Re: George Paragh
ORB File No: 6429
Hearing held on: Wednesday, February 19, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks Members: Dr. R. Kunjukrishnan Dr. G. Stones Ms. K. Weisbaum Mr. A. Mete
Parties Appearing:
Accused: George Paragh Counsel: Ms. J. Boissonneault
The person in charge of hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DECISION
(Dated March 26, 2025)
Introduction:
On November 8, 2013, George Paragh was found not criminally responsible on account of mental disorder (“NCR”) on a charge of aggravated assault, contrary to the Criminal Code of Canada (the “Criminal Code”).
Mr. Paragh is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated December 3, 2024, detaining him at the Forensic Program at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores” or the “hospital”), together with certain terms, conditions, prohibitions and privileges up to living in the community in 24-hour a day supervised accommodation as approved by the person in charge of the hospital.
On December 30, 2024, the hospital notified the Board that on December 21, 202, Mr. Paragh was arrested at his group home by Durham Regional Police Services and held in custody for a bail hearing. Mr. Paragh was charged with Assault with Weapon and Possess Weapon. It is alleged that on December 12, 2024, Mr. Paragh committed an unprovoked assault using a screwdriver on a member of the public. Mr. Paragh was escorted to the hospital by Durham Police following his bail hearing for admission.
On February 19, 2025, a panel of the ORB convened a hearing via Zoom videoconference at the hospital to review the period of increased restrictions on Mr. Paragh’s liberty during his readmission to the hospital from December 21, 2024 to the hearing date pursuant to s. 672.81(2.1) of the Criminal Code. Mr. Paragh was not in attendance at the hearing and his counsel, Ms. J. Boissonneault, requested that he be excused from attending. Ms. Boissonneault advised the Board that she had instructions to proceed and was prepared to do so in her client’s absence. Accordingly, the Board allowed Mr. Paragh to be excused from attending the hearing pursuant to s. 672.5(10) of the Criminal Code.
The panel considered whether the restriction on Mr. Paragh’s liberties was necessary and appropriate as well as the least restrictive and least onerous intervention available to the hospital, both initially and throughout its duration from December 21, 2024 to the hearing date.
For the reasons which follow, the Board found that there was a significant restriction on the liberties of Mr. Paragh from December 21, 2024 to the hearing date and that this was necessary and appropriate as well as the least restrictive and least onerous intervention in the circumstances, both initially and throughout its duration.
Positions of the Parties:
At the outset of the hearing, the parties were canvassed as to their recommendations to the Board. Counsel for the hospital submitted that the restriction of Mr. Paragh’s liberty was necessary and appropriate and the least onerous and least restrictive decision available to the hospital in the circumstances, both initially and throughout its duration.
Crown counsel supported the hospital’s position.
Ms. Boissonneault submitted that she was not taking issue with the initial restriction placed on her client’s liberties but she advised that her client now wished to be returned to his community residence.
All parties maintained their respective positions in closing submissions and all parties confirmed there was no request to review Mr. Paragh’s existing Disposition.
Index Offences:
- The circumstances giving rise to the index offences are set out in detail in the Hospital Report dated November 6, 2024 (the “Hospital Report”), but are summarized in last year’s ORB Reasons, as follows:
“The aggravated assault was committed in 2012. Mr. Paragh assaulted a panhandler in the town of Ajax. The victim was panhandling and approached Mr. Paragh to solicit change. This angered Mr. Paragh, who then struck the victim with two closed fist punches to the head and face. The victim fell to the ground causing significant injury to his nose and head area. Mr. Paragh was then followed by witnesses and was identified to police by these witnesses and arrested Mr. Paragh a short time later. This veracity of the assault was such that the victim was rushed to the hospital as he had suffered a brain bleed.”
Personal Background:
Mr. Paragh’s personal background and history are set out in detail in the Hospital Report to the ORB and need not be repeated at length here. Briefly summarized, he is 39 years old.
He came to Canada with his family at the age of 17. When the family was in Jamaica, Mr. Paragh’s mother noticed that he had significant gaps in knowledge and intellectual ability. He could not spell his name or recite his birthdate or address or understand monetary values.
Mr. Paragh has a grade six education. He has no history of using intoxicants. He receives social assistance in terms of his finances.
Legal History:
- Mr. Paragh does not have a criminal record. He had charges in 2009 that were diverted and withdrawn with no convictions entered. The charges were for shoplifting and obstruct police.
Psychiatric History:
Mr. Paragh’s only hospitalization prior to the index offence occurred when he was brought to the emergency department by police after he was reported missing and found wandering and confused in 2008.
