Ontario Review Board
Re: Anton Pavelic
ORB File No: 3821
Hearing held on: Monday, January 20, 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: Ms. M. Labrosse
Members: Dr. R. Buckingham Dr. W. Loza Ms. L. Banks Mr. W. Apted
Parties Appearing:
Accused: Anton Pavelic Counsel: Mr. A. Pollard
The person in charge of hospital: Representative: Dr. M. Choptiany
Attorney General of Ontario: Counsel: Mr. C. Ponesse
REASONS FOR DISPOSITION
(Dated March 18, 2025)
Introduction:
On August 7, 2003, Anton Pavelic was found not criminally responsible on account of mental disorder (“NCR”) on charges of mischief - not exceeding $5000, dangerous operation of a motor vehicle, two counts of failure to stop at scene of accident and assault with intent to resist arrest, all contrary to the Criminal Code of Canada (the “Criminal Code”). Since the finding of NCR, Mr. Pavelic has remained subject to Dispositions of the Ontario Review Board (“ORB” or the “Board”), most recently a Disposition dated February 2, 2024, detaining him within the Forensic Service at the Centre for Addiction and Mental Health (“CAMH” or the “hospital”) with privileges up to living in the community of the Greater Toronto Area in accommodation approved by the person in charge of the hospital.
On January 20, 2025, a panel of the ORB convened at CAMH to hold a hearing to review Mr. Pavelic’s current Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Pavelic was present and was represented by counsel, Mr. A. Pollard. Mr. Pavelic was also supported at the hearing by his father.
The issues to be considered at this hearing are whether Mr. Pavelic is a significant threat to public safety as defined in s. 672.5401 of the Criminal Code and, if he is found to be a significant risk to the community, the determination of the necessary and appropriate Disposition in the circumstances bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below, this Board has concluded that Mr. Pavelic continues to pose a significant risk to public safety. It is our view that the necessary and appropriate Disposition in the circumstances is that Mr. Pavelic be discharged subject to a variety of conditions as set forth at the conclusion of these Reasons.
Index Offences:
- The circumstances giving rise to the index offences are extracted from the Hospital Report to the ORB dated January 14, 2025 (the “Hospital Report”), as follows:
“The substance of the charges leading to the NCR finding is that Mr. Pavelic, while operating his motor vehicle stopped at an intersection, got out and smashed the window of a stranger's car in an unprovoked fashion. Mr. Pavelic then entered his car and drove away in an erratic manner. When driving later he lost control of his vehicle and spun around in a city intersection. He subsequently then proceeded through a red light and ignored traffic flow on the Queensway. He subsequently collided with another motor vehicle. Despite this he continued westbound on Queensway. He then struck another vehicle although he was not charged in this regard. Mr. Pavelic eventually stopped and when the police officer arrived, Mr. Pavelic was standing outside of his vehicle. Mr. Pavelic shoved the officer both hands and attempted to leave. A struggle ensued. Mr. Pavelic was arrested thereafter.”
Positions of the Parties:
- At the outset of the hearing, Dr. Choptiany advised of the hospital’s recommendation that Mr. Pavelic should continue to be detained on the same terms and conditions of his existing Detention Order, but for the following two amendments:
the addition of travel passes for up to two weeks outside of Canada, upon first obtaining approval of Mr. Pavelic’s itinerary by the person in charge of the hospital; and
a reduction of his reporting requirement in paragraph 4(d) of his Disposition to not less than once per month.
Counsel for the Attorney General supported the hospital’s recommendations.
Mr. Pollard indicated that he would not be challenging the issue of significant threat. He advised that his client was requesting a Conditional Discharge Disposition on terms substantially similar to the hospital’s proposed Detention Order.
All parties maintained their respective positions in closing submissions.
Personal Background:
Mr. Pavelic’s background and personal history are set out in detail in the Hospital Report and need not be repeated here. Briefly summarized, he is a 53-year-old man who was born in Toronto. He completed high school and attended Sheridan College for a three-year diploma program in business administration marketing and subsequently he completed a six-month computer diploma at CDI College. Mr. Pavelic had a number of short-term positions in his early 20s, but since 1994, he has been unable to maintain longer-term employment.
Mr. Pavelic began using alcohol at age 13 or 14 but does not appear to have ever met the criteria for alcohol or substance abuse or dependence. Substance use does not appear to have been an issue in terms of his previous criminal offences.
