Ontario Review Board
Re: Skylar Thomas Oliveira
ORB File No: 8206
Hearing held on: Monday, January 20, 2025
Place of Hearing: Providence Care Hospital, Kingston
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. K.A. Connidis
Members: Dr. R. Kunjukrishnan
Dr. P. Wright
Mr. A. Bouvier
Parties Appearing:
Accused: Skylar Thomas Oliveira
Counsel: Mr. C. Carter
Person in charge of hospital: Counsel: Ms. T. Tom
Representative: Dr. M. Chan
Attorney-General of Ontario: Counsel: Mr. A. Scott
REASONS FOR DISPOSITION
(Dated March 21, 2025)
Introduction, Issues, Positions of the Parties
On December 21, 2022, Mr. Oliveira was found not criminally responsible on account of mental disorder ('NCR') on a charge of manslaughter. He is currently subject to an Ontario Review Board Disposition dated January 29, 2024, which detains him at the Secure Forensic Unit of Providence Care Hospital ('Providence Care') with privileges extending to community passes within 20 kilometers of the hospital, indirectly supervised and with an approved itinerary.
On January 20, 2025, the Board convened at Providence Care to conduct the annual disposition review for Mr. Oliveira.
The evidence at the hearing included a Hospital Report dated December 6, 2024 (the 'Hospital Report'), and the viva voce evidence of Dr. M. Chan.
The issues to be decided were whether Mr. Oliveira presents a significant threat to the safety of the public at this time, and if so, what disposition is necessary and appropriate for him for the coming year. In deciding the second issue, the Board is required by s. 672.54 of the Criminal Code to consider four factors, being the safety of the public, as the paramount consideration, and Mr. Oliveira's mental condition, reintegration into society, and his other needs.
Ms. Tom advised that the hospital was recommending the current Detention Order continue with two added terms: the privilege of living in the community in 24-hour supported approved accommodation, reporting not less than once per week. Mr. Scott anticipated joining the hospital, but wished to hear evidence first. Mr. Carter expected there would be a joint position.
The Index Offence (August 22, 2020)
- The circumstances of the index offence are set out in the Hospital Report (pgs. 2-4), and have been summarized in previous Reasons for Disposition, essentially as follows:
On August 22, 2020, Belleville police and ambulance services attended at the home of Mr. Oliviera and his mother, Ms. Sandy Oliveira, after he called reporting that his mother had stabbed him. Upon their arrival, he said she had stabbed him, and he did not know where she was. After a lengthy search, they located her on the front porch of a nearby house, suffering from numerous stab wounds in her chest area. She was transported by ambulance to hospital, where she died from her injuries.
Meanwhile, Mr. Oliveira was discharged from hospital after receiving care for a minor stab wound to his left shoulder. He said he and his mother had become engaged in a verbal argument which had escalated, and that: His mother had grabbed a knife, so he grabbed a knife. She left the residence and he followed her. She stabbed him in the shoulder so he retaliated. He did not know how many times he stabbed her. After that, he returned home. He rinsed off the knife and laid in bed for five to fifteen minutes, and then decided he should call the ambulance for himself due to his shoulder.
Psychiatric Diagnoses, from Hospital Report
- Mr. Oliveira's current psychiatric diagnoses are: (1) Autism Spectrum Disorder, and (2) Attention Deficit and Hyperactive Disorder ('ADHD'), by history. While he has impaired vision due to a congenital condition, which has raised concerns about his own vulnerability, it is not seen to play a role in his index offence or his reoffence risk.
Prior Personal Background
The Hospital Report should be referred to for an extensive account of Mr. Oliveira's personal history relevant to the issues on this hearing. As that Report is an exhibit, its detailed contents need not be reiterated here, but the following points are briefly noted.
Mr. Oliveira is now 28 years old. At six years old, he was identified as having ADHD and symptoms of pervasive developmental disorder. At the age of ten, he was diagnosed with what is now called Autism Spectrum Disorder ('ASD'). He grew up in an abusive and traumatic environment, with his mother who had her own mental health, anger, and behavioural challenges. She was prone to mood swings, and to verbal outbursts which became physical and were directed at her son from a young age and throughout his childhood. His aunt and her husband attempted to intervene and, at various times, were able to offer him accommodation and support.
