Re: Melville Ince (DOB: 17.07.63)
ORB File No: 2558
Hearing held on: Monday, January 13, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. C. MacIntyre, K.C. Members: Dr. K. Patel Dr. W. Loza Ms. C. Murray Mr. S. Duffy
Parties Appearing: Accused: Melville Ince Counsel: Ms. A. Szigeti
The person in charge of hospital: Counsel: Ms. A. Marshall
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated January 27, 2025)
Introduction
[1]. On August 29, 1997, Melville Ince was found not criminally responsible on account of mental disorder (“NCR”) on a charges of sexual assault (x2), utter death threats, assault (x2), and weapons dangerous, all contrary to the Criminal Code of Canada (the “Criminal Code”).
[2]. On January 13, 2025, a panel of the Ontario Review Board (“Board” or “panel”) convened to review Mr. Ince’s current Disposition pursuant to s. 672.81(1) of the Criminal Code. At the time of the hearing, Mr. Ince was ordered detained within the Forensic Program of Ontario Shores Centre for Mental Health Sciences (“Ontario Shores” or the “hospital”), with privileges up to and including living in the community of Whitby in accommodation approved by the person in charge.
[3]. Mr. Ince was present for his hearing. He was represented by counsel, Ms. Anita Szigeti, throughout the proceedings.
[4]. A Hospital Report dated November 6, 2024, was entered as Exhibit 1. A Rule 13 Response correspondence of the Centre for Addiction and Mental Health (“CAMH”), dated January 7, 2025, authored by Dr. Chatterjee, was entered as Exhibit 2. An Update to the Hospital Report dated January 13, 2025, was entered as Exhibit 3.
[5]. The issues to be determined are whether Mr. Ince continues to represent a significant threat to the safety of the public, 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. Further, the Board is to consider the request for transfer to CAMH.
[6]. For the reasons set out below and based on the evidence and opinions before us, the Board found that Mr. Ince continues to represent a significant threat to the safety of the public. The Board finds that a Detention Disposition within the Forensic Program of Ontario Shores Centre for Mental Health Sciences is the necessary and appropriate Order having regard to the safety of the public, which is the paramount concern, and also having regard to Mr. Ince’s mental health, reintegration into society, and his other needs. Pursuant to Mr. Ince’s request, the Board also makes an order that he be transferred to CAMH.
Current Psychiatric Diagnoses
[7]. Schizoaffective Disorder, Bipolar Type Cannabis Disorder, severe Rule Out Antisocial Personality Disorder / Traits
Position of the Parties
[8]. At the commencement of the hearing, the parties were canvassed for their without prejudice positions. The hospital, represented by Ms. Anne Marshall, supported by counsel for the Attorney General, Ms. MacDonald, took the position that the necessary and appropriate Disposition is a continuation of the Detention Order at the Forensic Program at Ontario Shores with changes to the terms as set out on page 88 of the Hospital Report. The hospital and the Attorney General took no position regarding the transfer to CAMH.
[9]. Counsel for Mr. Ince took no position regarding the issue of significant threat or the recommended Disposition. She took the position that Mr. Ince should be transferred to CAMH.
Index Offences
[10]. The details of the index offences are included in the Hospital Report and are summarized as follows:
“On February 12, 1997, at 9:45 AM, Mr. Ince, who had been following the female victim and her friends, placed his hand in the area of her mouth and grabbed her about the body while she stood on the platform of the St. George subway station in Toronto. A scuffle ensued and she fell to the floor of the subway platform. The accused climbed on top of her and placed his pelvis against her thighs. He also grabbed her in the area of her breasts. Her sister attempted to help her, whereupon the accused tried to grab the sister in the area of her crotch and then kicked her in the same area. During the sexual assault, the accused threatened to kill the victim.
On the same day, when another individual witnessed the accused’s assault on the two young girls in the St. George subway station at 9:45 AM, the accused hit the other individual in the mouth with his fist. The victim took a stick from the accused, which he had been brandishing about. The stick was about 13 inches in length.
