Ontario Review Board
Re: Reginald Billing
ORB File No: 4916/4936
Hearing held on: Tuesday, January 21, 2025
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. J. Mills
Members: Dr. P.L. Darby Dr. G. Stones Ms. M. Chamberlain Ms. B. Naegele
Parties Appearing:
Accused: Reginald Billing Counsel: Mr. T.R. McIver
The Person in Charge of Hospital: Representative: Ms. T. Newman (via Zoom)
Attorney General of Ontario: Counsel: Ms. M. Levasseur
REASONS FOR DISPOSITION
(Dated March 26, 2025)
Introduction
On October 3, 2007, Reginald Billing was found not criminally responsible on account of mental disorder (“NCR”) on charges of criminal harassment (x4), fail to comply with conditions of an undertaking or recognizance (x2), fail to comply with probation order (x2) and attempt to obstruct justice, contrary to the Criminal Code of Canada (the “Criminal Code”). On November 8, 2007, Mr. Billing was also found NCR on a charge of assault, contrary to the Criminal Code.
Mr. Billing is currently subject to a disposition of the Ontario Review Board (the “Board”) dated February 12, 2024, discharging him with conditions.
On January 21, 2025, a panel of the Board convened to hold a hearing to review Mr. Billing’s disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Billing was present for his hearing and was represented by counsel throughout the proceedings.
The issues to be determined are whether Mr. Billing poses a significant threat to the safety of the public and, if so, the necessary and appropriate disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code.
At the commencement of the hearing, the representative for the Hospital submitted that Mr. Billing remains a significant threat to the safety of the public and there should be no change to his disposition except that the residence clause should be changed to reflect a recent move to 44 Donald Street, Barrie L4N 1E3. Counsel for the Attorney General agreed with the Hospital’s submission. Counsel for Mr. Billing indicated that Mr. Billing wished to be discharged absolutely. All parties maintained their respective positions in closing submissions.
For the reasons set out below, the Board finds that Mr. Billing continues to represent a significant threat to the safety of the public and that there should be no change to his current disposition, except that the residence clause shall be amended to reflect his recent move.
Evidence at the Hearing
- The Board received documentary evidence in the form of a Hospital Report dated December 2, 2024, and marked as Exhibit 1. The Board also heard viva voce testimony from Dr. Ismail, Mr. Billing’s treating psychiatrist.
Index Offences
- The circumstances of the index offences are excerpted from last year’s Reasons for Disposition as follows:
“In 2006, Mr. Billing was involuntarily hospitalized for around two weeks and refused medication. Shortly after his release from the hospital, Mr. Billing was charged and ultimately convicted of criminal harassment of his ex-wife and daughter. He received a suspended sentence and probation for 18 months which included a condition that he not have any communication directly or indirectly with his ex-wife and daughter. On February 16, 2007, Mr. Billing again was charged with criminal harassment (x3) involving the same victims. He was subsequently released on a recognizance with conditions including that he abstain from contacting his ex-wife and daughter and that he attend the Mental Health Office at the Finch Avenue courthouse. Mr. Billing failed to comply with both of those conditions. He continued to call his ex-wife.
On December 18, 2006 the victim was in the washroom in The Bay in downtown Toronto. Suddenly, without warning or provocation, Mr. Billing kicked the bathroom stall door open and struck the victim on the head. He then entered into the stall and struck the victim again in the head with his fist, knocking the victim to the floor. Mr. Billing then spat on the victim’s neck.”
The Hospital Report outlines Mr. Billing’s history and background and need not be repeated here in detail. Mr. Billing is currently 67 years old. Little is known about Mr. Billing’s formative years. He was married to the victim of the index offences for five years and they had a daughter together. Mr. Billing’s ex-wife reports that Mr. Billing was physically and emotionally abusive during their marriage and that his mental illness was apparent.
Mr. Billing has a history of problematic substance use, in particular alcohol. Prior to the index offences, he had a criminal record commencing in 1977 with thirteen convictions between 1977 and 1982. In 1992, he was convicted of assault and in 2006 he was convicted of criminal harassment.
According to the Hospital Report, Mr. Billing has a long history of mental illness and for many years appeared to be adequately treated as an outpatient in Orillia. Unfortunately, this changed in 2006 when he discontinued treatment.
Mr. Billing is currently diagnosed as suffering from schizophrenia and substance use in remission and major neurocognitive disorder, amnestic type. Mr. Billing continues to be assessed as incapable, and the Public Guardian and Trustee is his substitute decision maker.
