Ontario Review Board
Re: Jimmy Crispin
ORB File No: 6950
Hearing held on: Wednesday, December 3, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. D. Sandor
Members: Dr. R. Kunjukrishnan
Dr. S. Prat Mr. J. Weinstein
Mr. A. Bernardo
Parties Appearing:
Accused: Jimmy Crispin
Counsel: Ms. M. Lord
Person in charge of hospital: Representative: Dr. F. Wood
Attorney-General of Ontario: Counsel: Ms. E. Davies
REASONS FOR DISPOSITION
(Dated December 31, 2025)
Introduction
On May 9, 2016, Jimmy Crispin, was found unfit to stand trial on three charges of breaching probation, contrary to the provisions of the Criminal Code of Canada. He is currently subject to a disposition of the Ontario Review Board dated December 11, 2024, that discharges him subject to conditions. These included the requirement that he reside at a supervised group home known as “Mon Chez Nous” located in Casselman, Ontario and that he has no contact with his wife, Charlene Keyes, or their daughter, Samantha Crispin, except with their revocable consent or through legal counsel.
On December 3, 2025, the Board convened at the Royal Ottawa Mental Health Centre (hereinafter referred to as “the Hospital”) to conduct an annual review of that disposition. Mr. Crispin attended the hearing. On the consent of all parties, an order was made appointing his lawyer, Ms. M. Lord, as solicitor of record.
The record for the hearing included the Notice of Hearing dated February 26, 2025, the most recent Disposition (mentioned above) and the Reasons for that Disposition. On the consent of all parties, a Hospital Report dated November 4th, 2025, was entered into evidence as Exhibit No. 1.
The parties were canvassed for their positions. Dr. Wood, Mr. Crispin’s treating psychiatrist, spoke for the Hospital. He expressed the position that Mr. Crispin was permanently unfit, as that term has been explained by the Supreme Court of Canada in the case of R. v. Bharwani, 2025 SCC 26. Dr. Wood further expressed the position that Mr. Crispin continues to represent a significant threat to the safety of the public as set out in section 672.5401 of the Criminal Code and as further discussed by the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. Dr. Wood indicated that the evidence would support a continuation of Mr. Crispin’s conditional discharge, having regard to the objectives set out in section 672.54 of the Criminal Code, the paramount of which is the assurance of the safety of the public.
Ms. Davies, lawyer representing the Attorney General, agreed with the Hospital on all issues.
Counsel for Mr. Crispin disagreed. She submitted that while Mr. Crispin is permanently unfit to stand trial, the evidence would not establish to a Winko standard that he continued to represent a significant threat to the safety of the public, warranting, as a result, his return to court for a recommended stay of proceedings.
For the following reasons, the Board agrees with counsel for Mr. Crispin. While it is clear both that Mr. Crispin is permanently unfit and that he continues to pose some risk to the safety of the public, the Board cannot conclude that the evidence has established clearly that he represents a significant threat. As will be explained, the Board arrives at this conclusion considering Mr. Crispin’s history over the last 3 years, his limited means, his wife Sharlene Keyes’ control over all his finances, and the level of supervision Mr. Crispin receives at his place of supervised residence. The Board is also mindful of the relationship context existing between Ms. Keyes and Mr. Crispin and the legislative remedies available to her in both the Family Law Act and the Divorce Act should she wish to limit his capacity to communicate with her or attend at the matrimonial home.
Evidence at the hearing
The evidence at the hearing came from the Hospital Report mentioned and the viva voce evidence offered by Dr. Wood.
Turning first to the Hospital Report, it is cumulative in nature and provides a summary of the allegations that gave rise to the finding of Mr. Crispin’s unfitness. These are identical to those set out in last year’s Reasons for Disposition:
“On December 27, 2014, Ottawa police were called to Mr. Crispin’s home for a domestic dispute. His daughter had called the police when she heard an altercation going on between her parents. Mr. Crispin’s wife, Mrs. Sharlene Keyes, told officers that Mr. Crispin had smashed a cereal bowl and when she tried to speak with him to de-escalate the situation, he grabbed a smoke detector and threw it across the room causing it to break. He continued to call his wife vulgar names. She decided to leave the situation and take the dog for a walk and was attempting to leave by the garage door. Mr. Crispin took a broom from the kitchen, broke it, and pointed it in a prodding type of fashion trying to direct her out the garage door. He took recycling bins and garbage and threw them in her direction. Officers noted the garbage was thrown all over the garage. While in the garage Mr. Crispin grabbed the victim by both hands around her collar and scarf and continued to yell vulgar profanities at her. She managed to get away and attempt to contact her sister to call police. Although the victim indicated to police when they arrived that sometimes Mr. Crispin behaves in such a manner when his blood sugars are off, paramedics took his blood glucose levels at the scene, and they were in the normal range. He was charged with three counts of mischief, assault, and assault with a weapon.”
Following his arrest by the police, Mr. Crispin appeared in court where he was found guilty of assault. The court sentenced him to abide by terms of probation. He was required to not communicate with his wife or daughter and not be within 250 metres of their residence.
While bound by the terms of probation, Mr. Crispin reoffended on the following dates.
Between October 2 and 3, 2015, he left a note on the windshield of his wife’s car stating he needed money and that he did not want to deal with their intermediary (the sister) anymore. He signed his name at the bottom of the note.
Between October 3 and 4, 2015, Mr. Crispin left another note addressed to his wife, this time placing it on the garage door at their home. He signed his name.
Mr. Crispin also left 19 voicemails on his wife’s home phone after October 4, 2015, asking for money and stating who could or could not be allowed at the residence once he were to return home.
- These allegations formed the basis of the three breach probation charges that preceded the finding that Mr. Crispin was unfit to stand trial. Following this, on June 22, 2016, Mr. Crispin had his scheduled initial Ontario Review Board hearing. At 10 p.m. that evening, he attended his wife’s home. She saw him in the driveway. When he saw her, he said he was borrowing a ladder and left with the ladder after she asked him to leave.
