Re: Robert Frydman
ORB File No: 8475
Hearing held on: Tuesday, January 28, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences
Pursuant to: Section 672.47(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Flanagan
Members: Dr. B. Sheppard Dr. M. Kalia Ms. J. Greenwood Mr. J. Cyr
Parties Appearing:
Accused: Robert Frydman Counsel: Ms. M. Murphy
The person in charge of hospital: Counsel: Ms. A. Marshall
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated February 25, 2025)
Introduction
On October 27, 2023, Mr. Frydman was found not criminally responsible on account of mental disorder on a charge of arson disregard human life, contrary to the Criminal Code of Canada (“Criminal Code”). Upon a verdict of NCR, the Court declined to make a Disposition and remitted the matter for a hearing before the Ontario Review Board.
On January 28, 2025, the Board convened a hearing at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) pursuant to s. 672.47(1) of the Criminal Code. Mr. Frydman was present at his hearing and represented by Ms. Murphy. Mr. Frydman's mother was also in attendance at the hearing.
At the outset of the proceedings, the parties were canvassed as to their initial positions. All parties agreed with the proposed recommendation that there be no change to the Disposition.
At the end of the hearing, all parties maintained their initial positions and it was a joint submission before the panel.
Finding
- For the following reasons, the Board finds that Mr. Frydman represents a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Detention Order within the Forensic Service of Ontario Shores with the terms and conditions as recommended by the parties, which will reflect no change to last year's Disposition.
The Evidence
- The evidence at the hearing consisted of the Hospital Report dated January 3, 2025, marked as Exhibit 1, and the evidence of Dr. Wang, Mr. Frydman's treating psychiatrist.
Index Offences
- A summary of the index offences was taken from the Hospital Report. On January 28, 2023, Mr. Frydman was residing with his father on Berwick Crescent in Oshawa. On that day, he used WD40 to light a fire in the basement of the residence. He was later seen running shirtless from the property as the residence was on fire. His father, Barry Frydman, was in the residence at the time. His father advised police that his son had been admitted to Ontario Shores for the preceding two to three months and had just been released on January 23, 2023.
Background Information
The Hospital Report contains information about Mr. Frydman's background and psychiatric history. Mr. Frydman is currently 29 years of age and while growing up, he and his brother resided with their father, spending every other weekend and Mondays with their mother. In 2002, Mr. Frydman was assessed by a psychiatrist at the Hospital for Sick Children in Toronto. He was diagnosed at that time with attention deficit disorder and oppositional defiant disorder. He was prescribed various medications including Ritalin, Concerta and Vyvanse.
Mr. Frydman was enrolled in an alternative high school for Grade 10 when he began to experience symptoms of mental illness. He was referred to a psychiatrist at the Hospital for Sick Children and then was sent to a children/youth facility for persons with severe issues. For the first few days, Mr. Frydman stood in his bedroom without moving and was observed responding to internal stimuli. He refused to eat or drink and had to be readmitted to hospital. He eloped from hospital and was eventually admitted to the Adolescent Program at Ontario Shores.
In 2011, Mr. Frydman was admitted to Toronto East General Hospital. Mr. Frydman was experiencing hallucinations and paranoia along with intermittent catatonic states, in the context of cannabis use. His diagnosis upon discharge was schizophrenia. Over the following two years, Mr. Frydman had two six-month long admissions to Ontario Shores. He also became subject to a Community Treatment Order and followed by the Starting Treatment Early for Psychosis (STEP) program at St. Michael's Hospital.
Between 2014 and 2018, Mr. Frydman had nearly twenty more admissions to St. Michael's Hospital, most of them triggered by noncompliance with medication, followed by a deterioration in Mr. Frydman’s mental status. He would present with worsening psychosis, aggression, agitation, and disorganization.
Mr. Frydman was an inpatient at Ontario Shores until March 2020. He was afraid that he might hurt somebody if discharged and continued to suffer from extremely treatment resistant psychosis which was not appreciably improved despite high doses of medication, including clozapine. He was discharged but returned after a few days and was readmitted. He was “horrified and paranoid” after going home with his father and he began to start fires there. During the readmission, he engaged in self-harm and attempted to hang himself from the ceiling. There also were multiple incidents of fire setting in the hospital. After discharge, he was followed by the Durham Assertive Community Treatment (ACT) team. When Mr. Frydman was arrested and brought to hospital, he was noted as being "floridly psychotic and out of touch with reality".
