Ontario Review Board
Re: Donald Snoek
ORB File No: 3868
Hearing held on: Monday, February 3, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. P. Capelle Members: Dr. S. Lessard Dr. L. Leong Ms. C. Finley Mr. A. Bouvier
Parties Appearing: Accused: Donald Snoek Counsel: Mr. T.R. McIver
The person in charge of hospital: Representative: Dr. P. Darby Attorney General of Ontario: Counsel: Mr. C. Coughlan
REASONS FOR DISPOSITION
(Dated March 20, 2025)
Introduction
On October 29, 2003, Donald Snoek was found not criminally responsible on account of mental disorder on charges of utter threat to cause death, assault with a weapon, and fail to comply with probation order, contrary to the Criminal Code of Canada. Mr. Snoek is currently subject to a Disposition of the Ontario Review Board (ORB/the Board), dated February 20, 2024, detaining him at the General Forensic Unit of the Centre for Addiction and Mental Health (CAMH/the hospital), with discretionary privileges up to and including the ability to live in the community in approved accommodation.
On February 3, 2025, the Board convened to conduct the annual review of Mr. Snoek’s disposition pursuant to s. 672.81(1) of the Criminal Code, and to determine whether Mr. Snoek continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition. Mr. Snoek was present and represented by his counsel, Mr. Thomas McIver.
At the outset of the proceedings, all parties were canvassed as to their initial positions on the issues to be determined by the Board. Dr. Darby, on behalf of the hospital, submitted that Mr. Snoek remains a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order. Mr. Coughlan, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions. Mr. McIver did not contest that Mr. Snoek remains a significant threat but submitted that the necessary and appropriate disposition is a discharge with conditions.
Findings
- For the reasons that follow, the Board finds that Mr. Snoek continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current detention order with no changes.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated January 20, 2025 (ex. 1), and the viva voce evidence of Dr. Darby, Mr. Snoek’s attending psychiatrist.
The Index Offences
- The details of the index offences are taken from the Hospital Report, as follows:
On June 23, 2003 at approximately 17:45 hrs, 23-year-old Steven Welch and 7-year-old Kieran Welch were walking the trails by Goldie Mill Park in Guelph Ontario. Steven Welch observed the accused at the top of the trail, talking aloud stating: “it’s the faggot’s fault; it’s about the faggots”. Kieran and Steven were approximately eight feet from the accused when he turned towards them, pulled out a knife and began to open the blade. Mr. Snoek then stated: “and I have a knife too and I could kill them and I could kill you too and I will kill you”. Mr. Snoek had the knife in his hand, and he was pointing it towards the victims when he uttered this threat. Following investigation, Mr. Snoek was arrested. When searched he was found to be in possession of a multi-toll device, two utility knives, a hammer and one sharp drill bit, approximately eight inches long.
Background
The Hospital Report contains details about Mr. Snoek’s background and psychiatric history and need not be reviewed beyond the following material details. Mr. Snoek is a 61-year-old man who was born in British Columbia and moved to Ontario in the 1980’s in order to work with his father and brother in a factory in Guelph. In the early 1990s, Mr. Snoek reportedly began having considerable difficulty working due to increasing psychiatric symptomatology. He is presently supported by the Ontario Disability Support Program.
Mr. Snoek has a criminal record for possession of narcotics for the purpose of trafficking, assault with a weapon, assault, possession of a weapon dangerous to the public peace and uttering threats. He has been found in possession of knives in contravention of a probation order.
Psychiatric History
Mr. Snoek’s first psychiatric admission was in 1999. His symptoms included paranoia and guardedness, dismissiveness, belligerence, and physical aggressiveness. He became fixated on having weapons in his possession, due to believing that “homosexual rapists” were trying to attack him. He refused medications. He was deemed incompetent to consent to treatment and his sister became his Substitute Decision Maker. He received a diagnosis of Paranoid Schizophrenia and Polysubstance Abuse Disorder.
Following that admission, Mr. Snoek was hospitalized on approximately 10 occasions pursuant to the Mental Health Act from 1999 to 2000 for relatively brief periods of time at various hospitals in the Guelph area. These admissions were preceded by disruptive behaviour including death threats directed at complete strangers. He was described as grandiose, hypomanic, tangential, rude, lacking in insight, and exercising poor judgment. He regularly showed a lack of insight into his mental illness and the need for medication.
