Re: Chad A Fraser
ORB File No: 8624
Hearing held on: January 29, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care
Pursuant to: Section 672.47(1) of the Criminal Code
Before: Alternate Chairperson: Ms. T. Mann Members: Dr. A.D. Jones Dr. H. Moulden Ms. K. Tomaszewski Ms. C. Plyley
Parties Appearing: Accused: Mr. Chad Fraser Counsel: Mr. W. Glover The Person in charge of Hospital: Counsel Ms. J. Zamprogna Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated March 5, 2025)
Introduction:
[1]. The accused, Chad Fraser, was found not criminally responsible (“NCR”) on August 9, 2024, on a charge of break and enter a dwelling house, contrary to the Criminal Code of Canada (the “Code”).
[2]. Upon the verdict of NCR, the Honourable Court did not make a disposition and remitted the matter for hearing before the Ontario Review Board (the “ORB” or the “Board”). Mr. Fraser was the subject of an appearance notice for the index offence and was not bound by any conditions of release. He resided in the community following the NCR finding. On November 13, 2024, the ORB ordered an assessment of Mr. Fraser’s mental condition on an out-of-custody basis to determine an appropriate disposition.
[3]. On January 29, 2025, a panel of the Board convened a hearing at the Southwest Centre for Forensic Mental Health Care (the “hospital”) to determine of Mr. Fraser’s disposition pursuant to section 672.81 of the Code. The issues to be determined by the Board were whether Mr. Fraser constituted a significant threat to the safety of the public as defined in section 672.5401 of the Code and, if so, what was the necessary and appropriate disposition which was also the least onerous and least restrictive taking into account the factors set out in section 672.54 of the Code.
[4]. Mr. Fraser attended the hearing and was represented by his counsel, Mr. W. Glover. He was supported by Mr. H. VanderEnde, who attended the hearing as an observer.
[5]. The start of the hearing was delayed. Upon arriving at the hospital, Mr. Fraser experienced a brief period of aggression and anger. To his credit, Mr. Fraser was able to settle, and remained calm and cooperative throughout the hearing, interrupting to make an occasional comment.
[6]. The Board had before it the Record; An Initial Out of Custody Report dated December 23, 2024 (the “Report”) marked as Exhibit 1; and a Victim Impact Statement by Mr. D. Benn, marked as Exhibit 2.
[7]. Counsel for the Attorney General noted that the victim impact statement had not been reviewed by the Attorney General’s office for compliance with Code requirements.
[8]. The parties agreed to mark the victim impact statement as an exhibit, on the understanding that the Board use its best judgment, in accordance with the principles set out in Klem (Re) 2016 ONCA 119, to disabuse its mind of, and not be unduly influenced by, matters outside the scope of a victim impact statement permitted under the Code.
Position of the Parties:
[9]. At the outset of the hearing the parties were canvassed about their initial recommendations. Counsel for the hospital submitted that Mr. Fraser poses a significant threat to the safety of the public, and that the necessary and appropriate disposition is a detention disposition on the terms and conditions recommended by the hospital in the Report, with the addition of “or delegate” to section 2 (d), and with privileges up to and including living in the community Southwestern Ontario, in accommodation approved by the person in charge.
[10]. Counsel for Mr. Fraser submitted that Mr. Fraser did not pose a significant threat to the safety of the public, but that if the Board so found, the necessary and appropriate disposition is a conditional discharge.
[11]. Counsel for the Attorney General adopted the hospital’s position.
[12]. All parties maintained their original positions at the conclusion of the hearing.
Findings:
For the Reasons that follow, the panel found that the threshold for significant threat is met, and that the necessary and appropriate disposition is a detention disposition with the terms and conditions recommended by the hospital.
Index Offence:
[13]. The allegations giving rise to the index offence are set out in the Report and summarized as follows:
On the 12th of August 2022, police were dispatched to a mischief call at 82 Talbot St. E in the town of Blenheim. The complainant advised that someone had thrown a rock into an apartment 82 Talbot and was climbing through the window. Police arrived on scene and located broken upper and lower pane of the exterior window to unit 104, the residence of the victim. Police spoke to the witnesses of the event and three of the witnesses were able to positively identify the accused as the person they had seen breaking the window, enter, in or exit the apartment. Police looked at the balcony of the accused who was standing on his balcony at the time. They asked him if he had a minute to speak and he said he would come right down.
