Ontario Review Board
Re: Deano Pupo
ORB File No: 7637
Hearing held on: Monday, January 27, 2025
Place of hearing: St. Joseph's Healthcare Hamilton
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Weinstein
Members: Dr. R. Buckingham
Dr. L.O. Lightfoot
Mr. K. McKenna
Ms. B. Little
Parties Appearing:
Accused: Deano Pupo
Counsel: Mr. B. Hurst
The person in charge of hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Mr. B. Adsett
REASONS FOR DISPOSITION
(Dated February 25, 2025)
Introduction:
On November 20, 2019, Mr. Deano Pupo was found not criminally responsible on account of mental disorder, on charges of assault, assault with a weapon, forcible confinement and robbery using violence, all contrary to the Criminal Code of Canada (“Criminal Code”).
Mr. Pupo is subject to a Disposition of the Ontario Review Board (the “Board”), dated February 2, 2024, which orders that he be detained at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“St. Joseph's”).
On January 27, 2025, the Board convened a hearing at St. Joseph's to conduct the annual review of the current Disposition.
Mr. Pupo was present at the hearing, as was his father, and he was represented by his counsel, Mr. Brent Hurst.
A Hospital Report, dated January 10, 2025 (the "Hospital Report"), was entered as Exhibit 1.
The issue at this hearing is whether Mr. Pupo is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate Disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below and based on the expert evidence and opinions before us, the Board concluded that Mr. Pupo continues to represent a significant threat to the safety of the public. The Board ordered that the necessary and appropriate Disposition in the circumstances is a continuation of the existing Detention Order.
Current Psychiatric Diagnoses:
- Schizophrenia
Substance Use Disorder, in sustained remission, in a controlled environment.
Index Offences:
- The circumstances giving rise to the Index Offences are extracted from last year’s Board Reasons, as follows:
“On Tuesday, February 19, 2019 the victim, DM1, attended the accused's residence located at 20-1398 Pelham Street in the town of Pelham as she had promised to do after speaking with the accused a week before.
The victim attended the front door to the residence and the accused answered the door. She advised that she was now required to work and was not available for the 2:00 pm meeting they had previously arranged for later in the day.
The accused immediately demanded money from the victim. The victim had told the accused she was not going to give him any money and attempted to walk away from the residence. As the victim attempted to walk away the accused grabbed the victim by the hair pulling her to the ground causing the victim to land awkwardly and injure her ankle. The accused then pulled the victim by her hair and dragged her into the residence closing the front door behind them. The accused thus committed the offence of Assault contrary to Section 266 of the Criminal Code of Canada".
Count 2
After dragging the victim into his residence the accused grabbed a pink aluminum baseball bat from within his front foyer. While the victim was still lying on the floor, the accused held the bat in a threatening manner toward the victim while yelling at her. The victim was fearful of being beaten. The accused then grabbed the victim by the coat pulling her into the kitchen area forcing her to sit on a chair. While yelling, the accused pointed the end of the bat toward the victim and raised the bat over his head in an intimidating manner to the point that the victim felt as if she was going to be beaten with the bat at any time. In doing this the accused committed the offence of Assault with a Weapon contrary to Section 267(a) of the Criminal Code of Canada.
Count 3
During the time that the accused had dragged the victim into his residence and closed the door behind him, grabbed a weapon and used it in a threatening manner, and prevented the victim from fleeing the residence. The victim believed she was going to be held against her will until she agreed to the demand for money made by the accused. The victim told police she feared for her safety the entire time her brother confined her, at the end of a metal baseball bat, to a chair in his kitchen. The yelling and threatening lasted approximately ten to fifteen minutes where the victim felt that she could not escape. The accused was therefore charged with Forcible Confinement contrary to section 279(2) of the Criminal Code of Canada.
Count 4
While the victim was being held against her will within the residence the accused continued to yell at the victim demanding money while he was still waving the baseball bat at her. The accused demanded that the victim drive him to his bank. The accused was very specific with his directions in where the victim would park and threatened her if she were to alert anyone of her distress. The victim did in fact follow the directions of the accused as she was fearful of her safety and she drove the accused to the TD bank in the town of Pelham. The victim attended the ATM located inside the bank and withdrew $1000 as directed by the accused. The accused was waiting for the victim outside the door of the bank and was promptly given the money. The accused left on foot and the victim quickly departed the area in her vehicle where she later called for police and ambulance to tend to her injured ankle.
