Ontario Review Board
Re: Stephen E. Jones
ORB File No: 2823
Hearing held on: Wednesday, February 19, 2025
Place of hearing: Royal Ottawa Mental Health Centre Via Zoom Video-conference
Pursuant to: Section 672.82(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks Members: Dr. R. Kunjukrishnan Dr. G. Stones Ms. K. Weisbaum Mr. A. Mete
Parties Appearing:
Accused: Stephen E. Jones Counsel: Mr. M. Schloss
The person in charge of hospital: Representative: Dr. J. Gojer
Attorney General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated March 10, 2025)
Introduction:
On October 5, 1998, Stephen Jones was found not criminally responsible by reason of mental disorder (“NCR”) on charges of arson and assault with a weapon, contrary to the Criminal Code of Canada (“Criminal Code”).
Mr. Jones is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated December 4, 2023, by which he was ordered to be detained at the Forensic Assessment Unit (“FAU”) at the Royal Ottawa Mental Health Centre (“Royal Ottawa” or the “hospital”), with discretion given to the person in charge to transfer Mr. Jones to the Forensic Rehabilitation Unit (“FRU”) should his condition justify the transfer. Pursuant to that Disposition, Mr. Jones is ordered detained at the Forensic Program of the Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) until his transfer to the Royal Ottawa. This Disposition also contains certain privileges and prohibitions, including the ability to live in the community in 24-hour a day supervised Developmental Services Ontario (“DSO”) housing. Mr. Jones was transferred to the Royal Ottawa on November 19, 2024.
On Wednesday, February 19, 2025, a panel of the ORB convened an early hearing at the request of Mr. Jones by Zoom video-conference to review Mr. Jones’s current Disposition. Mr. Jones was represented at the hearing by his counsel, Mr. Schloss.
The issues for the Board to decide at this hearing were first whether Mr. Jones is a significant threat to the safety of the public and, if so, what is the necessary and appropriate Disposition for the coming year based on a consideration of the four factors in s. 672.54 of the Criminal Code.
For the reasons set out below, the Board concluded that Mr. Jones continues to represent a significant threat to public safety. The panel concluded that the necessary and appropriate Disposition remains his existing Detention Order at the Royal Ottawa and the Board denied Mr. Jones’ request to transfer him back to Ontario Shores.
Position of the Parties:
At the outset of the hearing, the parties were canvassed as to their recommendations to the Board. Dr. Gojer appeared as the representative for the Royal Ottawa. He advised of the hospital’s position that Mr. Jones remains a significant threat to public safety, and that the necessary and appropriate Disposition is a Detention Order. Dr. Gojer stated that the hospital took no position with regard to Mr. Jones’ request to be transferred back to Ontario Shores.
Counsel for the Attorney General supported Mr. Jones’ transfer request back to Ontario Shores.
Mr. Schloss appeared for Mr. Jones. Mr. Schloss advised that he and his client did not contest the issue of significant threat and he advised that his client was requesting a transfer back to Ontario Shores.
All parties maintained their respective initial positions in closing submissions.
Index Offences:
- The circumstances surrounding the index offences, which occurred in Toronto, are extracted from the Hospital Report dated February 8, 2025 (the “Hospital Report”), as follows:
"On April 29th, 1998, the accused was living in the Ambassador rooming house located at 209 Carlton Street. The house had provided food for dinner for the tenants and the accused was dissatisfied with the quantity and quality of the food. He stated that someone should burn this place to the ground and subsequently went into his bedroom, shut the door and set his blanket and mattress on fire. The fire alarm went off and the staff saw him running from his burning room. He was held for police and the fire department and the staff tended to the fire. The accused was interviewed... and stated that he had been told to set the fire by a voice inside his head. He was asked if he knew why he was under arrest and he stated, "Yes, I set the bed on fire.”
The charge of assault with a weapon was added as, after setting the fire, Mr. Jones threw objects at staff. At the outset of the hearing, the parties were canvassed as to their position on the issue.”
