Re: Andrew Murphy
(DOB: 07.03.80)
ORB File No: 6307
Hearing held on: Wednesday, January 15, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby
Pursuant to: Sections 672.81(1) and 672.81(2.1) 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: Andrew Murphy Counsel: Mr. D. Medd
The person in charge of hospital: Counsel: Ms. J. Szabo
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DECISION AND DISPOSITION
(Dated January 29, 2025)
Introduction
On March 14, 2013, Andrew Murphy was found not criminally responsible on account of mental disorder (“NCR”) on three charges of assault, failure to comply with probation order, and robbery, all contrary to the Criminal Code of Canada (the “Criminal Code”).
By letter dated December 18, 2024, Ontario Shores Centre for Mental Health Sciences (the “hospital” or “Ontario Shores”) notified the Board pursuant to s. 672.56(2)(b) of the Criminal Code that Mr. Murphy’s liberty had been significantly restricted for a period expected to exceed seven days as follows:
“On December 7, 2024, Mr. Murphy was readmitted to hospital subsequent to crack cocaine use in his group home. When Forensic Outpatient Services (FOS) attended the group home, Mr. Murphy presented as agitated and was observed dancing and walking in the street; at times in live traffic. When attempts were made to communicate with Mr. Murphy, he was dismissive and unwilling to cooperate with staff. Durham Regional Police Services (DRPS) arrived on scene after FOS contacted 911. While being apprehended Mr. Murphy resisted and struggled with police officers. He was taken to hospital for admission.
Mr. Murphy’s mental status is now back at his baseline. Discharge planning has commenced and Mr. Murphy is expected to be discharged back to his group home, however the hospital expects his admission to last longer than seven days.”
- On January 15, 2025, a panel of the Ontario Review Board (“Board” or “panel”) convened for two reasons:
a. to review Mr. Murphy’s current disposition pursuant to s. 672.81(1) of the Criminal Code. At the time of the hearing, Mr. Murphy was ordered detained at the Forensic Program of Ontario Shores with privileges up to and including living in the community in accommodation approved by the person in charge; and
b. to conduct a restriction of liberty (“ROL”) hearing.
The issues to be determined are whether Mr. Murphy 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. A further issue to be determined is whether the hospital’s decision to increase the restrictions of Mr. Murphy’s liberty was warranted, necessary and appropriate at the time of onset (December 7, 2024) and whether it continued to be so as of the date of this hearing.
Mr. Murphy was present for his hearing and was represented by counsel, Mr. Daniel Medd, throughout the proceedings.
A Hospital Report dated December 31, 2024, was entered as Exhibit 1. The ROL Notification Letter from Ontario Shores dated December 18, 2024, was entered as Exhibit 2.
For the reasons set out below and based on the evidence and opinions before us, the Board found that Mr. Murphy continues to represent a significant threat to the safety of the public. The Board finds that a Detention Disposition, with detention on Forensic Services at Ontario Shores, is the necessary and appropriate Order on the terms set out in our formal Disposition having regard to the safety of the public, which is the paramount concern, and also having regard to Mr. Murphy’s mental health, reintegration into society, and other needs.
Additionally, the panel found that the restriction of Mr. Murphy’s liberty on December 7, 2024, was significant and it represented the least onerous, and least restrictive measure at the time it was imposed, and it continues to be so as of the date of the hearing.
Current Psychiatric Diagnoses
- Schizoaffective Disorder, Bipolar Type Alcohol, Cannabis and Cocaine Use Disorders Borderline Intellectual Functioning
Position of the Parties
At the commencement of the hearing, the parties were canvassed for their without prejudice positions. The hospital, supported by the Attorney General, took the position that the necessary and appropriate disposition is a Detention Order at the Forensic Program of Ontario Shores on the same terms as last year. They further submitted that the restriction of liberty of December 7, 2024, was necessary and appropriate and continues to be so.
Mr. Medd did not contest the issue of significant threat to the safety of the public and supported the hospital’s position that a Detention Order on the same terms as last year remains necessary and appropriate. Mr. Medd also submitted that the restriction of liberty of December 7, 2024, was necessary and appropriate and continues to be so.
Therefore, there was a joint submission on all issues.
Index Offence
- The circumstances giving rise to the index offences are set out in detail in the Hospital Report. In brief, on October 10, 2012, while on probation which included a term that Mr. Murphy keep the peace and be of good behaviour, he twice approached strangers, requested money and hit them when they refused to give him money. Further, he approached a patient at St. Michael’s Hospital who was using the parking kiosk and punched her in the back of the head while robbing her.