Personal Background
The majority of the evidence contained in the Hospital Report was ably summarized in last year’s Reasons for Disposition. Inasmuch as little has changed over the course of this last review period from what was commented on there, it is appropriate to include the summaries found in both the majority and the dissent opinions expressed therein:
Mr. Crispin is 64 [now 65 years old]. Until 1999, when he suffered a severe stroke from a brain aneurism, Mr. Crispin had functioned well in society. He is fluently bilingual and has a High School education. He was employed at the automotive department at a Canadian Tire store in Ottawa for 20 years. He also worked with the federal public service for some years.
Mr. Crispin and his wife have been married since their twenties. Their adult daughter, Samantha, and her spouse, live in the same home with Mr. Crispin’s wife. Samantha has a young child. She provides care for both her child and her mother, Sharlene Keyes. Samantha’s spouse works outside the home, to support his family.
Before suffering the severe stroke in 1999, Mr. Crispin was a devoted father to his daughter and a devoted husband to his wife. He would cook and clean in the home and was described as a responsible husband. There is some earlier history of alcohol abuse in his life but, in earlier years, he had already left it behind him.
After the aneurism in 1999, friends and family members noted a change in Mr. Crispin’s personality. He began to display serious behavioural issues. These were exacerbated when his diabetes control was poor. Mr. Crispin would fall off from compliance with blood sugars medication. He was inconsistent and became frustrated. He refused to take medications. At times, in what seemed to be a fluctuating course, he would become resentful, angry, aggressive, and unpredictable. He began to scream, punch holes and break things around the house, particularly when he was with his wife, daughter, and mother-in-law. Ultimately a series of these behaviours culminated in the criminal charges which were laid in December 2014.
Of note, before December 2014, the police had already attended the family home more than once, due to earlier aggressive and angry outbursts. A previous incident, from August 28, 2014, saw police bring Mr. Crispin to the Ottawa Hospital. He was admitted to psychiatry on a Form 1 and kept there until discharged on September 3, 2014.
Upon discharge, Dr. Saul’s diagnostic impression was that of neurocognitive disorder secondary to acquired brain injury (impulsive anger outburst and behavioural dyscontrol), poorly controlled Type 2 diabetes, irregular adherence to medications, and relational turbulence with spouse.
Course in Care, following the Court’s Finding of Unfitness, May 2016 to October 2023
The hospital report documents several psychiatric and neuropsychological assessments conducted both before and after the May 2016 unfit finding. Initially in 2016, Mr. Crispin was living in an apartment. The hospital treatment team was concerned about Mr. Crispin’s ability to care for himself and manage his diabetes. He was refusing to consider moving into a facility that might assist him, such as a retirement home. He continued to believe his wife was conspiring to take his money.
In August 2016, with the involvement of Mr. Crispin’s wife, the adult daughter, the probation officer, and a concerned relative, Fern Richer, as well as the Ottawa Hospital rehabilitation therapist and neuropsychologist, it was decided that Mr. Crispin should no longer be living alone. This was due to his difficulties at managing finances, cooking, and managing his diabetes and medications. The Ministry of Transportation had revoked his driver’s license, and his car was taken off the road. Mr. Crispin was not taking his medications regularly. It was not clear how often he was checking his blood sugars. Mr. Crispin refused to allow community care workers to come to his apartment to assess his needs. By October 2016, Mr. Crispin agreed to come into the ROMHC rehabilitation unit.
Mr. Crispin remained on inpatient status at the hospital until June 2017. While in hospital, he demonstrated impulsive and extravagant spending habits. He was also overgenerous, giving money and gifts to peers. He showed low frustration tolerance in dealing with what he perceived as mistreatment or disrespect from staff and co-patients.
Poor short-term memory and limited ability to retain new information continued to be a problem. Mr. Crispin displayed poor medication and diabetes management. He tended to eat large quantities of junk food or go for long periods of time without eating at all. Through all his time in hospital Mr. Crispin remained unfit. In 2017, the assessing psychiatrist formed the opinion that Mr. Crispin’s unfitness was permanent and untreatable.
On June 13, 2017, Mr. Crispin was discharged from hospital and placed in a supportive supervised residence, Moose Creek Villa. By August 2017, Moose Creek Villa was reporting that Mr. Crispin was becoming more verbally aggressive and had broken some objects in frustration. He was upset about wanting items from his wife and was frustrated about finances. The owner of the facility, Ms. Marcoux, expressed concern that Mr. Crispin might escalate to physical violence and that she herself would likely be the object of his aggression.
On November 14, 2017, Mr. Crispin became verbally aggressive. He broke down a door. He threw salt and pepper shakers on the floor. Police attended the facility and took him to the Cornwall Community Hospital. Soon after, he was transferred to the hospital’s forensic assessment unit.
By the mid-December 2017, Mr. Crispin was described as still “easily irritated”. The attending psychiatrist modified his medication, adding a low dose of Risperidone, twice daily. Effexor was increased to help diminish his tendency to be disinhibited. Mr. Crispin then began to show improvement, with fewer incidents of aggressiveness and irritability. By the end of January, the owner of Moose Creek Villa was satisfied with Mr. Crispin’s progress and was ready for him to return. He did so, and was discharged from hospital, on February 8, 2018.
Unfortunately, within a few days, new difficulties arose at Moose Creek. Details are set out in the hospital report at p. 42, including a time when Mr. Crispin stated he would beat up Ms. Marcoux. However, in the following weeks and months, Mr. Crispin managed to stay at Moose Creek. This was largely the result of an ownership change at the facility, with Ms. Marcoux leaving, and because the treatment team was beginning to better manage Mr. Crispin’s blood sugar levels.
However, in the following year, with Mr. Crispin showing renewed behavioural problems, the police were called back to the residence on August 4, 2019. He was seen on an urgent basis at the hospital outpatient department.
On August 13, Mr. Crispin was admitted on a Form 1 to the Ottawa Hospital – Civic Campus, to await a bed at the ROMHC. Soon after, on August 13, 2019, he was transferred to the hospital Crisis Unit.
By October 2019, Mr. Crispin was once more allowed to return to the supervised Moose Creek Villa. By February 2020, with ongoing difficulties, discussion began about moving Mr. Crispin to a different group home. Things were not made any easier, given wider complications arising from the Covid-19 pandemic.