The accused was later arrested at his residence and further charged with Robbery with violence contrary to section 343(a) of the Criminal Code of Canada. The accused was read his right to counsel and caution before being transported to 2 District cells where he was held in custody pending a bail hearing. The accused was searched incident to arrest and $1000 was found within the accused's wallet. The money was seized and eventually returned to the victim in this incident.”
Course Since Last Disposition:
- Mr. Pupos’s course since his most recent Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing.
“In November 2024, Good Shepherd, Transitional Rehabilitation Housing Program, had a subsidized supportive apartment available and Mr. Pupo, who has remained at the top of the wait list even after declining two other attempts at housing in the past, was offered this accommodation. Mr. Pupo agreed to view the apartment and discussed the need to move forward in his recovery by living in the community.
Since his admission to Mountain 2, he has declined all therapeutic programs and does not use his privileges to the fullest extent. Social Work will continue to support and encourage Mr. Pupo to engage in skill building programs, meaningful activity, goals and community integration to assist him in his recovery and rehabilitation. It is promising Mr. Pupo is more receptive to community living and willing to consider a viable housing option.”
Position of the Parties:
Counsels for the hospital, the Attorney General, and Mr. Pupo advised this was a joint submission: all were adopting the hospital’s recommendation of a continuation of the existing Detention Order Disposition.
For the purposes of this hearing, counsel for Mr. Pupo advised that significant threat was not in dispute.
Evidence at the Hearing:
- The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Naidoo. Dr. Naidoo co-authored the Hospital Report and testified as follows:
a) He is Mr. Pupo’s treating psychiatrist.
b) He adopts the contents of the Hospital Report.
c) At the beginning of the reporting period, Mr. Pupo struggled in his motivation to enter the community, engage in activities and socialize appropriately. Mr. Pupo’s motivational impairments were partially driven by his anxiety and apprehension.
d) The treatment team optimized his medication regimen by increasing his medication to treat his anxiety. Mr. Pupo worked extensively with all members of the treatment team, including the social worker, vocational counsellor, recreational therapist and occupational therapist. As Mr. Pupo’s engagement with the treatment team increased, he gradually became more involved in the treatment team’s programs. He was more willing to enter the community, and he began to use his passes on a more regular basis.
e) Mr. Pupo voiced a positive attitude towards moving into the community and perhaps obtaining employment there.
f) It is not uncommon for individuals, such as Mr. Pupo, who have not entered the community for years, to develop a type of phobia, making it more difficult for them to move into the community.
g) To Mr. Pupo’s credit, he has just signed a contract to move into Emmaus Place, a 24-hour supported residence. The plan is to discharge Mr. Pupo into this residence.
h) In contemplation of Mr. Pupo’s discharge into the community, the treatment team will start granting him overnight passes, starting February 10. They will titrate these passes to see how he tolerates the stress of moving into his new residence.
i) Mr. Pupo has indicated that he has no cravings for substances, and he has not used them in the past reporting year.
j) Mr. Pupo has expressed insight into the negative effects of substances on his mental health and his life. This insight is based on his significant remorse about the Index Offences. Mr. Pupo understands how the Index Offences have affected both himself and his family.
k) Mr. Pupo has indicated that he intends to remain adherent to his medication regimen. He does believe he has a mental illness, which would likely reoccur, should he stop taking his medications.
l) Mr. Pupo’s insight into his symptoms, and how they manifested at the time of the Index Offence, may be described as “fair to good.”
m) Mr. Pupo has a long history of housing instability and substance use, when in living in the community.
n) Mr. Pupo requires ongoing monitoring by the treatment team as he transitions to live independently in the community. The efforts of the treatment team, Mr. Pupo’s willingness to engage with them, and the titration of his mood stabilizing medication have all contributed to his progress in the past reporting period. Mr. Pupo’s deepening relationship with his father, and his desire to further strengthen it, has been another positive factor that increased his willingness to live in the community.
o) Mr. Pupo recently received 12-hour passes to enter the community of Hamilton. He has exercised these passes with no issues.
p) The treatment team is recommending the continuation of the Detention Order, as the Mental Health Act would not likely be sufficient to manage Mr. Pupo in the community.
q) Mr. Pupo still needs to be assessed as to how he handles the stress of transitioning into the community and being exposed to substances, in an environment where relapse is very likely.
r) Mr. Pupo’s symptoms are quite subtle, and his decompensation would not be picked up in sufficient time for the Mental Health Act to be used to protect public safety.