Police met the accused in the front of the building and arrested him. Police read the accused his constitutional rights and upon stating he understood he then began to tell police that he needed police to contact Arnold Schwarzenegger, he was his lawyer of choice. He continued to advise that he was innocent as he was acting on behalf of the United States Marshalls and they were the ones to tell him to get into the apartment as he had a .357 Magnum hidden in a safe under his coffee table.
Police contacted dispatch and informed them that the incident would now be a mental health call and brought Mr. Fraser to the hospital. Dr. Paizza issued a Form 1 for a psychologist assessment to be completed. Mr. Fraser was discharged from the hospital on August 21, 2024. He was later arrested and released on an appearance notice.
[14]. Mr. Fraser’s self-report of these events is described by Dr. W.J. Komer in the January 5, 2024, NCR Assessment Report as follows:
Regarding the August 12, 2022, incident, Mr. Fraser said that he had not consumed any alcohol or drugs and had probably taken his medications that day. He referenced there being a “main frame” and satellites from space being linked to computers and tablets. Mr. Fraser stated, “It’s in the electrical control room. I wanted it turned off completely” so it couldn’t harness connections into it. He said that there was a “sound frequency thing” which was “making me deaf.” Mr. Fraser told me that there was a “sound tower aimed at my apartment” which was “violating my safety and privacy rights.” He stated, “I broke them out because I had to,” “They can kill people with these things. You got to look into it,” “Seemed like they were trying to kill me with pressure,” “I went in there to save my life,” “I couldn’t find anything, so I left,” “I found nothing, so I left,” “I didn’t care. Saving my life” and “My only intent to go in there was to turn off a switch to shut this down.” Mr. Fraser said that he wanted to stop being suffocated. He referenced pressure being around his head and nothing being done about it. When I asked him if other people would have done what he did if they had known what he knew, he replied, “I sure hope so.” Mr. Fraser explained that he tried to locate the device, shut it off, dismantle it, give it to the FBI as evidence and for them to be arrested. He referenced wanting to get access to the internal memory of the main frame to get the evidence and to do something before the system killed people. Mr. Fraser stated, “They still haven’t done it yet. It’s still running.” He said that he does not know where it is now, and it is no longer impacting him. Mr. Fraser told me that they had to remove him from the building so they could do repairs to his apartment. He said that he “definitely” tried to save other people’s lives and not just his own. Mr. Fraser told me that he wanted Arnold Schwarzenegger called because he is “an authority figure.” He said that he does not recall saying anything about the US Marshalls or a gun being in a safe. Mr. Fraser stated, “I’m on the side of good.” He reported that he was not too sure if he felt he would have been charged. Mr. Fraser said that all I have to do is get information from the internal memory. He referenced Bill and Melinda Gates being involved. Mr. Fraser expressed a belief that the judge will throw it out or pardon him “because I’m pretty not guilty with anything I did.” He reported that he did something good. Mr. Fraser said that he told the man why he went through his window and apologized to him.
Background Information Regarding the Accused:
[15]. Mr. Fraser was born in Chatham and had a normal birth and development. He has a younger full brother, three older stepbrothers and an older stepsister. His father died in 2019. His mother is still alive and is a personal support for Mr. Fraser.
[16]. Mr. Fraser has a grade 9 education. He “probably” had an Individualized Education Plan (IEP). He self reports that he had been suspended for fighting and expelled for truancy. Mr. Fraser participated in sports and volunteered.
[17]. Mr. Fraser reported that he displayed “a little bit” of behaviour problems as a youth including stealing, fighting, lying, truancy, running away from home, fire setting, vandalism, and defiance.
[18]. Mr. Fraser has a previous criminal record. He has convictions in February, April and July 2003 for offenses which include forcible confinement, attempting to obstruct justice and failing to comply with a recognizance.
[19]. Mr. Fraser has worked as a general labourer and in farming. He volunteered for the government years ago when he was on Ontario Works. He last worked “a long time ago.” He has been on ODSP for fifteen to twenty years.