At school, Mr. Oliveira had difficulty concentrating and forming relationships with his peers. He was bullied throughout elementary school due to behaviours related to his ASD. Despite, this, he graduated from high school and was able to attend one semester of post-secondary school at Loyalist College. He worked part-time in the family hardware store from about eighteen to twenty-two years old, where he had difficulty interacting with customers and co-workers. By his self-report, he first drank alcohol and used cannabis at nineteen years old, and his alcohol use escalated to the point where he occasionally binge-drank rum; however, his aunt has advised that she had not known him to drink alcohol or to be interested in it.
In 2018, at about twenty-two years old, he moved into his aunt and uncle's home, and then with their assistance to a motel, as his mother decided he was no longer able to live with her. However, late that year, his mother moved him back into her home. There continued to be verbal and physical threats and fights between them. Despite their serious conflict, there were also times when each expressed positive feelings towards the other, and when his mother sought professional help for her son from various mental health facilities.
In March 2020, Mr. Oliveira was noted to exhibit odd behaviours, which his aunt and uncle believed to be the start of a psychotic episode. The fighting between his mother and him continued to escalate in 2020. In May, it led to police involvement, but his mother did not wish to proceed with charges against him for an alleged assault. In August, it culminated in the index offence. Mr. Oliveira later said he had been intoxicated from drinking alcohol at the time. He also said he had not been taking medication and not seen a doctor in quite some time. Following his arrest, he was released on bail conditions allowing him to reside with his aunt and uncle, Mrs. and Mr. Bacon.
Mr. Oliveira has no prior history of involvement in the criminal law system, other than in the police attendance in May. He is financially supported by the Ontario Disability Support Program ('ODSP'), based on his developmental diagnosis and his congenital visual impairment.
Viva Voce Evidence of Dr. M. Chan
- Dr. Chan has been Mr. Oliveira's treating psychiatrist since September 2023, is a co-signatory of the Hospital Report, and adopted its contents, including his opinion on the significant threat issue. He testified further in chief, in summary, as follows:
(a) The opinion that Mr. Oliveira presents a significant risk rests primarily on how he relates to other people and the struggle he has with that, especially if he feels he has been intruded upon or treated badly; his history of emotional dysregulation, and the risk that his behaviour would escalate to physical action if he could not handle a verbal interaction.
(b) Overall, this has been a good year for Mr. Oliveira. He has worked closely with his psychometrist, Ms. M. Yeo, who is leaving shortly; this could unsettle him a bit, and that is an issue they are prepared to address. He has also worked closely with his occupational therapist, on daily living activities and lately meal preparation, and been doing very well.
(c) Mr. Oliveira prefers to walk rather than take public transit, He walks all the way from the hospital into downtown Kingston. His contact in the community at large has been limited. He is not interacting much unless he goes into a store.
(d) There has been some concern about what would happen if he got into an altercation in the community. The team is looking for more social types of opportunities for Mr. Oliveira to interact with other people. The difficulty is that with people with his type of struggles in socializing, there are very limited opportunity for progressing in this.
(e) The treatment focus for the upcoming year will be continue the same, working with his struggle interacting with others, and helping him learn coping strategies to deal with his frustrations.
(f) Cognitive rigidity is part of Mr. Oliveira's diagnosis, and Dr. Chan is not sure how much his interaction with others can change. Progress might be slow for him. The timeframe would be years rather than months.
(g) His environment will be important in mitigating his risk to the public, and the team has to help put in place an environment that can adapt to his illness. The environmental failure with his mother contributed to the index offence. He could not handle the difficulties of interacting with his mother. He did not get a lot of help growing up in a chaotic family, although he does have extended family.