Later that evening at 8:35 PM, another victim was standing on the westbound platform of the Bay Street subway station in Toronto when the accused approached her from behind and grabbed her over her right eye. Two passengers came to her aid and she managed to escape, but received a small bruise over her right eye.”
Background and History
[11]. The Hospital Report contains extensive information regarding Mr. Ince’s background and history, the entirety of which need not be repeated here in detail. However, the following particulars are noteworthy.
[12]. Mr. Ince is a 61-year-old single man from Montserrat. He moved to Canada in 1981 at the age of 18. He has one adult daughter.
[13]. Mr. Ince completed grade 12. He dropped out of the University of Toronto after a few months. He later obtained a tractor/trailer licence at George Brown College in 1990.
[14]. Mr. Ince has not been employed since 1992. Mr. Ince is currently financially supported by Canada Pension Plan Disability and Ontario Disability Support Program. He is capable of managing his finances.
[15]. Mr. Ince does not have an approved person. His sisters both reside in the Toronto area. He has regular telephone contact with them. He has occasional telephone contact with his daughter.
[16]. Mr. Ince is capable of consenting to psychiatric treatment.
[17]. Mr. Ince’s criminal record before being found NCR includes 12 convictions between 1992 and 1998 for trafficking in a narcotic, assault, assault with a weapon, carrying a concealed weapon, theft under, and robbery.
[18]. Mr. Ince had several psychiatric admissions / contacts commencing in 1985.
[19]. Mr. Ince has an extensive history of substance use, primarily involving crack cocaine and cannabis.
[20]. Mr. Ince is musically talented and enjoys sharing his songs with others.
Course Since Last Disposition
[21]. On February 12, 2024, Mr. Ince was transferred from St. Joseph’s Hamilton Healthcare to the Forensic Transitional Unit (FTU) at Ontario Shores.
[22]. Mr. Ince attended music therapy but declined to participate in any group programs offered by the hospital. As of the date of the Hospital Report he had met with the concurrent disorders counsellor twice.
[23]. Mr. Ince has used cannabis multiple times since his admission to FTU, which has resulted in a hold of his indirectly supervised privileges, sometimes for up to a week.
[24]. Mr. Ince has exhibited significant behavioural changes when using cannabis. During periods of cannabis use he becomes more antagonistic, agitated, and irritable, and is more prone to rapid mood swings. He also displays inappropriate behaviours toward women during periods of frequent cannabis use.
[25]. There were at least 11 dates in the reporting year that his urine samples tested positive for cannabis. There were also several instances where Mr. Ince submitted diluted samples.
[26]. Mr. Ince was adherent to medications throughout the reporting year. He believed that the medications helped with sleep and anger but was ambivalent about whether they provided any other benefits.
[27]. In November, 2024, due to extrapyramidal symptoms, including a tremor, Mr. Ince’s Clopixol was reduced from 250mg to 200mg every two weeks at his request. Mr. Ince’s mental state deteriorated subsequently and he presented with increased lability and agitation. Paranoia and manic symptoms emerged. On December 6, 2024, Mr. Ince’s indirectly supervised hospital grounds and community privileges were placed on hold. On December 10, 2024, Mr. Ince agreed to a medication increase of Olanzapine from 20mg daily to 30mg daily. He has shown signs of improvement.
[28]. On December 18, 2024, the hospital sent to the ORB a letter advising of the deviation of Mr. Ince’s liberty norm as outlined in paragraph 27, above. The hospital took the position that a reasonable person aware of the circumstances of Mr. Ince’s case would not believe the hospital’s decision to remove his access to indirectly supervised passes resulted in a loss of liberty so significant that the Board must convene a hearing to consider the restriction of liberty. The hospital advised that their letter was for information purposes only and was not a notification pursuant to s. 672.56(2) of the Criminal Code of a significant restriction of Mr. Ince’s liberty.
