Ontario Review Board
Re: Dimitri D. Hesson
ORB File No: 8088
Hearing held on: Thursday, January 9, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. M. Labrosse
Members: Dr. S. Lessard
Dr. G. Glancy
David D’Intino
Mr. M. Hajek
Parties Appearing:
Accused: Dimitri D. Hesson
Counsel: Ms. K. Lundrigan
Person in charge of hospital: Representative: Dr. J. Gojer
Attorney-General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated March 21, 2025)
Introduction
On June 9, 2022, the accused, Dimitri D. Hesson, was found not criminally responsible on account of mental disorder on a charge of harassment by watching and besetting contrary to the Criminal Code of Canada.
Mr. Hesson is currently subject to a disposition of the Ontario Review Board dated January 15, 2024 which discharges him on certain terms and conditions.
On January 9, 2025, a panel of the Ontario Review Board convened a hearing at the Royal Ottawa Mental Health Centre, hereinafter referred to as the hospital, to conduct Mr. Hesson’s annual hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Hesson was in attendance and was represented by his counsel, Ms. Keara Lundrigan. Also present at the hearing were a Salus Nurse and Mr. Hesson’s current Salus Case Manager, Rosa Ng. A hospital report dated December 15, 2024 was marked as Exhibit No. 1 for the hearing.
The issues for this hearing are whether Mr. Hesson continues to represent a significant threat to the safety of the public and, if so, to determine the disposition that is necessary and appropriate in the circumstances.
For the reasons set out below, the Board finds that Mr. Hesson continues to meet the threshold of significant threat to the safety of the public and that a conditional discharge with a requirement that Mr. Hesson report not less than once per month is the necessary and appropriate, least onerous and least restrictive disposition in all of the circumstances.
Index Offences
- The details of the index offences are set out in last year’s Reasons for Disposition as follows:
"On December 10, 2021, the victim was in her apartment when she heard repeated knocking on her wall, which was adjacent to the ground floor lobby. She also heard knocking coming from below her apartment coming from the storage area. She called 911, but police did not locate anyone. On December 12, 2021, the victim was in her apartment when she observed Mr. Hesson standing on the raised lawn out front of her building, looking into her window, and staring directly at her. She recognized Mr. Hesson, as she had seen him earlier in the hallway. When she asked if she could help him, Mr. Hesson continued to stare at her and then climbed down from the raised lawn and entered the building. The Crown Brief Synopsis further reported that, on December 13, 2021, the victim was in her apartment when she heard knocking at her front door. She saw Mr. Hesson through the peephole. Mr. Hesson began shouting at her to open the door, saying “I want to screw!”, “I will pay you money to screw!” The victim yelled that she was calling police and dialed 911. Mr. Hesson left her front door and went to the lobby, where he was seen on the camera checking mail and then the names on the buzzer, where he seemed to see the victim’s apartment number and name. He then proceeded outside and again approached her window, banging on it and yelling, “Emmy, let me in! Emmy open the door! Emmy open the window!” Police arrived and observed Mr. Hesson standing at the victim’s window and yelling. He was placed under arrest and placed in the rear of the police cruiser. According to the Arrest Detail & Bail Report, it was noted that Mr. Hesson lived I the same building as the victim, and that the victim had no prior knowledge or involvement with Mr. Hesson."
Background History
The details of Mr. Hesson’s personal, legal and psychiatric history are set out in detail in the hospital report. Briefly summarized, Mr. Hesson is 45 years of age and was born in Singapore, after which his family lived in Hungary for a few years and then moved to Ottawa. There is a history of parental discord. His father passed away in 2008.
Mr. Hesson completed CEGEP in Quebec and then registered at the University of Ottawa where he began studying philosophy. He left school during his third year, reportedly because he could not afford to continue. In respect of this account, however, information from his mother suggests that Mr. Hesson became paranoid at school and that this was the key factor prompting his decision to leave.
Mr. Hesson has had several different jobs, generally involving manual labour. His mother reported that he became paranoid in various workplace settings which would account for limited longevity in past employment.