In May 2002, Mr. Snoek expressed feeling that many people were against him, but particularly children, old people and the gay community. He began to verbalize that he “may have to kill a gay individual at the post office”. As on previous occasions, he refused follow-up care in the community and medication.
Shortly after being found NCR, Mr. Snoek exhibited ongoing sexual inappropriateness towards a female co-patient. Further, he struggled to follow hospital rules on interactions between male and female patients. Mr. Snoek often made sexually inappropriate comments to staff. He expressed a belief that various staff and co-patients were homosexual.
Mr. Snoek continued to show limited insight into the need for medication. Between 2006 and 2008, he appealed his findings of incapacity, resulting in long periods when he remained untreated. Following the discontinuation of antipsychotic treatment, evidence of a recurrence of symptoms became evident. Mr. Snoek became more sexually preoccupied.
Mr. Snoek was discharged to the community in July, 2010. Unfortunately, he had a series of readmissions to hospital, following a deterioration in his mental status after using substances, which included marijuana, cocaine and alcohol. Mr. Snoek remained of the opinion that modest use of substances would not have an impact on his mental state.
One incident in May 2018 is of particular concern. Mr. Snoek had a conflict with another tenant in his building. Mr. Snoek believed that the other tenant was making sexual advances towards him. He retaliated by placing some incendiary material against the co-tenant’s door and lighting it. This resulted in a small fire.
Mr. Snoek had a particularly good year in 2023. He was a patient representative on the hospital’s patient and family advisory committee, including being involved in planning of the new forensic building designs. Further, Mr. Snoek obtained employment as a cleaner at two LCBO store locations through Canadian Mental Health Association (CMHA). He also was discharged to reside at LOFT transitional housing, a 24-hour supervised facility.
However, Mr. Snoek continued to experience symptoms of his mental illness. In January 2023, Mr. Snoek told his case worker that he was working on an “underground journalism” project to expose Christians to overlooked points in the Bible. These points included the perspective that “god supports Satan, that “St Nicholas was a child trafficker” and “trafficked children get killed and eaten when they stop providing sex”. In November 2023, Mr. Snoek informed his treatment team that he recalled getting “poisoned” by his parents and that the same “changed my blood flow control.” He added, “My parents tried to kill me with lye powder … when I was 10.” Similarly, in December, 2023, Mr. Snoek stated that his father attempted to poison him when he was 10 years old. He also added that his parents were “sex abusers” who “planned to kill him” because “he had refused to have sex with them.” He was reluctant to consider these thoughts as possibly being an experience of delusions.
Course Since the Last Disposition
Mr. Snoek’s current diagnoses are Schizophrenia and Polysubstance Use Disorder. He has been deemed capable of consenting to treatment.
In February 2024, Mr. Snoek moved to another high support LOFT residence on O’Connor Drive. He has a bachelor apartment and prepares his own meals and cares for his apartment without any assistance from housing staff. All of his urine drug screens have been negative.
Mr. Snoek continues to work twice a week at the LCBO. He hopes to obtain more employment.
In September 2024, Mr. Snoek sent an email informing the patient and family advisory committee that he no longer wished to take part in the meetings. When asked why, he reported that he did not trust CAMH. He felt that CAMH exaggerated danger and stated he did not trust the operation. Mr. Snoek also indicated he believed the police thought CAMH was dishonest in reporting code whites and that the police were going to shut it down.
Dr. Darby testified before the Board. He indicated that he has known Mr. Snoek since 2003 and has been Mr. Snoek’s treating psychiatrist since his discharge to LOFT housing in February 2024. Dr. Darby reported that Mr. Snoek has had a good year. He has remained compliant with treatment and there have been no concerns about substance use. Mr. Snoek appears to be functioning well while residing at the LOFT residence.
Dr. Darby testified that the treatment team gave careful consideration whether to recommend a conditional discharge. Mr. Snoek has a pattern of fluctuating level of insight and commitment to treatment. At times he has been reluctant to engage with treatment and take prescribed medication. While Mr. Snoek has demonstrated more of a commitment recently, this has been in the context of a lot of negotiation, both with the type of medication and the dosage.
Dr. Darby testified that the reasoning behind Mr. Snoek’s decision to stop participating in the committee was of concern. Dr. Darby testified that he was actually a bit surprised when he spoke with Mr. Snoek just before the hearing and heard that these delusions are still fairly strongly held. Mr. Snoek continues to believe that CAMH is being dishonest about Code Whites, though the police do not appear to be investigating the issue. However, Dr. Darby was pleased to report that Mr. Snoek had just agreed to resume his participation on the committee notwithstanding his concerns.
