) and mood-stabilizing medications (Epival). The doctor opined that Mr. Darosa’s medications are currently optimized.

3. Dr. Prat testified that despite his compliance with prescribed medications within the structured environment of the hospital, at times, Mr. Darosa is observed mumbling to himself or making strange sounds. When asked, he denies experiencing any perceptual disturbances. He also denies thoughts of harm to himself or others. The Hospital Report indicates “Mr. Darosa did not endorse any hallucinations or delusions at this time, but his thought content and process were somewhat disorganized, non-linear and inclusive of extraneous or unrelated details.” Dr. Prat stated that Mr. Darosa requires close monitoring of his mental state.

4. Dr. Prat stated that when Mr. Darosa first came under his care in April 2025, he frequently requested a reduction in the dose of his antipsychotic medication and he stated that his intention was ultimately, to cease taking them. The doctor noted that as their therapeutic relationship developed, Mr. Darosa stopped making these requests.

5. The Hospital Report indicates that Mr. Darosa’s mood is usually good, but at times his thoughts are illogical and tangential. Overall, he typically presents in a cooperative and pleasant manner, though he is often quite disorganized and difficult to understand as he mumbles when speaking. When he displays psychotic symptoms (mostly grandiose delusions, for example, stating that he used to be a surgeon at the hospital), he is unable to appreciate the delusional nature of his comments.

6. The Hospital Report indicates that Mr. Darosa is generally adherent to his Disposition and to the unit rules and routines. There have been no episodes of physical aggression over the past reporting year. Unfortunately, Mr. Darosa relapsed to substance use in January 2025 when he smoked cannabis that he says he found on hospital grounds. Mr. Darosa’s isolated and impulsive incident of substance use did not lead to any aggressive conduct but there was evidence of intoxication and increased disorganization following his use. At the time, his urine drug screed (“UDS”) revealed that he was compliant with his prescribed medication. Mr. Darosa’s intoxicated state was quickly noticed by hospital staff and appropriate actions were taken to closely monitor him and prevent any further substance use.

7. Dr. Prat stated that when Mr. Darosa engaged in substance use, his passes were placed on hold. Dr. Prat commented that Mr. Darosa has not used methamphetamine over the past year; however, he tested presumptive positive for methamphetamine in April 2025. Subsequent confirmation testing indicated that his UDS was in fact negative for this substance. Notwithstanding his ongoing abstinence, Dr. Prat mentioned that a signficant risk factor for Mr. Darosa is his tendency to be influenced by negative peers, particularly in the area of substance abuse.

8. Mr. Darosa spends a significant part of his day sleeping or watching television on the unit. When using his passes on hospital grounds, he smokes cigarettes. He does not leave the hospital grounds unless he is accompanied with staff. Mr. Darosa has also been able to exercise level 4, indirectly supervised, passes in the community to attend a program or for a community outing, facilitated by staff. Mr. Darosa is accompanied by staff to get to the community outing/program and will later be accompanied by staff to return to the hospital. He is given some independently supervised access while on these passes to access nearby stores and restaurants that he is familiar with.

9. Mr. Darosa socializes appropriately with co-patients on the unit and in programs. Mr. Darosa does not have any Approved Persons at this time.

10. On April 29, 2025, Mr. Darosa was transferred from Waterfall 3 (where he was under Dr. Ferencz’s care) to Mountain 2. Dr. Prat explained that Mr. Darosa was transferred to Mountain 2 because his mental state was considered to be stable and he appeared ready to begin the process of moving towards community discharge. Mr. Darosa has transitioned well to his new unit with no acute management concerns.

11. Dr. Prat testified that the treatment team is concerned that Mr. Darosa is at risk of falling. The doctor noted that Mr. Darosa is often not receptive to using his walker; however, the team continues to encourage his use of his walker for safety reasons.

12. Throughout this reporting year, there have been no incidents of aggression, although there were isolated incidents of Mr. Darosa being rude and argumentative in his interactions with staff. These incidents are described in the “Notable Incidents” section of the Hospital Report on pages 39 and 40. Many of these incidents relate to Mr. Darosa smoking in areas of the hospital that prohibit smoking.

13. Dr. Prat advised that Mr. Darosa has extremely limited insight across all relevant domains. When asked, Mr. Darosa states that he does not suffer from any mental illness and he does not need his prescribed medication. He will comment that he receives no benefit from his medication. He also stated that there would be no effect on his mental state or behaviour if he were to stop his medications.

14. In terms of his eventual transition to community living, Mr. Darosa has the privilege of community living in supervised accommodation in his existing Disposition. He is currently on the wait list for housing for a 24/7 supportive accommodation through Indwell and Good Shepherd. Both of these programs have wait lists of at least five years.

15. Dr. Prat stated that Mr. Darosa completed neuropsychological testing to help the team assessing his suitability for placement in a long-term care (“LTC”) residential setting. Presently, an application for funding for placement in a LTC residence has been submitted to Ontario Health. There remain ongoing concerns regarding his safety, cognition, and mobility issues as well as the ability of such LTC residences to actively monitor Mr. Darosa’s risk of relapse to substance use. The doctor suggested that there are typically wait lists of approximately one year for most LTC facilities.

16. Mr. Darosa’s social network is quite limited. His main support is his sister, who acts as his SDM.

17. Over the course of the upcoming reporting year, Dr. Prat commented that he is hopeful that Mr. Darosa will become engaged in activities that he has commented are of interest to him. As well, the doctor testified that he hopes Mr. Darosa will become more accepting of the team’s direction and input, without becoming agitated or frustrated.