By Summer 2020, the forensic treatment team was concerned that group home staff at Moose Creek Villa were not adequately monitoring or supervising Mr. Crispin’s diet or insulin medications. The treatment team arranged for him to move to a new group home, Mon Chez Nous, in Casselman, where he still resides.
After coming to Mon Chez Nous in October 2020, Mr. Crispin’s diabetes management improved. Group home personnel monitored his sugars and supervised his insulin. He seemed to have a good relationship with staff members. However, concerns were noted about his tendency to spend a great time in bed: this brought on a concerning loss of physical conditioning. Memory difficulties continued, which are described in the report.
The reporting year ending in October 2023 saw a resumption of Mr. Crispin’s aggressive outbursts. Staff observed these coincided with elevated blood sugar readings.
Unfortunately, in August 2023, Mr. Crispin was the victim of theft by a cleaning staff member. The member had been fired before Mr. Crispin discovered his valuable items were missing. Among the items taken were a camera and tele-photo lens which he had purchased. Dr. Wood and the attending hospital social worker, Richard Robins, began to consider the potential need to have Mr. Crispin change group homes once again. However, by October, Mr. Crispin’s spirits had improved.
Mr. Crispin had contact with his wife and daughter in late 2023, facilitated by the ROMHC social worker, Mr. Robins. The background of family interaction is well described in the report at p. 83. As on past occasions, Mr. Crispin expressed his intention that he was waiting for his pending ORB hearing when, in his mind, he would be released. His only plan was to move back into the family home with his wife. His plan was not realistic. [Emphasis added.]
Dr. Wood and Mr. Robins planned to continue liaison with Mon Chez Nous staff and Mr. Crispin’s family physician, Dr. Hurley. This included continued management and optimization of Mr. Crispin’s diabetes medications to gain full control of his glucose levels and associated levels of irritability. Mr. Robins planned to continue facilitating graduated contact between Mr. Crispin and his daughter, son-in-law, and infant granddaughter.
Consideration was also given to encouraging contact between Mr. Crispin and his wife Sharlene. At the time, Dr. Wood noted it was likely Sharlene would require further support from a trauma-focused perspective, due to her previous experiences when she had been living with Mr. Crispin at home in his highly impaired state.
In last year’s report to the Board, Dr. Wood noted that he and Mr. Robins believed Mr. Crispin’s wife, Sharlene Keyes, appeared to be an appropriate Power of Attorney. She was providing reasonable explanations about her intention to remain in the role while knowing how it could aggravate Mr. Crispin. Both Sharlene and the daughter, Samantha, seemed aware that Mr. Crispin tended to cycle in his complaints, which would likely occur regardless of who ended up managing his finances.
This pattern of complaints had been observed over time by the treatment team with regards to other aspects of Mr. Crispin’s life, including with food and care staff. Dr. Wood and Mr. Robins believed it would likely become more challenging for the treatment team were the Public Guardian & Trustee to start managing Mr. Crispin’s finances: the PG&T is not always readily available to respond, so that they also could be targeted by Mr. Crispin’s irritability and aggression.
In last year’s report, Dr. Wood wrote as follows, see p. 87:
Sharlene appears to understand the risks of maintaining the Power of Attorney but also seems to want to remain involved in Mr. Crispin’s life to some degree and afford him the best opportunities to remain safe with regards to his health and care.
Last year’s Review Board panel determined that Mr. Crispin remained unfit to stand trial and would likely remain permanently unfit - due to his major neurovascular cognitive disorder, exacerbated by diabetes. Although Mr. Crispin had been stable in the previous ten months, and was living in a highly supportive environment, he continued to represent a significant risk to the community. Without a Board disposition, last year’s panel concluded, Mr. Crispin would likely stop taking his medication, suffer a relapse of his mental condition, and worsening of his diabetes, which would see his mental condition affected. Mr. Crispin was repeatedly stating his intention to leave his residence and to return home.
Given those concerns, the Board discharged Mr. Crispin with the requirement that he continue to reside at his assigned group home in Casselman. The Board also noted that his wife’s continued exercising Power of Attorney over property was an ongoing stressor and that this could only be resolved by a somewhat complicated family law proceeding involving navigation with legal aid and a family law lawyer.
Currently, the hospital social worker, Mr. Robins, continues to meet Mr. Crispin once every few weeks at the group home and to support him with multiple doctors’ appointments. In January 2024, Mr. Crispin needed guidance and medical attention: he was not eating properly, risking further instability to his blood sugar levels.
Mr. Crispin’s condition regarding fitness to stand trial has not changed. He remains the same, with cognitive impairments secondary to the 1999 stroke, resulting in continued inability to retain most information. He remains unable to meaningfully engage in the court process. Throughout the current reporting year, Mr. Crispin continues to repeatedly express to Dr. Wood and Mr. Robins his wish to move back home to live with his wife.
There has been some limited family contact in the reporting year, primarily with the daughter, son-in-law, and infant granddaughter. In March 2024, Mr. Crispin’s wife began treatment for cancer. A visit with Sharlene was organized but had to be cancelled due to the cancer diagnosis.
When Mr. Crispin separately met with his daughter Samantha in the early 2024, he brought up his wife in conversation. Mr. Crispin became very accusatory. He complained that his wife was “cheating on him.” He told the daughter his doctor had shown him pictures of his wife with another man.
This was very upsetting to Samantha. For her own mental health, she decided it was best to put visits on hold for the time being. Samantha reports it is difficult for her to come visit her father due to her own commitments at home, caring for her young child and her mother and while her husband is away at work for extended periods of time…
The Board also received direct testimony from the attending psychiatrist, Dr. Floyd Wood. Dr. Wood is a staff Forensic Psychiatrist with the Integrated Forensics Program at the ROMHC. He is the author of the hospital report filed in evidence. Dr. Wood provided further explanations while responding to questions asked.
Dr. Wood testified that Mr. Crispin sees the ORB as the main barrier keeping him away from his home and his wife. But for the Board’s involvement, Mr. Crispin would make real efforts to return home. In Dr. Wood’s opinion, a continuation of the conditional discharge, with the requirement to remain at the group home, is the main protective factor to keep everybody safe.
