Ontario Review Board
Re: Richard Prefontaine
ORB File No: 1537
Hearing held on: Wednesday, January 15, 2025
Place of hearing: North Bay Regional Health Centre – North Bay Site
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks via Zoom Members: Dr. J. Watts Dr. P.N. Wright Mr. P. Capelle Mr. J. Cyr
Parties Appearing:
Accused: Richard Prefontaine Counsel: Mr. C. Bracken
The Person in charge of Hospital: Representative: Mr. R. Holden Counsel: Mr. P. Trenker
Attorney General of Ontario: Counsel: Ms. P. Lambert-Belanger
REASONS FOR DISPOSITION
(Dated March 19, 2025)
Introduction
On December 14, 1992, Richard Prefontaine was found not criminally responsible on account of mental disorder (“NCR”) on a charge of second-degree murder, contrary to the Criminal Code of Canada (“Criminal Code”).
On Wednesday, January 15, 2025, a panel of the Ontario Review Board (“the ORB” or “the Board”) convened a hearing at the North Bay Regional Health Centre (“NBRHC”) pursuant to s. 672.81(1) of the Criminal Code of Canada. The annual review for Richard Prefontaine was held in person. Mr. Prefontaine was in attendance and was represented by his counsel, Mr. Chad Bracken.
Without Prejudice Position of the Parties
Mr. Trenker, on behalf of the Hospital, indicated no change was being recommended to Mr. Prefontaine’s existing Conditional Discharge Disposition. Both Mr. Lambert-Belanger and Mr. Bracken joined in the Hospital’s position and the hearing, therefore, proceeded by way of a joint position. Further, Mr. Bracken conceded the ongoing presence of significant threat.
Index Offences
The circumstances of the index offences are set out in last year’s Reasons for Disposition as follows:
“On January 7th, 1992, Mr. Prefontaine was a resident at a rooming house in Sudbury. The building was occupied mostly by disabled persons who are receiving government assistance. The victim, Mr. William Mulvaney, 72-years old, was also a tenant at this address.
Sometime in the late evening of January 7th, 1992, residents were aware that Mr. Prefontaine became agitated, pushing and slamming doors, and yelling and running in and out of the building. He was at one point heard yelling at the victim, “Don’t threaten me with that cane again, I’m going to split your guts wide open” and then yelling loudly, “I’ll split your guts wide open old man”. The victim, who was unable to walk, was heard to be making sounds followed by a loud crash and a thumping noise. Shortly thereafter Mr. Prefontaine visited another residence nearby where he presented himself in a hysterical state saying that his friend was dead and had fallen out of bed. The occupant of the nextdoor residence ran to the Montague Street Rooming House with the accused and the victim, Mr. Mulvaney, was found lying on the floor with a pool of blood around his head. A cane at the lower end of the bed was found, broken in two. The victim subsequently died of the injuries received. Mr. Prefontaine was taken to the police station where he confessed to the assault.”
Current Diagnoses
- Schizoaffective Disorder, Bipolar Type;
- Substance Use Disorder (Alcohol), Sustained Full Remission in a Controlled Environment;
- Neuroleptic-Induced Tardive Dyskinesia;
- Moderate Intellectual Disability.
Evidence at Hearing
Dr. Le testified on behalf of the Hospital. On the date of this hearing, she had been Mr. Prefontaine’s treating psychiatrist for just nine days subsequent to the resignation of his previously assigned psychiatrist.
The main objective for the 2025-2026 reporting year is to identify and secure appropriate supervised accommodation for Mr. Prefontaine. The plan is to transition him into the community as soon as a bed becomes available. Unfortunately, the timing of this is unknown. Responding to questions from Mr. Bracken, Dr. Le confirmed that her patient remains on a wait list for specialized DD TRHP housing in North Bay, as he was at the time of last year’s hearing. The doctor added that the residence only has two to three rooms and that turnover is infrequent. As a result, other options are being explored around the province by one of the hospital’s complex case managers. Regrettably, there are currently no other options. Dr. Le and the treatment team are aware that Mr. Prefontaine is willing to relocate anywhere in Ontario and these options continue to be explored. Mr. Prefontaine would very much like to have more freedom and his own space.
Mr. Prefontaine generally gets along well with people. There have been no serious outbursts or incidents of violence over the course of this reporting year. He does well with medication compliance and with re-direction.
Responding to a question from a panel member, Dr. Le confirmed that her patient is still receiving sex drive reducing medications which remain effective. During the past reporting year, he was noted to have made one inappropriate sexual comment but there were no overtly sexually inappropriate acts.
Closing Observations
No changes to the parties’ initial positions were brought forward. Mr. Bracken emphasized that his client is anxious to move into the community, to his own residence, as soon as possible.
Analysis and Decision
(a) Significant Threat
Ongoing significant threat to the safety of the public cannot be speculative. It must entail a real risk of serious physical or psychological harm arising from conduct that is both serious and criminal in nature.
