Ontario Review Board
Re: Harold Young
ORB File No: 7213
Hearing held on: Tuesday, January 28, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Section 672.81(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: Harold Young Counsel: Mr. C.P. Dobson
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated March 12, 2025)
Introduction
On September 6, 2017, Harold Young was found not criminally responsible on account of mental disorder on a charge up theft under $5000, contrary to the Criminal Code of Canada (the “Criminal Code”).
Mr. Young is currently subject to a Disposition of the Ontario Review Board dated February 12, 2024, discharging him to reside at a specific address in London, Ontario, subject to a number of conditions, including that he report to the person in charge of the Hospital not less than two times a month, take psychiatric treatment as recommended pursuant to s. 672.55(1) of the Criminal Code, and upon notice, attend before the Ontario Review Board as required.
On January 28, 2025, a panel of the Ontario Review Board (“the ORB” or “the Board”) convened an in-person hearing at the Hospital to review the issue of whether Mr. Young continues to pose a significant threat to the safety of the public and, if so, the necessary and appropriate Disposition to manage his risk and his care.
An order was granted excusing Mr. Young from attending the hearing, given his mobility challenges and illness due to a norovirus outbreak at his residence.
Position of the Parties
- At the outset of the hearing, the parties were canvassed as to their respective without prejudice recommendations to the Board. The Hospital, the Attorney General and Mr. Young were joined in recommending that Mr. Young be granted an absolute discharge.
Index Offences
- The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:
“On Thursday, March 30, 2017, at approximately 11:35 AM, the accused entered the CIBC, located at 370 Clarke Rd, London, Ontario.
The accused proceeded to teller, Jill FARMER who was behind her assigned wicket. The accused handed FARMER a bag along with a white note with instructions written in black ink which advised her to put money in the bag, and was signed "Harold YOUNG". FARMER obtained a quantity of Canadian Currency, approximately $1100. Included in this money was a quantity of “bait money" which the serial numbers of the bills are kept on record at the bank. The accused then exited the bank and headed Northbound across the parking lot.
At 11:40AM, the London Police Service was contacted and numerous officers attended the scene. FARMER provided officers with a description of the accused and the amount of money that was provided to him.
The description provided to Police included:
White male, black trench coat, 6 feet tall, short hair/bald, jeans, running shoes, bad teeth carrying a bag.
London Police Detective Constable Tyler LEPPARD attended the scene to assist with the investigation. Upon seeing the note with the name "Harold YOUNG" D/C LEPPARD recalled that a male matching this name and physical description from previous investigation and provided this over the radio to assisting officers.
At 12:30 PM Detective Constable Ryan HUTCHINSON attended the McDonald’s restaurant located at 1950 Dundas Street, London, where he observed Harold YOUNG sitting in the restaurant. D/C HUTCHINSON recognized YOUNG from previous dealings and also recognized that he matched the exact physical appearance that was described by the victim and other employees of the bank.
At 12:30 PM D/C HUTCHINSON advised the accused that he was under arrest for Robbery and handcuffed him. The accused was provided his Rights to Counsel and cautioned, to which he advised that he understood.
Upon a search of the accused, incident to his arrest, officers located a majority of the stolen Canadian Currency including most of the "bait money “with the matching serial numbers.
D/C HUTCHINSON subsequently transported the accused to London Police Service Headquarters Detention Unit where at 1:04PM the accused was booked into the Detention unit by SGT Andrew GOUGH.
The accused was interviewed by London Police Detective Constable Ryan HUTCHINSON, where the accused subsequently admitted his involvement in this robbery.
The victim was not injured as a result of this robbery.
As a result, the accused is charged with robbery, contrary to section 343(a) of the Criminal Code of Canada.
STOLEN:
$1100 Canadian Currency
RECOVERED:
$1095 Canadian Currency
AS PER ASST CROWN ATTORNEY D ROWS AND CROWN ATTORNEY M POTTER CC 334(B) -THEFT NOT EXCEEDING $5000 TO BE LAID IN THIS OCCURRENCE - NO ROBBERY CHARGES TO BE LAID”
Background
The Hospital Report dated November 28, 2024, provides a great deal of information concerning Mr. Young's personal and mental health history, details of the Index Offences, and his course following his admission to Hospital. Given that the Hospital Report was made an exhibit in this hearing, it is not necessary to reproduce in detail the information contained within it in these Reasons.