Asked by counsel for the Attorney-General what would happen without the Board’s involvement, Dr. Wood explained that Mr. Crispin’s blood sugars would not be effectively managed. This is due to his memory impairments. Mood issues and aggression would follow. Mr. Crispin’s blood sugar levels require treatment by multiple medications, including a low dose of the antipsychotic, Risperidone, coupled with Effexor. Were Mr. Crispin to not take medications prescribed, he would suffer a deterioration in both his physical and mental health. Without the Board’s involvement, Mr. Crispin could still have housing available to him at Mon Chez Nous. However, Mr. Crispin could choose to leave at any time. Were he to do so, which he is likely to do, he would lose his place there.
Dr. Wood explained that without the Board’s ongoing supervision, Mr. Crispin would be at high risk of future violence. Mr. Crispin has always believed he is able and entitled to return home. However, his wife is quite concerned about any potential return. Her concerns became even more elevated following the daughter’s report to her about Mr. Crispin’s conversation with Samantha in March 2024 – see paras. 44-47, supra.
On behalf of her client, Ms. Lord had questions for Dr. Wood. He explained that the couple remain technically legally married. No divorce proceeding has been started. Dr. Wood explained that the previous lack of blood sugar controls with associated irritability and aggression was the reason Mr. Crispin lost his placement at the previous group home, Moose Creek Villa. Other factors were also involved that saw the hospital determine that Moose Creek was not suitable. Dr. Wood added that when Mr. Crispin first arrived at Mon Chez Nous a few years ago, his condition was much worse before he began to show some improvement.
At Mon Chez Nous, staff attend to all of Mr. Crispin’s physical and medical needs. They dispense his medications, do the house cleaning and laundry, and prepare his food. Mr. Crispin’s wife manages his finances. She pays for him to stay there. The social worker, Mr. Robins, remains highly involved to offer ongoing liaison between the group home and the hospital.
Without the involvement of the Board, the social worker’s services and Dr. Wood’s involvement would continue but only for a limited one-year period following the granting of any absolute discharge. Mr. Robins’ involvement continues to be necessary to ensure that the residence provides ongoing care at maintaining the patient’s stability. Dr. Wood explained there are no other community services which can replace those available through the hospital under the jurisdiction of the Review Board.
Responding to questions from Board members, Dr. Wood advised that Mr. Crispin might be managed, but only to a point, under the Mental Health Act. Should Mr. Crispin leave Mon Chez Nous, or be required to leave, he more likely would have to stay in hospital for a long time. He would conceivably even be kept on a locked unit. In that light, Mr. Crispin’s life would be much more restricted than it currently is while he remains under ORB supervision.
A Board member asked if the hospital has attempted to educate Mr. Crispin to restore him to a state of fitness so that he might attend court for his trial. Dr. Wood explained that they have provided information in the past about the circumstances and procedures involved. In every discussion, Mr. Crispin becomes agitated, to the point where nothing can be accomplished.
With Mr. Crispin and his wife living in different towns (he is in Casselman while she is in Ottawa) Mr. Crispin can go into the community through the assistance of Mr. Robins who arranges a driver to get him to haircuts and to attend on errands. Since being placed at Mon Chez Nous, Mr. Crispin has not been involved in any reckless spending or exorbitant purchases. This had been a serious problem in earlier years.
Mr. Crispin continues to be counselled about his being under the Board’s controls and about his need to remain at the group home. In these discussions, Mr. Crispin has no real recall of any earlier conversations. These are brought to his attention mostly every month. When such conversations take place, it brings on agitation, to the extent that the topic cannot be further explored.
Evidence of Jimmy Crispin
Ms. Lord called her client to testify. Responding to questions framed by counsel, Mr. Crispin told the Board that if he went to court and had no more conditions imposed, he would stay where he is in Casselman. Mr. Crispin said he gets on good with the people who are there. He cannot see that the marriage will continue.
Mr. Crispin testified that the employees prepare his lunch and supper, clean his room, do his laundry, and provide his medications. If he lived in an apartment alone, ‘I probably could not do all those things.’ Mr. Crispin then added, ‘I think I could take my medication on my own… I understand medication is good for me.’
Mr. Crispin spoke of ‘Jeanne’ the owner of Mon Chez Nous: He was asked what would happen if something were to come up at the residence, without the restrictions of the ORB. Mr. Crispin replied, ‘I’d speak to Jeanne. I get along with her.’
Mr. Crispin said he is aware he has memory issues. If he had no conditions to not see Sharlene ‘… I probably would - because it was my home for thirty years.’ Asked how he would find out if she did not want to see him, Mr. Crispin replied, ‘I wouldn’t know.’
Dr. Wood asked Mr. Crispin who was his family doctor. He replied, ‘I don’t have a family doctor.’ Asked what it was he had told Mr. Robins about
plans for a family doctor, Mr. Crispin spoke instead of ‘the American doctor,’ who he is insistent on seeing ‘for very good reasons.’
- When a Board member asked Mr. Crispin if he would go see his wife, he answered that he was not sure if he would do so. Asked about Sharlene’s feelings of being unsafe, he said he did not know about that.
Mr. Crispin’s course over the last period of review
- Following on the 22 months of lack of violence leading to the last Board’s decision, Mr. Crispin has passed a further 12 months without resurgence of aggressivity. The Hospital’s update for the purposes of this hearing begins at page 98 of 104 of the Hospital Report. It explains that while Mr. Crispin “only occasionally” mentioned frustration about “a few” staff members at Mon Chez Nous “if prompted” during a conversation, he has not acted out with any threats (verbal or para-verbal) or aggressivity. The most severe conduct described, again, is “intermittent irritability.” Even following a tender and emotional reunion visit between Mr. Crispin and his wife, arranged by the Hospital, there was no mention of resurgence of irritability or aggressivity. This continued to be the case even following weekly phone calls with his wife. The worst that could be said was that, at one point over the course of the initial reunion with his wife, Mr. Crispin expressed some criticisms of some of their old friends with whom Ms. Keyes has maintained contact. But even in that regard, there is no evidence that Mr. Crispin engaged in hostile or inappropriate language over the course of the conversation, and certainly none that he subsequently expressed fixation on the friends that could be interpreted to manifest either a prolongation of significant threat or even the continuation of any possible dynamic of control over his wife. Indeed, the Hospital Report at page 102 says that
Mr. Crispin’s frustration towards his wife has decreased over the past year. He had a good visit with her last month, but he continued to be critical of the friends she kept, which caused her some concern. His wife remains his Power of Attorney, which increases the risk of him being frustrated with her in the future, which has been apparent whenever reminded that he would not be returning home. Mr. Crispin’s ability to cope with stress has been a concern. Nonetheless, there have been no physical or violent outbursts, likely due to improved glucose control and the structure of the group home and support from the team.