[20]. Mr. Fraser has never been married or been involved in any common-law relationships. He has no children. Mr. Fraser does not currently have a partner. He identifies his mother; a brother and a few friends as supports.
[21]. Mr. Fraser’s mother was interviewed on December 10, 2024. She reported that she lives 15 minutes away from Mr. Fraser by car and only sees him for his injections. He was banned from her apartment building because he verbally threatened one of the tenants. This happened one year ago, which is why she only has contact with him when he gets his injections.
[22]. After the index offence, Mr. Fraser lived in Blenheim. From October 2023 to May 2024, he was homeless, stating, "I slept in banks, and crashed on couches.” From May 2024 to October 2024, Mr. Fraser reported that he was living at a friend’s place; however, he had a conflict with him which required him to move. Since October 2024, Mr. Fraser has been living in another friend’s house. When asked whether he was comfortable living in his current situation, he replied stating, "I don’t know if there are devices in my house; but I won’t’ tear apart the walls because I don’t want to jeopardize my living situation."
[23]. Mr. Fraser accesses the local food bank and soup kitchen.
[24]. Mr. Fraser was interviewed at the Southwest Centre on December 10, 2024. As noted in the Report at pages 12 – 13:
During the interview, Mr. Fraser was cooperative; however, he presented with pressured, rapid speech, and delusional thought content, which was persecutory in nature, generally involving electronics, devices and lasers recording or interfering with him. Thought form was tangential, with client in most cases able to initially answer the questions partially, before adding statements that often were delusional in nature. When asked, he denied any delusions, paranoia, or visual hallucinations. When asked about voices he experiences, he replied, "they are stuff that's voiced out around my head, it has to do with psychological testing or accessibility or something like that." When asked if they were male or female, he replied "Whatever it wants, it does not have a name." Mr. Fraser reported that the last time he tried to talk to his voice was yesterday, stating "I asked the question, what are you a part of, and it wouldn’t say anything." He initially denied that the voices tell him to do things but then stated that, ‘they sometimes tell me to kill myself in irritating sounds". He said that he has never followed through on any of their instructions and never will. During the interview, he intermittently added tangential statements such as "It’s a government house; I’m pretty sure there's a speaker behind the wall that someone could wirelessly tap into; I think the hydro company has something to do with it, when they get fed into those lines; its Hydro impulse to reflex."
When asked, Mr. Fraser described his mood as "Good, a 10/10, " with a mildly blunted affect. He denied any thoughts of self-harm, suicidal ideation, violent ideation or any accompanying intent or plan, and he denied any suicidal attempts. In terms of self-harm, Mr. Fraser ported that he engaged in superficial cutting at age 12 or 3, "lots of self-withdrawal, the only time I would resort to cutting was so I could vent my aggression and so I wouldn’t cause anyone else harm." When Mr. Fraser was asked about any historical legal issues, he denied any issues with violent interactions with the law since December 2023. Upon further questioning; however, he stated, "In October, the police met with me and gave me a trespassing document for housing buildings and the post-office.” When asked whether he identified as someone that breaks the law, he replied, "No. i would rather help enforce it."
Psychiatric History:
[25]. Mr. Fraser is diagnosed with schizophrenia. Dr. Ajay Prakash, assessing psychiatrist, indicated during the hearing that Mr. Fraser has also been diagnosed with substance use disorder, with a history of using crystal methamphetamine, cannabis, and alcohol.
[26]. Mr. Fraser was in his early 30’s when he had his first contact with psychiatry and was under the care of a psychiatrist as early as 2010. After the index offence, Mr. Fraser had approximately four psychiatric admissions from 2022 to 2023.
[27]. During an admission in October 2022, Mr. Fraser left the hospital on a day pass and did not return. Following a discharge on January 26, 2023, Mr. Fraser failed to attend CMHA for his long-acting injection.
[28]. During an assessment in February 2023 by Dr. Oyebode, Mr. Fraser reported that wires in his home were affecting him. He wanted to return home to ensure that the superintendent switched off the machine which was causing his symptoms. Mr. Fraser said that this had nothing to do with his continued use of crystal methamphetamine, which he denied using, but was detected in his urine. He insinuated that a spirit was involved in salt being on his food without his knowledge.