(h) The forensic program in the hospital is very structured. Mr. Oliveira needs to have predictability and sameness. He gets thrown off when flexibility is required. In that event, he might avoid or withdraw, or stop and cool down. His needs will be the same in any community living setting. The staff there have to be aware of his issues, and have to adapt to them at some level. It is difficult to find the right setting.
(i) The hospital is asking for 24-hour supervised accommodation, because Mr. Oliveira needs those supports. He might think he can function independently, and he has done well, but he is not able to do that when he is experiencing challenging emotional issues. He needs assistance to be available to him in those times.
(j) Dr. Chan stressed that just the right community setting is needed for Mr. Oliveira. It would have to be staffed with people who are appropriately trained and skilled. They would need some background in working with the developmental population, and not be trained only in dealing with psychotic issues. In the DD-TRHP home, a lot of residents might be too low functioning for Mr. Oliveira and he might get irritated with them.
(k) Dr. Chan also stressed that it is important to get DSO funding for Mr. Oliveira, in order to get the right setting with the right staffing for him. While he has no intellectual disability, he does have cognitive limitations, but he is not doing too badly there and does not reach the threshold for DSO funding. This is going to be a challenge. Not having funding for him would be an obstacle in moving forward.
(l) At this time, the team is not working with any community agencies, and not working with either of the two developmentally-disabled community associations in Kingston and the greater Kingston area.
(m) What is available in Kingston is a regular Transitional Rehabilitation Housing Program ('TRHP') residence called “Lyon Street', and a Developmentally-Delayed ('DD') TRHP residence, which is more like a supported home and not an independent apartment.
(n) A transition to community living will not take place in the near future, because of the need for funding. The possibilities are being explored now, to see what is available and how it could work. It would be a supportive setting and not independent housing.
- In answer to questions from Mr. Scott for the Attorney General, Dr. Chan testified:
(a) Hypothetically, if appropriate housing is found in the community, before he would be in a position to move into it, the team would discuss how to implement what would have to be a very gradual transition process. They would identify what Mr. Oliveira needs in the community and what they can set up in the housing.
(b) Asked whether Mr. Oliveira has coping strategies in place or still needs more therapy to develop them, respecting a potential for conflict with housemates due to his ASD-related difficulty with relationships, Dr. Chan replied that there would be very detailed discussions and planning at the team level, to map out a much more deliberate and gradual process of transition to community living, taking into account the resources of the housing, the staffing, and the other residents there. This is why 24-hour staff trained in the skills required is needed.
(c) Respecting his indirect passes into the community, Mr. Oliveira has not been out much on them in the winter when it has been cold, but in the summer was out more than once every week, with no cause for concern whatsoever. His visual impairment means he has to get close to read or see things, which raised a concern he might get too close to people. But overall, there has been no issue with him. He keeps to himself, even when going swimming, and does his own thing. The team were more concerned with respect to his crossing streets at the traffic lights, but he has been able to negotiate that.
(a) In an example of Mr. Oliveira managing his behaviour with animals, he got too close to a goose who had chicks with her, and she became more aggressive; he backed down, and he also chuckled about it later. With respect to people, and getting him into social groups, it has also been Mr. Oliveira’s request to have more opportunities to socialize with people. They would ideally like to see him have more opportunity for interpersonal interactions, and to do that in groups, before he moves into a community home. He wants that too.
There were no questions from Mr. Carter, counsel for Mr. Oliveira.
In answer to questions from Board Panel members, Dr. Chan testified:
(a) As an example of the kinds of social challenges that flow from Mr. Oliveira's rigid, detailed, verbose qualities, Dr. Chan described the very precise itineraries that Mr. Oliveira fills out, and the tension that arises if staff challenges what he has indicated. There is tension in his interactions with the security staff, because they get irritating for him, and he then mouths off verbally and walks away. It has not gone beyond that. There have not been any physical alterations.
(b) Asked how the psychometrist sessions have worked with respect to Mr. Oliveira's social interactions, Dr. Chan noted that he and Ms. Yeo have worked together for 18 months, and Ms. Yeo has noted his ability to engage more, and that he might back off if he gets emotionally riled, and then take time to cool off.
