Re: David Jason Miles
ORB File No: 3858
Hearing Held On: Tuesday, September 23, 2025
Place of Hearing: Waypoint Centre for Mental Health Care
Pursuant To: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. T. Mann Members: Dr. K. Hand Dr. G. Kerry Ms. A. La Viola Ms. R. Chopra
Parties Appearing: Accused: David Jason Miles Counsel: Ms. C. Francis Person in charge of Hospital: Representative: Ms. T. Newman Attorney-General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DISPOSITION
(Dated December 19, 2025)
OVERVIEW
- On October 17, 2003, David Jason Miles was found not criminally responsible due to mental illness on a charge of aggravated assault, contrary to the Criminal Code. Mr. Miles’ last annual review was conducted on April 11, 2024. He is currently subject to a disposition of the Ontario Review Board dated April 23, 2024, detaining him at the Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs, with privileges allowing him hospital and grounds access, beyond the secure perimeter escorted by staff.
ISSUES
On September 23, 2025, the Board convened at Waypoint for a hearing further to s. 672.81(1) of the Criminal Code to review the disposition. The Board was asked to determine whether Mr. Miles represented a significant threat to the safety of the public at the time of the hearing, and further, what the necessary and appropriate disposition is in the circumstances according to the factors set out in s. 672.54 of the Criminal Code.
At the outset of the hearing, the representative for the Hospital and Counsel for the Attorney General submitted their respective views – Mr. Miles continues to represent a significant threat to the safety of the public – both agreeing that he continues to require the high secure forensic hospital setting at Waypoint, under the current disposition, with no change. On the other hand, Counsel for Mr. Miles took the position requesting that her client be discharged absolutely, or in the alternative, either a community living clause be added to the current disposition, or a conditional discharge be granted so that he can return to living in the community.
In addition, as a preliminary matter, Counsel for Mr. Miles stated that he has refused to attend his annual hearing due to ongoing illness since last April. Counsel also stated that she obtained instructions during their conversation yesterday and again on the morning of the hearing. Mr. Miles informed the staff that he did not wish to attend the hearing, and it would be stressful for him if the board mandated his attendance. His niece (who maintains close contact with him) attended the hearing (virtually) in place of Mr. Miles’ sister. The Board issued an order permitting Mr. Miles’ absence pursuant to s. 672.5(10)(a) of the Criminal Code.
FINDINGS
- After reviewing both the documentary and oral evidence, and submissions of the parties presented at the time of the hearing, the Board found that Mr. Miles’ persistent auditory hallucinations, episodes of catatonia, and ongoing lack of insight into his mental health condition pose a significant risk to public safety. His violent behaviour, including assaults on staff and unpredictable aggression during psychotic episodes, underscores the urgent need for stringent supervision and management. The Board determined that a high secure hospital setting is essential for ensuring both Mr. Miles’ safety and that of the community, as less restrictive alternatives, such as conditional or absolute discharges, are not viable options at this time. A detention order is deemed both necessary and appropriate to facilitate Mr. Miles’ ongoing treatment, while protecting public safety.
PERSONAL BACKGROUND
Hospital Reports dated March 4, 2025, and August 13, 2025, were entered as exhibits at the hearing. The following background information, including the events surrounding the 2003 index offence, has been taken from the reports, summarized here as follows.
On Sunday August 3, 2003, the victim was walking along a street in Mississauga. She was alone and was returning to her boyfriend’s home having just been to the corner store. Mr. Miles approached the victim from behind and suddenly plunged a large knife into her. The knife penetrated her lower right back and went through her entire body, causing a second visible wound to her lower right abdomen. Mr. Miles pulled the knife out of the victim and then fled on foot. Neighbours who heard the victim’s screams, called 911. Emergency service workers attended, and the victim was transported to hospital with life threatening injuries. On arrest, Mr. Miles advised police that he had stabbed the woman in the back because the voices told him to do so.
Mr. Miles is presently 52 years old. He is the youngest of four siblings. Mr. Miles began showing signs of mental illness when he was a teenager. He left school at the age of nineteen, having completed grade twelve. Mr. Miles has never been employed. He has not been involved in intimate relationships. He was living with his mother prior to the index offence.