[29]. During that same admission, after Mr. Fraser went on a fresh air pass, his urine tested positive for amphetamines, he remained unpredictable and chronically delusional, he did not want to stay in hospital, and he wanted to be discharged. His prognosis was noted to remain poor because he would continue using crystal methamphetamine.
[30]. Mr. Fraser was assessed by Dr. Awoniyi on July 11, 2023. He was stable but still had delusions about electromagnetic fields. He was diagnosed with schizophrenia, a substance related psychotic disorder, and a substance use disorder-methamphetamines and amphetamines.
[31]. On September 11, 2023, Mr. Fraser saw Dr. Awoniyi again. He reported that he continued doing well but had chronic delusions about electromagnetic fields and continued talking about conspiracy theories. Mr. Fraser talked about notifications through the speaker system in his apartment and viruses in the computer system. He said that his apartment was due to be renovated the following week, during which time, he would be staying with his mother or cousin. Mr. Fraser reported that he had not used any crystal methamphetamine in a long time and was aware that it affects his mental health and would never use it again. He was diagnosed with schizophrenia, a substance related psychotic disorder, and a substance use disorder-methamphetamines and amphetamines. Mr. Fraser was prescribed Invega Sustenna 100 mg by injection every four weeks, Zyprexa 10 mg at bedtime and Clonazepam 1 mg at bedtime.
[32]. During the team’s interview with Mr. Fraser’s mother on December 10, 2024, she reported that Mr. Fraser’s delusions and his anger had "gotten increasingly worse" over the past year or so. In terms of anger, she mentioned that Mr. Fraser had broken a chair in her house; and punched her windshield out because he thought there were spirits in her car.
[33]. At page 14 of the Report,
Mr. Fraser’s mother reports that he had vaguely stated he wanted to kill some family members when he gets annoyed with them in the moment. She also reported that he will make comments that he wanted to kill himself when he gets dysregulated, but never mentioned any method or rationale for doing either. She denied that Mr. Fraser ever committed violence towards another person or to her. Finally, she also reported that she does not feel like Mr. Fraser is a threat currently, but added "If things don’t go his away, he will get aggressive, but he has never laid hands on me yet."
Regarding other psychotic symptoms, Mr. Fraser’s mother mentioned that she sees him talk to himself a lot but that he never tells her what the voices were telling him to do. Instead, she reported that Mr. Fraser believes these voices are giving him information on things. Regarding substance use, she reported that "he says no, but at times I think he’s been using". When asked why she thinks so, she replied "I don't know, you just sense it, he goes through money like crazy."
Finally, regarding support systems, Mr. Fraser’s mother reported that she was his main support along with a friend Harold, and another person named Bev that he goes to church with. She denied having any knowledge of Mr. Fraser presenting to the emergency room or being hospitalized for his mental health in the past year. When asked whether he has had any issues with the law in the past year, she replied that she did not know, as Mr. Fraser does not tell her everything.
[34]. Mr. Fraser has poor insight across all spheres. When asked about the index offence, he continued to state that he had no intention of hurting anyone and that his actions were justified. He believes that he does not have a mental illness and does not need a psychiatrist. He has poor insight into his need for medications. When asked if he would reoffend in the future, he stated, “I don’t know.”
Evidence at the Hearing:
[35]. Dr. Ajay Prakash, Mr. Fraser’s assessing psychiatrist, adopted the contents of the Report and gave evidence on behalf of the hospital.
[36]. Dr. Prakash met with Mr. Fraser prior to the hearing, but because of his agitated state, was unable to complete an assessment of Mr. Fraser. From Dr. Prakash’s observations of Mr. Fraser on the date of the hearing, it was the doctor’s opinion that Mr. Fraser’s presentation on the date of the hearing was the same as that described in the NCR Report prepared for the Court, and in the Report.
[37]. On the date of the hearing, Mr. Fraser presented with guardedness; a degree of resistance to supervision and systems in general; behavioural and affective instability; and a brief period of aggression and anger immediately prior to the hearing.
[38]. Dr. Prakash stated that in December 2024, Mr. Fraser told him that he had not used crystal meth for “a long time” (about a year) and had not used cannabis in the previous six months. Dr. Prakash had no updated information about Mr. Fraser’s use of substances but noted that in the past a urine drug screen had tested positive for substances when Mr. Fraser denied their use. Mr. Fraser visits the apartments of people who use crystal meth.
