Re: Joey Wilkins
ORB File No: 7792
Hearing held on: Tuesday, January 21, 2025
Place of hearing: Thunder Bay Regional Health Sciences Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. Joel Goldenberg
Members: Hon. E. Kruzick Dr. G. Eayrs Dr. M. Green Mr. A. Mete
Parties Appearing:
Accused: Joey Wilkins Counsel: Mr. G. Iwasiw
The Person in charge of Hospital: Representative: Ms. M. Davidson
Attorney General of Ontario: Counsel: Mr. S. Down
REASONS FOR DISPOSITION
(Dated March 21, 2025)
Introduction
On October 22 2020, Mr. Joey Wilkins was found not criminally responsible on account of mental disorder (NCR) on charges of mischief, killing or injuring animals, cruelty to animals, and break an enter, contrary to the Criminal Code of Canada (Criminal Code). Mr. Wilkins is currently subject to a disposition of the Ontario Review Board (ORB or Board) dated February 1 2024, detaining him at the Secure Forensic Unit of the Thunder Bay Regional Health Science Centre, Thunder Bay (TBRHSC or hospital) with privileges up to and including living in the community in the accommodation approved by the person in charge. As a result, the Mr. Wilkins is currently under the jurisdiction of the ORB.
On January 20, 2025 a panel of the ORB convened at the TBRHSC to review the current disposition. The hearing was held in person. Mr. Wilkins appeared by video telecommunication from Red Lake, his counsel, Mr. Iwasiw, as well counsel for the Attorney General, Mr. S. Down, appeared by video telecommunication from Kenora, Ontario.
Initial Positions
At the outset of the hearing the parties were canvassed by the Alt. Chair as to their initial positions. Ms. Davidson, on behalf of the hospital, indicated that Mr. Wilkins continues to represent a significant threat to the safety of the public and that the hospital seeks a Conditional Discharge with the terms and conditions set out in the Hospital Report. Mr. Down anticipated joining the hospital however expressed that he wanted to hear the evidence. On behalf of this client, Mr. Iwasiw agreed with the position of the Hospital.
The Alt. Chair enquired about a letter from the hospital to the ORB dated June 7, 2024 reporting Mr. Wilkins’ admission to hospital on the May 14, 2024. The hospital asked the ORB whether a restriction of liberties (ROL) hearing, pursuant to s. 672.56(2) of the Criminal Code, was necessary. It was unanimously agreed that Mr. Wilkins’ admission to hospital was on a voluntary basis which included overnight stays however the admission did not constitute a restriction of liberties to warrant a hearing.
Issues at the Hearing
- The issues to be dealt with by the Board on this hearing were a review of Mr. Wilkins disposition in accordance with s. 672.81(1) of the Criminal Code to determine if Mr. Wilkins poses a significant threat to the safety of the public, and if so, what is the necessary an appropriate disposition in the circumstances.
Findings
For reasons that follow, the panel found that the threshold for significant threat to the safety of the public is met and that the necessary and appropriate disposition is a discharge on the conditions set out in Hospital Report.
The allegations giving rise to the index offences are well summarized in last year’s Reasons. On September 22, 2019, Mr. Wilkins was charged with mischief after he smashed the back window of his brother’s car with a paddle and threw various items around the garage, porch, and yard of his family home. This was the first index offence. Mr. Wilkins’ father reported to police at the time that his son was refusing to take his medication, and that he believed his son’s behaviour was the result of his poor mental health.
Following the charge in September 2019, Mr. Wilkins was not permitted to return to his family home. He lived at the Shelter House until November 2019, when his parents allowed him to move back in with them. Mr. Wilkins was not taking medication and continued to present with symptoms of psychosis and unusual behaviour. On at least one occasion (on November 17, 2019), his parents expressed concerns for their safety and contacted the police for assistance. When seen at the emergency department at the Red Lake hospital Mr. Wilkins was offered antipsychotic medication and a psychiatry referral, but he declined.
In early December 2019, Mr. Wilkins was admitted to the LWDH after police found him walking along a highway of about 30 km from his home. He had been attempting to camp in -20-degree weather. He reported that he had stopped taking his antipsychotic medication after one week as he felt better off medication. In hospital, he was treated with a low dose of antipsychotic medication. On discharge on December 23, 2019, the diagnosis was psychosis NOS and cannabis abuse disorder.