Mr. Pavelic never married and has no children.
Criminal History:
- Mr. Pavelic was convicted with break and enter at the age of 14, and in 1999, he was charged with dangerous operation of a motor vehicle. In 2002, he was charged with sexual assault which allegedly occurred while he was in a psychiatric unit of a general hospital. Those charges were stayed.
Psychiatric History:
Mr. Pavelic’s psychiatric history indicates he first saw a psychiatrist in 1993 with concerns about attention deficit disorder. According to the Hospital Report, he was treated with a stimulant at that time and Mr. Pavelic has since developed the belief that treatment with the stimulant was solely and completely responsible for his later psychological and social difficulties.
Since 1995, he has had multiple admissions to hospitals for which he has been treated with both oral and injectable antipsychotic medications. He does not believe that he has ever obtained any benefit from these medications.
Mr. Pavelic was initially discharged to the community in 2004; however, there were early re-admissions to the hospital in 2004, 2006, and 2008.
Mr. Pavelic has had several further discharges to the community which have ended in readmission to hospital due to psychotic decompensation. He was previously subject to a Conditional Discharge; however, he required readmission to hospital due to psychotic decompensation from February 14 to April 19, 2014. Mr. Pavelic returned to live in the community in January 2015 under a Detention Order.
Mr. Pavelic has remained in the community under a Detention Order until September 19, 2019, at which time he was again conditionally discharged. Mr. Pavelic was readmitted to hospital from May 12 to June 24, 2020, March 30 – June 30, 2021, and again from September 8, 2021 – February 10, 2022, due to deteriorations in his mental state. He has remained in the community since February 2022.
Current Diagnosis:
- Mr. Pavelic’s current diagnosis is Schizophrenia, residual type.
Evidence at the Hearing:
The evidence at this hearing consisted of the Hospital Report together with the oral testimony of Dr. M. Choptiany, who has been Mr. Pavelic’s attending forensic psychiatrist since 2015. He advised that there were no significant updates.
Dr. Choptiany testified that Mr. Pavelic continues to reside independently in the community in his own condominium in Toronto. His housing is unsupervised and there is no support on site. Over the past reporting year, there have been no concerns with his housing and his unit has been well maintained. This has been the case for many years. Mr. Pavelic continues to be financially supported by ODSP.
Mr. Pavelic is supported in the community by the hospital’s Forensic Outpatient Service (“FOS”) team and he meets with his FOS transitional caseworker, Ms. Di Bernardo (who was in attendance at the hearing) either virtually or in person, every two weeks. He follows up with Dr. Choptiany on a monthly basis. Over the past reporting year, he has been compliant with all scheduled appointments and there has been no need for any hospital readmissions.
Mr. Pavelic continues to be assessed as incapable of consenting to psychiatric treatment and the Public Guardian and Trustee acts as his Substitute Decision Maker (“SDM”). Under the SDM’s consent, Mr. Pavelic continues to be treated with a long-acting injection (“LAI”) of the antipsychotic medication, zuclopenthixol, which is administered every two weeks. Dr. Choptiany stated that there have been no dosing changes to this medication over the year in review and that Mr. Pavelic’s illness has responded well to this treatment.
The Hospital Report indicates that, “Mr. Pavelic’s mental status remained stable throughout the year. There were no positive symptoms of psychosis including no hallucinations, delusions, or grossly disorganized or catatonic behaviour. There were no episodes of aggression. His mood was stable. He had no suicidal, violent, or homicidal ideation.”
As has been the case for many years, Mr. Pavelic continues to express a fragile level of insight with regard to the importance of his antipsychotic medication. He acknowledges that he suffers from Schizophrenia but he cannot identify the symptoms or early warning signs of his illness. While he has remained compliant with his LAI, he does not believe that it offers him any benefit. Mr. Pavelic does not understand that he would be at risk of relapsing to psychosis if he were to stop his medication. Dr. Choptiany also advised that Mr. Pavelic does not have any real appreciation for his risk of violence when he is unwell nor does he appreciate the need for hospitalization when experiencing mental state instability.
The doctor reminded the panel that Mr. Pavelic has a relatively recent history of recurrent decompensations accompanied by severe verbal aggression which, at times, has required management with seclusion and restraints in the context of sub-optimal medication, or non-adherence with medication, or breakthrough symptoms.