Of note, however, is that Mr. Young is now 64 years old. Mr. Young has a lengthy psychiatric history dating back to his early 20s, with multiple admissions to psychiatric facilities. Despite treatment with various medications over the years, Mr. Young remained largely treatment resistant. He also has an extensive criminal history dating back to 1987, including convictions for assault, uttering threats and criminal harassment. Many of Mr. Young's offences were either property-related or reflected his inability to comply with court orders at the time. His homelessness and transient lifestyle affected his ability to follow through with treatment, including treatment with psychiatric medication, and recommended follow-up.
Currently, Mr. Young has a diagnosis of schizoaffective disorder, as well as some cognitive deficits. He receives medication by virtue of the substitute consent of his brother, Norman Young. A cognitive assessment conducted in May 2018 found Mr. Young's full-scale IQ to be within the extremely low range and his general ability index in the borderline range. Mr. Young was also described as having profound difficulties with various facets of memory. These conditions persist to this day.
Evidence at last year's hearing revealed that Mr. Young has lived at Glendale Crossing, a long-term care (LTC) home, since August 2021. He lives in a locked unit. Mr. Young likes living at Glendale Crossing and has developed strong therapeutic relationships with some of the staff.
Over the course of the 2023 to 2024 reporting period, Mr. Young had several notable incidents wherein he demonstrated frustration and suspiciousness of others. In an effort to cope with these incidents, he left Glendale on three different occasions. The staff at LTC handled each of these elopements very well and on each occasion, Mr. Young came back to the unit when asked to do so by staff.
The treatment plan last year involved planning for having Mr. Young’s care transferred to the Parkwood Institute’s Discharge Liaison Team (GDLT) Psychogeriatric Program. The transfer was expected to take place gradually over a number of months. For the transfer of care to occur, it was necessary for Mr. Young to be subject to a conditional discharge. Based on Mr. Young’s compliance with treatment since he entered the forensic system, and the strong likelihood he would return to the Hospital voluntarily and remain for treatment, it was felt that the civil commitment provisions of the Mental Health Act were sufficient to protect the public in the event of a decompensation in Mr. Young’s mental state, a conditional discharge was granted.
Progress since last Annual Review
From the Hospital Report, it is clear that Mr. Young has had another very good year. He continued to reside at Glendale Crossing for the entirety of the reporting period and had no re-admissions to hospital. He continues to have a room on the locked unit of the home. His psychiatric care continues to be provided by Dr. Arun Prakash.
On August 20, 2024, Mr. Young was accepted to the Parkwood Institute’s Geriatric Discharge Liaison Team (GDLT) and began seeing a primary nurse on that team. Should he be granted an absolute discharge, he will be followed by a geriatric psychiatrist, Dr. Lisa Van Bussel. Mr. Young has attended all GDLT meetings and has been co-operative with and accepting of his new team.
Clinically, Mr. Young has not demonstrated any active psychotic symptoms nor did he experience major, sustained fluctuations in his mood. Consistent with his baseline, he did experience periods of mood lability, irritability, and anxiety and at times he demonstrated exit-seeking behaviour. In this regard, strategies were implemented which proved effective in managing this behaviour.
Cognitively, Mr. Young exhibited disorganized thinking; periodically presenting as tangential, circumstantial, and easily distracted. He continued to experience long-standing paranoid thoughts related to fears of violence against him, but these concerns did not appear to be as prominent as they were in previous reporting periods. Occasionally, Mr. Young had difficulty tolerating some of the other residents in the home, tending to perceive their intrusive behaviours as personal attacks rather than recognizing that they were influenced by dementia or other mental health issues. He was particularly impacted when new residents to the home exhibited challenging behaviours and he required a transition period to become familiar with the residents and to accept potential disruption to his established routines. Notably, the treatment team assessed Mr. Young as demonstrating resilience by gradually stabilizing himself as he acclimated to changing dynamics on his floor of the home.