- The Hospital Report asserts a conclusion that all that prevents Mr. Crispin from attempting to return home is the involvement of the Ontario Review Board. The second last paragraph suggests that, absent that involvement, Mr. Crispin would return to the matrimonial home, resulting in police involvement and further frustrations, incarcerations and questions of fitness that would be re-traumatizing for his wife and daughter. The foundation for this conclusion is grounded in the fact that Mr. Crispin’s cognitive impairments leave him struggling to recall the original alleged offences and make it impossible for him to remember that the charges he faces remain active and that there are conditions of judicial interim release that remain in place that bar him from attending at the matrimonial home in the absence of an ORB disposition. Paradoxically though, the Hospital Report also states that Mr. Crispin “could not recall the previous ORB’s or what was discussed in those hearings.” It would appear from this then that there is doubt as to whether it is singularly the existence of an ORB disposition that produces what since 2019 has been Mr. Crispin’s lack of attempts to attend at the matrimonial home. Nothing in the Hospital Report’s update supports the conclusion the Board’s dispositions, in Mr. Crispin’s mind, are more compelling, in conjunction with the support and direction of staff at Mon Chez Nous, than are existing judicial interim release orders or other prohibitions that may be available to his wife on application to the Superior Court of Justice pursuant to the provisions of the Family Law Act or the Divorce Act.
Dr. Wood’s viva voce evidence at the hearing
Dr. Wood testified that Mr. Crispin has been doing well at Mon Chez Nous since the stabilization of his blood sugar levels almost three years ago. He explained though that Mr. Crispin continues to “look forward to being done with the ORB so he can return home.” Dr. Wood explained that when this happens, Mr. Crispin needs to be engaged in discussions of his living situation and the fact that he and Ms. Keyes are no longer a couple. Dr. Wood did not describe any aggressivity, fixation or oppositionalism coming from Mr. Crispin over the course of or following these reminders.
Dr. Wood updated the Board regarding ongoing efforts engaged in by Ms. Keyes and Mr. Crispin’s case manager, Mr. Robins, to rebuild their relationship to the extent possible. Dr. Wood testified that Mr. Crispin and Ms. Keyes would have a birthday meeting in the community in mid-December, with Mr. Robins providing initial supervision.
In spite of this progress in terms of relationships, and the fact that Ms. Keyes remains Mr. Crispin’s power of attorney for property and finances, Dr. Wood’s evidence was consistent in his opinion that, absent an ORB disposition, Mr. Crispin would visit the matrimonial home, cause a disturbance, and return to a jail setting on the breach. Dr. Wood expressed appropriate concern for the global impact detention in a jail would have on Mr. Crispin.
In response to questions from Ms. Davies for the Attorney General, Dr. Wood testified that Mr. Crispin has not been physically violent for years. There have been no threats, fixations, incidents of violence or aggressivity from the time Mr. Crispin arrived at Mon Chez Nous. Dr. Wood also testified that not only does Ms. Keyes exercise a power of attorney for Mr. Crispin’s property, but she is also his substitute decision-maker for medical care. Dr. Wood explained that Mr. Crispin is not capable of making decisions relative to his own treatment. Consent to treatment lies exclusively in the authority of Ms. Keyes. While Dr. Wood later expressed that, absent a disposition, Mr. Crispin may cease taking the medications that have maintained his non-aggressive state over the past few years, he limited this possibility to a situation where Mr. Crispin was no longer in a supportive environment. The body of the evidence meanwhile suggests that, so long as Ms. Keyes is exercising her power of attorney and functioning as Mr. Crispin’s substitute decision-maker for treatment purposes, the stability of his medication and supervised dwelling is not in question. It remains speculative as to whether any of that would change should Ms. Keyes relinquish her responsibilities to the Office of the Public Guardian and Trustee.
Questioning from counsel for Mr. Crispin, Ms. Lord, drew somewhat on the dissent in last year’s Reasons. In response to her questions, Dr. Wood confirmed that:
Last year, Mr. Crispin testified about his intentions to stay at Mon Chez Nous absent a disposition.
Mr. Crispin has not engaged in any form of physical violence since residing at his previous residence in Moose Creek, and that, even there, years ago, the height of concerns expressed was aggressivity in the form of posturing. While there was a similar concern expressed at Mon Chez Nous over a year prior to this Review Board hearing, nothing of the same nature has occurred since the change in Mr. Crispin’s medications. Mr. Crispin’s irritability level as “been much improved.”
While Mr. Crispin does still say that he is content at Mon Chez Nous, he says still that he cannot wait for the ORB to be “done so he can go home” with Ms. Keyes. Dr. Wood added thought that, when he further discusses the matter with Mr. Crispin, recollection returns. Dr. Wood did not mention any upset, fixation or increase in irritability following these reminders. In fact, he testified that “we provide him with education that he cannot return home to help control his upset.” In fact, the only mention of frustration over Mr. Crispin’s inability to return home comes from a singular statement included in the Hospital’s Risk Assessment, which will be discussed further below. There is no evidence that Mr. Crispin has not been dealing with that frustration appropriately.
In spite of memory issues, Mr. Crispin has not attempted to return home. He has no transportation source of his own with which to do so, nor social supports that would assist him unwittingly to that end. He has never called for a taxi, uber or attempted to make the trip himself. Dr. Wood did testify that Mr. Crispin has said that it is the review board that prevents him from doing so.
The resumption of weekly telephone contact and periodic in-person meetings between Mr. Crispin and his wife is a new development that the Hospital would like to monitor more longitudinally.