Mr. Frydman continued to reside at Ontario Shores following his arrest. He presented with periods of agitation and in June 2023, Mr. Frydman unfortunately attacked a staff member.
Course in Hospital Since NCR Finding
Mr. Frydman’s current diagnoses are schizoaffective disorder and cannabis use disorder, in remission in a controlled setting. He continues to exhibit a thought disorder responding to voices that affect his interactions with staff; he often makes incongruent statements and has incoherent speech. There has been no evidence of noncompliance with medication, and he displays insight into the need for medication.
Dr. Wang testified before the panel. He advised that he has been Mr. Frydman's physician for some time including performing the assessment for the Court on the issue of not criminally responsible. Mr. Frydman was moved from the forensic assessment unit (FAU) to the forensic assessment and rehabilitation unit (FARU). Although he has privileges to access the community, he has at times been reluctant to do so or loses interest in doing so. Dr. Wang advised that overall, Mr. Frydman has had a good and positive reporting year.
There were two updates to the Hospital Report and those included that Mr. Frydman's father had sadly passed away in January 2025, and two weeks ago, on January 14th, 2025, Mr. Frydman engaged in an unprovoked assault on a security guard on the unit. Dr. Wang indicated that this was Mr. Frydman's first incident of aggression or violent behaviour. It was Dr. Wang’s view that this was an isolated incident, and that Mr. Frydman had been stable since and back at his baseline. As a result of this incident, the treatment team made some medication changes. The team decided to split Mr. Frydman's clozapine dose so that he would receive some in the evening and the bulk of the dose at bedtime. It was Dr. Wang’s evidence that this incident was entirely psychotically driven; that Mr. Frydman is not aggressive or antisocial but rather felt threatened by the security guard having heard bad or scary voices that caused him to lash out. Dr. Wang advised the panel that Mr. Frydman has residual symptoms of psychosis even at his baseline.
When asked about the treatment team’s plan to optimize Mr. Frydman's medication, Dr. Wang advised that adjustments have been made to the clozapine dose and Epival was added as a medication. The treatment team's plan would be to continue to optimize Mr. Frydman's medication while noting that he has a very treatment-resistant form of schizophrenia and that any changes that are made must be slow and considered as he is already on high doses of several different medications. Dr. Wang indicated that there had been some positive progress over the last reporting year and that there was an improvement in Mr. Frydman’s symptom burden, while slow and steady, it was notable. Dr. Wang also advised the panel that even Mr. Frydman's mother had noticed this was the best she had seen him do in some time.
Dr. Wang also advised the panel that Mr. Frydman has insight. He acknowledges he has an illness. He knows he hears voices. He agrees to medication changes when proposed and he feels his medications are helpful. Dr. Wang indicated the only area where there are challenges with insight is around Mr. Frydman hearing voices, some of those voices are positive while some of them are negative. With respect to the voices, he hears some that are positive, he takes comfort in them and would feel a sense of loss if those voices were gone. Dr. Wang indicated that with the medications as prescribed, they treat all the voices and cannot target some (i.e., the bad ones) and not others.
Currently, Mr. Frydman is on the FARU which is a medium secure forensic unit, and the treatment team hopes to see him use his privileges more reliably and consistently over the next reporting year in order to work towards a move to the general forensic unit. Currently, Mr. Frydman has access to privileges, but Dr. Wang advised it has been a bit of a challenge encouraging him to use them. He often loses interest in going out.
Dr. Wang gave evidence about two incidents that occurred when Mr. Frydman used his escorted on hospital grounds privileges: one, he left the group as he needed to use the washroom and, on another occasion, he heard voices while out for a walk on hospital grounds and tried to return to the hospital, leaving the group. The treatment team did not view these incidents as elopement attempts but rather impulsive behaviours responding to the voices he was hearing. As a result, the treatment team is cautious and wants to encourage him to use his privileges appropriately. The team’s goal is, with encouragement, he will have more independence and be able to use privileges going forward over the coming year. Dr. Wang’s evidence was that it is possible Mr. Frydman will be ready for a move to a general forensic unit over the coming year and hopes to see him engage further with the team and consistently and reliably use his privileges. Dr. Wang indicates he has met with Mr. Frydman's mother who also assists in supporting him and indicates to Dr. Wang that she has seen progress. Mr. Frydman's mother is an approved person. She is involved in his care, and she is his substitute decision maker. It appears that this is a very positive support for Mr. Frydman.