On February 5, 2020, Mr. Wilkins was arrested and charged after a motorist, Gabriel Jette, flagged down police and advised that his rabbits and chickens had been killed at his home in Balmertown. He also said he had just removed one of his dead chickens from the mouth of a dog who was walking on the road with a male, later identified as Mr. Wilkins. When police attended at Mr. Jette’s residence, they found 12 dead rabbits and 7 dead chickens in a tote bin. On arrest, Mr. Wilkins admitted to killing the animals with his bare hands, an ice pick, and a scythe. When police asked why he had done this, he responded, “I felt like I had to.” These were the second set of index offences
Background
Mr. Wilkins is currently 28 years of age. He is an Indigenous male born in Red Lake. He is the third in a sibling line of four raised by his parents. It is reported there was a change in his behaviour when he started high school, at which time he became less social. He was at that time using marijuana frequently. He eventually stopped attending school and withdrew in grade 11 at age 20.
In March 2019, Wilkins entered, uninvited, into one of his childhood homes. He was arrested and brought to hospital in Red Lake. His parents reported that there had been a three-to-six-month deterioration in his mental state, behaviour, and functioning including paranoia, grandiose delusions, auditory hallucinations, and impulsivity. Mr. Wilkins acknowledged the use of drugs. After being discharge to his parents’ home, three weeks later, Mr. Wilkins was brought to emergency after pushing over his father during a conflict. He admitted to not taking his prescribed antipsychotic medication and his urine was positive for cannabinoids. Following the second index offence, Dr. Klassen, in his NCR assessment, made the diagnosis of schizophrenia.
Current Diagnoses
- The Hospital Report sets out Mr. Wilkins’ current diagnoses as follows:
Schizophrenia
Alcohol use disorder
Cannabis use disorder
Evidence At the Hearing
At the hearing the Board heard the oral evidence of Dr. P. Schubert. Entered as an exhibit was the Hospital Report, dated December 27, 2024. Dr. Schubert, who co-authored the report, adopted its contents.
Doctor Schubert testified that he has been Mr. Wilkins’ psychiatrist since 2020, effectively for five years, when Mr. Wilkins came under the Board following the NCR finding by the court.
Pursuant to last year’s ORB detention disposition, Mr. Wilkins lives in the community of Balmertown, a small community which is a six-hour drive northwest of Thunder Bay. Mr. Wilkins lives there with his parents, the support of his family, a local support worker and an outpatient team. Previously, Mr. Wilkins lived on his own and in his own accommodations.
Following last year’s hearing, held on January 22, 2024, Mr. Wilkins had a difficult time in the early part of 2024. He was reporting auditory hallucinations, bizarre delusions and suicidal ideation which was interfering with his ability to function. His mental health was in decline.
In May of 2024, because of Mr. Wilkins’ progressive decline in mental health status, the option of introducing Clozapine to his medication regime was discussed with him and his family. He agreed to a trial of the medication. Due to the potential adverse effects related to the new medication, Mr. Wilkins agreed to be admitted to hospital so that he could be closely monitored for side effects and for a measure of effectiveness of the new therapy. A date was negotiated with him that suited both Mr. Wilkins and his family's needs and he was admitted to the hospital on a voluntary basis on May 14th 2024. He had off unit privileges while in hospital including overnight stays with his family when they were in town.
Mr. Wilkins was voluntarily admitted to the TBRHSC on May 14, 2024 and discharged on June 27, 2024. He did well while in the hospital and was able to transition on Clozapine. From the Hospital Report, the following extract from the discharge notes outlines Mr. Wilkins course in the hospital:
“Mr. Wilkins’ mood remained generally good while on the inpatient unit. He was not involved in any conflict. Sleep, appetite and energy are reported as normal. He continued to express auditory hallucinations at times often stating they were “vague, hard to understand” or occasionally he would hear his sister. He reported in the week of discharge that things had settled a fair bit, although he was occasionally getting auditory hallucinations that are less intense, easier to ignore not saying to him as they were preadmission. He states Clozapine had been helpful thus far. In terms of delusions, he predominantly has somatic delusions often regarding a lump in his throat or globus feeling as well as collarbone. He did pull at his collar bone a fair bit during our assessments, but he stated this was not bothering him.