Background and History
The Hospital Report contains extensive information regarding Mr. Murphy’s background, mental health history, criminal history and his course in hospital subsequent to his NCR finding, the entirety of which need not be repeated here in detail. However, the following particulars are noteworthy.
Mr. Murphy is a 44-year-old man. From 1997 until he came under the auspices of the ORB, Mr. Murphy was primarily homeless.
Mr. Murphy was exposed to alcohol and many substances in utero. His mother was abusive and negligent towards Mr. Murphy until the age of two when he was made a crown ward. He began using alcohol at the age of five or six. He began having hallucinations and paranoia beginning as early as the age of nine. Mr. Murphy had multiple accidental overdoses as a child. In his childhood he displayed concerning behaviours including fire setting and abuse of animals.
Mr. Murphy has a long history of psychiatric treatment and admissions. His first clinical contact was at age six, when he was diagnosed with a behavioural disorder associated with a tic disorder. Historically, Mr. Murphy’s hospital admissions often required involuntary admission under the Mental Health Act. He has a history of elopement and leaving hospital against medical advice.
He did not complete a high school education.
Mr. Murphy is capable of consenting to psychiatric treatment. In November 2024, Mr. Murphy was found incapable to manage his finances and property, which is now managed by the Public Guardian and Trustee. He receives financial support through Ontario Disability Support Program.
Mr. Murphy has an extensive criminal history including crimes of violence.
Course Since Last Disposition
Mr. Murphy was discharged to the Dual Diagnosis Transitional Rehabilitation Housing Program (DDTRHP) in April 2024. He is supported by the Forensic Outpatient Service (FOS) as well as a Forensic Transitional Case Manager. DDTRHP provides 24 hour highly supportive housing. Staff also includes the support of a behavioural therapist and recreational staff.
Mr. Murphy has struggled living in the community. He has had four readmissions in the reporting year (August 12 to 20, September 3 to September 11, September 21 to November 4, December 7 to present). His primary difficulty with maintaining his community living is attributed to his relapses to crack cocaine use.
During the September 3, 2024, readmission, Mr. Murphy adamantly denied using substances other than cannabis.
On September 21, 2024, a change of behaviour was evidenced by staff at the home, and they became concerned by his behaviour and demeanor. He readily admitted to crack cocaine use.
With respect to the December 7, 2024, readmission, Mr. Murphy’s group home contacted Ontario Shores with concerns he had relapsed to crack cocaine use and was using substances in his room. Mr. Murphy was observed by his FOS team running and dancing up a main street near his group home. He moved near and into live traffic. He was uncooperative with police but was apprehended using a Form 49.
Mr. Murphy met with Dr. Levi over the reporting year for individual therapy. His attendance and participation were consistent. His level of engagement depended on his mood and proximal stressors. At times, Mr. Murphy showed some insight into his internal and external triggers, high risk situations, and other relapse prevention skills. Other times, Mr. Murphy was distracted by residual paranoid ideation involving thoughts of persecution by those in authority.
Mr. Murphy maintained regular contact with various family members during this reporting year.
Evidence at the Hearing
The Board had available to it the evidence and documents forming the Record, the Exhibit, and oral evidence of Dr. D. Pallandi, Mr. Murphy’s psychiatrist and author of the Hospital Report.
Dr. Pallandi testified that Mr. Murphy was readmitted on December 7, 2024, because he was using crack cocaine in his bedroom at his residence. Initially, there were some issues bringing him back to hospital but he has not attempted to leave hospital. Since his readmission his mental status settled once the substances metabolized. Unfortunately, the circumstances leading to his readmission may jeopardize his housing at DDTRHP. The hospital, treatment team, and home are having back and forth discussions currently to determine if Mr. Murphy can go back to live at the home. Housing at DDTRHP is specialized. If Mr. Murphy loses his housing at DDTRHP, a new housing search will be very challenging and likely lengthy.
Approximately, five days prior to this hearing he received privileges for grounds passes. Unfortunately, he used cocaine while on passes. Therefore, his privileges are on hold again to detoxify him. If he is welcome back to DDTRHP, Dr. Pallandi expects that he will be able to return within weeks. However, if he loses his housing at DDTRHP then it will be a long process to find appropriate housing for him.
Mr. Murphy has had all available therapy over the years for his substance use. His risk is elevated when he uses substances, particularly crack cocaine. When using substances he becomes paranoid, irritable, erratic in behaviour, and has violent ideas. His drug use contributes to his violent conduct. Substance use directly relates to his legal problems.
Mr. Murphy is capable to consent to treatment. He takes his medication.