Mr. Young continues to have a tendency to ruminate and have self-deprecating thoughts, particularly in connection with his criminal past. He worries that because of his past, other people might not want his peers to be around him. He worries that if he does not pay his bill at Glendale, people might think that he is free-loading and unwilling to work or help out around the home. However, his ruminations about this issue did not raise any major behavioural difficulties.
This year, Mr. Young has shown greater comfort in expressing his feelings to Glendale Crossing staff. Mr. Young continues to fear he will lose his placement at Glendale Crossing, which leads to feelings of anxiety and stress about his finances and ability to pay his rent there. Here, again, the home proactively and independently addressed these challenges without the support of the Forensic Outreach Team, by reassuring Mr. Young as to his financial situation, reminding him that his finances are managed by the Office of the Public Guardian and Trustee (OPGT) and he did not have to worry about this issue.
On two occasions over the review period, Mr. Young voiced suicidal ideation and low mood. To his credit, he was able to communicate his feelings to LTC staff and did not require readmission to hospital. The LTC home staff developed a response protocol which included increased staff support and the level of monitoring. With these supports in place, Mr. Young was no longer voicing suicidal ideation within about 24 hours. Some of the factors contributing to Mr. Young’s episodes of suicidal and low mood on these occasions were receiving a denture bill of a considerable amount of money, as well as the presence of new residents on the unit who were accessing Mr. Young’s room and rearranging his belongings. These triggers to decompensation reflected his long-standing worries about his finances and vulnerability to disruption in his living environment or his routine.
Overall, Mr. Young continues to be very sensitive interpersonally to perceived slights of others and is stress vulnerable. However, the LTC home staff understand him well and are both proactive, creative, and responsive in addressing Mr. Young’s needs and behaviours.
Consistent with his baseline, Mr. Young exhibited exit-seeking behaviour on four occasions within a four-week period, in which he either attempted to leave the unit or refused to re-enter the building. Again, LTC staff were able to successfully utilize strategies from Mr. Young’s crisis prevention plan, including putting a hold on all off-unit programming and holding his privileges until he was reassessed to persuade him to come back to Glendale, which he did.
There was an incident in July 2024 during a community outing with his brother when Mr. Young declined to return to Glendale. Although his brother attempted to convince Mr. Young to return voluntarily, it became necessary to contact the police for assistance. The police attended shortly after the call and reportedly were very kind and understanding towards Mr. Young. Mr. Young was calm and collected throughout the entire interaction and complied with the officers’ request to return home in his brother's car without incident.
Mr. Young has not shown any physically aggressive actions towards other residents or staff over the review period. As noted above, the LTC home’s behavioural support team has developed a program to assist Mr. Young to cope better with his peers and to decrease exit-seeking behaviours.
Mr. Young’s social skills remain underdeveloped, which makes it challenging for him to engage in reciprocal conversation. This is noticeably more apparent when interacting with new residents or staff but when communicating with individuals with whom he has more therapeutic rapport, he presents as more engaged and talkative. When discussing topics of personal interest to him, such as his family history or significant events, he can become quite engaged and attentive. He has a tendency to think in a very concrete and rigid manner and finds it difficult to engage in discussions when discussing sensitive topics, such as his finances, his mood, or suicidal thoughts. He continues to present with short-term memory impairment.
Mr. Young has continued to be devoted to his job of folding towels and aprons for the laundry department. He displayed meticulous attention to detail and a strong sense of time management; this role was very meaningful to him and played a role in stabilizing his mood and increasing his willingness to participate in leisure activities.
Mr. Young continues to enjoy tasks that involve helping others. He engages in many volunteer activities in an effort to “give back” and to acknowledge all of the hard work that the staff put into running the home. He responds well to staff guidance and encouragement and has established a positive therapeutic relationship with personal support workers and recreation staff. Mr. Young expresses tremendous respect for and appreciation of all the staff at the LTC home has done for him, including the safety and security they provide.