Mr. Snoek’s paranoid and delusional themes underscore the fragility of his mental stability, which has fluctuated. Dr. Darby testified that although Mr. Snoek’s delusions are largely under quite good control, they are always just under the surface. “It is possible that it is a harbinger that there are other things there that may be floating underneath the surface that might also pop back up.” Fortunately, Mr. Snoek has a good relationship with the treatment team and appears to be very open with Dr. Darby about his beliefs and open to discussing them with the doctor.
When asked if Mr. Snoek was optimally treated, Dr. Darby testified that he would like to increase the dosage of Mr. Snoek’s medication but Mr. Snoek is adamant that the 3mg of Risperidone is as much as he will accept.
In Dr. Darby’s opinion, if Mr. Snoek were to experience an increase in his delusions resulting in a further decompensation to his mental status, he would not return to hospital voluntarily upon the treatment team’s request. Mr. Snoek has a history of challenging findings of incapacity on a number of occasions. Given that he is currently capable of making treatment decisions, Box B under the Mental Health Act would not be available to admit him to hospital. Dr. Darby indicated that the provisions of the Mental Health Act would not be adequate to manage Mr. Snoek’s risk while living in the community.
Dr. Darby testified that he did not feel that a detention order was necessary to approve Mr. Snoek’s housing. Mr. Snoek was settled at LOFT and by all appearances was content to remain there. Thus, the basis for the hospital’s recommendation rested on the adequacy of the Mental Health Act.
Dr. Darby pointed to previous incidents when Mr. Snoek experienced a deterioration in his mental status. He has sent threatening email, has been sexually inappropriate, threatening and voiced paranoid delusions. The hospital was able to intervene in a timely manner to prevent a further deterioration and possible violent behaviour similar to the time of the index offence. In Dr. Darby’s opinion, the breach provisions of the Criminal Code also would not be adequate.
In response to questions from Mr. McIvor, Dr. Darby agreed that Mr. Snoek has demonstrated a commitment to abstain from substances. He has been in the community for 15 months and all drug screens have been negative. Dr. Darby indicated that he would want to see Mr. Snoek maintain mental stability for a longer time in the community before recommending a conditional discharge.
All parties maintained their initial positions.
Analysis and Conclusion
- The panel carefully considered the Hospital Report and the evidence of Dr. Darby and unanimously concludes that Mr. Snoek remains a significant threat to the safety of the public. Mr. Snoek’s risk flows from his diagnoses of Schizophrenia and Polysubstance Use Disorder. He has a long history of noncompliance with treatment and experiencing a resulting deterioration in his mental status. As stated in the Hospital Report at p.50:
Absent ORB involvement, it is likely that he will fall away from treatment, re-experience an acute psychotic episode with symptoms of paranoia, evidence aggression and hostility, and engage in violent or threatening behaviours towards individuals that are encapsulated in his delusional beliefs. These would include members of the public that are in his proximity.
Having found that Mr. Snoek continues to represent a significant threat to the safety of the public, the panel must consider the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code, which includes the need to protect the public from dangerous persons, the mental condition of the accused, the integration of the accused into society and the other needs of the accused.
Mr. Snoek is on a positive trajectory. He has successfully transitioned to supportive housing in the community and is working two days a week. He has been abstinent from substances and compliant with medication. This compliance has been under the careful supervision of the treatment team and the staff at the residence with much negotiation. Although the team has recommended a transition to a long-acting version to ensure ongoing compliance, Mr. Snoek has declined. History has shown when Mr. Snoek ceases taking his oral medication, he experiences a very rapid decompensation.
The panel is mindful of Mr. Snoek’s long history of fluctuating levels of insight and engagement with treatment. He continues to voice paranoia and delusions notwithstanding compliance with medication. The panel accepts Dr. Darby’s expert opinion that, should Mr. Snoek’s mental status again deteriorate, the Mental Health Act would not be available to admit him to hospital. History has shown when Mr. Snoek ceases taking his oral medication he experiences a very rapid decompensation. Accordingly, the panel orders that Mr. Snoek continue to be subject to a detention order with the same terms and conditions.
Mr. Snoek has had two good years and by all accounts is on a positive trajectory. The panel wishes him well over the course of the next clinical year. Another twelve months of stability in the community will augur well for Mr. Snoek.
DATED this 20th day of March, 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Finley Legal Member
Office of the Registrar Ontario Review Board