There was some estrangement between Mr. Hesson, his mother and sister, but Mr. Hesson currently has a positive relationship with his mother.
Criminal History
- Mr. Hesson’s criminal record according to the CPIC shows no convictions. The hospital report does detail that Mr. Hesson was previously placed under the jurisdiction of the ORB for ten years from 2008 to 2018 on one charge of assaulting a peace officer and one charge of injuring an animal.
Psychiatric History
Mr. Hesson has an extensive psychiatric history beginning at age 18 with an assessment at Pierre Janet Hospital, in respect of which he was diagnosed with schizophrenia. He was subsequently hospitalized again in Gatineau and was again diagnosed with schizophrenia. His third psychiatric hospitalization occurred at the Vancouver Hospital where he was treated again for schizophrenia.
In 1998, he was assessed by the Schizophrenia Program at the Royal Ottawa Hospital.
The hospital report reflects, from a synthesis of his psychiatric history, the view that Mr. Hesson had become progressively more aggressive in the several years prior to the incidents leading to his first set of charges in 2008. Mr. Hesson maintained stability for some time while under the jurisdiction of the ORB and he was granted an absolute discharge in 2018. After this, due to issues with medication compliance, Mr. Hesson’s illness began deteriorating. He became more withdrawn and exhibited persecutory delusions as well as disorganized thoughts and behaviour.
Mr. Hesson’s current diagnosis is schizophrenia.
Evidence at the Hearing
The hospital’s evidence was provided through its report dated December 15, 2024, and through the oral testimony of Dr. Julian Gojer, who attended the hearing virtually due to his medical condition arising from a serious accident late in 2024.
Dr. Gojer adopted the contents of the hospital report and indicated that though he took over Mr. Hesson’s care in late November of 2024, he has known Mr. Hesson for approximately a year. Mr. Hesson’s previous attending psychiatrist, Dr. Selaman, left the hospital late last year after which Dr. Gojer was involved in a serious motor vehicle accident and had limited opportunity to meet with Mr. Hesson in the last few months.
In the hospital report, Dr. Gojer cautiously recommends an absolute discharge, though he expresses reservations due to Mr. Hesson’s history, including his previous NCR finding and course under the ORB, between 2008 and 2018. Upon being granted an absolute discharge in 2018, Mr. Hesson promptly stopped taking medication, decompensated and committed the offences in 2020 which led to the second NCR finding on June 9, 2022.
Due to Mr. Hesson’s history, Dr. Gojer would prefer to test Mr. Hesson’s compliance with treatment by removing the consent to treatment provision in his current disposition.
Dr. Gojer’s other concern is regarding the fact that Mr. Hesson has been disconnecting and disengaging from the hospital over the course of the past year. Mr. Hesson has made it clear that he wishes to minimize his dealings with the Forensic Program of the hospital, including having indicated a preference to receiving his long-acting injectable antipsychotic medication from his family doctor. Dr. Gojer believes that Mr. Hesson will most likely not continue to engage with the hospital, in any capacity, if he is granted an absolute discharge.
Mr. Hesson is an introverted and guarded individual. He does not engage with any groups available to him in the Forensic Program and is quite unhappy about being under the care of psychiatry and under supervision by the Ontario Review Board.
Dr. Gojer believes that it would be better to test Mr. Hesson’s engagement to treatment by having a conditional discharge for a further year, where he is not required by the terms of his disposition to take treatment.
Dr. Gojer testified that when one looks at the whole picture, Mr. Hesson is doing quite well. His mental health has been stable for some time. He is compliant with treatment and functions quite well in the community. In some respects, this situation cries out for an absolute discharge, however, Dr. Gojer remains ambivalent given the history and the fact that Mr. Hesson has made it quite clear that he does not wish to continue engaging at all with the hospital.
