Re: Carl J. Desjardins-Paquette, 2025 CanLII 28957

Ontario Review Board

Re: Carl J. Desjardins-Paquette

ORB File No: 7319

Hearing held on: Thursday, February 27, 2025

Place of Hearing: Royal Ottawa Mental Health Centre

Pursuant to: Section 672.81(2.1) of the Criminal Code

Before: Alternate Chairperson: Ms. M. Labrosse Members: Dr. S. Lessard Dr. G. Nexhipi Mr. D. Sandor Ms. K. Brisson

Parties Appearing: Accused: Carl J. Desjardins-Paquette Counsel: Unrepresented Amicus Curiae: Ms. M. Munsterman The person in charge of hospital: Representative: Dr. J. Gojer Attorney-General of Ontario: Counsel: Mr. J. Wright

REASONS FOR DECISION

(Dated April 2, 2025)

Introduction

1On March 16, 2018, Carl Desjardin-Paquette, who was 38 years old at the time of the hearing, was found not criminally responsible on account of mental disorder on one charge of committing an indecent act contrary to the Criminal Code of Canada. Mr. Desjardins-Paquette is currently subject to a Decision and Disposition of the Ontario Review Board dated June 26, 2024 (as amended) that detains him in the Secure Forensic Unit of the Royal Ottawa Mental Health Centre, Ottawa (hereinafter referred to as "the Hospital") with privileges up to and including to live in the community in 24-hour a day supervised accommodation approved by the person in charge. That Decision and Disposition imposes certain conditions on Mr. Desjardins-Paquette. These include a condition to abstain from the use of substances as well as a condition to submit samples of his urine and/or breath for the purpose of analyzing compliance with the abstention condition.

2By letter dated November 22nd, 2024, the Hospital advised the Ontario Review Board that Mr. Desjardins-Paquette was readmitted to hospital on November 15th, 2024, and had experienced a decrease in his privileges for a period exceeding seven days. This constituted a significant increase in the restriction of his liberty and necessitated a hearing pursuant to section 672.81(2.1) of the Criminal Code.

3On February 27th, 2025, the Ontario Review Board convened at the Royal Ottawa Mental Health Centre, to review that restriction of liberty. Mr. Desjardins-Paquette attended the hearing and was unrepresented. Ms. Marni Munsterman appeared as Amicus Curaie.

4The record for the hearing included the Revised Notice of Hearing, the Hospital's Restriction of Liberties Notice mentioned above, the Ontario Review Board's response to the Hospital's ROL Notice, the most recent Order and Amended Decision and Disposition, the Reasons for that Decision and Disposition and an ROL and Hospital Report dated June 6, 2024. On the consent of all parties, a Hospital Report dated February 9, 2025, was entered into evidence and marked as exhibit 1.

5At the outset of the hearing, the parties confirmed that the only issues to be addressed were associated with the restriction of Mr. Desjardins-Paquette's liberties. In this regard, the Hospital offered the position that the subject restriction was justified and necessary, and represented the least onerous and least restrictive course of action available to the Hospital to manage the elevating risk Mr. Desjardins-Paquette was posing to the public at the time. Both the representative of the Attorney General and Mr. Desjardins-Paquette agreed with the Hospital. None of the parties contested that Mr. Desjardins-Paquette's liberty norm had been significantly restricted as a result of his being readmitted to the Hospital.

6Proceeding on the basis of this joint submission, the panel deliberated and concluded that the joint submission was appropriate and supported by the evidence. What follows are the reasons for that conclusion.

Evidence at the Hearing

7The evidence for the hearing primarily came from the Hospital Report marked as Exhibit 1 and the live evidence provided by Dr. Gojer, Mr. Desjardins-Paquette's treating psychiatrist. The Hospital Report is cumulative in nature and includes the synopsis that was referenced in the last set of Reasons for Decision and Disposition.

On 07 Jun 17, 2017, Cst. Peach observed a male in front of 1311 Cumberland Street, walking in circles on the sidewalk and driveway portion of the residence. Upon getting closer to the male, Cst. Peach observed him to have no shirt on with black baggy jogging pants. The pants were down slightly, exposing the male's pubic hair and penis. The male looked at police as the cruiser passed him and made no effort to pull up his pants, until he saw the cruiser turn around in a next-door neighbour's driveway. Upon driving back to the male's residence and exiting the cruiser, the male, whom police recognized from previous dealings as Carl Desjardins-Paquette began talking and his pants again, fell down, exposing his pubic hair and entire penis.

8Inasmuch as this hearing was limited to considerations associated with the significant increase in the restriction of Mr. Desjardins-Paquette's liberties and also proceeded on the basis of a joint submission, it is not necessary to provide a detailed summary of Mr. Desjardins-Paquette's history as contained both in the Hospital Report and in previous Reasons for Decision and Disposition. It is sufficient to indicate that Mr. Desjardins-Paquette has a significant criminal record that includes convictions for violent offences (notably sexual assault and forcible confinement) and a difficult history of struggling with major mental illness. He experienced severe trauma as a child, was involved with child protective services and attained only to a grade 10 level of education. He has been placed on the Sex Offender Registry and has a history of suicidality. His current diagnoses are:

• Schizoaffective Disorder, Bipolar Type, Multiple episodes, currently in partial remission
• Paraphilia NOS
• Stimulant Use Disorder, in sustained remission, in a controlled environment
• Attention Deficit Hyperactivity Disorder, combined type
• Antisocial Personality Disorder
• Hypothyroidism.