Mr. Pavelic lacks structured daily activities in the community. He typically socializes with friends and family, goes for walks, meets friends from his building for coffee, and watches television or listens to the radio. Though he has considered engaging in employment, he has not taken any steps to pursue this goal and he has declined vocational support including transitional employment services.
Mr. Pavelic’s father remains his primary source of social support. He also maintains contact with his sister.
Despite the fact that his Disposition does not contain a prohibition on substance use, Mr. Pavelic has not engaged in alcohol or substance use over the year in review.
According to the clinical assessment of risk contained in the Hospital Report, Mr. Pavelic’s key risk factors include:
“Major Mental Illness - Mr. Pavelic has a longstanding history of schizophrenia. Even when compliant with antipsychotic medication his mental state can quickly deteriorate leading him to have catatonic and disorganized behaviour, including significant aggression requiring hospitalization and restraint;
Lack of Insight - Despite years of successive re-hospitalizations following decompensation due to medication non-compliance, Mr. Pavelic continues to have little insight into his psychotic illness or need for medication. He continues to believe that he would not be at risk for a decompensation in his mental state were he to stop antipsychotic medication. When discussing the index offence and his risk of re-offending in the future, he does not have insight into the link between his symptoms of schizophrenia and his risk for violence. When acutely unwell, Mr. Pavelic’s already limited insight decreases further, and he has in the past made requests to decrease or stop his antipsychotic medication;
Treatment and Supervision Response - Mr. Pavelic has had a positive year in terms of his willingness to attend appointments with his psychiatric team and receive his medication. However, this has been an area of significant concern in the past and he has a long history of not presenting to the hospital voluntarily when advised to do so by his doctors. In the past, he has required police to bring him to the hospital on numerous occasions. He also has a long history of medication non-compliance.”
Dr. Choptiany concurred with findings of the Risk Assessment indicating that: “Overall, taking into account of Mr. Pavelic’s PCL-R score, his VRAG score, HCR-20 items and protective factors in addition to his history it can be concluded that Mr. Pavelic is in a low-moderate risk category for violent recidivism under the current detention order.”
Dr. Choptiany was asked several questions by panel members about why the hospital was advocating for a continuation of a Detention Order Disposition. The doctor stated that although Mr. Pavelic had been managed under a Conditional Discharge Disposition in the past, in his opinion (and that of the treatment team), the necessary and appropriate Disposition at the present time was a Detention Order. Dr. Choptiany stated that only this Disposition provides the hospital with the ability to expeditiously readmit Mr. Pavelic at an early juncture should he suffer any decompensation in the community. If Mr. Pavelic were subject to a Conditional Discharge Disposition, Dr. Choptiany expressed his view that under the Mental Health Act (“MHA”), the treatment team may not be able to react as quickly. According to the doctor, Mr. Pavelic’s illness is such that he requires quick intervention to address any emerging signs of decompensation, and a Detention Order ensures a more effective response by his treatment team. The doctor stated that Mr. Pavelic would not be likely to agree to a voluntary readmission to hospital if he were already in a decompensated state.
Dr. Choptiany acknowledged that Mr. Pavelic’s community housing has already been approved by the treatment team and is regarded as stable. While a Detention Order is often regarded as a preferred Disposition when a patient’s choice of housing requires hospital oversight, that is not the case in Mr. Pavelic’s situation.
Dr. Choptiany commented that Mr. Pavelic was in the community under a Detention Order until September 19, 2019, at which time he was conditionally discharged. His first hospital readmission occurred on May 8, 2020 when Mr. Pavelic failed to attend for his schedule injection of antipsychotic medication. He received his injection in hospital on May 9, 2020 and was discharged back to his home from the ER on May 10, 2020. Dr. Choptiany advised that Mr. Pavelic was discharged to his community home prior to his FOP team having conducted an assessment of his suitability for discharge.
His second readmission occurred just a few days later on May 12, 2020, due to his mental status decompensation. Mr. Pavelic was admitted to hospital under the MHA. He remained in hospital until he was re-stabilized and discharged on June 24, 2020.