Personal Background:
The Hospital Report provides much information about Mr. Jones’ personal and mental health history, details of some of his criminal convictions, and details of his numerous hospital admissions prior to the NCR finding. As the Hospital Report was made an Exhibit at the hearing, it is not necessary to summarize the information contained therein in these Reasons. The panel also relies upon the recent Reasons for Disposition dated December 27, 2024.
In summary, Mr. Jones is now 69 years old. He was 42 years old when he came under the Board’s jurisdiction 27 years ago. He is single and has no children.
Mr. Jones reported that he completed high school. His employment history is sparse. He has not had stable housing: when not in hospitals or correctional/detention centres, he lived on the streets in Toronto, in various boarding homes, or in group homes.
Psychiatric History:
Mr. Jones’ mental health history and psychiatric admissions date back well before his NCR finding. His first psychiatric admission was at age 15, and lasted from December 3, 1971 to April 27, 1972. He continued to experience frequent psychiatric admissions and other hospital visits between 1972 and 1997. Notably, he had several lengthy admissions to what was then the Oak Ridge Division, Penetanguishene Mental Health Centre. These admissions occurred from January 9, 1973 to September 6, 1973; October 11, 1973 to May 12, 1977; August 24, 1979 to August 27, 1981; November 20, 1981 to March 25, 1982; November 23, 1982 to August 9, 1985; and January 16, 1986 to May 23, 1989 (both Oak Ridge and Regional Divisions).
Mr. Jones’ initial ORB Disposition resulted in a transfer to the Waypoint Centre for Mental Health Care (“Waypoint”) which occurred in January 1999. Mr. Jones was later ordered transferred to Ontario Shores on February 4, 2004 pursuant to an ORB Disposition. In November 2006, the ORB ordered Mr. Jones transferred to St. Joseph’s Health Care in Hamilton.
In July 2013, Mr. Jones was transferred to Waypoint, where he remained until his transfer back to the secure forensic service at Ontario Shores on February 26, 2019. He remained at Ontario Shores until his recent transfer to the Royal Ottawa on November 19,2024.
Current Diagnoses:
- Mr. Jones’ current diagnoses are:
Schizoaffective Disorder, bipolar type;
Pedophilic Disorder; and
Borderline Intellectual Functioning.
Legal History:
- Mr. Jones has a lengthy criminal record dating back to 1972 when he was convicted on three separate occasions of auto theft at the age of 16. The record includes three separate sexual assault convictions, in 1989, 1990, and 1992. There are several assault convictions, one conviction for assaulting a peace officer, and one for aggravated assault, the latter in 1994. Other convictions include: numerous property offences, mischief, failing to comply with various types of court orders, and dangerous driving.
Course Following the NCR Verdict:
Mr. Jones’ initial Disposition resulted in an admission to the Waypoint Centre for Mental Health Care (“Waypoint”) on January 5, 1999. He transferred to Ontario Shores, (formerly Whitby Mental Health Centre and Whitby Psychiatric Hospital) on February 4, 2004. After spending some two years at Ontario Shores, he was transferred to St. Joseph’s Health Care, Hamilton, on November 14, 2006. On July 11, 2013, he returned to Waypoint, where he remained until his transfer back to the secure forensic service at Ontario Shores on February 26, 2019. His behavioural course at the various hospitals was difficult, and he has never been discharged to live in the community.
Mr. Jones demonstrated progressively deteriorating behaviour during his most recent admission at Ontario Shores, including frequent verbal and physical threats of harm, as well as actual assaults causing injury to hospital staff. There were repeated utterances of threats to kill staff as well as physical gestures such as the raising of his fists. In June of 2022, he abruptly struck his psychiatrist on the chin with a closed fist and, three days later, repeatedly punched his nurse in the face and continued to attempt to kick her while being restrained.
Mr. Jones had a very difficult year from 2022-2023, leading to his ORB hearing in November of 2023. Behavioural incidents ranged from racial epithets and swearing (44 instances), to threatening gestures (14 occasions) to physical assaults on peers and staff members (15 occasions), along with destruction of hospital property (31 times). Acts of physical violence were unprovoked. Mr. Jones had also had several incidents of self-harm with no apparent trigger other than his sheer frustration with being detained at Ontario Shores.