Both Mr. Miles’ mother and father are now deceased. In June 2020, Mr. Miles’ mother passed away. He was supported in attending the funeral service and was able to see many family members he has not seen in more than 20 years. Notably, following the death of his father in 2022, Mr. Miles was able to attend the memorial service in Mississauga (escorted by Waypoint staff). His behaviour was appropriate throughout the entire service, and he also read one of the eulogies.
A check of the Canadian Police Information Centre database showed entries in 2001, which included mischief over $5000, dangerous operation of a motor vehicle, and failure to stop at the scene of an accident. A stay of proceedings was entered for all three charges, for reasons unknown at this time. Some information indicates that other criminal charges were laid against Mr. Miles but either stayed or dealt with through diversion. The charges alleged include acts such as slashing tires, damaging windshield wiper blades on vehicles, dangerous operation of a motor vehicle and failing to stop at the scene of an accident. An updated criminal records check verified that Mr. Miles has an outstanding warrant for an assault, but no further information has been provided.
PSYCHIATRIC BACKGROUND
Mr. Miles’ current psychiatric diagnosis is Schizophrenia – Paranoid Type. Notably, he had been deemed capable of consenting to treatment in the past, and he stopped taking clozapine as a result. On September 18, 2023, he was found incapable of consenting to treatment, but he is capable of managing his finances independently. After his mother’s death, his sister became his substitute decision maker. He is financially supported by the Ontario Disability Support Program.
Mr. Miles’ psychiatric history prior to the index offences is outlined in the Hospital Report. He has been involved in the psychiatric system for about 30 years. The following summary captures his mental health background before and after being found not criminally responsible for the index offence.
The first psychiatric admission occurred in July 1995 at Credit Valley Hospital in Mississauga, at the age of 23. He lost around fifty pounds over six months due to refusing food, which was associated with his belief that his mother was trying to poison him. He was later diagnosed with Paranoid Schizophrenia during multiple admissions to Trillium Health Centre, where he received various treatments.
Despite treatment, he continued to experience persistent auditory hallucinations, particularly hearing voices that harassed him. His hospitalizations often resulted from behavioural issues in the community, leading to property damage and occasional assaults against his mother and psychiatric staff, which stemmed from his hallucinations, but did not result in criminal charges.
His longest stay was from July to September 2000 after assaulting his mother. Following his discharge, he was monitored by the Mississauga Assertive Community Treatment team until the index offence. Notably, ten days before the offence, he assaulted two staff members at Trillium without provocation, though no criminal charges were laid.
At Oak Ridge (now known as Waypoint), Mr. Miles was treated with medications, including clozapine. Staff noted a significant reduction in paranoid thoughts, and he was polite and respectful. His improved insight and stability led to a transfer to the less secure setting at Ontario Shores in April 2006.
While at Ontario Shores, he showed continued progress, leading to a transfer to the minimum secure unit in February 2008. However, after assaulting a co-patient, he faced restrictions and was returned to Waypoint. His appeal against this decision was denied. In August 2014, the Board re-transferred Mr. Miles to the less secure setting at Ontario Shores. He remained there until September 2020, when he returned to Waypoint after serious assaults on staff, which he attributed to the voices he heard.
For the most part, Mr. Miles continues to hold paranoid beliefs, fearing staff were poisoning him. He attempted assaults and refused medication and meals multiple times. In 2021, he was placed in the highly structured Awenda program at Waypoint, where he improved compliance with his medication. He has remained quiet and self isolated, with no assaults for most of his stay, however, he required instances of seclusion during the review period.
Mr. Miles struggles to navigate complex situations on his own and he relies on his treatment team to guide him through the forensic mental health system. His behaviour over the reviewing year shows that he continues to exhibit dismissive tendencies towards staff. His difficulty in collaborating with others has resulted in his overall reclusive behaviour. Nonetheless, he has had several visits from family, with two positive interactions with his sister in July 2025 following improvements in his medication compliance, and he attends Electroconvulsive Therapy (ECT) sessions.
EVIDENCE AT THE HEARING
The evidence included comprehensive testimony from Dr. A. Mishra regarding Mr. Miles’ current mental health status and behaviour. In reference to Mr. Miles’ risk assessment, Dr. Mishra confirmed that it formed the basis for his opinion that Mr. Miles remains a significant threat to the safety of the public.