Mr. Pavelic remained in the community until March 30, 2021. He was readmitted to the hospital under Box B criteria of the MHA, after Mr. Pavelic’s caseworker had attempted to obtain a Form 2 earlier the same day but it was declined. Dr. Choptiany stated that Mr. Pavelic’s readmission was facilitated by the fortuitous presence of the police at precisely the time that Mr. Pavelic suffered an acute decompensation. Mr. Pavelic remained in hospital until June 30, 2021.
Mr. Pavelic was again readmitted to the hospital after presenting with signs of decompensation, on September 8/9, 2021 pursuant to a Form 1, Box B MHA. He was restabilized and, by September 23, 2021, Mr. Pavelic agreed to remain in hospital as a voluntary patient. He was not discharged until February 10, 2022 but he has remained in the community with no further readmissions since that time.
Dr. Choptiany testified that historically Mr. Pavelic is prone to fairly rapid decompensations, typically within weeks to months. Dr. Choptiany stated in his more recent hospital readmittances, Mr. Pavelic experienced unpredictable mental status decompensations even in the context of medication compliance. Despite this, the doctor commented that Mr. Pavelic has had another successful year in the community and has been able to sustain stability in his mental status for approximately three years without requiring a hospital readmission.
Dr. Choptiany stated that the request for the addition of a travel privilege came from Mr. Pavelic as he wished to accompany his father on trips, subject to approval of his itinerary by the hospital. Dr. Choptiany stated that this proposed privilege was reasonable provided that the trip not extend beyond two weeks in duration so that Mr. Pavelic could receive his scheduled LAI medication.
With regard to the reduced reporting being recommended by the hospital, the doctor reported that the clinical team was in favour of relaxing Mr. Pavelic’s reporting requirements in the context of his sustained stability. According to the doctor, the reduction in the frequency of his reporting will be initiated on a graduated basis.
In summary, Dr. Choptiany stated that the treatment team is of the opinion that a further year of sustained stability, in the context of reduced reporting, is warranted, before the treatment team would recommend a Conditional Discharge for Mr. Pavelic.
No further evidence was introduced.
Analysis and Conclusion:
Having heard and considered all of the evidence and the submissions from all the parties, the Board had no difficulty in finding Mr. Pavelic continues to represent a significant threat to the safety of the public. All parties have conceded this point and this was not in issue at this hearing. We agree with the joint position of the parties in this regard and find there is a foreseeable and substantial threat that Mr. Pavelic would commit a serious criminal offence if discharged absolutely at this time.
Mr. Pavelic suffers from Schizophrenia. When unwell, he suffers from delusions and hallucinations, primarily of a paranoid and persecutory nature. His symptoms have driven his behaviours, prompting him to perceive a need to defend himself, leading to aggressive behaviours towards others. When he is unwell, he presents a risk of violence towards any member of the public in his proximity. We also note that Mr. Pavelic has demonstrated previous stalking and sexually assaultive behaviours, which would place females in the community at additional risk of harm.
We are also mindful that Mr. Pavelic has a significant history of noncompliance with psychiatric follow-up and prescribed medications, and he lacks insight into the fact that he suffers from a major mental illness and needs treatment with antipsychotic medication in perpetuity. Dr. Choptiany stated that Mr. Pavelic, as recently as the week preceding the hearing, again reiterated that he does not suffer from a mental illness and he would be fine in the absence of his prescribed medication.
The treatment team is of the opinion that absent an ORB Disposition, Mr. Pavelic poses a high probability of discontinuing his psychiatric medications with the resultant probability of florid psychosis and violent re-offence. For all of these reasons, we find that Mr. Pavelic continues to satisfy the threshold test of posing a significant threat to public safety.
Having determined the issue of significant threat, we must arrive at the necessary and appropriate, as well as least restrictive and least onerous Disposition for Mr. Pavelic, bearing in mind the paramount goal of public safety.
The evidence before the Board indicates that Mr. Pavelic’s risk management is reliant, to some extent, on the external oversight and professional care from the FOS team and, in particular, the consistent support, supervision, and monitoring he receives from his case manager, Ms. Di Bernardo, and his psychiatrist, Dr. Choptiany. These supports will continue to be available whether he is under a Detention Order or a Conditional Discharge. As well, we note the many protective factors identified in the Hospital Report (pages 30 and 31) that also serve to attenuate his risk.