Evidence at the Hearing
[29]. The Board had available to it the evidence and documents forming the Record, the Hospital Report, and oral evidence of Dr. Misha Hartfeil, Mr. Ince’s psychiatrist and author of the Hospital Report.
[30]. Dr. Hartfeil testified that she has been Mr. Ince’s psychiatrist since his transfer to Ontario Shores.
[31]. Initially when Mr. Ince was transferred to Ontario Shores, he worked hard on abstaining from cannabis use. However, cannabis use increased as time went on.
[32]. Mr. Ince has a fragile mental state that is affected by stress, cannabis use, and medication changes. When he deteriorates as a result of these factors, his risk to the public increases. When he deteriorates, he displays aggression, disengagement from the treatment team, increased grandiosity, and paranoid thoughts. For this reason, he remains a significant risk to the safety of the public at this time.
[33]. If Mr. Ince were to reduce his antipsychotic medications or increase cannabis, particularly in the context of stressors, his risk would increase.
[34]. To Mr. Ince’s credit, in November when Mr. Ince requested a medication dose change due to his tremor, he agreed to an increase in clozapine and clonazepam. Mr. Ince deteriorated significantly. He eventually agreed to start Invega Sustenna. There has been a significant improvement since that time. He is close to being back to his baseline.
[35]. Dr. Hartfeil testified that her therapeutic relationship with Mr. Ince has been good most of the year. During the past couple of months, when he was more paranoid, he refused to meet with her. However, the relationship is improving again as he becomes less accusatory and less angry.
[36]. Even at his most deteriorated state, Mr. Ince was able to be managed on a General Forensic Unit.
[37]. The hospital has had conversations with Mr. Ince about discharge. Mr. Ince wants to be discharged to an independent apartment. However, the hospital opinion is that he will require supervision when discharged to community living. Mr. Ince continues to require monitoring of his substance use, he tampers with toxicology samples, and it is necessary to monitor his mental state to be able to provide verbal de-escalation. On-site staff will be necessary for a successful transition to community living. However, it is possible that he could eventually achieve independent living.
[38]. Collaborative Residents Enabling Assisted Transitional Engagement (“CREATE”) housing is a group home that provides more privacy than other group homes. This is a possibility for moving him toward independent living.
[39]. Mr. Ince’s insight into his cannabis use is underdeveloped. He understands that it is a breach of his Disposition if he uses cannabis. However, he denies that cannabis affects him negatively. He doesn’t understand the connection between cannabis use and his mental state.
[40]. Mr. Ince has been minimally involved in programming. He has not had programming to deal with anger.
[41]. If Mr. Ince receives a transfer to CAMH, it is likely that the transfer would take 18 months to two years to effect. In the meantime, Ontario Shores would work to move him back to his regular bedroom in the general forensic unit at the hospital and assist him in regaining some of his privileges.
[42]. Mr. Ince’s relationship with his family runs hot and cold. He describes them as both a source of support and a source of stress.
Analysis and Conclusions
Significant Threat
[43]. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Ince remains a significant threat to the safety of the public.
[44]. Mr. Ince has a diagnosis of Schizoaffective Disorder and Cannabis Disorder. Over the reporting year, Mr. Ince has repeatedly engaged in cannabis use, which has caused alterations in his mental state including antagonism, agitation, irritability, and mood swings. Inappropriate behaviours toward women increased during periods of frequent cannabis use. He often presented with grandiose ideations and persecutory beliefs. He has failed to appreciate how his symptoms contributed to his past acts of violence and the index offences, which he continues to deny. Mr. Ince has poor insight into the relationship between substance use and his mental stability. He denies changes to his mental status when he uses cannabis despite clear historical evidence of the same.
[45]. Mr. Ince committed the index offences while experiencing symptoms of his major mental illness.
[46]. The Board therefore accepts the joint submission on significant threat and finds that Mr. Ince continues to present a significant risk to the public.