Mr. Young's insight into his index offence, mental health, need for medication and risk for violence is assessed as fair overall. It has been consistent for the last number of years. Mr. Young's insight into his index offence is limited in part because he does not appreciate how his actions might have affected the victims. He understands that he has a schizoaffective disorder and that this sometimes makes him paranoid about things. With respect to medication and treatment, he is able to express that he takes medication for his schizoaffective disorder. Although unable to identify the names of his medications, he understands that he needs them and states that he finds it helpful to address his paranoid thoughts. He also recognizes that taking his medications allows him to remain living at Glendale. He has been able to identify that if he were not to reside at Glendale or at the Hospital, he likely would not have access to his medications which are important to his stability.
Mr. Young's insight into his risk for violence is good. He often presents as worried regarding his risk of violence, fearing that he will hurt others because he has done that in the past. He has developed coping strategies over the years that assist him to behave acceptably towards others. He is able to identify that his risk factors of acting out violently or re-offending include financial distress, threats of violence towards him and perhaps becoming violent out of instinct.
Mr. Young has a number of chronic physical health conditions which are all being treated by medication and monitored by a general practitioner affiliated with the home. Administration of medications are supervised by LTC staff.
Mr. Young remains incapable of managing decisions related to his mental health and his brother Norman Young is his substitute decision maker for treatment. With the support of LTC staff, Mr. Young is adherent to his medication regimen. The cost of his medication is covered by the Ontario Disability Support Program (ODSP). Mr. Young has a number of professional supports in place, including the Forensic Outreach Team, Glendale staff and the Parkwood Geriatric Discharge Liaison Team.
Mr. Young is very family-oriented and caring in nature. He finds contact with his siblings to be very meaningful.
Going forward, it is anticipated that Mr. Young will continue to reside on the locked/secure unit at Glendale which is a permanent placement for him. He will continue to have the support of the LTC home and the Geriatric Discharge Liaison Team.
With the support of Mr. Young’s brother, and the Geriatric Discharge Liaison Team, arrangements are being made for a community treatment order. The geriatric team is aware of the forensic team’s recommendation for an absolute discharge and are in support of this. His brother is supportive of the Hospital’s recommendation as well.
An application to the Office of the Official Guardian and Trustee for a companion to engage in activities and social outings with Mr. Young at the home has been made; it is hoped this will help him better cope with feelings of isolation and anxiety. This remains pending.
Evidence at the Hearing:
The Board had available to it information contained in the documents comprising the record, the Hospital Report, and the oral evidence of Dr. Prakash. Dr. Prakash endorsed the Hospital Report as comprising his evidence and gave a brief overview of Mr. Young’s progress over the review year, including some updates to the Hospital Report.
According to Dr. Prakash, Mr. Young remains quite settled at Glendale and has no intention of leaving. He gets along with the staff there even better than he did with members of the Outreach team. He is also very happy with his new discharge liaison team and has met with Dr. Van Bussel. His mental state remains unchanged from previous years in that he shows periods of instability and depression in response to situational stressors, but these episodes are far more fleeting than in the past, typically resolving in 24 hours or so, as opposed to a week or more.
Glendale has developed a plan to address ongoing periodic fluctuations in Mr. Young’s mood, including 1:1 supervision by staff. If Mr. Young requires hospitalization, he would likely be admitted to Parkwood. There is an elopement protocol in place to manage Mr. Young’s exit-seeking behaviour, and he resides in a locked dementia unit. A community treatment order requiring him to live at Glendale is now in place. He continues to be compliant with treatment and his participation in programming is excellent.
Dr. Prakash noted that Mr. Young’s brother, Norman Young, has stepped into the role Mr. Young’s mother used to play in his life, as SDM, advocate, nurturer and companion. Mr. Young enjoys his brother’s visits, even though he cannot always remember what they did together. He does, however, continue to remember the names of his nieces and nephews.
A physician affiliated with Glendale prescribes Mr. Young’s psychiatric and other medications and will continue to do so in the future. Mr. Young’s current psychotropic medication regimen is optimized and addresses any break-through symptoms that may be expected to occur from time to time.