Behavioural therapy interventions have had some effect in managing Mr. Jones’ challenging behaviour. When such interventions were applied during periods of elevated mood, there was a significant reduction in rates of aggressive behaviours within days of their application. Reportedly, the most significant challenges with behaviour management include the need for staff to recognize mood shifts and apply the correct interventions with immediacy and consistency in implementation given a large staffing pool, staff changes, and limited staffing resources.
In 2023, Mr. Jones’ treatment team felt they were at a treatment impasse with him. The therapeutic relationship had deteriorated and was no longer seen as beneficial to him. A transfer to the Royal Ottawa was hoped to allow him the opportunity to develop a therapeutic relationship with a new treatment team and give Mr. Jones the fresh start he was looking for. The Board agreed and ordered his transfer to the Royal Ottawa, which occurred on November 19, 2024.
Evidence at Hearing:
The Board admitted into evidence the Hospital Report, and the January 23, 2025 Ontario Shores response to the Rule 13 transfer request (“Rule 13 Response”). The Board also had available to it the documentary evidence contained in the Record and Exhibit List. Dr. Gojer testified at the hearing on behalf of the Royal Ottawa. He adopted the contents of the Hospital Report and stated that the status quo described therein remains the same.
Dr. Gojer stated that Mr. Jones has not exhibited any psychotic symptoms since his transfer to the Royal Ottawa. Dr. Gojer stated that Mr. Jones remains capable of consenting to treatment for his psychiatric illness and he has remained compliant with his prescribed medications since being admitted to the Royal Ottawa.
The Hospital Report indicates that while at the Royal Ottawa, Mr. Jones has presented with some problematic behaviours, namely: throwing food and hot items at staff, inappropriately touching and hitting people, and throwing himself on the floor. A Behavioural Plan has been devised to assist in managing these challenging behaviours.
Since his admission to Royal Ottawa, Mr. Jones has been assessed as being at high risk of choking. Due to his history of aspiration, he has been placed on a soft minced food diet and this has angered Mr. Jones. He will frequently lash out verbally or physically towards staff at mealtimes. Mr. Jones indicated very early after his transfer to Royal Ottawa that the main reason he wants to return to Ontario Shores is that he was allowed to eat whatever he wanted at Ontario Shores. The Hospital Report indicates that in order to manage Mr. Jones’ throwing of food items during meal times, he eats in an interview room, with one item presented to him at a time, under close staff supervision.
The Hospital Report also indicates that Mr. Jones has had a handful of episodes of throwing himself on the floor in his room. Staff have managed this behaviour by requiring that he lift himself off the floor on his own.
Mr. Jones has engaged in three recorded incidents of sexually inappropriate behaviour at the Royal Ottawa. On one occasion, he slapped a female co-patient’s buttocks. On the other two occasions, he was observed by staff rubbing male co-patients’ genitals. Staff were able to intervene before these situations escalated further. In Dr. Gojer’s opinion, these sexually inappropriate behaviours are likely driven by antisocial personality traits rather than by Mr. Jones’ paraphilic disorder.
The Hospital Report also indicates that Mr. Jones is noted to attend at the FAU nursing station frequently on a daily basis and will often yell staff names loudly and repetitively until he gets the attention or request answered that he is seeking. When he does not receive the attention he seeks, he is prone to act out with physical aggression.
At the present time, Mr. Jones is detained on the FAU, the hospital’s secure assessment unit. On this unit, he is not allowed any access to the community. Mr. Jones often complains about the lack of community access, drawing comparisons to the community access he had at Ontario Shores with his previous treatment team.
Dr. Gojer testified that on the FAU, the most liberal privilege available to Mr. Jones is staff accompanied walks on the hospital grounds; however, to date, Mr. Jones has only been granted staff accompanied privileges and he was marginally able to tolerate same given his behavioural presentation. He has not progressed to earning walks inside the hospital.
Dr. Gojer commented that if Mr. Jones were to be transferred to the hospital’s rehabilitation unit, his community outings would be unlikely to occur with the same frequency that he enjoyed at Ontario Shores.