- In response to questions from the panel, Dr. Wood testified that:
Mr. Crispin speaks with Ms. Keyes weekly and obtains transportation to run errands outside of Mon Chez Nous once a week but has never used that transportation to attempt to attend at Ms. Keyes’ residence.
Mr. Crispin has settled into Mon Chez Nous and has a core group of peers he now socializes with.
If the charges against Mr. Crispin were stayed, he would continue to receive the support of his case manager, Mr. Robbins, for a year over which time attempts would be made to put appropriate community supports in place. Mr. Crispin would be Box B certifiable if there was any indication of decompensation or return to aggressivity.
Mr. Crispin will need indefinite support in terms of medication management. That support has been provided by staff at Mon Chez Nous since his placement there and would continue to be provided there. Mr. Crispin’s ability to remain at Mon Chez Nous will not be jeopardized by the granting of a stay of proceedings. That being said, it will be difficult to locate community supports for Mr. Crispin that match the level of care provided by Mr. Robins and the forensic system.
Mon Chez Nous has been effective in the administration of Mr. Crispin’s medications. So long as Mr. Crispin remains at Mon Chez Nous, Dr. Wood does not have concerns about medication compliance.
Mr. Crispin does remember his old address but has not attended at that home since 2019 in spite of weekly access to the community to run errands as mentioned.
Psychiatric Diagnoses
Mr. Crispin’s current diagnoses are:
Major Vascular Neurocognitive Disorder (Dementia).
History of delirium related to hyper and hypoglycemic episodes.
Latent Autoimmune Diabetes in Adults (insulin dependent)
Current Violence Risk Assessment
- Dr. Wood made recent use of the HCR-20 v.3 structured clinical judgment assessment tool to assess the risk of future violence. Dr. Wood’s assessment contained in the report at pages 101 and 102 is as follows:
“The writer used the HCR-20 version 3 structured clinical judgment assessment tool to assess Mr. Crispin’s risk of future violence. With regards to future violence, both verbal and physically aggressive behaviour towards caregivers and towards his wife and daughter were considered.
It is the writer’s opinion that Mr. Crispin’s current level of risk of verbal or physical aggression to his wife or daughter remains low due to his lack of contact with them. However, this risk would be high were it not for the oversight of the ORB and the residence condition. Also, his risk of verbal and physically aggressive behaviour to those in his immediate environment, specifically staff members responsible for his wellbeing and the condition of his living environment, remains moderate. Currently, these individuals include group home staff members. His blood sugar levels have been stabilized since the change in his medications, which improves this risk while acknowledging the need for medication reminders and compliance.
Mr. Crispin’s static or historical risk factors are largely unchanged over the past year. In terms of dynamic factors, he has not demonstrated any incidents of aggression since his move to Mon Chez Nous in October 2020. With the stabilization of his blood sugars after a change in his glycemic medications, there has also been a noted improvement in his irritability levels. His neurocognitive disorder remains unchanged and there does not appear to have been any deterioration in Mr. Crispin’s cognition. However, there remains no likelihood of improvement either. Mr. Crispin continues to have the support of our outpatient team.
Mr. Crispin’s frustration towards his wife has decreased over the past year. He had a good visit with her last month, but he continued to be critical of the friends she kept, which caused her some concern. His wife remains his Power of Attorney, which increases the risk of him being frustrated with her in the future, which has been apparent whenever reminded that he would not be returning home. Mr. Crispin’s ability to cope with stress has been a concern. Nonetheless, there have been no physical or violent outbursts, likely due to improved glucose control and the structure of the group home and support from the team.”
Victim Impact Statement
As was the case in last year’s hearing, the Board was provided with a Victim Impact Statement authored by Ms. Keyes. The statement is brief and substantively offers nothing more than what was stated by Dr. Woods in his viva voce evidence.
As a general proposition, Victim Impact Statements are not admissible in ORB proceedings involving the unfit accused. This is driven by Part XX.1 of the Criminal Code, sections 672.5(14), (15) and (15.2) that limit the use of Victim Impact Statements to circumstances where the commission of an offence has been proven at trial (i.e. in circumstances involving an accused person that has been found not criminally responsible on account of mental disorder). In the case of an unfit accused, no offence has yet been proven. The unfit accused continues to benefit from the presumption of innocence regarding what remain unproven allegations. The language employed in section 672.5 in this regard employs a purposeful exclusion:
672.5(14) A victim of the offence may prepare and file with the court or Review Board a written statement describing the physical or emotional harm, property damage or economic loss suffered by the victim as the result of the commission of the offence and the impact of the offence on the victim. Form 48.2 in Part XXVIII, or a form approved by the lieutenant governor in council of the province in which the court or Review Board is exercising its jurisdiction, must be used for this purpose.
Copy of statement
672.5(15) The court or Review Board shall ensure that a copy of any statement filed in accordance with subsection (14) is provided to the accused or counsel for the accused, and the prosecutor, as soon as practicable after a verdict of not criminally responsible on account of mental disorder is rendered in respect of the offence.
Inquiry by court or Review Board
(15.2) The court or Review Board shall, as soon as practicable after a verdict of not criminally responsible on account of mental disorder is rendered in respect of an offence and before making a disposition under section 672.45, 672.47 or 672.64, inquire of the prosecutor or a victim of the offence, or any person representing a victim of the offence, whether the victim has been advised of the opportunity to prepare a statement referred to in subsection (14). [Emphasis added.]
This issue was comprehensively considered in the unreported case of Re Nedd, Ontario Review Board Reasons for Disposition dated January 5, 2024, as well as in last year’s Reasons for Disposition that formed part of the record for this hearing. Last year, the Board agreed with the analysis provided in Re Nedd but and recharacterized a Victim Impact Statement received from Ms. Keyes as “brief written comments” and “written submissions” so as to be able to benefit from the substance of the Statement in circumstances where, it appears, her evidence was not otherwise readily available.
