Re: Garett Seepaul
ORB File No: 6150
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: Garett Seepaul Counsel: Mr. B. Irvine
The person in charge of hospital: Representative: Dr. M. Pearce
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated February 25, 2025)
Introduction
On June 22, 2012, Garett Seepaul was found not criminally responsible on account of mental disorder on charges of repeatedly following other person from place to place (x2), assault and failure to comply with probation order, all contrary to the Criminal Code.
Mr. Seepaul is currently subject to an Ontario Review Board disposition of February 2, 2024, which orders him discharged subject to conditions including that he refrains from contact from the victims of the index offence and on his consent shall take medications further to s. 672.55(1) of the Criminal Code.
On January 15, 2025, the Ontario Review Board convened at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) to conduct Mr. Seepaul’s annual review and to make a disposition further to s. 672.81(1) of the Criminal Code.
At the outset of the hearing, the hospital maintained that Mr. Seepaul remained a significant threat to the safety of the public and recommended a continuation of his current disposition. This position was supported by the Crown Attorney and by Mr. Irvine, counsel for the accused. Mr. Irvine noted that his client would like to have an absolute discharge, but his client also understands that he would then be on his own without any support. He is therefore content with the hospital’s recommendation.
Index Offences
- Last year’s Reasons for Disposition described the circumstances of the index offences as taken from the hospital report of November 30, 2023:
“The accused had been convicted of assault on July 8, 2011, and had been placed on probation with a condition to keep the peace and be of good behaviour. The following day the female victim, who did not know the accused, was walking towards her apartment building. The accused and the victim met on the sidewalk near the building and the accused immediately changed his direction and began to walk next to her in close proximity towards the building. While walking, he stared at her while saying nothing. The victim was fearful of his actions.
Despite attempted restraint by two men believed to be the accused's father and brother, the accused aggressively pushed past them and followed the victim into the apartment building and onto the elevator. He was eventually pulled out of the elevator by the two men. The victim reported the incident to the police and he was arrested on July 18.
The accused was charged with criminal harassment as a result of a December 23, 2011, incident when he followed a 17-year-old female victim into the elevator while staring at her. He followed her down the hallway when she exited the elevator.
On December 24, 2011, the accused grabbed a female victim's arms and tried to pull her towards him into his apartment building. The victim was hysterical and screamed loudly. The emergency task force was contacted and the accused barricaded himself in his apartment and told officers to go away and that he would kill anyone who tries to get in and he will kill himself.”
Background
A hospital report of December 18, 2024, filed as Exhibit 1, should be referred to for detail regarding Mr. Seepaul’s personal, criminal, and psychiatric background. Mr. Seepaul is now 44 years old. He completed his high school in Trinidad where he spent most of his early years. He returned to Canada at the age of 19 where he graduated with a Bachelor of Arts degree from the University of Toronto.
It appears he was employed in a full-time basis for about four years from the age of 19 but has not been fully employed since. Mr. Seepaul began consuming alcohol at the age of 15, and he relates a history of daily drinking. He has acknowledged that his alcohol use interfered with his academic performance and his ability to maintain full employment. He reports no involvement with illicit substances.
Mr. Seepaul has convictions for failing to comply with recognizance and conditions in 2007, and assaults in June of 2009 and July of 2011.
His first hospital admission with a psychiatric diagnosis took place at the Whitby Mental Health Centre (now Ontario Shores) for a two-month period between December 2008 and February 2009. He was admitted there for an assessment of fitness following an alleged offence of sexual assault involving Mr. Seepaul’s aunt. His aunt reported that Mr. Seepaul had deteriorated mentally following the death of his mother in 2003 and that he had developed sexually inappropriate behaviours, including touching her from behind and staring at her intensely.
In that December 2008 hospital period, he was treated with olanzapine which seemed to result in a moderate improvement in his mental status. The diagnosis on discharge was psychotic disorder, not otherwise specified (NOS) with major depressive disorder with psychotic features as a possibility.
Other admissions to hospital took place at the Scarborough hospital in December 2011 and February 2012. These hospitalizations arose from the index offences. Diagnoses included “bipolar affective disorder versus schizoaffective disorder and alcohol abuse or dependence. Other diagnoses were psychosis NOS, seems most consistent with schizophrenia versus schizoaffective disorder and alcohol abuse” and “likely schizophrenia”.
At last year’s annual review, the Board heard evidence that Mr. Seepaul had an unstable course. During that reporting year he was incapable of consenting to psychiatric treatment and his father acted as his substitute decision maker. Despite being mostly compliant with clozapine medication, his psychotic symptoms were still active. A readmission to hospital was required from his community residence following his use of cannabis. A clinical assessment observed that Mr. Seepaul was not invested in taking medications and he had refused them a number of times. Mr. Seepaul has indicated that he responds to command voices telling him to refuse medication.