[39]. To Dr. Prakash’s knowledge, Mr. Fraser has not been tested for drug use in the past year. Mr. Fraser has been unreliable in his reports regarding substance use in the past. Dr. Prakash could not comment on the accuracy of Mr. Fraser’s assertions that he has not used substances recently. However, the doctor noted that, to Mr. Fraser’s credit, he has not been admitted to hospital in the past year, and that this could reflect not using crystal meth.
[40]. With respect to housing, Dr. Prakash indicated that it was generally unstable. While his current roommate seems like a good friend, Mr. Fraser has indicated that he will move out soon.
[41]. The doctor told the Board that it will be necessary for the hospital to approve future accommodations because of the risk factors noted at page 20 of the Report, and the lack of protective factors identified under the SAPROF (at page 20 of the Report).
[42]. Mr. Fraser’s main source of support is his mother, who drives him to receive his injections. Dr. Prakash pointed out that his contact with her is limited because he is banned from the building where she lives, and that he would not likely disclose details of substance use to her.
[43]. Dr. Prakash adopted the risk assessment and reoffence scenario set out in the Report at pages 17-19.
[44]. Mr. Fraser does not believe that he has a mental illness or that he needs medications. He only takes the medications to maintain his ODSP payments.
[45]. Dr. Prakash was unsure of who currently prescribes Mr. Fraser’s medications. The last psychiatric appointment the doctor was aware of was in September 2023.
[46]. In the doctor’s opinion, Mr. Fraser will require immediate psychiatric assessment and medication optimization.
[47]. Dr. Prakash stated that for Mr. Fraser to remain living in the community he must at least be able to comply with the Disposition; follow the treatment plan (e.g. abstain from substances); take medications as prescribed including changes or increases of medications; and permit conversation by team members with his personal support system (friends, family).
[48]. The doctor noted that on the positive side, Mr. Fraser’s mother does feel safe enough to drive him to his appointments twice per month; Mr. Fraser does have friends so may have some ability to form relationships, which is essential for connecting with the hospital’s team, and has some ability to comply with treatment and follow-up recommendations.
[49]. More than once, Dr. Prakash emphasized the need to protect the safety of members of the Forensic outreach team if Mr. Fraser continues to live in the community.
[50]. Dr. Prakash asked the Board to issue the Disposition on an expedited basis, as soon as reasonably possible. When asked if he was requesting an expedited Disposition “today,” Dr. Prakash agreed.
[51]. No further evidence was provided.
Closing Submissions:
[52]. All parties maintained their original positions.
[53]. Ms. Zamprogna submitted for the hospital that Mr. Fraser poses a significant threat to the safety of the public. His presentation today and in earlier assessments is similar to his presentation at the time of the index offence. He has a history of treatment non-adherence, and treatment has been only partially effective. His substance use has not been addressed, and this has contributed to several admissions since the index offence. He needs an immediate medication adjustment, and his insight across all spheres is underdeveloped. His living situation is unstable. The HCR-20 (V. 3) indicates a medium to high risk of violence under a detention disposition.
[54]. The Mental Health Act (“MHA”) has been only partially effective to date. It is reactive not proactive. The hospital needs the ability to return Mr. Fraser to the hospital quickly if he decompensates, in a proactive and not a reactive manner. The hospital needs to be able to approve Mr. Fraser’s accommodation. The risk to the safety of the public can only be managed under a detention disposition.
[55]. Mr. Glover, submitted on behalf of Mr. Fraser that Mr. Fraser did not pose a significant risk to the safety of the public. He has good friends, as evidenced by the attendance of Mr. VanderEnde at the hearing. Mr. Fraser’s mother supports him. He receives medication from CMHA and has a community psychiatrist. He has a family doctor. By his own statements, Mr. Fraser indicates that he is not a danger to others and can be trusted to keep the peace. There is evidence to support a conclusion that he has stayed out of trouble this past year.
[56]. In the alternative, if the Board finds that Mr. Fraser poses a significant threat to the safety of the public, a conditional discharge is appropriate. He says he has stable housing. He says he will abstain from substances.