Mr. Murphy’s cocaine use is driven more by psychological factors (stress, boredom, isolation, frustration) than pleasure seeking. Mr. Murphy’s intellectual disability likely keeps him from understanding that minutes-long cocaine use is compromising his housing long term.
Although Mr. Murphy does not have a diagnosis of fetal alcohol syndrome, there are elements of Mr. Murphy’s presentation that are consistent with fetal alcohol symptoms.
Mr. Murphy’s cannabis use seems to be recreational. Cannabis doesn’t appear to be harmful to his mental state. Dr. Pallandi suspects that Mr. Murphy is using cannabis as an inpatient.
Mr. Murphy is not gaining a clinical benefit from remaining in the hospital. Dr. Pallandi feels it would not hurt Mr. Murphy to attend a residential treatment program and agrees that the disposition should allow for Mr. Murphy to attend such a program. Dr. Pallandi is not sure that attendance at residential treatment would be a ‘game changer’ to assist with housing approval. However, he agreed to the clause.
Mr. Medd advised that Mr. Murphy would support a clause in the disposition for a residential treatment program. Ms. MacDonald also supported the inclusion of a term permitting attendance at a residential treatment program.
Analysis and Conclusions, Annual
Significant Threat
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Murphy remains a significant threat to the safety of the public.
Counsel for Mr. Murphy did not contest a finding of significant threat to the safety of the public. Despite this, the Board makes its own finding of significant threat based on the oral evidence, the Hospital Report, Winko and its related authorities.
Mr. Murphy has a diagnosis of Schizoaffective Disorder, substance use disorders, and borderline intellectual functioning. His substance use issues are persistent. The use of substances, particularly crack cocaine, significantly exacerbates his major mental illnesses. This is evident from the multiple readmissions required throughout the year to manage his risk.
Mr. Murphy has an extensive history of violent offences. Cocaine use elevates his risk to the public.
The Board accepts the joint submission on significant threat.
Necessary and Appropriate Disposition
In light of the Board’s finding of significant risk, it is charged with shaping a Disposition for the coming year.
The Board relies on the following excerpt of the Clinical Assessment of Risk found at page 65 of the Hospital Report:
“All of Mr. Murphy’s risk factors as they have been previously well-articulated continue to exist to the present. The overarching contributor to his risk at this juncture is his inability to bring his substance misuse under control. During these times his risk is substantially elevated from his baseline.
Mr. Murphy continues to require high degree of supervision, oversight and surveillance including for the use of substances via urinalyses or other modes of detection.
It is fully expected that until Mr. Murphy has a more firm grasp on control over the use of substances that he will require intermittent, crisis-based admissions to detoxify him and control his behaviors and risk.”
Mr. Murphy’s risk would increase significantly in the context of a Conditional Discharge. He has a history of elopement. The Mental Health Act would not be sufficient to manage his risk to the public. His housing is precarious given his ongoing substance use and necessity of several readmissions to hospital. Mr. Murphy is struggling living in the community despite living at the specialized DDTRHP dual diagnosis 24-hour supportive housing.
It is clear that the hospital continues to need to be able to approve housing.
All parties agreed to the inclusion of a term for Mr. Murphy to be permitted to attend a residential treatment program, as directed by the person in charge.
The Board finds that that the necessary and appropriate, least onerous and restrictive Disposition, is continuation of the Detention Order, with terms as set out in our formal Disposition.
Analysis and Conclusion, Restriction of Liberty
The evidence supports a finding that the initial restriction of Mr. Murphy’s liberty was necessary and appropriate; this was not contested at the hearing. He engaged in substance use which caused his mental status to decompensate dramatically. Upon approach by the FOS team, he left the home on foot while continuing to dance up the street and move into live traffic. Mr. Murphy was apprehended by police due to his psychotic symptomology.
Since readmission, Mr. Murphy has returned to his baseline mental state.
It was the treatment team’s assessment that the restriction of liberty was necessary and appropriate to interrupt Mr. Murphy’s illicit substance use (which caused significant mental status decompensation) and restabilize him.
Mr. Murphy has been in hospital for approximately 92 of the past 135 days. His liberty norm at this time is detention within the hospital, with breaks to community living for approximately only 43 days. Although the current readmission was reported as a restriction of liberty, should he have future quick admissions when discharged, a restriction of liberty hearing may not be available to him.
The Board accepts the evidence set out in the Hospital Report and oral evidence of Dr. Pallandi and finds that Mr. Murphy’s ongoing restriction of liberty is warranted, appropriate and necessary.
DATED this 29th 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