Re Chantal E. Trudel, 2025 CanLII 28953

Ontario Review Board

Re: Chantal E. Trudel

ORB File No: 5234

Hearing held on: Thursday, January 16, 2025

Place of Hearing: Brockville Mental Health Centre

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. R. Bigelow

Members: Dr. Y. Alatishe

Dr. G. Kerry

Mr. K. McKenna

Ms. K. Brisson

Parties Appearing:

Accused: Chantal E. Trudel

Counsel: Mr. A. Sheivari

The Person in Charge Representative: Dr. J. Gray

Attorney-General of Ontario: Counsel: Mr. K. Schultz

REASONS FOR DISPOSITION (Dated April 2, 2025)

Introduction

1. On December 10, 2008, Ms. Trudel was found not criminally responsible on account of mental disorder (NCR) on a charge of aggravated assault contrary to the Criminal Code. She is currently subject to a disposition of the Ontario Review Board date January 17, 2024, ordering her detention at the Secure Forensic Unit of the Brockville Mental Health Centre (the Hospital) with privileges up to and including residence in the community in approved accommodation.

2. On Friday January 16, 2025, the Board convened a hearing to review Mr. Trudel’s disposition pursuant to section 672.81(1) of the Criminal Code. Ms. Trudel was present at the hearing and represented by Counsel, Mr. Sheivari.

3. The issues to be determined at the hearing were whether Ms. Trudel continued to constitute a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, determine what is the necessary and appropriate disposition which is also the least onerous and least restrictive taking into account the factors set out in section 672.54 of the Criminal Code.

Positions of the Parties

4. At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. The Hospital representative advised that the position of the Hospital was that Ms. Trudel continued to represent a significant threat to the safety of the public and that the necessary and appropriate disposition was a continuation of the current detention order without change.

5. Counsel for the Attorney General supported the Hospital position. Counsel for Ms. Trudel advised that, although he was not contesting the issue of significant threat, in his submission the necessary and appropriate disposition would be the granting of a conditional discharge.

Evidence at the hearing

6. The evidence at the hearing consisted of a copy of Ms. Trudel’s criminal record (Exhibit 1), the Hospital Report dated January 4, 2025 (Exhibit 2), and the oral evidence of Dr. Gulati, Mr. Trudel’s treating psychiatrist.

Findings:

7. For the Reasons that follow, the Board finds that Ms. Trudel continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current detention order without change.

Index Offence(s):

8. The circumstances surrounding the index offences taken from last year’s reasons for disposition are as follows:

On October 25, 2008, Ms. Trudel agreed to have sex with Mr. N. for $60. He paid her $20 and said he would pay the balance after they had sex. At some point they were lying naked on a futon, when she pulled out a knife and stabbed him in the chest. Mr. N. reported that this was unprovoked, and that Ms. Trudel did not say a word, “like a robot or something.” He suffered two chest wounds. She dressed and fled. He called 911. Ms. Trudel was later arrested and charged with aggravated assault.

Background Information Regarding the Accused:

9. Ms. Trudel is currently 37 years of age and was born into difficult circumstances. From the age of 15 months, she was cared for by her grandparents and then by her grandfather after her grandmother died. She was placed in group homes commencing at the age of 12 and subsequent lived intermittently with her grandfather and for a brief period of time with her father where she was abused.

10. Her grandfather reported that she began to have severe behavioural problems at 14 or 15, quit school and began using drugs including crack cocaine on a regular basis. By the age of 16 or 18, she was working in the sex trade, lost touch with her grandfather and in lived a life on the street mainly focused on drug use and obtaining funds to pay for that use.

Legal History:

11. Ms. Trudel has a lengthy criminal record commencing in the Youth Court when she was 16 and including convictions for obstruct police (x5), unlawfully at large (x2), resisting arrest (x2), possession of narcotics, communicate for the purpose of prostitution, cause disturbance and innumerable counts of breaches of court orders.