In the case before us, the information from Ms. Keyes found in the Victim Impact Statement was provided by Dr. Wood over the course of his viva voce testimony. Dr. Wood testified of Ms. Keyes’ concerns, her ongoing care for her husband and the efforts underway to facilitate some measure of restoration of their relationship within the context of Mr. Crispin’s need to continue living at Mon Chez Nous separate and apart from Ms. Keyes. None of the parties otherwise referred to the Victim Impact Statement and none advocated for its inclusion as an exhibit on this hearing. Accordingly, the Board disregarded the Victim Impact Statement and accepted the evidence associated with Ms. Keyes’ cautious support and reservations provided by Dr. Wood.
No further evidence was presented.
Submissions
At the end of the hearing the parties renewed their submissions largely as expressed at the hearing’s outset. All maintained that Mr. Crispin was permanently unfit. This fact was clear on the evidence. Mr. Crispin has no capacity to maintain or communicate a reality-based understanding of the outstanding proceedings. He has no capacity to effectively communicate with counsel in what would be a trial of some complexity. There is no realistic likelihood of improvement in the neurological and cognitive deficits driving his incapacity. The Board has no difficulty endorsing this finding.
The parties from that point however expressed differences on the key issue of significant threat and disposition. Dr. Wood, speaking for the Hospital argued that a disposition was required to protect the public, namely Ms. Keyes, from a real risk of serious psychological harm associated with the commission of serious criminal offences by Mr. Crispin in the absence of a Board disposition. In his submission, the evidence established that, absent a disposition, Mr. Crispin would attend at Ms. Keyes’ home and cause her to experience fear. He indicated however that, if it was the Board’s conclusion that the threshold had not been met, the Hospital would work with Mr. Crispin for one year, attempting to put in place resources and supports that either Mr. Crispin would consent to, or that Ms. Keyes would authorize and direct.
Ms. Davies for the Attorney General agreed with the Hospital in all respects. She submitted that Mr. Crispin was doing well specifically because of the ORB disposition in place and argued that, but for that disposition, the threat posed to the public, or specifically to Ms. Keyes as a member of the public, is significant.
Counsel for Mr. Crispin disagreed. She framed Mr. Crispin’s successes in terms of the support he receives from staff at Mon Chez Nous and the peer associations he has made there as he has settled in. She highlighted evidence that the treatment team was not maintaining Mr. Crispin in the community on a daily basis. She confirmed the consistency of Mr. Crispin’s intentions as expressed at last year’s Review Board hearing that he intends to maintain his residence at Mon Chez Nous and that he is happy there and wants to be there. She highlighted the dissent from last year’s Reasons and noted that this now represents a further year wherein Mr. Crispin manifest no aggressivity and made no attempt to attend at Ms. Keyes’ home. She highlighted that Mr. Crispin’s stability persisted even when reminded that his relationship with Ms. Keyes, as it once was, is over, that he lives at Mon Chez Nous and she lives at her house, and that he is not able to go there. She also noted that Mr. Crispin has accepted this when reminded of it, even though he is having weekly contact and periodic in-person meetings with his wife who remains his power of attorney and substitute decision-maker.
Analysis and conclusion
- This matter raises two questions: is Mr. Crispin permanently unfit? If so, does he continue to represent a significant threat to the safety of the public? These questions arise as a result of the operation of section 672.851 of the Criminal Code:
672.851 (1) The Review Board may, of its own motion, make a recommendation to the court that has jurisdiction in respect of the offence charged against an accused found unfit to stand trial to hold an inquiry to determine whether a stay of proceedings should be ordered if
(a) the Review Board has held a hearing under section 672.81 or 672.82 in respect of the accused; and
(b) on the basis of any relevant information, including disposition information within the meaning of subsection 672.51(1) and an assessment report made under an assessment ordered under paragraph 672.121(a), the Review Board is of the opinion that
(i) the accused remains unfit to stand trial and is not likely to ever become fit to stand trial, and
(ii) the accused does not pose a significant threat to the safety of the public.
[Emphasis added.]
As mentioned above in paragraph 26, the Board accepts that Mr. Crispin is permanently unfit, applying the test for unfitness set out by the Supreme Court of Canada in Bharwanni. The more pressing question is whether he continues to represent a significant threat to the safety of the public.
Section 672.5401 defines “significant threat to the safety of the public” as
“a risk of serious physical or psychological harm to members of the public – including any victim of or witness to the offence, or any person under the age of 18 years – resulting from conduct that is criminal in nature but not necessarily violent.”
In Winko, the Supreme Court of Canada confirmed the basic legal content of the significant threat threshold. It explained that there is no presumption of dangerousness. An accused person is not presumed to pose a threat merely because of their mental disorder. A finding of significant threat must be established on evidence or a “real risk” of serious physical or psychological harm to individuals in the community. That risk must be real and not speculative. The potential harm must be serious in nature, and not just trivial or annoying. The conduct underlying the risk must be criminal in nature. The accused person bears no burden to show that they do not represent a significant threat.
The Ontario Court of Appeal has emphasized these principles repeatedly. Two examples include Re Carrick, 2015 ONCA 866 and Re Marmalejo, 2021 ONCA 130, the latter illustrating the importance of establishing a link between an accused person’s mental defect or unfitness and the significant threat being asserted. It is insufficient to assert that because an accused person suffers from a mental defect impacting criminal responsibility or fitness, they represent a significant threat to the safety of the public. There must be a logical connection between the accused person’s factual circumstances, and a significant threat as defined in section 672.5401. This requires a principled consideration of several factors that may include an accused person’s history, including the index offences; their current course of treatment and treatment response; the length and consistency of periods of stability; protective factors independent of a Board disposition that arise in the public domain or lives of victims; and protective factors, independent of a Board disposition that mitigate risk in spite of continuation of acute factors associated with mental defect experienced by the accused.
In last year’s Reasons for Disposition, the majority expressed the following concerns:
It lacked evidence beyond Mr. Crispin’s assurance that he would remain at Mon Chez Nous absent a disposition. The Board expressed concern that Mr. Crispin, in spite of his evidence, would attempt to attend at Ms. Keyes’ home.
The evidence before it demonstrated a clear history of aggressive and assaultive conduct linked to the combined condition of permanent brain injury and chronic diabetes.