After the index offence, Mr. Paragh was initially found unfit to stand trial but he eventually became fit and was returned to court. He was maintained on a ‘keep fit’ order until he was found NCR.
Mr. Paragh has low frustration tolerance and a history of fighting on the hospital unit. He has caused property damage when frustrated. At times, he has escalated and occasionally needed restraints.
Current Diagnoses:
- Mr. Paragh’s current psychiatric diagnosis is Intellectual Disability – moderate to severe.
Evidence at the Hearing:
Dr. D. Pallandi, Mr. Paragh’s out-patient forensic psychiatrist for approximately the past year, gave evidence at the hearing to supplement the documentary evidence available to the Board, including the Hospital Report. Dr. Pallandi adopted the contents of the Hospital Report and indicated there were no material updates.
Dr. Pallandi reminded the panel that in February 2024, Mr. Paragh was discharged from a general forensic unit at the hospital to the Karis group home in the Dual Diagnosis Transitional Housing Program (“DD-TRHP”) in Oshawa. The home provides 24-hour high support staffing through a partnership between the hospital and Karis Disability Services. Dr. Pallandi advised that there is a behavioural therapist on-site at the home. Mr. Paragh and another forensic client are the only two residents at the Karis home.
Since his discharge to the community, Mr. Paragh has required two brief readmissions to hospital. The first occurred after he became environmentally destructive and threatening and the second readmission occurred after Mr. Paragh went AWOL from his group home. His last discharge back to the community from the hospital was on September 24, 2024.
On December 21, 2024, Mr. Paragh was arrested at his residence and charged with assault with a weapon and weapons dangerous. It is alleged that on December 12, 2024, he left the group home at night, waited by a housing complex of the adult male victim and attacked him with the blunt end of a screwdriver. It is alleged that he struck the victim on the head. The victim sustained minor injuries.
The Hospital Report indicates that following the bail hearing, Mr. Paragh was released into the custody of Ontario Shores, where he has remains detained. He is currently subject to terms of a Release Order dated December 21, 2024 which, among others terms, requires that he refrain from contact or communication with the alleged victim, he not attend within 100 metres of any place where the alleged victim resides, works, attends school, or any other place where the alleged victim is known to be, and that he not possess any weapon. The criminal charges are currently outstanding and have not yet been adjudicated.
Dr. Pallandi testified that Mr. Paragh’s clinical presentation during his current hospital admission is consistent with his past admissions in that he has intermittent behavioural outbursts and will engage in property destruction when frustrated.
Overall, Dr. Pallandi stated that Mr. Paragh demonstrates low frustration tolerance and he can become extremely angry, dismissive, and impulsive in response to his misperceptions of his surroundings and/or interactions with others. Dr. Pallandi testified that Mr. Paragh is linguistically significantly impaired and that it is exceptionally difficult to understand what he says. In addition, the doctor stated that Mr. Paragh’s presentation is consistent with his diagnosis of moderate to severe intellectual disability. Adaptive behaviour, including the ability to execute routine activities of daily living, is significantly impaired which results in high dependency needs from adult caregivers. Mr. Paragh is unable to articulate his thought process and he generally cannot engage in meaningful conversations. In response to a question from a panel member, Dr. Pallandi advised that despite attempts to ascertain why Mr. Paragh engaged in the alleged assault on his neighbour, Mr. Paragh was unable to articulate any coherent rationale.
Mr. Paragh also presents with intermittent episodes of property aggression, verbal threats of harm and uses profane language. He has also acted out in a physically aggressive manner at times. Dr. Pallandi commented that as quickly as Mr. Paragh can escalate in his behavioural presentation, he is also prone to settle very quickly. Mr. Paragh expresses very poor insight into his problematic behaviours. Dr. Pallandi stated that a behavioural plan has been utilized to assist in appropriately managing Mr. Paragh’s care.
The doctor testified that shortly following Mr. Paragh’s re-admission to the hospital in December 2024, he has essentially been at his baseline and he had not been evidencing signs of psychosis.
In terms of his privileges, Mr. Paragh was granted indirectly supervised hospital grounds privileges which he managed well. Unfortunately, on January 25, 2025, he engaged in property damage which led to a brief one-day period locked seclusion.
The Hospital Report indicates that on February 3, 2025, Mr. Paragh was transferred from a general forensic unit to the FPRU, another general forensic unit, in order to create some distance between Mr. Paragh and another developmentally delayed patient as the two did not interact well.