[57]. On behalf of Mr. Fraser, Mr. Glover indicated that Mr. Fraser asks for the continued ability to drink alcohol socially. He objects to submitting urine/breath/blood samples. He agrees to not have weapons; not to contact or communicate with the victim of the offence; to transfer the administration of his medications from CMHA to the hospital; and to report every two weeks (but not a minimum of four times per month).
[58]. Mr. Rows, counsel for the Attorney General, adopted the hospital’s submissions.
Analysis and Conclusion:
Significant Threat to the Safety the Pubic:
[59]. The Board must determine if Mr. Fraser is a significant threat to the safety of the public. For completeness, we set out the legal test which must be applied.
[60]. Parliament has defined that term in s. 672.5401 of the Code to mean “a risk of serious physical or psychological harm to members of the public...resulting from conduct that is criminal in nature but not necessarily violent.” Public safety has been determined by Parliament to be the paramount consideration. Thus, by the words chosen, the level of harm which could be created must be significant, not minimal or a mere annoyance.
[61]. The Supreme Court decision in Winko remains instructive as to how to interpret this section. A risk must be real and objectively supportable, not remote, theoretical or exist only due to one person’s fears. (See: Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] S.C.J. No. 31, at paras. 57, 62).
[62]. Further, the Board must determine if, at the time of the hearing, the evidence has established a risk of serious harm. It is not sufficient that, at some time in the future, the subject person could commit other, unspecified offences. Nor is it sufficient that at some time the subject will make a decision which is deleterious to his own mental health or stability. As stated by McLachlin, J. (as she then was) at para. 69:
“It is for the court or Review Board, acting in an inquisitorial capacity, to investigate the situation prevailing at the time of the hearing and determine whether the accused poses a significant threat to the safety of the public. If the record does not permit it to conclude that the person constitutes such a threat, the court or Review Board is obliged to make an order for unconditional discharge.”
[63]. The Court of Appeal has also emphasized that the test to be applied is stringent, and there must be both a likelihood of risk materializing and the likelihood of serious harm occurring. Speculation as to the level of risk is not sufficient, and the risk of a mental health relapse is not congruent with the standard to be applied and cannot justify detention. It is recognized that the absence of violent behaviour in itself does not eliminate the risk of significant harm to the public. Similarly, lack of insight into the index offences, the discontinuation of medication and substance abuse are all factors to consider (See: Re: Sheikh, 2019 ONCA 692; Re: Krist, 2019 ONCA 802; Re: Abdulle, 2019 ONCA 812).
[64]. That Court re-emphasized the onerous test in Re: Gibson 2022 ONCA 527, per Lauwers J.A. at para. 9:
Huscroft J.A. said in Carrick (Re), 2015 ONCA 866, 128 O.R. (3d) 209, at para. 17, that “the ‘significant threat’ standard is an onerous one”. He added that “[t]he board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the appellant in order to deny him an absolute discharge”. Mere speculation is insufficient. See also, Sim (Re), 2020 ONCA 563, at paras. 63-65, per Strathy C.J.O., Marmolejo (Re), 2021 ONCA 130, 155 O.R. (3d) 185, per Tulloch J.A., at paras. 33-37.”
[65]. Having heard all the evidence and considered the submissions of counsel, the Board makes a positive finding that Mr. Fraser poses a significant threat to the safety of the public.
[66]. There is no doubt that Mr. Fraser has a serious mental illness. He has been diagnosed with schizophrenia and substance use disorder. The Board does not suggest that these illnesses in and of themselves make him a serious threat to the safety of the public. It is not the presence of an illness which the Board must consider, but whether due to that illness a person will act in such a way as to create a reasonable likelihood of danger to the public. That danger must be real; it must be beyond annoyance, as set out by the Supreme Court.
[67]. The evidence indicates that since the index offence, Mr. Fraser has not engaged in physical violence directly against others. Based on this, if the Board was only considering the likelihood of whether he would commit an actual assault, the test for serious threat would likely not be made out.
[68]. However, while living in the community since the index offence Mr. Fraser has exhibited environmental aggression and had several psychiatric admissions to hospital. The use of substances was a factor in these admissions. During those admissions, Mr. Fraser expressed delusions similar to those which precipitated the index offence.