- In response to questions from counsel for the Attorney General, Dr. Naidoo testified:
a) He would like to see Mr. Pupo engage in further relapse prevention and addiction support. He would also like Mr. Pupo to continue his engagement with the occupational therapist and vocational counsellor, to obtain work, and to maintain employment when living in the community.
- In response to questions from counsel for Mr. Pupo, Dr. Naidoo testified:
a) Mr. Pupo does have significant remorse for the Index Offences. His insight into the core symptoms of his psychosis, and how they impacted his actions at the time of the Index Offence, is good.
b) It is unclear how fulsome his insight is into the effect that substances have on his illness and whether he can fully appreciate the necessity of abstinence. Mr. Pupo still needs to be assessed on whether he can remain abstinent when living independently in the community, when he is subject to additional stressors, such as moving and living in an apartment for the first time in years.
- In response to questions from the panel, Dr. Naidoo testified:
a) Mr. Pupo will receive his medications from staff at Emmaus Place. They will observe him taking his oral medication.
b) The treatment team will look for appropriate relapse prevention programming in the community for Mr. Pupo once he transitions to independent housing. He has engaged appropriately with addiction prevention programs in the past, but it will be important for him to engage with relapse prevention programming as he moves into the community; addiction is a lifelong illness, and ongoing involvement with addiction programs is very important for Mr. Pupo.
c) Mr. Pupo does appreciate that substances can increase his psychotic symptoms, and he is quite focused on maintaining stability. Mr. Pupo’s current ability to remain abstinent is based primarily on being in a controlled environment; however, while living in the community, he will be subject to additional stressors and increased availability of substances. Mr. Pupo’s ability to remain abstinent while living in the community needs to be assessed before his insight to abstain from substances could be described as “full.”
d) The Mental Health Act would not be sufficient to protect public safety, as Mr. Pupo’s symptoms are quite covert when he is unwell, and he is guarded about them. Therefore, the Mental Health Act could not be employed to protect public safety, because of Mr. Pupo’s presentation when he decompensates.
e) The treatment team needs to approve housing for Mr. Pupo, to monitor his mental stability and to make sure he remains abstinent from substances.
- No other evidence was called.
Analysis and Conclusions:
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: Mr. Pupo remains a significant threat to the safety of the public.
In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Naidoo, in addition to the documentary evidence before us.
Mr. Pupo is just moving into the community for the first time after many, many years. It is unknown how he will handle the stress of living independently, whether he will be able to remain abstinent from substances, and if he would discontinue treatment.
In particular, the Board relies on the following extracts from the Clinical Risk Summary, set out in the Hospital Report:
“Notwithstanding those positive factors, Mr. Pupo has for the most part avoided off unit programs and had not yet made a successful transition to the community. Given that he has never been able to maintain independent accommodation or to support himself, a gradual approach to reintegrating him into the community is imperative. In addition, although he has abstained from substances while continuing to reside on a highly supportive and structured setting, his ability to remain abstinent is unlikely without ongoing forensic psychiatric support and monitoring. Historically, Mr. Pupo has a history of significant substance use, a major mental disorder, employment challenges and few supportive relationships.
Overall, the treatment team is of the view that Mr. Pupo continues to meet the threshold for significant threat. Absent and ORB Detention Order, it is highly likely that Mr. Pupo would be unable to cope with community stress or secure appropriate accommodation. In that scenario, it is highly likely that he would resume substances, discontinue treatment, and then engage in serious, violent criminal acts.”
The Board wants to commend Mr. Pupo on the progress he has made in the past reporting year. His engagement with the treatment team’s various programs is very positive, as is his significant remorse about the Index Offence.
In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Pupo, his reintegration into society and his other needs, the necessary and appropriate Disposition is the continuation of the existing Detention Order.
DATED this 25th day of February, 2025, at the City of Toronto, in the Region of Toronto.
Mr. J. Weinstein
Alternate Chairperson
Office of the Registrar
Ontario Review Board