According to the Hospital Report, “Due to his choking risk, his food related outings will not happen here, which is his primary wish for outings. We would be able to facilitate outings to the community, pending earning the privilege to do so. However, he would require 1:1 outings and our staffing complement and capacity does not support doing that more than once every 3-4 weeks. Mr. Jones is not showing signs of being able to handle independent community access or even group access to the community.”
The doctor advised that Mr. Jones will remain on Royal Ottawa’s FAU until such time as he is able to demonstrate adequate behavioural management to allow for his transfer to a secure rehabilitation unit. In the doctor’s assessment, given Mr. Jones’ presentation to date, such a transfer may take several months to achieve. Further, the doctor commented that his eligibility to transfer to a rehabilitation unit may not be possible if Mr. Jones continues to present with his challenging behaviours.
According to the Hospital Report, “The transfer to Ottawa has been a step back for Mr. Jones and he is not going to enjoy any of the benefits that he had at Ontario Shores. A detailed risk assessment was conducted at Ontario Shores and I concur that he has prominent psychopathic traits, that clinically there is a high risk of low to moderate grade violence that will be perpetrated towards staff, co patients and to self. These behaviors will be the result of his needs being denied or stymied. The trajectory of his aggression, if reviewed from 1997 is a decrease in frequency and severity of aggression and an aging factor has to be considered as a possible contributory reason. He has shown response to Clozapine in the past and whether this has been due to a beneficial effect on presumed psychotic symptoms or just aggression, is hard to gauge, as the behavioral problems have persisted after periods of quiescence clinically and administratively, Mr. Jones will have relatively more freedom in Ontario Shores than at the Royal Ottawa Hospital.”
In Dr. Gojer’s opinion, Mr. Jones was able to enjoy more freedom at Ontario Shores than he currently does at the Royal Ottawa. The doctor explained that at Ontario Shores, there were no food restrictions placed on Mr. Jones. As well, in the doctor’s assessment, the staffing compliment at Ontario Shores appeared to allow Mr. Jones to exercise staff accompanied community access on a more frequent basis than is expected to be available to him at the Royal Ottawa.
Of note, Ontario Shores’ Rule 13 Response indicates that: “It is important to highlight that central to Mr. Jones’ presentation is his impulsivity and low frustration tolerance related to his borderline intellectual functioning. He was consistent in his desire to transfer to Ottawa, and settled in well, but then experienced frustration over his diet, and is now asking to return to Ontario Shores. This is a hallmark behavior for Mr. Jones and will likely settle in time, but it should be noted that his presentation is marked by these type of impulsive reactions to situations in which he does not have the outcome he would like. I am of the opinion that it is not in his best interest to acquiesce to every wish borne out of impulsivity and low frustration tolerance, as this early request to transfer back to Ontario Shores is. It would rather be therapeutic for him to stay at the Royal and learn to work with the team, as he needs to be able to learn to adapt to transitions, as he will when eventually transitions to the community. Allowing him to transfer back to Ontario Shores at the first sign of dissatisfaction will not motivate him to work constructively with providers, and will hamper future community integration.”
When questioned about Ontario Shores’ Rule 13 Response, Dr. Gojer stated that if the Board does not grant Mr. Jones’ request for a transfer back to Ontario Shores then the Royal Ottawa clinical team will continue in its efforts to safely manage Mr. Jones’ risk and encourage his engagement with the treatment team. The doctor anticipated that if not granted his transfer request, then Mr. Jones would be likely to present with elevated frustration which would, in turn, be likely to lead to an escalation in his challenging and aggressive behaviours. Dr. Gojer testified that if there was no notable improvement in Mr. Jones’ behavioural presentation within the next two months or so while detained at the Royal Ottawa, then Dr. Gojer expected that the hospital would request an early hearing and recommend Mr. Jones be transferred to Waypoint where his risk to the safety of staff and co-patients could be optimally managed.
Dr. Gojer commented that Mr. Jones has been in the forensic system for over 27 years and has never progressed to the point of being a candidate for discharge to the community. In the doctor’s assessment, Mr. Jones is extremely institutionalized. Yet, despite Mr. Jones’ diagnosis of Borderline Intellectual Functioning, the doctor commented that Mr. Jones is quite adept at manipulating hospital staff to achieve his desired goals.