9The Update to the ORB for the Restriction of Liberty Hearing is located at page 61 of the Hospital Report. It explains that Mr. Desjardins-Paquette was admitted to the Forensic Assessment Unit on a Form 49 following a period of noncompliance with his prescribed anti-psychotics. Mr. Desjardins-Paquette had engaged in ongoing drug use and had displayed verbal aggressivity in the community. It explains that while Mr. Desjardins-Paquette has been living at the Kimberlane group home where he enjoys positive rapport with staff, that staff had been reporting increased concerns associated with his substance use, noncompliance with medication and verbal instigation of altercations with other residents. The Hospital was advised that Mr. Desjardins-Paquette's housing was at risk as a result of these behaviours, with staff indicated that he (Mr. Desjardins-Paquette) "is going to die, he is too sick to live here anymore, he is worse than last time." Mr. Desjardins-Paquette's urine was testing positive for opiates and stimulants and he acknowledged active use. He presented as dishevelled, unkempt and malodours. He was unable to hold a conversation and had marked formal thought disorder.

10The Hospital Report describes the rapid progress Mr. Desjardins-Paquette made once receiving two doses of Invega in the Hospital. His thought disorder abated; he began attending substance use counseling; he participated in the risk and recovery group on the Forensic Assessment Unit. He became pleasant and easy to talk to, and acknowledged his difficulties with substance use. He expressed a desire to return to Kimberlane and expressed appreciation for his relationship with staff there.

11As a result of his progress, Mr. Desjardins-Paquette was slated for transfer to the Forensic Rehabilitation Unit, but owing to lack of beds he was discharged back to Kimberlane on January 30, 2025, with strict out-patient follow-up routine for drug screening, attendance with his case manager, treating psychiatrist (Dr Gojer) and the risk and recovery group and addictions counseling. To the date of the report, he was responding well to a combination of lithium and Invega.

12In his evidence to the panel, Dr Gojer echoed the contents of the Hospital Report. He summarized that Mr. Desjardins-Paquette was significantly decompensated when being admitted to the Forensic Assessment Unit and that it took approximately one month to stabilize him on the Invega treatments. He explained that, where an individual was showing signs of decompensation to the point seen with Mr. Desjardins-Paquette, the preferred course would be to transition the patient from the Forensic Assessment Unit, to the Forensic Rehabilitation Unit, and then back to housing, but as there were no beds available on the Forensic Rehabilitation Unit, and as the Hospital had a strong working arrangement with Kimberlane, they were able to move Mr. Desjardins-Paquette directly back to his home after a period of medication compliance, expression of insight, and engagement in the groups and counseling mentioned. He explained that prior to discharge, Mr. Desjardins-Paquette had formulated a relapse prevention strategy with his addictions counselor at the Hospital. He confirmed that Mr. Desjardins-Paquette has a good working relationship with his new case manager, and that he is more relaxed, is not expressing any paranoia, and is feeling less of a need to use drugs. He updated the panel that Mr. Desjardins-Paquette is no longer taking lithium, but is being managed solely on Invega. He expressed the opinion that no changes were needed on Mr. Desjardins-Paquette's reigning Decision and Disposition.

Submissions

13At the end of the hearing, the parties renewed their submission as stated at the outset. All agreed that the move from a group home to the Hospital's Forensic Assessment Unit constituted a significant restriction of Mr. Desjardins-Paquette's liberties. All agreed that this action was justified and necessary and represented the least onerous and least intrusive measure available to the Hospital at the time.

Analysis and Conclusion

14As stated, the panel on consideration of the evidence agrees. The significant increase in the restriction of Mr. Desjardins-Paquette's liberties was occasioned following a decompensating period of noncompliance with medication and use of substances including opiates. Mr. Desjardins-Paquette's state of deterioration was described in concerning terms by group home staff with whom he shared a good therapeutic alliance. He was becoming a threat to other residents, was aggressive and was showing increasing symptoms of his major mental illness. He was at risk of losing his place of supervised accommodations. The evidence clearly established that Mr. Desjardins-Paquette had experienced a significant restriction of his liberties for a period of 4-6 weeks and that his return to the Hospital was necessary and justified.

15The evidence also supported the conclusion that this course of conduct was the least onerous and least restrictive course available to the Hospital at the time. Mr. Desjardins-Paquette's noncompliance with his medication was aggravated by his use of substances. He required a Form 49 to bring him to the Hospital. Once he was treated with Invega in that setting he began to settle and was able to engage in programs and counseling. As he stabilized, the Hospital engaged in active steps to minimize the intrusion upon his liberties such that he was able to promptly return to the group home where he was residing at the time of the hearing.

16For these reasons, the panel concludes that the significant increase in the restriction of Mr. Desjardins-Paquette's liberty was justified and necessary and represented the least onerous and least restrictive option available to the Hospital.

17The panel thanks all who helped with this hearing, and wishes Mr. Desjardins-Paquette good progress as he engages in his treatment and works with his treatment team and addictions counsellors.