Mr. Wilkins was requesting to go home. I think at this point requesting to go home as he had plans with his family this summer, they are building a cabin and he is quite excited about this.
While in hospital he utilized his privileges well, primarily to smoke cigarettes. He minimally participated in on-ward programming. He did overnight pass with his mother who is in town for work, and they stayed in a hotel and he enjoyed that very much; that was from June 5 to 7th. He also attended the Indigenous Day Pow-Wow at the Marina on June 21st. There are no reported problems as mentioned when off-ward for privileges.”
Dr. Schubert testified that Mr. Wilkins did quite well in the impatient unit and tolerated the introduction of Clozapine. Following Mr. Wilkins’ discharge from hospital he continued to reside at his parents’ home in Balmertown, where he has the support of his mother. He also spends time, particularly on weekends, with his brother Kiefer who lives in Red Lake and who has an apartment there. Mr. Wilkins also works on the family cabin which is being built on a local lake outside Balmertown.
Mr. Wilkins has the oversight of his case manager Mr. McGuire, who meets with him weekly. In addition, his community worker, Hilary Smith, maintains contact with him every two weeks. She assists Mr. Wilkins with his depot medications, blood work and drug screening.
Dr. Schubert meets with Mr. Wilkins one a month by video conferencing. Following his discharge during the summer and fall months Mr. Wilkins maintained compliant with his Clozapine depot and depot antipsychotic medication. Dr. Schubert reported that Mr. Wilkins’ compliance with medication has been fully maintained.
Mr. Wilkins urine drug screens for common substances were all negative and all the samples confirmed the presence of his prescribed medications. Mr. Wilkins did acknowledge two occasions this past year when he consumed alcohol in the form of beer this included a weekend in September when he stated he consumed 8 beers at the family camp and in mid-October following a successful moose hunt when he consumed 4 beers.
Dr. Schubert testified that these are still early days for Mr. Wilkins so that any change to the disposition without conditions would be a risk to the safety of the public. The ORB disposition of February 1. 2024 contains no contract provisions with the victim of the index offences. Dr. Schubert stated that the Wilkins residence is well enough away and there are no reported concerns.
Dr. Schubert was asked to comment on the proposed change of wording in the disposition which currently orders Mr. Wilkins to live “in the community of Northwestern Ontario”: Specifically, does the wording in last year’s disposition present a problem when Mr. Wilkins travels outside of Balmertown. Dr. Schubert testified that Mr. Wilkins being with his brother in Red Lake as well as his outings in the community with his family are covered by the proposed wording of Northwestern Ontario. In any case, Dr. Schubert left the issue for the Board to decide.
In a question about Mr. Wilkins’ consumption of alcohol as referenced to in the evidence, Dr. Schubert opined that while it is concerning to him and the hospital team, because the conduct violates the terms of the detention order. There is some comfort in the fact that the lapses only occurred on special or celebratory occasions, when Mr. Wilkins has the oversight of his family, and more importantly, that it is not patterned behaviour which would give rise to Dr. Schubert having serious concern.
In response to a question about the administration of the Clozapine medication, Dr. Schubert stated that the Red Lake Hospital can deal with the depot medication and do the necessary blood work so that Mr. Wilkins is well-served in the community.
Dr. Schubert testified that Mr. Wilkins’ insight continues to improve. He has a reasonably good appreciation of the benefits he has received from the prescribed medication. Mr. Wilkins appears to better understand that being on medication reduces his psychotic symptoms and his improved mood. Nevertheless, Dr. Schubert opined that if Mr. Wilkins were to decompose and breach the proposed conditions disposition should include a condition for Mr. Wilkins to delivered to the TBRHSC.
Mr. Wilkins has a history of aggression and interpersonal conflict when actively psychotic as well as when under the influence of alcohol and cannabis. He was involved in physical conflicts with a co-patient while he was hospitalized in May, 2021. The killing of several animals as referenced in the index offences was in response to command hallucinations and delusional thinking. There has now been significant improvement in Mr. Wilkins’ circumstances so that a detention order, as was in place last year, would not be necessary.
In the circumstances of this case and bearing in mind the index offences, Dr. Schubert opined that oversight of the ORB is necessary and appropriate to protect the safety of the public. Dr. Schubert and the hospital team are of the view that with the safeguards now in place, Mr. Wilkins can be safely managed in the community under a discharge with the conditions as set out in the Hospital Report.