Dr. Mishra highlighted several factors that led to this conclusion. Approximately one year ago, Mr. Miles was very catatonic, spending hours in a state of significant mental deterioration, which necessitated a trial of clozapine and ECT. Now, there are days when Mr. Miles is very engaged and articulate, a notable difference, compared to other days when he stares blankly and remains most of the day in bed.
He explained that Mr. Miles had previously refused medication for three days, which requires restarting at a very low dose, but that he had refused it only once within this past year. Nonetheless, Mr. Miles continues to attend ECT. Dr. Mishra expressed hesitance regarding transitioning Mr. Miles to a less secure environment, asserting that based on his knowledge of Mr. Miles, it would not be advisable at this point. Given his ongoing mental instability, he still experiences persistent auditory hallucinations and paranoid delusions. Mr. Miles articulates these experiences during relatively good days, often describing the derogatory nature of the voices he hears.
Dr. Mishra emphasized that the significant threat Mr. Miles poses remains particularly concerning due to the recent violent incidents. He stressed the necessity for the ability to seclude Mr. Miles rapidly, if required. When questioned about Mr. Miles’ potential privileges within the community, Dr. Mishra expressed doubt, noting that Mr. Miles struggles with basic self-care and often does not engage in conversations. On good days, he may maintain a reasonable discussion, but on bad days, he remains unresponsive.
Family interactions were discussed, and Dr. Mishra stated that Mr. Miles’ sister has noted improvements in his demeanor during their visits, although he still displayed anger toward her despite her attempts to engage.
In response to inquiries about episodes of aggression, Dr. Mishra described them as impulsive and unpredictable, indicating a serious risk to others in more active environments. He observed that Mr. Miles has shown less aggressive behaviour lately, but he also pointed out that he may suddenly exhibit threatening behaviour towards specific individuals. Dr. Mishra also remarked that Mr. Miles has opportunities to leave his room but has shown very little interest.
Finally, Dr. Mishra detailed the administration of ECT, noting it is performed twice weekly, expressing optimism for maintaining this positive trend with continued treatment, even though the persistent psychotic symptoms continue to pose ongoing treatment challenges.
SUBMISSIONS
- The Hospital and Counsel for the Attorney General both submitted that supervision and support under the Board’s current disposition remains necessary and appropriate at this time. Mr. Miles represents a significant threat to the safety of the public, based on the evidence presented in the Hospital Report, and also from Dr. Mishra’s description of Mr. Miles’ ongoing auditory hallucinations and paranoid delusions. Despite Mr. Miles exhibiting a relatively good comfort level at times, he continues to engage in throwing behaviours (throwing food and liquids at staff), which underscores the level of aggression that poses a serious risk of harm to others. Mr. Miles experiences fluctuations between good and bad days, with these changes occurring dramatically throughout the day. Managing him effectively has been possible within the high secure setting at Waypoint. Counsel for Mr. Miles added that the family is very happy with the care being provided by Dr. Mishra and the treatment team.
ANALYSIS AND CONCLUSION
(a) Significant Threat
The Board must first determine whether Mr. Miles continues to pose a significant threat to the safety of the public as defined in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. Based on the totality of the evidence, including the testimony of Dr. Mishra, recent clinical findings, and the actuarial risk assessment results, the Board concludes that Mr. Miles continues to meet the legal threshold for a finding of ‘significant threat.’
Recent clinical observations indicate that Mr. Miles has experienced a resurgence in symptoms of catatonia, encompassing stupor, mutism, grimacing, and posturing. During this review period, he required hospitalization for neuroleptic malignant syndrome, and the discontinuation of all antipsychotic medications. Following this medical condition, Mr. Miles experienced heightened paranoia and catatonic episodes, impacting on his food intake and overall mental health. The Board also notes that following a tapering off of medication, and decreased frequency of ECT treatments, his mental state deteriorated. Although, he seems to have shown some improvement, his continuously erratic behaviour, characterized by internal distractions and non-engagement, weighs heavily against any potential for safe community integration.
Based on the HCR-20 assessment, it is noted that Mr. Miles possesses seven out of ten historical risk factors, indicating a heightened risk for future violence. Notably, he has assaulted staff and has demonstrated an inability to maintain consistent interpersonal relationships or independently adhere to therapeutic recommendations. Such behavioural instability reinforces the presence of risk management concerns, even though Mr. Miles has shown some improvements in his mental state, he continues to grapple with paranoia – especially around food – and he displays very poor insight into his condition.