We agree that from the hospital’s perspective a Detention Order Disposition confers upon the hospital the authority of a Warrant of Committal which allows for Mr. Pavelic to be readmitted and maintained in the hospital without him having to satisfy MHA criteria for an involuntary readmission. However, we believe that at this juncture, Mr. Pavelic’s risk to public safety can be managed under a less restrictive Conditional Discharge Disposition.
Mr. Pavelic has had yet another successful year in review. He has remained medication compliant and his mental status has been stable. He has not engaged in any incidents of aggressive or problematic behaviour. He has engaged appropriately with his treatment team and has maintained stable housing. He has abided by the terms of his Disposition. In fact, he has been successful in the community and stable over the past near-three years, since February 2022. We note that Mr. Pavelic has achieved this while living independently with no staff supports on-site.
It is clear that his current residence has been a stable environment for him and there was no evidence adduced to. Indicate that Mr. Pavelic is planning to leave and relocate to unsuitable housing. The authority of a Detention Order for the sole purpose of allowing the hospital oversight with regard to Mr. Pavelic’s community placement does not appear necessary or warranted or even pertinent in this case at this time.
The panel also heard evidence that a Detention Order remains necessary and appropriate as it will ensure Mr. Pavelic’s prompt re-hospitalization in the event he suffers a decompensation in his mental state. We also heard that Mr. Pavelic is prone to fairly rapid decompensations and that he lacks insight to recognize emerging symptoms and, during those times, he does not appreciate the need for hospitalization and that he would be unlikely to cooperate in a voluntary admission.
The doctor’s evidence indicated that the MHA is a less viable mechanism to effect Mr. Pavelic’s prompt re-admission to hospital as it would require that he satisfy criteria for an involuntary readmission should Mr. Pavelic not consent to a voluntary readmission. Further, in order for Mr. Pavelic to be maintained in the hospital for a lengthier admission, he would have to continue to satisfy MHA criteria or agree to a voluntary admission. The doctor’s evidence also indicated that the MHA has not been sufficient to manage Mr. Pavelic’s risk in the past.
At the present time, however, the evidence indicates that Mr. Pavelic’s medications are optimized and, despite his underdeveloped insight as to the importance of his treatment in maintaining his mental health, he has been fully compliant over his past three years while living independently in the community. Further, he has not suffered any notable decompensations requiring readmission for almost the past three years.
The panel also notes that in all of the hospital readmissions effected from May 8, 2020 to February 2022 (referred to above in paragraphs 34-37 above), the MHA was, in fact, relied upon with success to effect same. Some of these admissions were lengthy and, in at least two instances, Mr. Pavelic was cooperative to remain in hospital as a voluntary patient, once he was psychiatrically stable.
We also note that because Mr. Pavelic remains incapable to consent to his psychiatric treatment, the Box B criteria under the MHA could be relied upon to assist with his prompt involuntary readmission should that he be required. These criteria were utilized in the past and can be used in the future to involuntarily hospitalize him if Mr. Pavelic misses his scheduled injectable medication and is at risk of substantial mental deterioration.
In our assessment, we find that the least restrictive and least onerous Disposition that can effectively manage Mr. Pavelic’s risk to public safety is a Conditional Discharge Disposition. In fact, despite the years of instability Mr. Pavelic experienced from 2019 to the early part of 2022, reliance on the MHA was sufficient to manage his risk to the public.
Accordingly, the Board orders Mr. Pavelic be discharged on the following conditions:
he submit samples of his/her urine and/or breath to the person in charge of the hospital for the purpose of analyzing whether he has ingested alcohol, drugs or any other intoxicant;
he refrain from having in his possession any firearm, ammunition or other offensive weapons, or being in the company of any person possessing a firearm other than a peace officer;
he refrain from contact or communication, direct or indirect, with Amber Graydon and not to attend any location where she is known to be other than CAMH, Toronto;
he advise the person in charge of the hospital, or his/her designate, in advance, of any absence from his residence of 24 hours or more;
he notify, in writing, the person in charge of the hospital, or his/her designate and the ORB 24 hours in advance of any change of existing address or telephone number; and
he not engage in domestic or international travel unless he has first obtained approval of his itinerary by the person in charge of the hospital and provided further that such travel not extend longer than two weeks.
- In making our decision the Board has carefully considered the need to protect the public from dangerous persons, the mental condition of Mr. Pavelic, his reintegration into society and his other needs.
DATED this 18^th^ day of March, 2025 at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar Ontario Review Board