No further evidence was called.
Submissions
- As expressed at the outset of the hearing Ms. Davidson, on behalf of the hospital, submitted that Mr. Wilkins continues to represent a significant threat to the safety of the public and recommended a conditional discharge with the conditions as set out in the Hospital Report. After hearing the evidence Mr. Down joined the hospital in their position. It was further submitted by Mr. Down that a narrow residence clause might be in order in any disposition. On behalf of his client, Mr. Iwasiw submitted that he agreed with the position of the hospital. Mr. Iwasiw submitted that a more specific residence clause was not necessary, however he would leave the issue to be determined by the Board.
Analysis
Significant Threat:
The Board considered and accepts the evidence of Dr. Schubert and the contents of the Hospital Report. Pursuant to the decisions in Winko v. British Columbia (Forensic Psychiatric Institute) [1999] SCC 625 and Marchese (Re), 2018 ONCA 307, in our task, the Board carefully considered the evidence regarding events of Ms. Wilkins’ reporting year and as summarized by Dr. Schubert in his evidence and as expanded by the Hospital Report.
In our review of the evidence and applying the standard and the statutory provisions of ss. 672.54 and 672.5401 of the Criminal Code the panels finds that Mr. Wilkins continues to pose a risk of serious physical or psychological harm. Based on the facts of this case Mr. Wilkins’ conduct, as set out in the index offences summary, is criminal in nature and involves serious criminal offences.
From the evidence the panel relies on Mr. Wilkins’ deterioration in his moods, behaviour an exacerbation of symptoms in the early part of this reporting year. Mr. Wilkins’ mental health improved with the introduction of the change in medication. It is Mr. Wilkins’ ongoing psychotic symptoms that found the basis of our finding that he continues to remain a significant threat, particularly in the context of the bizarre and violent nature of the index offence.
The Board relies on the evidence before us that Mr. Wilkins suffers ongoing symptoms of schizophrenia, including delusions and auditory hallucinations. He a history of substance issues in the past. As noted in the evidence, despite the provisions of last year’s disposition he consumed beer. While the conduct is concerning, as expressed by Dr. Schubert, it not a pattern of behaviour so that it changes his or the hospital team’s recommendation for a conditional discharge.
Disposition
In our deliberation the Board considered the appropriate disposition given the facts as we find them. The panel unanimously concluded that recommendation of the hospital team for a conditional discharge is appropriate. The evidence supports that Mr. Wilkins has done well with the changed medication and in his communication and collaboration with the treatment team. He also has strong family support who are engaged with the treatment team. From the evidence we also conclude that Mr. Wilkins’ family are not only there to support him but to report to the hospital team any concerning changes in Mr. Wilkins’ mental health.
In our deliberation the panel is mindful of the strong the dissenting opinion in last year’s Reasons which then supported a conditional discharge. Based on the evidence at this hearing we conclude that there have been positive improvements in Mr. Wilkins. He has stable living arrangements, and a high degree of support from his family and the support of the hospital team. We bear in mind the positive adjustment in Mr. Wilkins’ medication, his compliance with the new medication which has resulted in his improved state of mental health.
In our review of the evidence, a conditional discharge in the circumstances of this case would suffice and be appropriate based on the evidence. We accept the evidence of Dr. Schubert and the hospital team who recommend specific terms and conditions as set in pp. 36 & 37 of the Hospital Report.
In our deliberation the panel gave serious consideration to the submission of ordering a more specific residency clause in the disposition. On the evidence of Dr. Schubert, which we accept, we conclude that the wording in last year’s order was and remains sufficient. In the end, we find that a more specific or limiting disposition is neither appropriate nor necessary.
On that evidence we find that a conditional discharge is necessary and appropriate and the least onerous and least restrictive.
Conclusion
In conclusion, the Board commends Mr. Wilkins and his supportive family for the progress he has made this past year. We wish him continued good progress in working with Dr. Schubert and the hospital team.
On the evidence we conclude that a discharge subject to conditions as set out in the Hospital Report is sufficient and in the circumstances, is appropriate, the least onerous and least restrictive.
DATED this 21st of March 2025 at the City of Toronto, in the Toronto Region.
E. Kruzick
Legal Member
____________________________
Office of the Registrar
Ontario Review Board