[69]. The index offence was serious. Mr. Fraser broke into an innocent neighbour’s apartment and caused damage to the apartment and its contents in response to his delusions. Mr. Fraser has no insight in to the index offence and believes that his actions were justified. Mr. Fraser continues to be at risk for repeating this behaviour in response to his delusions. Mr. Fraser told the hospital that as recently as October 2024, “the police met with me and gave me a trespassing document for housing buildings and the post-office.” Despite this, Mr. Fraser perceives himself as upholding the law.
[70]. Mr. Fraser has not participated in substance use programming. Although it appears that Mr. Fraser may have abstained from crystal meth during the past year, the Board has little confidence that he can remain substance-free in the community without extensive support and oversight of mental health professionals.
[71]. Furthermore, as noted by Mr. Glover in his closing submissions, Mr. Fraser wishes to continue to use alcohol, and objects to testing for substance use.
[72]. Mr. Fraser’s capacity to consent to treatment has not yet been assessed by the hospital, thus legally he remains capable to consent to treatment for schizophrenia. He does not believe he has a mental illness and does not believe he needs medications. He is externally motivated to comply with medications to maintain ODSP benefits, and he has a history of failure to comply with treatment and follow-up. He went AWOL on a hospital day pass, and during a different admission, tested positive for crystal meth use after a pass. The Board has little confidence that he will remain compliant with medications in the community without extensive support and oversight of mental health professionals.
[73]. The Board adopts the Re-Offence Scenario set out at page 19 of the Report:
Absent extensive psychiatric supervision and treatment, Mr. Fraser will continue to experience his intense psychotic symptoms, including auditory hallucinations, delusions, and disorganized behaviours, despite treatment. If he were to discontinue his treatment, or experience increased stress related to his paranoid delusions, he would likely have an exacerbation of his symptoms. As a result, he likely would be unable to cope with stressors related to the exacerbated symptoms of his mental illness, significantly increasing his risk of reoffence and future violence. Also, his judgment would become increasingly impaired in the context of psychosis, and he would perceive any innocent individual as a threat and would act out violently, as in the index offence.
[74]. The Boards notes that Mr. Fraser was destabilized by the stress of attending the ORB hearing. He experienced agitation, anger, and aggression immediately prior to the hearing. Although Mr. Fraser was able to remain calm throughout the hearing, Dr. Prakash expressed concern about the safety of team members visiting Mr. Fraser’s home and went so far as to request an expedited Disposition.
[75]. The Board adopts the overall clinical assessment of risk set out on page 20 of the Report:
- Mr. Fraser’s mental illness is chronic. He continues to experience positive symptoms of his mental illness, including hallucinations and delusions. His psychotic symptoms contributed to his index offence and those have remained unchanged. His cognitive limitations, including concentration and his ability to problem solve, will continue to impact him. In response to his symptoms, Mr. Fraser has been violent in the past;
- Mr. Fraser does not have insight into his mental disorder and its presentations. It is unknow if he would be able to recognize signs of decompensation and if he would seek professional help;
- While Mr. Fraser has maintained himself in the community, his living situation has been unstable and he has fixed delusions about hearing voices in the walls, which cause him distress;
- Although Mr. Fraser’s mother is his primary personal support, he is unable to visit her at her apartment due to the no trespass order thus causing their interactions to be limited; and
- Mr. Fraser’s HCR V3 shows all clinical and future-oriented risk factors as being present and relevant. This illustrates a significantly elevated risk of violence.
Disposition
[76]. The Board considered whether a conditional discharge disposition would be necessary and appropriate in the circumstances.
[77]. The Board carefully considered Mr. Fraser’s strengths as acknowledged by Dr. Prakash, and as outlined by Mr. Glover. The Board also took into consideration that Mr. Fraser currently attends his injection cooperatively; remained calm and respectful during the hearing; was responsive to counsel when asked not to interrupt; verbally stated that he will cooperate with home visits by the team; had no psychiatric admissions during the past year; and says he will abstain from substances.
[78]. However, the Board notes that even under a detention disposition, Mr. Fraser’s risk for violence would be moderate to high while living in the community in his current circumstances e.g., unsupervised housing; minimal professional and personal supports; lack of structure; medication not optimised; no addiction programming; underdeveloped insight etc. Without the ability to approve accommodations, or to bring Mr. Fraser to hospital expeditiously under a Warrant of Committal, that risk would be higher.