(c) A big challenge for Mr. Oliveira remains his difficulty in understanding how people might perceive him, or "perspective taking" skills. This is a very complicated concept for a person like him, to see how others might see him, and he has not made much progress in that. It is a work in progress, as he gets more opportunity. He may need more proscribed teaching to deal with specific situations for potential discharge.
(d) The team's occupational therapist has been locating socialization opportunities for him from community agencies; in the beginning, he takes Mr. Oliveira to them, and then backs off when Mr. Oliveira gets comfortable with the steps needed (such is using TTC). The psychometrist has also been working with him on this. The nursing staff is not involved in that kind of work.
(e) It is very important, given his diagnosis and his enjoyment of time alone, that Mr. Oliveira have a truly private space for himself. It is yet to be determined whether he will be able to have that in a community accommodation
(f) Mr. Oliveira has been in hospital for over two years now, and has not received any medications. As to a secondary diagnosis of “impulse control disorder, Mr. Oliveira has problems regulating his emotions if he gets irritated or frustrated, but he is not an impulsive guy. He does like to plan things. He does not like to change things much, and finds that stressful. He has low frustration tolerance, rather than an impulse control disorder. He has an ADHD history that is still being looked at, but that was diagnosed before he was diagnosed with Autism Spectrum Disorder.
(g) Mr. Oliveira's interactions with his family have been very limited. His aunt and uncle in Madoc, Mrs. and Mr. Bacon, and approved persons for him and have visited him; this past year they have not been able to visit, due to a series of issues, but they have been in contact by phone. Mr. Oliveira has a cousin who lives locally, who has now visited him.
(h) Alcohol or other substance use has not been an issue in the community for Mr. Oliveira.
(i) His visual problem since childhood involves Albinism and another congenital condition. He does not use a white can because he does not want to call attention to himself. He had an eye consultation when he was younger, and has glasses. He has lost his glasses at this point, and says he cannot afford to replace them, but he should be using them.
(j) Mr. Oliveira’s insight into his index offence is limited. In the past when they tried to broach the topic, he would say his mother got angry at him and came at him with a knife. He has made some progress in his insight into his symptoms, but does not have a whole lot of insight into his illness and his personality problems. It is slow-going but it is coming along. His insight into the index offence has not often been broached, and would be important to address as part of his long term progress. It is the same issue with problem-solving that he has to develop. Dr. Chan repeated that it is very important for him to come to terms with this.
(k) With respect to how soon Mr. Oliveira could be transferred into community living, it would not be happening within this year. Dr. Chan characterized it as something that would take a long while, for the reasons he had already indicated, being the problems of funding and of locating the right setting and staffing for him.
Closing Submissions
- In closing, the parties joined in the hospital's recommendation. Ms. Tom submitted that it is possible, while not probable, that an approved residence could be found and Mr. Oliveira's preparation and gradual transition to community living could begin in the coming year. Mr. Scott noted the concern raised about the risk arising from Mr. Oliveira's emotional dysregulation, and also noted the substantial progress made in the past year, and indicated he was satisfied on Dr. Chan's evidence that the transition to community living would be appropriately managed by the hospital, would be slow and gradual and not in the distant future, and would clearly be to a very specialized residence with 24-hour staffing and properly trained people. Mr. Carter had nothing further to add to this joint submission.
Findings and Conclusions of the Board
On the first issue, we find that Mr. Oliveira presents a significant threat to the safety of the public at this time. This was not contested, and the finding is well supported by the evidence.
The term “significant threat” is defined in s. 672.5401 of the Criminal Code as “a risk of serious physical or psychological harm to a member of the public … resulting from conduct that is criminal in nature but not necessarily violent.” A significant threat finding must be guided by the principles of law established in the Winko decision, 2 S.C.R. 625, as applied and elaborated in numerous judicial decisions since then. To state this jurisprudence in only a nutshell: A finding of significant threat cannot be speculative; it must be based on evidence. It requires positive findings, supported by the evidence, that the threat that a person would engage in criminal conduct is a “real” threat , and that the harm this conduct would cause would be “serious”. Both findings are required: Neither a miniscule risk of grave harm, nor a high risk of trivial harm, is sufficient to find a real threat of serious harm.
