Re: Graham K. Mosher
ORB File No: 4232/6131
Hearing held on: Wednesday, January 15, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. MacIntyre, K.C. Members: Dr. K. Patel Dr. W. Loza Ms. C. Murray Mr. S. Duffy
Parties Appearing:
Accused: Graham K. Mosher Counsel: Ms. J. Boissonneault
The person in charge of hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated February 25, 2025)
Introduction
[1]. On July 4, 2005, Graham Mosher was found not criminally responsible on account of mental disorder on a charge of assaulting a peace officer, contrary to the Criminal Code.
[2]. Further, Mr. Mosher was on June 4, 2012, found not criminally responsible on account of mental disorder on a charge of aggravated assault, contrary to the Criminal Code.
[3]. Mr. Mosher is currently subject to an Ontario Review Board disposition of January 18, 2024, which detains him within the general forensic service at Ontario Shores Centre for Mental Health Sciences with privileges up to and including to live in the community in accommodation approved by the person in charge.
[4]. On January 15, 2025, the Ontario Review Board convened at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) to conduct Mr. Mosher’s annual review and to make a disposition further to s. 672.81(1) of the Criminal Code.
[5]. At the commencement of the hearing, the parties were invited to present their preliminary positions. It was jointly agreed that Mr. Mosher receive a conditional discharge with a reporting period of not less than once per month and a requirement that he reside at Halsey Lodge at 875 Lake Drive East, Jackson’s Point, Ontario.
Index Offences
[6]. A Hospital Report of December 31, 2024 was filed as Exhibit 1 to this hearing. The circumstances of the index offences are outlined in this report and were summarized in last year’s Reasons for Disposition as follows:
On April 24, 2006, Mr. Mosher was serving a penitentiary sentence at Joyceville Institution. He was taken to Kingston General Hospital after he had inflicted significant injuries to himself. He refused medical care and pulled out his intravenous lines. When correctional officers intervened he punched one of the guards in the head and attempted a second assault before being restrained.
On February 11, 2012, Mr. Mosher was under the jurisdiction of the Board and was detained in Mental Health Centre Penetanguishene (now Waypoint). He approached a nurse from behind and without provocation struck him on the left side of his head with a closed fist. The victim was hit with such force that he was stunned by that punch. Mr. Mosher struck him again on the left side of the head. The nurse reported a slight fracture with some bleeding on the brain.
Background
[7]. The hospital report should be referred to for detail regarding Mr. Mosher’s personal, criminal, and psychiatric background.
[8]. Mr. Mosher is now 59 years old and was born in Halifax, Nova Scotia. According to Mr. Mosher’s sisters, Mr. Mosher was affected by the death of his mother in 1991 and subsequently of his grandmother with whom he lived after his mother’s death. Mr. Mosher’s sisters began seeing signs of his mental illness when he was in his early 20s.
[9]. Mr. Mosher has limited formal education. He failed grade 8 and did not go to high school. He worked at a number of labour-type jobs but ultimately lived an itinerant lifestyle. He had begun drinking at the age of 13 and was reported to have used other substances such as LSD, mushrooms, hallucinogens, and cocaine.
[10]. The hospital report notes an early hospitalization at the Nova Scotia hospital in December of 1992. He was discharged with a diagnosis that queried whether he was in the early phase of schizophrenic illness. A discharge summary from the Brockville Mental Health Centre written by Dr. Ahmed on December 15, 2009, stated: “Mr. Mosher has in fact had a number of psychiatric admissions in the Halifax/Dartmouth area, London, Calgary, and British Columbia. The usual pattern of these hospitalizations would be a stabilization of Mr. Mosher’s positive symptoms of schizophrenia through the use of medications and arrangements with psychiatric outpatient treatment, which Mr. Mosher would not follow through with.”
[11]. The hospital report outlines a number of hospital admissions between 1992 and the year of his first index offence in 2005. These admissions were often as a result of him committing a criminal offence or because of his deteriorated mental state, including thoughts of harming himself.
[12]. Mr. Mosher’s criminal record begins in 1998 up to 2005. His convictions include mischief, assault peace officer, theft, and robbery.
[13]. Following the first NCR finding in July of 2005, Mr. Mosher was ordered detained at the Brockville Mental Health Centre. After problematic management and four elopements from that hospital, he was transferred to Oak Ridge (now Waypoint) in December of 2009.