When asked if Dr. Gojer had explained to Mr. Jones that if his behaviours do not improve in the near future that the hospital would consider recommending Mr. Jones’ transfer to Waypoint, Dr. Gojer responded by stating that it is exceptionally difficult to have a meaningful discussion with Mr. Jones. The doctor stated that Mr. Jones is unable to tolerate such discussions and will either become selectively mute or just repeat “When can I go to Ontario Shores?”.
Dr. Gojer testified that, at the present time, Mr. Jones’s is able to be safely managed at the Royal Ottawa but he added that the mainstay of Mr. Jones’ treatment at this juncture was simply medication administration and his containment for safety. Dr. Gojer stated that the hospital has not yet reached the point of recommending Mr. Jones’ transfer to Waypoint.
Ms. Setter, a Behavioural Therapist working with Mr. Jones at the Royal Ottawa, also testified at the hearing. She advised that she has been meeting with Mr. Jones on a weekly basis since his admission. She indicated that the Royal Ottawa treatment team has been implementing the Behavioural Management Plan devised at Ontario Shores, albeit with some slight modifications. Ms. Setter advised that when she has discussed Mr. Jones’ challenging behaviours with him, he has become rude and dismissive. She testified that when he becomes escalated, Mr. Jones is directed by staff to return to his room to settle. She noted that he has been physically assaultive to staff. Ms. Setter stated that although Mr. Jones regularly threatens staff with physical aggression, there has been a reduction in incidents of physically assaultive behaviour as staff are quick to intervene to prevent same.
With regard to Mr. Jones’ challenging behaviours at mealtimes, Ms. Setter reiterated that Mr. Jones eats alone in a private room to manage risk of harm to others. She also advised that on the FAU a coffee cart is available for patients to access, typically three times daily. She advised that Mr. Jones’ independent access to the coffee cart is closely monitored by a staff member being in proximity and that Mr. Jones often manages himself well and enjoys his hot beverage away from others.
When asked by a panel member whether the clinical team at Royal Ottawa had employed any behavioural intervention strategies to assist in Mr. Jones’ food management, Ms. Setter indicated that she is unaware of same and she advised that the team’s dietician has determined that Mr. Jones is unable to safely consume solid foods due to his risk of choking which she understood to be driven by his impulsivity when he eats and his refusal to wear his dentures.
No further evidence was called by the parties.
Analysis and Conclusions:
The Board accepts Dr. Gojer’s evidence and the evidence contained in the Hospital Report and we have no hesitation in finding that Mr. Jones remains a significant threat to public safety. We need only look at a history of criminal convictions and his assaults on co-patients and hospital staff to conclude that he remains a significant threat to public safety. All parties agreed that at the present time a Detention Order is both necessary and appropriate and the panel endorses same.
The question that the panel weighed was whether it was necessary and appropriate, as well as least restrictive and least onerous, to transfer Mr. Jones from the Royal Ottawa back to Ontario Shores, bearing in mind the paramount goal of managing his risk to public safety.
The panel is aware that while detained at Ontario Shores, a treatment impasse had been reached between Mr. Jones and Ontario Shores. In fact, by 2023, Mr. Jones no longer wished to engage with any treatment team at Ontario Shores. For almost two years, Mr. Jones was steadfast in his expressed desire that he wished to be transferred from Ontario Shores to the Royal Ottawa. After a lengthy wait, Mr. Jones was transferred on November 19, 2024 to the Royal Ottawa.
The panel notes that, according to the ORB’s most recent Reasons for Disposition dated December 27, 2024, “The therapeutic relationship had deteriorated and was no longer seen as beneficial to him. A transfer to another hospital of Mr. Jones’ choosing was thought to be potentially helpful in developing a therapeutic relationship with a new treatment team and give Mr. Jones the fresh start he was looking for. The Board agreed and ordered his transfer to the ROMHC [Royal Ottawa] last year, as noted.”