The evidence is that Mr. Oliveira has a diagnosis of severe autism spectrum disorder ('ASD'), with features or deficits that include cognitive rigidity, extremely slow cognitive processing, low frustration tolerance, very poor emotional regulation, and a poor grasp of interpersonal and social norms, and have led to a history of antisocial behaviour reflecting these deficits, and a self-reported history of cannabis and/or alcohol use. These ASD features have made challenges in interactions with others very difficult for him to manage, and they resulted, in the course of a very challenging conflict with his mother, in his serious violence in the index offence. While Mr. Oliveira has made clear progress in this work in the past year (noted below), it has been slow (as would be expected in keeping with these ASD features) and his risk assessment has not changed from last year.
Dr. Chan's 'Summary of Risk and Conclusions' is set out in the Hospital Report as follows:
'Mr. Oliveira is a very unique NCR accused, his risk being related to his autistic struggles. This in turn had been shaped by a deprived and conflicted environment growing up with his mother, who was his primary caregiver. In our setting he remains protected and untested until he has much more engagement with the community and broader public. When he encounters situations that frustrate him or that he finds upsetting he will need to demonstrate that he can negotiate these without behavioral escalation to physical action.
'This past year he has made gains in the areas of socialization and emotional regulation but there is still more work to do. I therefore see him as remaining a significant risk to the safety of the public, but it [is] very much dependent on the situations that he encounters.'
At the hearing, Dr. Chan confirmed and elaborated on that opinion. Based on all the evidence, we have no hesitation in finding that, if Mr. Oliveira were not under the Board's jurisdiction for the coming year, there is a real risk that he would not be able to manage his risky behaviour on his own, and in particular that his difficulty in verbal interactions with others would escalate to his physical behaviour and serious criminal conduct, such as happened in the index offence and in his previous assaultive behaviour.
On the second issue, we agree with the parties that a detention order remains the necessary and appropriate disposition for Mr. Oliveira for the coming year. There is no evidence or argument to support a conditional discharge at this point, and no dispute that to protect the public and ensure his ongoing treatment, risk management, and wellbeing – including steps forward in the community – will require ongoing close oversight and support from his hospital treatment team.
With respect to the terms of the new detention order, we also agree that all the current terms should continue this year, along with the requested addition of both a privilege to live in the community, in an approved 24-hour-staffed supportive residence, and a requirement to report as requested and not less than once per week while doing so.
The question of an appropriate approved community residence for Mr. Oliveira was the major focus of this hearing. Dr. Chan testified that Mr. Oliveira has overall had a good year. He has been exercising his passes into the community, and has been working closely with his psychometrist and occupational therapist, in individual therapies and community orientation. He is noted in the Hospital Report to have continued to be stable and to slowly improve in the very structured and predictable hospital setting. He has shown improvements in his insight into social interactions, his sharing of his emotional experience during psychotherapy, his ability to regulate his emotions, and his community engagement. Ongoing progress is expected to be slow, again in keeping with his autism features, but it appears that, in the right environment, it could be expected to be steady.
The difficulty is in finding ad putting in place that necessary environment for Mr. Oliveira. This will require a residence which continues to provide a very structured, stable, and secure environment, with full-time residence staff well trained in the skills of working with residents such as Mr. Oliveira. It will require support for his individual and group work in individual therapies and community socialization, to help him continue his progress of the past year and go further. It will require funding to support these necessary treatment and community initiatives for Mr. Oliveira, to enable him to move forward towards a safe and secure life in the community.
We wish all the best to Mr. Oliveira in this year ahead, in his work with his treatment team, and in his time with his supportive family members, which have clearly been strengths for him.
DATED this 21st day of March 2025, at the City of Toronto, in the Toronto Region.
Ms. K.A. Connidis
Alternate Chairperson
Office of the Registrar
Ontario Review Board