Necessary and Appropriate Disposition
[47]. In light of the Board’s finding of significant risk, it is charged with shaping a Disposition for the coming year.
[48]. There is a stark contrast between Mr. Ince’s mental state during periods of cannabis use as compared to his baseline mental state where he experiences improvements in emotional stability, better adherence to treatment, and a more collaborative attitude toward his care team. The contrast indicates that cannabis use has a significant impact on his mental state, highlighting the need for increased support during periods of cannabis use, as well as the necessity for ongoing monitoring for substance use.
[49]. The Board agrees with and relies on the following excerpts from the Clinical Assessment of Risk at page 87 of the Hospital Report:
“In the context of inadequate supervision and support, Mr. Ince would likely use cannabis (and, eventually, other substances) more frequently and in higher quantities, and he would also likely eventually become non-adherent or only partially adherent to his medications. In the context of increased substance use, perhaps exacerbated by medication non-adherence, he would likely experience an exacerbation of his residual psychotic symptoms including paranoid delusions, grandiose delusions, disorganization, agitation, and behavioural disinhibition. In that context, he would be likely to again engage in threatening, aggressive, violent, or sexually violent behaviours towards a member of the public causing serious physical and / or psychological harm.”
“A continued Detention Order is necessary to maintain Mr. Ince in hospital until such time that his mental state and substance use stabilize and he is ready to transition to the community. A detention order is also necessary to ensure that he will not gravitate towards inappropriate and inadequately supportive housing. When he eventually transitions to the community, ongoing supervision will be necessary to ensure adherence to his medication regimen, monitor for any resurgence of psychotic symptoms, and monitor for substance use. Additionally, a Detention Order will be necessary to intervene quickly should he experience a deterioration of his mental state while residing in the community which would elevate his risk for re-offence.”
[50]. For the above reasons, the Board finds that a Detention Order is necessary to manage Mr. Ince’s risk.
[51]. The Board considered the terms of the Disposition requested by the hospital. Because Mr. Ince has transferred to Ontario Shores, terms 2 through 4 of last year’s Disposition are no longer relevant. These will be excluded from the Disposition.
[52]. The Board received a Rule 13 notification on December 30, 2024, indicating that Mr. Ince would be requesting a transfer to the Centre for Addiction and Mental Health (CAMH) for the purpose having more options for housing, better community resources, and supports for his music endeavours. Additionally, he may have other family supports in Toronto.
[53]. On January 7, 2025, CAMH responded to the Rule 13 request. CAMH noted that Mr. Ince was just recently transferred to Ontario Shores from St. Joseph’s Healthcare Hamilton. The CAMH response also noted that there is an extensive waitlist of 18 months to two years before he could be admitted. CAMH opined that a transfer would likely result in a further delay of Mr. Ince achieving his goal of discharge to the community. Despite this, Ms. Szigeti submitted that Mr. Ince was well aware of this delay and nonetheless wished to proceed with a transfer to CAMH. He is familiar with Toronto, transportation within Toronto, and feels Toronto is a better place for him to pursue his music career.
[54]. The Board notes that since Mr. Ince’s transfer to Whitby, family members have visited in person. The Board acknowledges the importance of family supports in a patient’s rehabilitation and progression through the Ontario Review Board system. A transfer to CAMH may or may not increase regularity of his family support, but it is hoped that a transfer to Toronto will make visits with the family more regular.
[55]. The Board agrees that a transfer to CAMH may achieve the goal of having more options for housing, community resources, and supports for his music endeavours.
[56]. The Board finds that the necessary and appropriate, least onerous and least restrictive Disposition is a Detention Disposition within the Forensic Program of Ontario Shores, with terms requested by the hospital as set out in our formal disposition. Further, the Board makes a finding for a transfer of Mr. Ince to CAMH on the terms set out in our formal disposition.
DATED this 27th day of January 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Murray Legal Member
Office of the Registrar Ontario Review Board