[14]. With some improvement on clozapine medication, Mr. Mosher was transferred to Ontario Shores in April of 2013. He was incapable of consenting to his own psychiatric treatment at that time.
[15]. In December of 2014, he eloped three times from Ontario Shores after he was transferred to a less secure rehabilitation unit.
[16]. There have been at least three attempts to place him in a group home in the community and all have failed to date.
[17]. At last year’s annual review, Mr. Mosher was on a waitlist for housing with Community Homes for Opportunity (CHO).
Evidence at the Hearing
[18]. In May of 2024, Mr. Mosher was discharged from the hospital to reside at Halsey Lodge Adult Care Facility located in Jackson’s Point, Ontario. This is a 24-hour supervised home providing assistance with meals, administering his medication and help with his activities of daily living. Dr. Pallandi testified that beyond his own expectations and given Mr. Mosher’s past lack of success in being placed in the community, he has done very well since his discharge.
[19]. Dr. Pallandi testified that there has been a dramatic change in Mr. Mosher’s well-being at this home. Mr. Mosher likes it there and staff “love him.” Mr. Mosher’s psychotic symptoms have “dampened down” and his paranoid symptoms have abated. Dr. Pallandi is quite impressed with the level of care and the relationship that staff at the Halsey Lodge seem to be able to develop with their clientele. There are many long-term residents there. Medical care is provided and blood work can be done on site.
[20]. Substance use has not been an issue for Mr. Mosher for some time and no urine samples are collected and Mr. Mosher has no wish to return to substances. Halsey Lodge staff are quite vigilant and aware of the use of substances in the home and there has been no issue with Mr. Mosher.
[21]. There have been no elopement attempts since his discharge from hospital. Dr. Pallandi believes that that risk is progressively lessening. Dr. Pallandi sees Mr. Mosher as being treatment capable. He is a very agreeable man and Dr. Pallandi is confident that if Mr. Mosher were asked, he would agree to come to hospital and that the Mental Health Act would be sufficient to manage any risk.
[22]. An absolute discharge is considered premature at this time, but Dr. Pallandi does see it in the future if Mr. Mosher continues on the positive trajectory that he has had in the past year.
[23]. Because of a lack of any recent history of use of substances or wish to use substances, the hospital does not see a substance prohibition or testing for substances as necessary in Mr. Mosher’s disposition.
[24]. Dr. Pallandi agrees that the Halsey Lodge provides typical local trips and events for its clients but there are no programs conducted similar to those provided by the hospital. Dr. Pallandi states that Mr. Mosher has completed hospital programs over the years and he does not think there would be any benefit to a repeat of them.
[25]. Dr. Pallandi also observes that with clozapine medication, the positive effects of this can continue for some time and in Mr. Mosher’s case, the symptoms of his mental illness seem to be attenuating.
[26]. All parties in their submissions commended Mr. Mosher for the excellent year that he has had. It was also jointly agreed that the evidence did not support an inclusion of a substance use prohibition or testing for substances.
Decision
[27]. The Review Board agrees with the joint position of the parties. As far as Mr. Mosher’s risk is concerned and whether that is significant, the psychological risk assessment report completed on December 24, 2024, and referred to in the hospital report states:
“Currently, Mr. Mosher is very comfortable with his 24-hour supervised complex care housing and with the intensive supportive services he receives from the Ontario Shores FOS team and the Halsey Lodge staff. If Mr. Mosher was granted the discretion to choose his own housing, he has stated he would elect to remain within his current residence, where the level of supervision/monitoring for medication adherence, elopement and substance use are deemed sufficient to mitigate current risk concerns.”
[28]. In the clinical assessment of risk portion of the hospital report it states that Mr. Mosher “... is very content in his current surroundings and there have been no behavioural or management issues whatsoever. This suggests that his ability to maintain stable housing has improved quite significantly following this discharge.
While all of the relevant risk factors are set out above, the clinical team opines that the principal issue at this juncture is the recency of his discharge to the community. His residential stability is essential for managing his risk with additional oversight we anticipate that his risk will become subthreshold.
At this juncture, we remain of the opinion that the patient’s risk is in the low moderate range and above the threshold of significance.”
[29]. In all the circumstances, the Board finds that Mr. Mosher remains a significant threat to the safety of the public and that the necessary and appropriate disposition is a conditional discharge with the terms and conditions above described.
DATED this 25^th^ day of February, 2025, at the City of Toronto, in the Toronto Region.
Mr. C. MacIntyre, K.C. Alternate Chairperson