In response to questions posed to him by counsel for the Attorney General, Ms. Dufort, Dr. Gojer testified as follows:
i) It is not clear to him why Mr. Hesson wanted to transfer his long-acting injectable from the hospital to his family doctor, as Mr. Hesson did not give any reason for this.
ii) Mr. Hesson is not engaged in any employment or volunteer work in the community and that there is a general lack of information on what he does with his time. Dr. Gojer acknowledged that Mr. Hesson has had three different Salus workers in the last six months, however this appears to be for administrative reasons and not because of Mr. Hesson.
iii) Mr. Hesson has an FHSP subsidy for housing and that this requires him to engage with the Salus Program periodically. Dr. Gojer does not know whether Mr. Hesson will continue to engage with Salus or what the requirements might be in the long term for him to maintain his subsidy.
iv) Despite the fact that Mr. Hesson lives very close to the hospital, he does not want to work with the Forensic Program.
v) Dr. Gojer stated that he has not had an opportunity to ask Mr. Hesson why he discontinued treatment after receiving his absolute discharge in 2018.
vi) According to Dr. Gojer, Mr. Hesson knows how to say the right thing. He has stated that he would continue to take treatment and follow-up in psychiatry, however, Dr. Gojer is quite certain that Mr. Hesson will completely disengage himself with the hospital upon receiving an absolute discharge.
vii) Mr. Hesson’s insight is more cognitive than emotional. He is very difficult to read and says very little. Dr. Gojer does not want to penalize him for how he presents. During his appointments with Dr. Gojer, Mr. Hesson is polite and pleasant but it is clear that he prefers not to share any information about himself and his situation.
viii) Dr. Gojer is not aware of any friends that Mr. Hesson might have in the community, nor any other support. Currently Mr. Hesson meets with someone from the treatment team, either Dr. Gojer and/or another team member at a frequency of once every two weeks. Mr. Hesson does what he is required to do under his current disposition but nothing more. In Dr. Gojer’s opinion there is a strong argument in favour of an ongoing conditional discharge, however this must be balanced against the fact that Mr. Hesson has some insight into his mental health and the need for medication.
vi) Finally, Dr. Gojer acknowledged that the index offences, though not involving physical violence, would have caused serious psychological harm to the victim. Dr. Gojer also acknowledged that Mr. Hesson’s first NCR finding was based on two index offences involving physical violence, namely two charges of assault and one charge of endangering animal life.
In response to questions posed to him by counsel for Mr. Hesson, Ms. Lundrigan, Dr. Gojer does not believe that a Community Treatment Order would be an option for Mr. Hesson. Not only does he not likely meet the criteria for a CTO, but Mr. Hesson could easily disengage with it as he is capable of consenting to treatment and is already demonstrating a clear lack of engagement. According to Dr. Gojer, Mr. Hesson’s non-engagement “sticks out like a sore thumb”.
In response to questions posed to him by members of the Panel, Dr. Gojer acknowledged that Mr. Hesson suffers from chronic relapsing schizophrenia, with which he was diagnosed at the age of 18. Mr. Hesson can become very ill when his illness is not adequately treated, as was the case at the time of the index offences, when a treatment order was needed due to how decompensated Mr. Hesson was at the time.
Dr. Gojer admits that it has been difficult to gauge Mr. Hesson’s progress because of the infrequent meetings. When they do meet, Mr. Hesson is very guarded and does not share information. In Dr. Gojer’s opinion, Mr. Hesson is not a risk cross-sectionally but if he is non-compliant, he will decompensate and become psychotic. Dr. Gojer acknowledged being aware of the results of a recent study which has looked at the risk of recidivism of NCR patients who get absolute discharges and that the results have been that that recidivism rate is quite high, up to 1/3 of patients granted absolute discharges have reoffended.
Dr. Gojer believes that Mr. Hesson has a low to moderate risk of future violence but that the risk is high that he will discontinue taking medication. Mr. Hesson was previously under the Board for a period of ten years of treatment and engagement and then promptly stopped taking medication after being granted an absolute discharge. More recently, Mr. Hesson has been disengaging from treatment, even prior to getting an absolute discharge.
Dr. Gojer further testified that Mr. Hesson has refused to attend rehabilitative group programming, reasoning that doing so was not required by his current disposition.