In determining whether Mr. Prefontaine continues to represent a significant threat to the safety of the public, the Board has carefully analyzed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
The Board unanimously finds that Mr. Prefontaine continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Le that Mr. Prefontaine continues to pose a significant threat. The Board also relies on the Hospital Report and psychologist Dr. M. Lariviere’s November 15th 2024 Risk Assessment contained therein in determining that Mr. Prefontaine suffers from Schizoaffective Disorder, Bipolar Type, a major mental illness, that in the past has been complicated by an Alcohol Use Disorder and continues to be impacted by both Neuroleptic-Induced Tardive Dyskinesia as well as Moderate Intellectual Disability. Factors enhancing his risk, set out at page 111 of the Hospital Report, are reproduced below:
Mr. Prefontaine suffers from a serious and persistent mental disorder, namely Schizoaffective Disorder, Bipolar Type. When he is not well, he has auditory and visual hallucinations, disordered thinking, aggressive and explosive behaviour, and sometimes hypomania. He is currently well treated and stable.
Mr. Prefontaine is cognitively impaired because of a developmental disability. IQ testing indicates Moderate Intellectual Disability, a condition that is characterized by impairment of adaptive functioning. Individuals with this condition may be predisposed to use disruptive and aggressive behaviour as substitutes for adequate coping with common life demands and expectations of personal independence.
Mr. Prefontaine has a history of numerous hospital admissions for violent and aggressive behaviour, as well as for noncompliance with medication. With adequate supervision and treatment in a well structured environment he does not manifest this behaviour.
Mr. Prefontaine has only a rudimentary understanding of his mental illness and the need for medication on an ongoing basis.
Mr. Prefontaine has a history of abuse of both alcohol and illicit substances, which contributed to his aggressive and violent behaviour prior to the index offence.
Due to his poor impulse control, low tolerance for frustration, and daily need for emotional support, Mr. Prefontaine requires a structured environment in order to manage his risk of re-offending. The risk that Mr. Prefontaine poses to the safety of the public requires that he be managed in a highly structured, supportive environment. The index offence occurred while Mr. Prefontaine was residing in a room-and-board accommodation in Sudbury. His case manager at the time advised that Mr. Prefontaine had insisted on moving from the group home shortly before the index offence. He clearly does not have the capacity to live independently in the community, so the decision to allow him to do so was obviously a contributory factor in the index offence.
Mr. Prefontaine has a history of inappropriate sexual conduct. He receives medication to decrease his sex drive.
Mr. Prefontaine has a history of reacting in an intimidating and explosive manner when agitated, requiring intervention by staff members trained and experienced in managing and responding to this kind of behaviour.
The protective factors identified include medication compliance in a supervised setting, the absence of a criminal record, abstinence from substances within a controlled setting as well as receptiveness to any future community monitoring and supervision. Nonetheless, these factors cannot overcome the litany of factors enhancing his risk as enumerated above.
Given the foregoing in tandem with this panel’s independent analysis, the Board accepts that absent an ORB Disposition, Mr. Prefontaine would likely become non-compliant with prescribed medications which would lead to decompensation, use of substances and the re-emergence of behaviours similar to those seen at the time of the index offences. We are satisfied that absent an ORB Disposition, it is likely that Mr. Prefontaine will again cause serious physical or psychological harm to members of the public and such conduct will likely be criminal in nature.
(b) Disposition
Flowing from the Board’s finding that Mr. Prefontaine continues to pose a significant threat to the safety of the public, it must shape a Disposition for the year ahead. Its paramount consideration in doing so must be the safety of the public while also considering Mr. Prefontaine’s needs pursuant to s. 672.54 of the Criminal Code.
The necessary and appropriate Disposition for Mr. Prefontaine provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.
In considering Mr. Prefontaine needs, the Board was attentive to the understandable level of frustration he is experiencing as he awaits a suitable community placement. To his credit, he nevertheless continues to demonstrate a level of mental stability sufficient to reside in the community if and when an appropriate placement opportunity arises. Dr. Le testified that Mr. Prefontaine’s prospects to be placed in appropriate housing in the North Bay area is limited to but one low-capacity specialized DD TRHP residence with infrequent turnover. A complex case manager is pursuing other options that may be available for him in other parts of the province and Mr. Prefontaine is receptive to relocating so as to access the appropriate housing that he desires. The Board is hopeful that a placement with suitable supports will be identified in the year ahead so that Mr. Prefontaine will be residing in the community at the time of his next Ontario Review Board hearing.
Conclusion
Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Prefontaine poses to the safety of the public while still meeting his needs is a renewal of his current Conditional Discharge Disposition.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Le and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Prefontaine’s mental condition, his reintegration into society and other needs.
DATED this 19th day of March 2025, at the City of Toronto, in the Toronto Region.
Philippe Capelle Legal Member
Office of the Registrar Ontario Review Board