18. An updated Psychological Risk Assessment was completed in 2025 by Dr. H. Moulden. The Assessment, among other things, reviews Mr. Darosa’s clinical risk factors over the past reporting year and notes:

“Mr. Darosa evidences some cognitive instability as a result of the burden of chronic psychiatric and substance use disorders, the symptoms of which impact his judgement, impulse control, and insight. However, this is much improved from an affective and behavioural perspective compared to previous years, with significantly fewer incidents. His limited insight diminishes his ability to recognize the adverse impact of his symptoms, the need for treatment, and the risk he poses to the safety of the public if unwell or using substances. He is compliant with medication (under the consent of his SDM), but limitedly motivated for, and engaged in, rehabilitation programs.”

40. The conclusions reached in the Risk Assessment indicate that. “… Mr. Darosa’s current risk for violence is estimated to be in the low-moderate range under the current disposition. While the direct oversight of the forensic program appears to adequately manage his risk for violence, with the anticipated transition to the community and the increased risk for medication noncompliant and substance abuse, his risk, even with supports increases. Absent any such support, such as in the case of an absolute discharge, his risk would increase significantly secondary to unmitigated substance abuse and medication noncompliance, which consistently leads to psychiatric decompensation and aggression. Without supervision and the ability to intervene, Mr. Darosa’s psychosis would worsen, and aggression towards people and property would likely follow…. If he were to reoffend, Mr. Darosa would be at risk to engage in physically aggressive behaviour toward an indiscriminate range of victims, including those known to him and strangers.”

41. The Hospital Report indicates that, at the present time, Mr. Darosa could not be safely managed on a Conditional Discharge Disposition as he continues to require an in-patient admission. Further, it will remain imperative at such time as he is ready for discharge to the community that the hospital have oversight with regard to his community placement to ensure that Mr. Darosa’s housing provides him with the necessary level of structure, support, supervision and monitoring. His history suggests that Mr. Darosa might be unlikely to cooperate in a voluntary return to the hospital should he suffer a decompensation in mental status.

42. The doctor commented that the Mental Health Act would be insufficient to safely manage his risk to public safety as it would not allow for Mr. Darosa’s expeditious return to hospital until he satisfied criteria for certification. In the treatment team’s assessment, a Detention Order remains critical for risk management purposes.

43. According to the risk assessment contained in the Hospital Report, “Overall, based on Mr. Darosa’s HCR-20 V3 scoring, he is judged to be in the high-risk range of future violence, low risk range for serious physical harm and imminent violence while residing in hospital and in high support housing.”

44. No further evidence was called by the parties.

Analysis and Conclusions:

1. The panel agrees with the joint recommendation of the parties that Mr. Darosa continues to pose a significant threat to the safety of the public. Mr. Darosa’s primary risk factors are his residual psychotic symptoms and his risk of relapse to substance use. The evidence indicates that he is generally stable but continues to display residual symptoms of psychosis and he presents with periods of irritability with staff members. Over the past reporting year, he engaged in an episode of impulsive substance use while exercising a pass on hospital grounds. He continues to require a high level of supervision and support, without which his medical and psychiatric status would be likely to deteriorate significantly, with the result of a likely increase in his risk of harm to others.

2. The Hospital Report indicates “If he were to reoffend, Mr. Darosa would be at risk to engage in physically aggressive behaviour toward an indiscriminate range of victims, including those known to him and strangers.” Further, the panel notes that Mr. Darosa continues to lack insight into the nature of his mental illness and the need for adherence with his prescribed treatment. His compliance with medication is likely based on having acquired the habit of taking these medications rather than understanding the need for them.

3. Having come to a finding of significant threat, the panel must craft a Disposition which is necessary and appropriate, as well as least restrictive and least onerous. The panel notes that Mr. Darosa has not yet exercised the ceiling of privileges available to him under his existing Detention Order Disposition. He is awaiting residential placement in the community that will provide him with significant support and oversight to assist him in his progression to full community reintegration. Until appropriate community housing has been secured, Mr. Darosa requires ongoing detention in hospital.

4. In our assessment, the risk management tools provided under a Detention Order Disposition remain necessary and appropriate as the hospital must have oversight with respect to Mr. Darosa’s placement in the community to ensure that his residence provides him with the necessary level of supervision, monitoring, support, and structure required to safely manage his risk. Further, once Mr. Darosa is residing in the community, a Detention Order will be required in order to effect his prompt readmission to the hospital should he suffer a decompensation in his mental state as a result of breakthrough symptoms, relapse to substance use, non-adherence with medication, or otherwise. Neither a Conditional Discharge Disposition nor the provisions of the Mental Health Act are sufficient to manage his risk at this juncture.

5. In light of the foregoing, this Board finds that the necessary and appropriate Disposition to manage Mr. Darosa’s risk to public safety is that he be detained at the hospital on the terms set forth in his current Disposition subject to the following amendment:

• the geographical boundary of “within the catchment area of the St. Joseph's Healthcare Hamilton, West 5th Campus” referred to in paragraphs 2(h) and (i) of the existing Disposition be replaced with “within the community of Southern Ontario”.

The rationale for the extension of the geographical area of the passes referred is to allow the hospital greater latitude when seeking an appropriate residential placement for Mr. Darosa.

1. In coming to its decision, the Board has considered Mr. Darosa’s mental status, his reintegration into society, his other needs and, the paramount need for public safety.

Dated this 31^st^ day of December 2025, at the City of Toronto, in the Toronto Region.

Ms. L. Banks

Alternate Chairperson

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Office of the Registrar

Ontario Review Board