As of the hearing date, Mr. Jones had been at Royal Ottawa for only three months. Mr. Jones had appeared to initially settle in well at the Royal Ottawa and according to Dr. Strike’s testimony at Mr. Jones’ recent ORB hearing on November 28, 2024, he had not engaged in any incidents of aggression as at that time. Dr. Strike noted that staff were supporting him in relation to his challenges, including noise levels, interacting with co-patients, and food issues. However, by January 8, 2025, Mr. Jones’ legal counsel advised that Mr. Jones was requesting to return to Ontario Shores. Mr. Jones’ change of heart appears to have been initially prompted by the fact that he was unhappy with the food restrictions placed on him at the Royal Ottawa related to his choking risk. Dr. Gojer testified that Mr. Jones had also expressed that he was displeased that he had remained detained on the FAU at Royal Ottawa as he had expected that he should have already been transferred to a rehabilitation unit at Royal Ottawa. Mr. Jones understood that on a rehabilitation unit, he might have been eligible to progress to more liberal privileges.
Dr. Gojer was careful in expressing the Royal Ottawa’s position which was that the hospital was neither supportive of, nor opposing, Mr. Jones’ transfer request. However, the doctor’s evidence indicated that given Mr. Jones’ expected trajectory at the Royal Ottawa based on his behavioral presentation to date, it was not anticipated that Mr. Jones would be a candidate for a transfer from the FAU to a rehabilitation unit for several months, if at all. Dr. Gojer testified that while Mr. Jones was detained at Ontario Shores, he had enjoyed considerably more liberal privileges, including staff accompanied community access. Dr. Gojer reiterated that he did not expect Mr. Jones would be eligible for such privileges at the Royal Ottawa in the near future. Accordingly, the doctor anticipated that Mr. Jones’ return to Ontario Shores would potentially provide him with an opportunity to progress up the privilege ladder at a rate faster than was expected to occur at the Royal Ottawa.
While the panel agrees that Mr. Jones had, in the past, achieved more liberal privileges at Ontario Shores than he currently enjoys after three months of being detained on the FAU at the Royal Ottawa, we do not concur that if Mr. Jones is transferred back to Ontario Shores that he would necessarily progress to the same privilege level once again. We are mindful of the fact that when most recently detained at Ontario Shores, Mr. Jones’ level of aggression and violence raised concerns of his treatment team and the hospital administration that he might not be able to be managed in conditions of a secure forensic unit and the hospital was considering whether his transfer to Waypoint might be required to safely manage his risk of harm to others.
The Board is also aware that the record indicates that over his years at Ontario Shores from 2019 to 2024, Mr. Jones engaged in numerous instances of unpredictable and unprovoked physical aggression and violence, verbal abuse, sexual violence (directed at both staff and other patients) as well as incidents of self-harm, necessitating code responses and seclusion on multiple occasions. These problematic behaviors were attributed to his Borderline Intellectual Functioning and not his psychotic illness.
Despite attempts by Behavioral Therapy experts to craft strategies to manage Mr. Jones’ aggressive behaviors, Mr. Jones refused to engage meaningfully with his clinical team at Ontario Shores and these interventions were generally unsuccessful. In fact, as stated above, in the collective opinion of his treatment team, a therapeutic impasse had been reached with Mr. Jones at Ontario Shores by the fall of 2023.
According to the Rule 13 Response received from Ontario Shores, “Thus, given the impulsive nature of this request, the detriment to a quick return to Ontario Shores in his recovery trajectory, the treatment impasse and significant and repeated episodes of violence at Ontario Shores, we respectfully decline the request for transfer to Ontario Shores. Despite intensive behavioral therapy and interprofessional input from various teams across the organization, we were not able to move Mr. Jones forward in his rehabilitation given his unhappiness at this organization and refusal to engage meaningfully in his rehabilitation. He has for years been asking for a transfer to Ottawa and it is noted that he has had a positive initial settling in period. Thus, I am of the opinion that he should continue to remain at the Royal Ottawa Hospital for his rehabilitation and community reintegration in the future. Additionally, he has no family or ties to the Durham region suggesting a need to transfer to this region.”
Further, the panel finds merit in the comments expressed in Ontario Shores’ Rule 13 Response specifically, “…it is not in his best interest to acquiesce to every wish borne out of impulsivity and low frustration tolerance, as this early request to transfer back to Ontario Shores is. It would rather be therapeutic for him to stay at the Royal and learn to work with the team, as he needs to be able to learn to adapt to transitions, as he will when eventually transitions to the community. Allowing him to transfer back to Ontario Shores at the first sign of dissatisfaction will not motivate him to work constructively with providers, and will hamper future community integration.”