[79]. The Board adopts the reasoning of Dr. Prakash set out at pages 20-21 of the Report:
…the Mental Health Act of Ontario will be insufficient to manage his risk. Mr. Fraser has a history of violence related to the presentation of his mental disorder. He continues to experience active psychotic symptoms and lacks insight into his mental disorder. He has difficulty in shifting his mental state and in regulating his mood, and potential violence may be provoked by internal stimuli and may take place in an impulsive manner. Historically, he was not forthcoming with mental health professionals when he was offered treatment and a follow-up plan. Therefore, the clinicians would unlikely be able to predict the risk of violence in his case which is a prerequisite for using the requirements of the Mental Health Act of Ontario to manage the risk; therefore, a Warrant of Committal would be able to serve in a pro-active rather than a reactive manner ensuring public safety. As well, moving forward, the Hospital would be required to approve accommodation.
[80]. The Board finds that a Conditional Discharge is not sufficient to manage the risk to the safety of the public, which is the paramount consideration, and that the necessary and appropriate disposition is a Detention Disposition.
[81]. The hospital requires the ability to bring Mr. Fraser to the hospital if he decompensates. There are no supports in place which could detect early signs of decompensation.
[82]. Mr. Fraser has no insight into his mental illness and continues to hold the types of delusions which precipitated the index offence. He does not recognize these as symptoms of mental illness. When his mother tried to explain that he was suffering from delusions, he thought she was lying to him.
[83]. His contact with his mother is limited to driving to receive his antipsychotic injection, and she indicated to the hospital in December 2024 that Mr. Fraser “does not tell her everything.” Mr. Fraser’s mother is not in a position to detect early warning signs of decompensation. As well, Mr. Fraser’s housing is unstable, and the team has not spoken to his roommate.
[84]. Mr. Fraser responds with environmental violence to anger. Mr. Fraser’s mother told the team that Mr. Fraser had broken a chair in her house. He also punched her windshield out because he thought there were spirits in her car. He has thoughts of violence toward others when he is annoyed with them. As noted above, she stated that "If things don’t go his away, he will get aggressive, but he has never laid hands on me yet."
[85]. For the foregoing reasons, the Board is of the view that a Detention Disposition on the terms recommended by the hospital, is the least onerous and restrictive disposition that is necessary and appropriate in the circumstances.
[86]. The requirement to abstain from the non-medical use of alcohol or drugs and the testing requirement provide extrinsic support for abstinence from substances. Substance use has been closely associated with decompensation in the past, and was present at the time of the index offence.
[87]. Because Mr. Fraser and the victim of the index offence both live in the same small community, a slight modification was made to the non-contact provision to exempt incidental contact while accessing community services.
[88]. The evidence and comments from Mr. Fraser indicated to the Board that he is highly motivated to stay living in the community, and this term is consistent with least onerous and least restrictive disposition. Mr. Fraser has lived in the community for a year without significant aggression or other behaviour management concern. There is a reasonable likelihood that if Mr. Fraser cooperates with assessment, medication optimization, participation in rehabilitative initiatives, and maintains a positive trajectory, he will be appropriate for community living in approved accommodation.
[89]. Approving housing is an important risk-mitigation strategy particularly where, as here, an individual is experiencing residential instability which in turn contributes to stress/increasing the likelihood of mental decompensation.
[90]. In making this Disposition, the Board has considered the criteria set out in s. 672.54 of the Code, which are the safety of the public, being the paramount consideration, the mental condition of Mr. Fraser, the reintegration of Mr. Fraser into society and the other needs of Mr. Fraser.
[91]. The Board considered it necessary and appropriate in the interest of public safety, including the safety of treatment team members, that the Disposition be issued on an expedited basis.
[92]. The Board commends Mr. Fraser for remaining calm during the hearing and wishes Mr. Fraser every success in working with the hospital to optimize his mental stability in the upcoming year.
DATED this 5th of March 2025, at the City of Toronto, in the Toronto Region.
Katherine Tomaszewski Legal Member
Office of the Registrar Ontario Review Board