Dr. Prakash addressed the issue of significant threat and attributed its diminution to the excellent rapport he has developed with the staff at Glendale and members of the discharge liaison team and the resiliency with which he has managed transitioning from the Outreach team. Dr. Prakash expressed confidence that civil commitment provisions of the Mental Health Act, working in conjunction with the terms of the CTO, would be adequate to manage any problematic behaviours arising secondary to decompensation in his mental state. Mr. Young has said he will miss the Outreach team and Dr. Prakash and is appreciative of all that has been done for him over the last number of years.
In response to questions from Mr. Dobson, Dr. Prakash confirmed that the likelihood Mr. Young will actually leave Glendale is negligible, given that he is compliant with his medication and not ruminating on issues of concern the way he once did. Dr. Prakash observed even if Mr. Young were to elope from Glendale, “he always comes back anyway”.
In response to questions from the Board, Dr. Prakash observed that Mr. Young is starting to understand that the patients who come into his room are not targeting him, and that their behaviours might be connected to them being less mentally well than he himself is. Mr. Young is not as invested as he once was in resolving his financial worries by stealing and that he has come to view Glendale as a safe place to be. Mr. Young’s CTO will be reviewed and renewed every six months; Dr. Van Bussel will take care of this aspect of his care going forward.
Analysis and Conclusion:
Having heard and considered all of the evidence and submissions from the parties, this panel of the Board agrees with the joint submission that Mr. Young’s current constellation of symptoms and behaviours no longer poses a significant threat to the safety of the public. However, quite apart from the joint submission, the panel has no difficulty coming to an independent conclusion to the same effect.
In coming to this conclusion, the Board relies on the clinical risk assessment set out at pp 136-137 in the Hospital Report that with the current supports in place, which essentially mimic the support and supervision provided by the forensic Outreach team, Mr. Young has a low risk for future violence towards others in the context of an absolute discharge.
The Board accepts the uncontroverted opinion of Dr. Prakash and the treatment team that Mr. Young no longer meets the threshold of significant threat.
In coming to this decision, the Board carefully considered the decision of the Supreme Court in Winko v. British Columbia. In Winko, the Supreme Court of Canada held that restrictions can only be imposed on an NCR accused’s liberty if the evidence before the Board demonstrates that the accused actually constitutes a significant threat to public safety. Such threat is not to be presumed, and there is no legal or evidentiary onus on the accused to demonstrate that he/she is not a significant risk: see Winko at paragraphs 46 and 54.
Section 672.54 of the Criminal Code does not permit a Review Board to refuse granting an absolute discharge if it has doubts whether the accused poses a significant threat to public safety. Rather, there must be a positive finding of significant risk to support restrictions on an individual’s liberty. Something less, for example, uncertainty, cannot suffice. If a Review Board cannot resolve the question of whether an NCR accused actually constitutes a significant risk of committing a serious criminal offence, the Board must grant an absolute discharge: see R. v. Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 at paragraph 49.
In closely examining the range of evidence identified by the Supreme Court of Canada in Winko, the Board has no difficulty concluding that Mr. Young no longer poses a significant risk of committing a serious offence. His risk is minimal and diminishing. He resides in a locked dementia unit which meets his needs and where he is content. He has appropriate community-based mental health supports in place, chief among which are the Geriatric Discharge Liaison Team and Dr. Van Bussel. On these facts, the Board cannot make a positive finding of significant threat.
For the foregoing reasons, it is the firm, unanimous and considered opinion of the Board that Mr. Young no longer meets the threshold test for significant threat to the safety of the public, as defined in Winko. Therefore, Mr. Young is entitled to an Absolute Discharge. A Disposition will issue accordingly.
The Board wishes Mr. Young well in his future endeavours.
In arriving at our Disposition, the Board has considered the paramount factor of the safety of the public, Mr. Young’s community reintegration, his mental condition, and his other needs, all as required by s. 672.54 of the Criminal Code.
DATED this 12^th^ day of March 2025, at the City of Toronto, in the Region of Toronto.
Ms. T. Mann Alternate Chairperson
__________________
Office of the Registrar Ontario Review Board