Dr. Pallandi provided an update to the Hospital Report and stated that on February 18, 2025, Mr. Paragh was becoming irritable and his behaviour was escalating so staff tried to get him to go into a quiet room on the unit. He was unresponsive to staff direction and six staff were needed to direct him into seclusion. In the process, Mr. Paragh kicked a staff member in the leg. No injuries were sustained by the staff member. Mr. Paragh required chemical and mechanical restraints and a brief period of seclusion to settle. Dr. Pallandi stated that as of the hearing date, Mr. Paragh is out of restraints and seclusion and has settled well back into his unit’s milieu.
Dr. Pallandi testified that Karis group home has indicated that Mr. Paragh will be welcome to return to his community group home but that the housing operator has decided to first augment its on-site night staff complement prior to Mr. Paragh’s return in order to optimize his safe management. Once Karis has augmented its staffing complement, the hospital expects to be able to commence discharge planning.
In response to questions posed, Dr. Pallandi indicated that Karis residence has secured funding to employ additional staff for their residence but that as of the hearing date, no additional night staff had yet been hired. The doctor reiterated that as soon as the additional staff member is hired, the clinical team will be alerted and, provided Mr. Paragh maintains clinical stability and is at his baseline, he will likely be able to begin the process of his transition back to community living at Karis residence. In the interim, Mr. Paragh will be required to remain detained in hospital as he does not have alternative approved community accommodation available to him.
Dr. Pallandi acknowledged that the Release Order mandates that Mr. Paragh refrain from contact or communication with the alleged victim of the December 12, 2024 incident and that he not attend within 100 metres of any place where the alleged victim resides, works, attends school, or any other place where the alleged victim is known to be. The doctor stated that he believe the alleged victim resides approximately 200 to 300 metres away from the Karis home. The doctor stated that the housing operators and the hospital’s forensic out-patient team will have to ensure that Mr. Paragh understands the geographical prohibition placed on him and that he learns how to comply with all terms of the Release Order. The doctor commented that the Release Order should not pose as a barrier to returning Mr. Paragh to the Karis residence.
If for any reason, Mr. Paragh is not able to return to the Karis group home, Dr. Pallandi stated that the treatment team will then seek out alternative highly specialized housing in the community for him. The doctor advised that it could take years for the team to secure alternative high-support community housing. Dr. Pallandi stated that at the present time, he has no reason to believe that Mr. Paragh would not be an appropriate candidate to return to the Karis residence. Dr. Pallandi stated that the timeline for Mr. Paragh’s return to his residence is unknown at this time.
In response to a series of questions posed by a panel member, the doctor advised that the recent episode requiring a brief period of locked seclusion for Mr. Paragh would not likely be of significant concern to the Karis home operators as they are well acquainted with what Dr. Pallandi described as Mr. Paragh’s “behaviour repertoire”.
No further evidence was called by the parties.
Analysis and Decision:
The analytical framework established by Campbell (Re), 2018 ONCA 140 requires the Board to consider the liberty norm and the liberty status of an accused on a restriction. The liberty norm and liberty status for each restriction must be examined to determine the significance of the increase (if any) on the restriction of an accused’s liberty caused by the restriction. In determining the liberty norm of an accused at the outset of each period of restriction, the Board must “take a contextual approach, one that considers the individual’s pattern of liberty in the recent past.” ((Re) Campbell, ibid at para. 66). The liberty she/he was actually experiencing (rather than what she/he was entitled to) at the time of the increase is what the Board is to consider, and that “liberty must be of sufficient duration to have become, objectively speaking, the NCR accused’s norm” ((Re) Campbell, supra at para. 65).
Pursuant to the decision of (Re) Campbell, the Board agreed that a restriction of liberty had taken place. The Board found that the restrictions of liberty imposed on Mr. Paragh arising from his readmission to the hospital on December 21, 2024 and continued detention to the hearing date represented the least onerous and least restrictive intervention in the circumstances. We find his admission to the hospital and the resultant restriction of his liberty throughout this time frame was warranted and necessary for public safety. His initial restriction was triggered by his alleged assaultive behaviour in the community. Mr. Paragh’s ongoing detention in the hospital is necessary and appropriate as he is not yet able to return to his community residence as the operators of the Karis residence are not prepared to accept Mr. Paragh back to that facility until they are able to augment their night-time on-site staff complement. Until that happens, Mr. Paragh must remain detained in hospital as he does not have alternative approved community accommodation available to him.
In reaching our Decision, the Board carefully considered public safety, Mr. Paragh’s mental condition, his integration into society and his other needs.
DATED this 26th day of March 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar Ontario Review Board