With respect to Mr. Hesson’s support in the community, Dr. Gojer acknowledged that he does have a sister, however he is unaware of what contact Mr. Hesson has with her. Dr. Gojer added that he would be quite prepared to become one of Mr. Hesson’s supports in the community in the long term and hopes that they are able to develop a rapport.
Evidence of Rosa Ng
Ms. Ng, who is Mr. Hesson’s Salus Case Manager, testified at the hearing and confirmed that to maintain his rent support supplement, Mr. Hesson is required to meet once per month with the Salus Case Manager and also to comply with a three-month apartment check. According to Ms. Ng, Mr. Hesson has not kept up with the monthly case management meetings. The meetings that have taken place are typically of a ten-minute duration because Mr. Hesson is so guarded that the conversation is not productive.
Mr. Hesson told Ms. Ng that he was planning to terminate the services with Salus, however this is not possible without terminating the rent supplement. Mr. Hesson was made aware of that by Ms. Ng today. Mr. Hesson has suggested that he might also apply for a housing allowance with the City of Ottawa which could be a substitute for the Salus rent supplement. Mr. Hesson will have to apply for this housing allowance on his own and until such time as he secures it, he can continue to have the FSHP rent supplement, however he will be required to continue to comply with the three-month apartment check. Ms. Ng also stated that Mr. Hesson has previously had a City of Ottawa housing allowance and that he had told her that it was not ideal.
Ms. Ng testified that Mr. Hesson has stated that he does not consider that he is required to meet with the Salus Case Manager. As long as he is complying with the reporting provision of his ORB disposition, he does not believe that he is required to do more.
In response to questions posed to her by counsel for the Attorney General, Ms. Dufort, Ms. Ng stated that the goal of the work of a Salus Case Manager is to perform the apartment checks for cleanliness and stability and any indication of drug use, as well as having face-to-face meetings with the client to assess mental health. Mr. Hesson is not open to discussing his mental health with Ms. Ng, but in fairness to him, they have not had much of an opportunity to develop a rapport as she has only recently taken on his case. Ms. Ng stated that Mr. Hesson has never discussed the issue of medication with her. Ms. Ng also confirmed that Mr. Hesson would be able to remain in the apartment should he obtain the City of Ottawa housing supplement. Finally, Ms. Ng was asked whether she believed that Mr. Hesson would stop attending the Royal Ottawa Hospital if granted an absolute discharge, and she responded that it was her belief that he would.
The hospital’s risk assessment is found at page 28 of the hospital report and summarized as follows:
"Mr. Hesson’s risk of future violence was assessed using the HCR-20, version 3, which is a structured clinical judgement tool widely used in forensic psychiatry and psychology to assess future risk by combining both historical or static (unchangeable) risk factors and dynamic (potentially modifiable) risk factors for violence. After using this tool and considering other valid clinical risk factors for violence that he might have, it is my opinion that Mr. Hesson presents a moderate risk for future violence, specifically behaviours that he has exhibited in the past such as harassment and physically assaultive behaviour.
Mr. Hesson’s primary historical risk factor is his long standing major mental illness, schizophrenia. He has a history of noncompliance with medications and fluctuating insight with respect to his illness and need for treatment. Violence in the past, including the offences from his initial finding of NCR in 2008, has been in the context of being in a decompensated state of his illness. He has had periods of independent living and employment, when his mental state has been more stable. He does not have a history of violence outside of periods of decompensated illness and he does not have a history of violent attitudes. He has a history of difficulty with engaging with treatment teams, when in a decompensated state due to paranoia.
Mr. Hesson’s primary dynamic risk factors include his major mental illness. Although he is currently compliant with long-acting injectable medications, compliance has been a problem in the past given Mr. Hesson’s fluctuating insight. His insight is currently adequate and will continue to be monitored. Mr. Hesson, although at times guarded and superficial, has maintained all of his appointments and followed the conditions of his disposition. His social supports have improved, although he tends to enjoy his solitary time. His current housing is stable".
- No other evidence was presented.