Psychiatric History

12. Ms. Trudel’s first involvement with mental health related care was in 2006 when she saw a psychiatrist at the Children’s Hospital of Eastern Ontario (CHEO). The psychiatrist at that hospital summarized her history at the hospital as follows:

Ms. Trudel has been intermittently under my care since my initial contact with her in 2006. When she has been out of jail, she has tended to come to appointments. She has ongoing difficulties with taking her medications. Since my initial contact with her, Ms. Trudel has been set up with the Canadian Mental Health Association. She has proved again to be a somewhat challenging patient, due to her antisocial lifestyle and drug-use. She has always been agreeable for follow-up and for taking medications during our appointments. However, follow-through is difficult for her. A team meeting with her CMHA worker, Ms. Trudel and Ms. Trudel's probation officer (Heather Bazinet) had been booked on September 17, 2008 but Ms. Trudel could not be located. his Prior to the index offences, Ms. Trudel had never sought any mental health support even during the times that he felt quite depressed. He had never been admitted to hospital for any mental health issues and his mental state had never been evaluated.

From a social perspective, Ms. Trudel has made little if any progress. She had lived intermittently with her grandfather, but lost touch with him. Apparently, there was no one at the family home. She has not had any real social contact, and most of her activity involves "life on the streets" focussed around using drugs and paying for that use. Despite promises to stay drug free and attend treatment, she has been unable to do so. It also appears that she has moved around frequently, getting arrested in other areas of the province and in Quebec. Ms. Trudel's major impairments appear to be her schizophrenia, ongoing cocaine use and antisocial behaviours.

Current Diagnosis

13. Ms. Trudel’s current diagnoses are:

• Schizoaffective disorder, bipolar type

• attention deficit hyperactivity disorder, combined presentation

• antisocial personality disorder

14. Ms. Trudel’s history subsequent to NCR finding is well summarized in last year’s reasons for disposition dated March 22, 2024, as follows:

At the time of the NCR finding in 2008, Ms. Trudel was detained at Royal Ottawa hospital. Her initial Disposition in 2009 was a transfer to Brockville MHC under a Detention Order, having been eloping, using substances, and unmanageable at Royal Ottawa. Since then, she has been detained at Brockville under successive Dispositions, with potential privileges extending to a wide range of community passes and to living in approved accommodation in the community.

Up to 2019, Ms. Trudel had managed to abstain from substance use. Elopements are noted in 2011 and 2013. In February 2019, she was discharged from hospital to live in the Forensic Intensive Treatment Team (‘FITT’) House, a residence on the hospital grounds, with 24-hour staff support and supervision, for forensic patients transitioning to independent living in the community.

This placement lasted until October 2020. At FITT House, she had continuing symptoms of her major illness, including paranoia. She questioned her need for medications, and required daily support to take them. She incurred a number of debts, said to be due to poor money management. In August 2020, she eloped from FITT House, bought drugs, took a taxi to a hotel in Ottawa, did not sleep for days, and then asked a mall security guard for help to get back to the Brockville hospital. She returned four days later in a decompensated state, having taken an unknown quantity of illicit substances, which proved on screening to be cocaine, fentanyl, and methamphetamines. She later admitted to having shared a crack pipe, apologized for eloping, and promised to never do it again.

Ms. Trudel was next discharged from hospital to Salus Fisher House, a 24-hour supervised group home in Ottawa, for adults with serious mental illness, after temporary leaves there between July and November 2021. This placement lasted until August 2022.

At Salus Fisher House, she was medication compliant (at first) and did well in groups, but missed curfew most nights, despite frequent reminders to follow House rules. She appeared to be negatively influenced by a friend (he was banned from the House), and had some issues in co- living with others. In April 2022, she was briefly readmitted to hospital due to substance use. On August 20, she was evicted from Salus Fisher for ongoing rule violations, and substance use for two weeks in a row (cocaine and alcohol, then cannabis and crack cocaine), despite warnings and promises. She had also become non-compliant with medication.

She was readmitted to the hospital on August 20, 2022. This restriction of liberty was upheld on a Board review as necessary and appropriate in the circumstances; it was noted that her use of crack cocaine in the community created a situation of mental instability and corresponding risk to herself and others.

Ms. Trudel has remained in Brockville hospital since then, while efforts are ongoing to find an appropriate placement for her in the community.