Mr. Crispin required carefully supervised medical management with both diet and medication to control the blood sugar and other factors that contributed to what that the majority of that Board described then as a “significant degree of unpredictable reactivity.”
Mr. Crispin, on the basis of history preceding his attendance at Mon Chez Nous, posed a real and significant threat to his residential care staff requiring forensic support.
Absent Board involvement, Mr. Crispin would suffer loss of his placement at Mon Chez Nous.
- The minority of last year’s panel disagreed. They stressed the following factors:
There have been no instances of violence or aggression since Mr. Crispin moved to Mon Chez Nous in October 2020 (a fact not disputed by the majority).
Over at least that same period of time, Mr. Crispin has not been involved in any criminal conduct. This Board notes that absence of criminal conduct includes an absence of any uttering of threats or forms of criminal harassment.
The last time Mr. Crispin attended Ms. Keyes’ home was in 2019. Since living in the community and particularly since living at Mon Chez Nous, he has not made any attempts at leaving the residence, securing a taxi or uber for that purpose, or attempting to be in contact with Ms. Keyes other than as arranged.
It is not the function of this Board to weigh in as between the majority and the minority reasons expressed by the previous panel. They did assist this panel however in assessing what has taken place, or what has continued to take place over the course of this last review period that would address the concerns enumerated by the majority in last year’s Reasons, as well as any other concerns arising over the course of this hearing.
Mr. Crispin has now resided at Mon Chez Nous since October 2020. Over the course of at least 3 years now he has expressed to his doctor, a previous panel by way of testimony, and to this panel through his lawyer, that he is content at Mon Chez Nous and neither wants nor plans to move from that residence. This is not to say that Mr. Crispin does not have residual longings for an earlier state of things when it comes to where he lives and how his relationships with family are lived. Mr. Crispin expresses frustration in this regard but not fixation. There have been no attempts by Mr. Crispin to reach out to Ms. Keyes other than arranged and with her consent. Mr. Crispin, though running weekly errands in the community, has not attempted to attend in the vicinity of Ms. Keyes’ home since 2019. When he did last attend it was to obtain a ladder. There was no aggression or threatening conduct. The evidence before this Board again is that Mr. Crispin has formed positive peer associations at Mon Chez Nous and that there have been, for what is now 4 years, no instances with staff – certainly, nothing along the lines of what the previous majority panel described as amounting to a “real and significant threat” to support staff.
It is notable that Mr. Crispin’s sustained appropriate conduct and nonattendance at Ms. Keyes’ home comes in a setting where Ms. Keyes has invited weekly phone calls and has met with him in controlled but not entirely supervised settings. Those meetings were positive though emotional. Even following the first of such in-person visits, Mr. Crispin made no attempt to contact Ms. Keyes or attend at her home. He showed no perseveration associated with the home. He continued to live at Mon Chez Nous and to travel to perform errands weekly in the community.
In our view, these facts all contribute to the reliability of Mr. Crispin’s expressed intention to remain at Mon Chez Nous.
Several years have now passed since Mr. Crispin last manifest the type of aggressivity that gave the previous majority panel pause. While Mr. Crispin continues to suffer from the same mental defects noted previously, his symptoms are well-managed by staff at Mon Chez Nous that provides medication and nutritional support and direction independent of the Hospital. It was clear to this panel that, in terms of Mr. Crispin’s day-to-day care, this is provided by staff at Mon Chez Nous and not by the treatment team. Dr. Wood confirmed that, so long as he does not move from Mon Chez Nous, Mr. Crispin is able to continue living there and benefitting from current levels of support offered by their staff absent a Board disposition.
It is notable that Mr. Crispin is not competent to make treatment decisions. His substitute decision-maker is his wife, Ms. Keyes. Ms. Keyes has been courageous, compassionate, and resilient in following through with her responsibilities as such, even when dealing with cancer. Mr. Crispin is also incompetent to deal with finances and property, and the rights associated with ownership. Ms. Keyes is Mr. Crispin’s power of attorney in this regard. As such, Ms. Keyes wields significant authority that supports Mr. Crispin’s continued residence at Mon Chez Nous, as well as his non-attendance at her home.
The Board notes that Ms. Keyes’ authority in this regard is not without latent legal support should she feel it is necessary to obtain further orders that, for Mr. Crispin, would impose as much of an external motivator prohibiting his unwanted attendance or contact with her as that offered by a Board disposition. While the Board’s authority hinges on the onerous threshold of “threat of significant harm,” the standards for restraining orders available on application under the Family Law Act or the Divorce Act consider different factors that are more appropriately attuned to the context of familial relationships where intimate partner violence is alleged to have occurred. The Board is not convinced that it has an influence beyond that of a justice of the peace or a judge of the Superior Court of Justice imposing limitations on Mr. Crispin’s ability to either communicate with Ms. Keyes or attend at her home.
There is no doubt that Mr. Crispin will require ongoing support and supervision to manage his medications and his diet. But this is now a further year where that support and supervision is provided by Ms. Keyes’ exercise of her authorities and is administered primarily by staff at Mon Chez Nous. There is no evidence of fragility in either of these important supports. If Ms. Keyes for any reason determines that it is appropriate to cease exercising her power of attorney or function as a substitute decision-maker for Mr. Crispin, the Public Guardian and Trustee exists to fill that void. It is, in our view, speculative that, even in this event, Mr. Crispin will experience such a lapse in services that he will cease receiving medication, engage in nutritional practices that compromise his stability and occasion an increase in irritability and aggressivity leading to significant threat of the kind envisioned by section 672.5401. It is further speculative that he will either attend at Ms. Keyes’ home or that, if he does so, serious psychological harm will result to Ms. Keyes or any other member of the public. While there may be a risk, the Board on the evidence before it cannot conclude to the Winko standard of certainty that the risk is “significant.”
Accordingly, the Board has concluded that Mr. Crispin does not represent a significant threat to the safety of the public and remits the matter back to the Court for consideration of a stay of proceedings.
The Board thanks all who participated in this hearing for their assistance.
DATED this 31st day of December 2025, at the City of Toronto, in the Toronto Region.
Mr. D. Sandor Alternate Chairperson
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Office of the Registrar
Ontario Review Board