Submissions of the Parties
At the conclusion of the hearing, Dr. Gojer indicated that he was no longer prepared to recommend an absolute discharge following the evidence in this hearing. Dr. Gojer indicated that he has only recently taken on this case and that he hasn’t had much contact with Mr. Hesson. When one takes a backward view and a forward view of Mr. Hesson’s situation, Dr. Gojer believes that the threshold of significant threat continues to be met. Accordingly, the hospital submits that Mr. Hesson continues to meet the threshold of significant threat to the safety of the public and that the necessary and appropriate and least onerous and least restrictive disposition would be a conditional discharge without a consent to treatment provision and with reduced reporting of once per month.
Counsel for the Attorney General, Ms. Dufort, submits that the threshold for significant threat continues to be met and if one looks at the history of this matter and the ongoing situation of disengagement, it is more than likely that Mr. Hesson will stop taking medication and will decompensate. Mr. Hesson has two NCR findings. The second finding, though it did not involve any physical violence, had Mr. Hesson repeatedly knocking on the woman’s door asking for sex which clearly caused psychological harm to the victim. Mr. Hesson could have remained engaged in treatment and the fact that he has already started to disengage should be a window to what is coming should Mr. Hesson be granted an absolute discharge. He will stop engaging with Salus. He will stop attending the hospital. He keeps to himself and has very little support in the community. If one looks at the Reasons for Disposition of last year, the panel’s analysis of significant threat is still applicable this year.
Counsel for Mr. Hesson, Ms. Lundrigan, submits that Mr. Hesson no longer presents a significant threat to the safety of the public and that he should therefore be granted an absolute discharge. Ms. Lundrigan points to Mr. Hesson’s record of consistent compliance with treatment and that there is currently no evidence that he intends to stop taking medication. Mr. Hesson is polite, keeps a clean apartment and will continue to have to report with the Salus program as he receives the rent supplement. Mr. Hesson will also continue to meet monthly with his family doctor to receive his injection.
Analysis and Conclusion
Having considered all of the evidence presented at the hearing, and the submissions of the parties, the Board finds that Mr. Hesson continues to meet the threshold of significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code of Canada and as further defined in by Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
Mr. Hesson suffers from with chronic relapsing schizophrenia which was diagnosed close to 30 years ago. He has a history of serious psychotic decompensation when not adequately treated, along with a history of violent offending when he has been psychotic.
Mr. Hesson was previously under an Ontario Review Board disposition for a period of ten years, and upon being granted an absolute discharge in 2018, he promptly disengaged and discontinued treatment. The most recent offences took place within two years of receiving the absolute discharge. In this instance, past behaviour cannot be overlooked. Within two years of receiving an absolute discharge, Mr. Hesson relapsed and recidivated.
Mr. Hesson has functioned relatively well under the oversight of the ORB, though he is not availing himself of any of the supports that are offered to him now. He is only doing the bare minimum of what needs to be done to follow his disposition. The evidence also points to the fact that Mr. Hesson has already started disengaging from the Forensic Program and other supports available to him. This leaves little doubt that he will completely disengage if granted an absolute discharge.
It remains unclear whether Mr. Hesson will continue taking treatment, if he is not required to. It is very difficult to gauge Mr. Hesson’s insight because he is so guarded and tends to say the right thing, though his psychiatrist believes that this is indicative of insight that is more cognitive and superficial. A conditional discharge, without a consent to treatment provision, would provide some opportunity to test his willingness to take treatment in the long term when not specifically required to, as would providing additional time for Dr. Gojer to attempt to establish a therapeutic relationship with Mr. Hesson.
Accordingly, having considered the four factors set out in s. 672.54 of the Criminal Code, namely the protection of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society and his other needs, the Board finds that a conditional discharge with monthly reporting is the necessary and appropriate and least onerous and least restrictive disposition in all of the circumstances.
DATED this 21^st^ day of March 2025, at the City of Toronto, in the Toronto Region.
Ms. M. Labrosse Alternate Chairperson
Office of the Registrar
Ontario Review Board