Mr. Miles remains unable to articulate plans for reducing his risk factors. This inability is compounded by a history of violent behaviour, including serious violent offences that resulted in serious injury to others. There were multiple incidents of violence against both staff and co-patients, particularly female individuals, reflecting a pattern of reactive aggression that continues to occur in various contexts, and different settings. His reclusive behaviour, paranoia regarding food, and the necessity for seclusion following aggressive outbursts, highlight the ongoing concerns for safety.
Mr. Miles currently remains in the Awenda program, and his psychiatric condition continues to be characterized by treatment-resistant schizophrenia. This has raised serious concerns about his ability to manage his behaviour and comply with essential treatment protocols. Mr. Miles’ ongoing threat to public safety primarily stems from his profound lack of insight into his mental illness and the risks associated with his non-compliance with treatment.
As noted, Mr. Miles has shown some improvement with ECT, leading to increased engagement with staff and time spent outside of his room. He was also compliant with clozapine. Although there are documented instances of improved interaction with staff and family members, Mr. Miles remains at risk for severe sudden decompensation, particularly in the absence of structured care.
In conclusion, based on the comprehensive review of Mr. Miles’ history, current mental state, and risk assessment outcomes, it is evident that he continues to pose a significant threat to public safety. His historical behaviour, compounded with current indicators of instability and untreated symptoms, firmly necessitates ongoing secure care and supervision. As a result, continuous reassessment of his clinical presentation and adherence to treatment protocols will be crucial in managing Mr. Miles’ risk levels, while ensuring community safety.
(b) Necessary and Appropriate
The Board must next determine the disposition that is necessary and appropriate in the circumstances. The disposition must embrace the principle of ‘least onerous, least restrictive,’ with due consideration given to Mr. Miles’ liberty interests, which must also be consistently weighed together with concerns about public safety (the paramount concern), his mental condition, and his potential for successful reintegration into society, as required by s. 672.54 of the Criminal Code.
Given Mr. Miles’ ongoing psychiatric issues, including persistent auditory hallucinations and episodes of catatonia, any form of discharge – whether conditional or absolute – poses a significant risk to both him and the public. His history of violent behaviour, including assaults on staff and unpredictable aggression, reinforces this concern. Recent incidents have illustrated that he remains susceptible to acting violently when influenced by his hallucinations. The risk of decompensation without consistent supervision and appropriate treatment remains considerable, suggesting that he is not currently equipped to manage the complexities of community living.
For successful integration into the community, Mr. Miles would have to demonstrate stability in his mental health, a robust support system, and effective coping mechanisms. Mr. Miles has not established these necessary components. Despite some improvements in his symptoms due to treatment, he continues to demonstrate erratic medication compliance and has significant gaps in insight into his mental health condition. His lack of consistent communication with his support network and his difficulty in navigating personal care highlight his unpreparedness for independent living.
In contrast, effective community living would require Mr. Miles to engage with therapeutic resources actively, maintain regular medication adherence, and develop constructive interpersonal relationships. Given his current inability to do so, the likelihood of successful integration remains low. Instead, the continued need for a structured, supervised treatment setting is vital for addressing Mr. Miles’ mental health needs while safeguarding the community from potential harm. Therefore, a conditional or absolute discharge is not only imprudent but poses a significant risk to public safety.
A high secure hospital setting is the most appropriate environment for Mr. Miles due to the complexity of his mental health needs and the significant risks associated with his condition. Waypoint provides the structured support Mr. Miles requires, including intensive psychiatric care, regular medication administration, and continuous supervision to manage his symptoms effectively. The presence of a comprehensive treatment team within a high secure setting ensures that Mr. Miles receives the individualized care required to stabilize his condition, while also minimizing the risk of harm to himself and others.
A detention order is deemed necessary and appropriate to ensure the safety of both Mr. Miles and the community. Without the constraints of a detention order, there is a substantial risk that Mr. Miles could disengage from treatment, thereby jeopardizing his stability and increasing the likelihood of violence. Maintaining his detention in a high secure hospital is critical for both his rehabilitation and the protection of the public, as it allows for a focused approach to address his mental health challenges, while ensuring that he remains in a safe environment.
DATED this 19th day of December 2025, at the City of Toronto, in the Toronto Region.
Ms. A. La Viola Legal Member
__________________ Office of the Registrar Ontario Review Board