Dr. Wang was asked questions by counsel for the Attorney General to clarify the incidents that occurred when he was using his privileges on the hospital grounds with staff. It was clarified that the treatment team did not view these incidents as elopements, rather Mr. Frydman needed to be educated about the importance of staying with the group and the treatment team viewed the second incident, where he responded to voices, as Mr. Frydman returning to the safety of the hospital. Despite the team's understanding of Mr. Frydman's concerns, the team is cautious in advancing privileges for him and wants to see him move forward in a positive way. The voices and psychosis appear to be the greatest impediment for his ability to move forward and use privileges in a community.
Dr. Wang was asked questions by defence counsel, Ms. Murphy on behalf of Mr. Frydman, to clarify the incident that Dr. Wang gave evidence about that occurred two weeks ago when Mr. Frydman struck a security guard unprovoked. Ms. Murphy asked clarifying questions about the circumstances of that incident, but Dr. Wang was not able to provide greater detail. Ms. Murphy suggested that perhaps Mr. Frydman had not received his medication on time or that there were issues happening on the unit. Dr. Wang was not able to add any detail to those suggestions. Ms. Murphy also asked Dr. Wang who agreed that Mr. Frydman, other than the incident two weeks ago, had a very positive reporting year. She asked Dr. Wang, and he agreed that Mr. Frydman is open to talking about his symptoms, understands the need for medication and understands the need for treatment, highlighting that he has a great deal of insight given his symptom burden.
Clarification regarding the ADHD diagnosis was requested from Dr. Wang. He stated that ADHD is not a current focus of treatment, and that the diagnosis is based solely on historical documentation. He further explained that the impulsivity symptoms are more likely related to underlying mental illness rather than ADHD. Dr. Wang agreed to remove ADHD from the list of diagnoses. The treatment goal at present is to address Mr. Frydman’s symptoms of psychosis.
Dr. Wang was also asked to clarify some of the details around the assault on the security guard from two weeks ago. Dr. Wang provided some additional information that the security guard was present on Mr. Frydman's floor for reasons that had nothing to do with him. However, Mr. Frydman believed that this security guard was going to hurt children or hurt someone, and he wanted to stop that. He punched the security guard as a result. Dr. Wang advised that police were not called. This incident was seen by the team as psychotically driven and Dr. Wang did not know if there were any injuries because of this incident.
Submissions
- At the conclusion of the hearing, the parties were canvassed as to their final position. All parties maintained their joint submission that there be no change to the Disposition. In submissions, the parties highlighted that other than the incident two weeks ago, Mr. Frydman had had a good reporting year. He had engaged in some programming, had used some privileges and the treatment team was working with him to optimize his treatment. He had positive support from his mother and all parties wanted to congratulate him on that progress.
Analysis and Conclusion
The Board carefully considered the Hospital Report, and the evidence of Dr. Wang and unanimously accepted the joint submission. Although the issue was not contested by the parties, the Board makes its own finding that Mr. Frydman continues to represent a significant threat to the safety of the public. Mr. Frydman suffers from a major mental illness, schizoaffective disorder. It was clear on the evidence that his mental illness is ultra-treatment resistant, and he continues to experience residual symptoms despite the treatment regimen. He has a history in the past of noncompliance with medication and substance abuse. When his mental status deteriorates, his command hallucinations are difficult for him and cause him to act out in ways that risk the safety of the public. This was clear in the example of what occurred two weeks ago when Mr. Frydman heard voices, which caused him to punch the security guard.
Given that Mr. Frydman continues to represent a significant threat to the safety of the public, the Board must consider the necessary and appropriate Disposition taking into account the criteria set out in 672.54 of the Criminal Code which include the need to protect the public, the mental condition of the accused and the reintegration of the accused into society and the other needs of the accused.
The Board unanimously agrees with the joint submission and finds that the necessary and appropriate Disposition is a Detention Order. Now that Mr. Frydman is on a forensic rehabilitation unit, he has access to privileges and with the support of his treatment team and his mother, it is hoped that he can access those privileges more consistently and reliably. Mr. Frydman appears to have a good therapeutic alliance with his doctor, Dr. Wang, and his treatment team. Accordingly, the Board finds a Detention Order with the terms and conditions as recommended by the parties and as stated in the Disposition of last year is necessary and appropriate. The Board has considered the paramount factor of the safety of the public, Mr. Frydman's community reintegration and his other needs.
DATED this 25th day of February, 2025, at the City of Toronto, in the Toronto Region.
Ms. J. Greenwood Legal Member