Testimony of Dr. Ismail
Dr. Ismail testified that Mr. Billing’s suffers with treatment resistant schizophrenia and mild cognitive impairment which is progressing. Recently, he has been prescribed medication to try to slow down the progression of his cognitive decline. The onset of Mr. Billing’s dementia means that he has become more disorganized (and will be unlikely to be able to administer his own medications), that he will suffer with forgetfulness and poor impulse control. Mr. Billing has also experienced falls, and his medication (Haldol) was discontinued to help manage that situation.
Mr. Billing needs assistance with his activities of daily living and has recently moved to a new residence where his meals and medications are provided to him. He has done well with the transition; however, the MTST team see him weekly to assist with any potential instability associated with the move. In July 2023, Mr. Billing was placed on a medication watch because of low clozapine readings, likely due to noncompliance (although not confirmed). This has now stabilized, and his clozapine levels are in the therapeutic range.
Mr. Billing does not appreciate the importance of being on medication and states that his spirituality will protect him. If he does discontinue his medication, he will decompensate and his risk to the safety of the public will increase. When Mr. Billing starts to decompensate, he becomes more guarded, and it is difficult to ascertain what is going on with him. Mr. Billing’s risk would likely manifest itself in unwanted conversations and following people.
If Mr. Billing was transferred to a civil MTST team, he would have to accept their assistance and given his lack of insight into his major mental illness this may not happen. Unfortunately, his dementia is now a major issue factoring into his risk. If he were to receive an absolute discharge, he could remain at the retirement home although they likely require clients to have a psychiatrist. In the absence of a psychiatrist, they would likely take him to an emergency room. Mr. Billing does not meet the criteria for a CTO as he has not been in the hospital for several years.
Analysis
The Board accepts the testimony of Dr. Ismail as supported by the Hospital Report and finds that Mr. Billing remains a significant risk to the safety of the public.
Mr. Billing suffers from treatment resistant schizophrenia. He has no insight in the need for medication and no appreciation of the consequences of his behaviour. In addition, Mr. Billings suffers from dementia and his behaviour is becoming increasingly disorganized and impulsive, which contributes to his risk. The Assessment of Clinical Risk at p. 75 of the Hospital Report indicates that:
“Although there have been no recent reports of violent ideations or intent, Mr. Billing’s paranoia and impulsivity remain concerning. His inability to fully assess the consequences of his actions, coupled with his history of inappropriate and intrusive behaviors, underscores the latent risk he poses to others, particularly in unstructured or unsupervised settings. His chronic persecutory delusions, a core feature of his schizophrenia, persist despite some improvement in paranoia. These delusions contribute to his social withdrawal, flat affect during periods of distress, and ongoing vulnerability to destabilization.”
The Board has considered the nature of Mr. Billing’s risk to the safety of the public. The Board recognizes that Mr. Billings has not recently been physically violent; however, as a consequence of his poor impulse control, limited insight and highly intrusive behaviour, he continues to represent a psychological risk to the safety of the public. In this regard the Board has considered the nature of the index offences and the more recent incidents in 2015-16 and 2017-18, where his behaviour resulted in reports to the Hospital that people were fearful of him. For these reasons, the Board finds that Mr. Billing remains a significant threat to the safety of the public.
The Board further finds that Mr. Billing’s risk to the safety of the public can continue to be managed on his current disposition with one change to reflect his current address. Mr. Billing has been living in the community for many years and, although early days, Mr. Billing has managed the transition to his new residence without difficulty. As Mr. Billing’s dementia increases his ability to care for himself, including taking his medication, will diminish and Mr. Billing will continue to require support and supervision provided by his current disposition.
The Board is also mindful of Mr. Billing’s increased age and the likelihood that his dementia will become progressively worse. In these circumstances, it may benefit Mr. Billing to be connected with appropriate mental health services that can provide additional assistance to him going forward.
Disposition:
In making a disposition, the Board must take into consideration the criteria set out in s. 672.54 of the Criminal Code, which is the safety of the public, which is the paramount consideration, the mental condition of the accused, the reintegration of the accused into society and the other needs of the accused.
For the foregoing reasons, the Board finds that Mr. Billing continues to represent a significant threat to the safety of the public and that there should be no change to his disposition, except as outlined in the formal disposition
DATED this 26^th^ day of March 2025, at the City of Toronto, in the Toronto Region.
Ms. J. Mills
Alternate Chairperson
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Office of the Registrar
Ontario Review Board