His current diagnoses are schizophrenia and cannabis and alcohol use disorders-in early remission.
Evidence at the Hearing
Except for about a three-week period in June of this year, Mr. Seepaul has remained living in the community. In general, his mental state seems slightly improved compared to prior years. In the past, Mr. Seepaul’s substitute decision maker, his father, had not agreed to increase his son’s dose of clozapine. However, in the summer of 2024, he did agree, and as a result, Mr. Seepaul has been able to maintain improved stability while living in the community.
Mr. Seepaul seems to routinely skip a dose of his clozapine once or twice a month, claiming that peers at his home instruct him to do so. On these occasions he responds favourably to encouragement and reassurance from the Forensic Outpatient Team.
On June 9, 2024, Mr. Seepaul had to be readmitted to hospital. He had been noncompliant with his clozapine for three days and admitted to smoking cannabis and drinking cannabis-infused beverages.
He reported that he had been experiencing auditory hallucinations which instructed him to not take his medication. He agreed to admission to hospital when asked. His sleep pattern had been poor, and he was disorganized. The admission was necessary to address these problems and to re-titrate his clozapine. He was discharged back to his residence on July 2, 2024.
Apart from the above lapse in adhering to his medication, there is no report of any behavioural concerns at his residence. Although Mr. Seepaul’s insight into his illness is quite limited, he seems to recognize and understand that he must take medication to successfully stay in the community.
Dr. Pearce testified and provided an update to Mr. Seepaul’s progress. Over the holiday period Mr. Seepaul did quite well, although he did refuse one of his medications, again feeling that other residents were telling him to stop.
Dr. Pearce affirms that there is a high risk that Mr. Seepaul would discontinue his medication and resume cannabis use if it were not for the Ontario Review Board’s oversight and the structure and supervision he receives at the hospital and in his home. If clozapine is stopped, there would be a fairly rapid mental deterioration. Mr. Seepaul likely knows that his caregivers are unhappy about his cannabis use but does not necessarily know why its use is discouraged. He is at risk of harm to himself without medication, but Dr. Pearce thinks that he does not know this. He knows he has to take his medications because he has been told to do so, but sometimes his hallucinations overwhelm him.
There appears to be a temporal connection between stopping medication and cannabis use. Dr. Pearce testified that stopping his clozapine likely comes first and then cannabis use follows.
To obtain an improvement in his insight Mr. Seepaul would have to develop an understanding that the auditory hallucinations are symptoms of his illness and are not real and, parenthetically, that he should not follow their instructions.
In the hospital report, Dr. Pearce states that:
“Mr. Seepaul’s salient risk factors are identified by the HCR-20 and include a treatment-resistant mental illness with residual symptoms, limited insight into same and a substance use disorder. Absent a Disposition of the Board, he would likely discontinue his medication and relapse to substance use. Given the brittle nature of his condition, florid symptoms of psychosis would follow within days to weeks. At that juncture, there would be a real risk of serious physical or psychological harm to members of the public, given his history.”
- In submissions, the hospital maintained its original position that Mr. Seepaul was a significant threat to the safety of the public and that his disposition continue without change. Ms. MacDonald affirms that Mr. Seepaul’s risk appears to be the lack of insight into his need for medication and the risks that develop when he stops medication. Ms. MacDonald suggests that perhaps extra programming could be helpful.
Decision
The Review Board accepts the evidence provided by Dr. Pearce and as contained in the hospital report to support that Mr. Seepaul remains a significant threat to the safety of the public. It also agrees that the least onerous and least restrictive disposition is a continuation of Mr. Seepaul’s detention order with no change in the conditions.
It is clear that from time-to-time Mr. Seepaul will stop his medication, believing that he is being instructed to do so through his hallucinations. The use of substances, particularly cannabis, appears to coincide with this.
Fortunately, and as a result of the oversight and monitoring provided by the outpatient team and his home staff, this pattern of noncompliance is being dealt with. As a result, the hospital has been able to maintain him in his home setting, albeit with readmission to hospital from time-to-time when his behaviour shows signs of relapse.
It is clear that there is a need for Mr. Seepaul to remain under the Review Board’s jurisdiction and to abide by the terms and conditions of his conditional discharge. This is necessary to maintain him in the community and to ensure the safety interests of members of the public. Accordingly, the necessary and appropriate disposition is the conditional discharge agreed to by the parties.
DATED this 25th day of February, 2025, at the City of Toronto, in the Toronto Region.
Mr. C. MacIntyre, K.C.
Alternate Chairperson