In our assessment, these are very early days in Mr. Jones’ detention at the Royal Ottawa. To his credit, he has remained medication compliant since his admission. As well, according to his Behavioural Therapist’s testimony, although Mr. Jones continues to engage in verbal threats of harm directed at staff, the frequency of his assaultive behaviours has in fact decreased as a result of staff’s early intervention and proactive management his care.
Although it is not the only source of conflict, the decision by the Royal to move Mr. Jones to a soft food diet appears to have been the precipitating factor for the onset of his recent acting out and remains a major bone of contention behind his request for a transfer back to Ontario Shores. Based upon the evidence provided by the Hospital, at present it is not clear to the Board that all avenues to modify Mr. Jones’ impulsive behaviour have been explored, much less exhausted. In recognition of Mr. Jones institutionalization, antisocial personality traits and intellectual limitations, the Board fully appreciates that this case presents complex case management challenges.
The Board recognizes that in any custodial milieu, the food a patient is offered or is able to access (in terms of variety, taste and texture, etc.) represents possible opportunities or points of leverage to shape behaviour. Bearing that in mind, the Board is hopeful that a revised behaviour modification plan might be considered by the hospital’s multi-disciplinary treatment team, including the dietician, with a view towards crafting a creative, reinvigorated approach to be trialed that safely manages Mr. Jones’ risk to himself at mealtimes, reduces his oppositional behaviour towards others and enhances his alliance with treatment providers.
At this early juncture, the panel agrees that it is not in Mr. Jones’ long-term best interest and rehabilitation to acquiesce to his transfer request which appears to be driven, to an extent, by his impulsivity and low frustration tolerance. It may be more therapeutic for him to remain for a longer period of time at the Royal Ottawa, engage with his treatment team and learn to better adapt to his new environment.
In our assessment, Mr. Jones’ transfer back to Ontario Shores after such a brief period of detention at the Royal Ottawa is not necessary or appropriate, nor is it likely to be least restrictive or least onerous, given his history at that institution. We are aware from the record that Mr. Jones can be a difficult patient to forge a therapeutic alliance with; however, in our assessment, this is a process that takes time. He has only been at the Royal Ottawa for three months.
To Mr. Jones’ credit, he has engaged with the hospital’s Behavioural Therapist on a weekly basis since his admission to the Royal Ottawa and there appears to be a reduction in his documented incidents of assaultive behaviour.
Dr. Gojer’s evidence is that the hospital is still able to manage Mr. Jones’ challenging presentation and level of aggression and the hospital is not yet recommending that a transfer to Waypoint is necessary at this juncture. The doctor testified that if there is not significant improvement over the next several months then such a transfer may be warranted. It is possible that reinforcing that message with Mr. Jones and allowing him an extended period of time to settle into the relatively new environment of the Royal Ottawa may be of assistance to both Mr. Jones and his current treatment team.
Dr. Coleman, Medical Director, Forensic Program & Director Quality at Ontario Shores. clearly responded in the Rule 13 letter that given their hospital’s extensive history in managing Mr. Jones, the treatment impasse ultimately reached with him, and the significant and repeated episodes of violence that Mr. Jones engaged in at Ontario Shores, the hospital was declining his transfer request. We note that from 2019 to November 2024, Ontario Shores attempted to work collaboratively with Mr. Jones to progress him through the forensic system. Unfortunately, his admission there was characterized by behavioral instability, physical aggression and violence, verbal abuse, and sexually inappropriate behaviours, and by 2023, Mr. Jones refused to engage meaningfully in his rehabilitation. We concur that a lateral move to Ontario Shores is not necessary or appropriate, particularly bearing in mind the paramount goal of public safety.
In reaching our Disposition, the Board has taken into consideration public safety, Mr. Jones’s mental condition and his other needs, and Mr. Jones’s reintegration into society.
DATED this 10^th^ day of March 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
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Office of the Registrar Ontario Review Board