Evidence of Dr. Gulati

21. Dr. Gulati indicated that Ms. Trudel had a reasonably good reporting year and was discharged to the FITT House in October 2024. She continues to experience intermittent symptoms of her mental illness including a belief that she is being followed by zombies. She also regularly asked for medication changes. Prior to her discharge in October, she had expressed frustration with the delays in her returning to the community. However, Dr. Gulati noted that the treatment team had a very difficult time finding a residence appropriate for her needs which would accept her. Her history of substance use, elopement and unsuccessful previous discharges resulted in many residences not being prepared to accept her.

22. Dr. Gulati stated that although Ms. Trudel was medication compliant, insight into her illness, the need for medication and the impact of substances on her mental health is limited. She is also somewhat overconfident in her abilities to live in the community without supports. FITT house is usually considered to be a transitional residence and where Ms. Trudel could go after leaving is a serious challenge.

23. On a very positive note, Dr. Gulati noted that Ms. Trudel had been offered a six-week job placement at a local department store, and had completed it successfully and been offered an extension of the placement.

24. In response to questions from counsel for the Attorney General, Dr. Gulati indicated that her transition to FITT house went well but cautioned that there have been repeated discharge failures and impulse control continued to be a significant issue. Likely next steps would be a transfer to a less supervised residence and that the Salus Fisher House has indicated that they would be prepared to reconsider Ms. Trudel for residence after some time at FITT house.

25. Also, in response to questions from counsel for the Attorney General Dr. Gulati stated that in his opinion the Mental Health Act would not be sufficient to manage Ms. Trudel’s risk and that when unwell and/or using substances, she is unlikely to return to hospital voluntarily. He also indicated that when unwell Ms. Trudel is paranoid and believes that she needs to protect herself resulting in a significant potential for acting out aggressively.

26. In response to questions from counsel for Ms. Trudel Dr. Gulati confirmed that Ms. Trudel had displayed no signs of aggression over the reporting year and that her last use of illicit substances was in October 2023. Her current work hours were twice weekly four-hour shifts.

27. Dr. Gulati also indicated that he was aware of an individual named Peter Smith who had been an approved person but there had been no assessment of his residence as appropriate for Ms. Trudel. In response to questions from panel members, Dr. Gulati indicated that in his opinion Ms. Trudel continues to need supervision at her accommodation and that the relationship between her and Mr. Smith was unclear, but he did note that Mr. Smith had been banned from Salus Fisher House.

Analysis and Conclusion, Significant Threat:

28. Although the issue of significant threat was not contested at the hearing, the Board nevertheless makes an independent finding that Ms. Trudel continues to represent a significant threat to the safety of the public. Ms. Trudel suffers from a major mental illness, schizoaffective disorder bipolar type, and has also been diagnosed with antisocial personality disorder. She continues to suffer from breakthrough symptoms of her illness and has a long history of serious substance abuse negatively impacting on her mental health as well as noncompliance with recommended treatment, elopement and breaches of numerous court orders.

29. Although she is currently compliant with medications and has been abstinent from substances since October 2023, she has little insight into the effect of substance use on her mental health or the need for medication. Given her history and the seriousness of serious substance abuse history, there continues to be a significant risk of relapse to substance use with associated decompensation and disengagement from treatment without the supervision of the Board and the Hospital.

30. The Board accepts the evidence of Dr. Gulati that when unwell Ms. Trudel experiences paranoia which can result in her acting out aggressively and causing serious physical and/or psychological harm to members of the public similar to that of the index offence.

Analysis and Conclusion Necessary and Appropriate Disposition

31. The Board finds that there is no air of reality to consideration of a conditional discharge in the circumstances. Given the significant risk of a return to substance use and impulsivity, the Hospital requires the ability to approve accommodation in order to ensure that Ms. Trudel is abstinent from substance use and compliant with medication. The Board also accepts the evidence of Dr. Gulati that the provisions of the civil mental health system are insufficient to manage risk.

32. The Board also notes that the Board does not have jurisdiction to delegate the authority to approve accommodation to the hospital under the terms of a conditional discharge. Although Ms. Trudel is currently resident in the community, her residence is a transitional residence, not intended for long-term stays and in the circumstances, it would not be appropriate to require her to continue to reside at that residence and the Board has no information with respect to other appropriate residences which may be prepared to accept her.

DATED this 2nd day of April, 2025, at the City of Toronto, in the Toronto Region.

Mr. R. Bigelow

Alternate Chairperson

__________________

Office of the Registrar

Ontario Review Board