Re: Jerry Jacob
ORB File No: 5818
Hearing held on: Wednesday, February 5, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley
Members: Dr. S. Lessard Dr. L. Leong Mr. P. Capelle Mr. A. Bouvier
Parties Appearing:
Accused: Jerry Jacob Counsel: Ms. M. Perez
The Person in charge of Hospital: Counsel: Ms. L. Senko
Attorney General of Ontario: Counsel: Mr. C. Coughlan
REASONS FOR DISPOSITION
(Dated April 3, 2025)
Introduction
On March 3, 2011, Jerry Jacob was found not criminally responsible on account of mental disorder on two charges of assault and one charge of failure to comply with probation order, all contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Jacob is currently subject to a Disposition of the Ontario Review Board (the "Board") dated February 22, 2024, detaining him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH”), with privileges up to living in the community in accommodation approved by the person in charge.
On February 5, 2025, a panel of the Ontario Review Board (the "ORB" or the "Board") convened a hearing pursuant to s. 672.81(1) of the Criminal Code of Canada. Mr. Jacob was in attendance and was represented by his counsel, Ms. Perez.
Without Prejudice Position of the Parties
Ms. Senko, on behalf of the Hospital, advised that no changes were being sought to the current disposition. Mr. Coughlan, on behalf of the Crown, supported the hospital. Ms. Perez, on behalf of Mr. Jacob, indicated that her client was seeking a conditional discharge and towards that objective would consent to a s. 672.55 treatment provision and a residence clause specifying the address of: 96 Dowling Avenue, City of Toronto.
Background and Index Offences
The Hospital Report details Mr. Jacob’s background prior to coming under the jurisdiction of this Board. Of particular note is that Mr. Jacob was born in Calcutta, India on December 15, 1967 and has one sister. As a child, he was social and outgoing. During his teenage years, he developed behavioral problems, becoming withdrawn and antisocial. He isolated himself in his room and had episodes of rage and violence. At 19, he was diagnosed with schizophrenia, and at 21, he attempted suicide. His father reports that doctors diagnosed him with schizophrenia at that time.
In 1989, Mr. Jacob was seen by Dr. Goldbloom, who noted he had already been in "almost every hospital in Toronto" and tried "almost every medication." These included risperidone, olanzapine, clozapine, and many injectable antipsychotics, often combined with mood stabilizers like lithium, Epival, and Tegretol. He was also diagnosed with "probable paraphilia" and given medication to reduce sex drive, including Lupron, which seemed to decrease his inappropriate sexual and aggressive behaviors.
Although accepted into the University of Toronto's Bachelor of Commerce program, he quit two credits short of graduating. He struggled to relate to other students and found university too stressful. After leaving university, Mr. Jacob worked various general labour jobs including factory work. His violent behaviour strained his relationships with his parents and sister, leading them to get restraining orders against him. Since leaving his parents' home, he has lived in apartments, boarding houses, rooms, shelters, and sometimes on the streets. Mr. Jacob has an extensive criminal record, including convictions for making threats, assaulting a peace officer, criminal harassment, and death threats. He has repeatedly spent time in jail.
The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:
“Charges 1 and 2: Assault
On Friday, April 2, 2010 at 2:10 p.m., Victim #1 [male victim’s name] had just exited a TTC bus at Keele and Dundas Street West and was speaking to someone on his cell phone. As Victim #1 was crossing from the east side of Dundas Street West to the west side, the accused who is not known to the victim was approaching from the east. The accused, without provocation, bumped the victim as he walked by and then in an aggressive tone challenged the victim to a fight.
Victim #1 ignored the accused and continued walking westbound while talking on his phone. The accused then continued crossing the intersection eastbound and approached Victim #2 [female victim’s name], who was standing on the southeast sidewalk at Keele Street and Dundas Street West. The accused again without provocation shoved Victim #2 with both hands on her shoulders causing her to fall backwards striking a stationary vehicle. The victim then fell to the ground. Victim #1, not wishing to fight, ignored the accused and started walking away. Victim #2 began arguing with the accused, when he turned towards Victim #1 with a closed fist, striking him on the left side of his face causing his hearing aid to fall on the ground. The accused then kicked Victim #1 in the groin area as he attempted to pick up his hearing aid.
Victim #2 and several citizens then told the accused that police were on their way. Police arrived on scene shortly after and located the accused who was arrested without further incident.
Injuries:
Victim #1: Slightly swollen left side of face. (No medical attention required.). Victim #2:
Four inch scrape to right forearm. (No medical attention required.) Swollen right thumb. Sore hip.
Charge 3: Failure to Comply with Probation
On the 1st day of May, 2008, the accused attended the Old City Hall courthouse and was convicted of the offence of Assault. He was placed on probation for a term of two years with the condition of keeping the peace and being of good behaviour. The accused was then placed on several more probation orders (approximately 8 to date) dating from the 27th day of May 2008, 5th day of September 2008, 19th day of November 2008, 2nd day of December 2008, 10th day of March 2009, 6th day of April 2009 and the 21st day of October 2009. All of the probation orders stipulated that the accused keep the peace and be of good behaviour. On today’s date of 2nd day of April 2010, the accused was arrested and charged with two counts of Assault. As a result of the two new criminal charges being laid, the accused was found to be in breach [of] his conditions of keeping the peace and being of good behaviour. The accused was charged accordingly and held pending a bail hearing the following day.”
Current Diagnoses
- Schizophrenia,
- Substance Use Disorder, in remission,
- Paraphilia not otherwise specified.
Evidence at Hearing
Evidence of Dr. Ali:
Dr. Ali advised that the only required change to the Hospital Report was at page 42:
On January 5, 2025, Mr. Jacob was sent to Toronto Western Hospital by ambulance after falling while getting out of bed, soiling self, and hitting his head. He was admitted to General Internal Medicine after assessments showed signs of pneumonia and overall weakness. He remains in hospital with plans to be transferred to rehab [emphasis added].
Mr. Jacob was in fact discharged to his residence, rather than to the rehabilitation unit, as the wait time was too long.
In the course of this reporting year there has been an increase in socially inappropriate behaviours toward both peers and staff with whom he comes in contact with. Mr. Jacob has participated in programming in this regard but there have been limited gains and those inappropriate behaviours have increased. Specifically, observations of inappropriate hugging and kissing on the cheek.
Dr. Ali testified that some of her patient’s behaviours are not driven by overt psychosis. These inappropriate behaviours could increase but may not be sufficient to certify her patient under the Mental Health Act (MHA). Nevertheless, these behaviours would pose a risk to others and would require admission to hospital.
Mr. Jacob’s housing has represented a bone of contention for a number of years. Only at the start of the hearing did Dr. Ali hear that Mr. Jacob had told his lawyer that he wished to stay in his current housing. There is a concern that absent the ability to direct where he lives that the hospital would not know where he goes and there is uncertainty that he would meet MHA criteria for return to hospital and readmission.
Mr. Jacob would like to have housing that allows him to have visitors. Dr. Ali advised that the treatment team is unaware if Mr. Jacob has had romantic partners. He says he has girls who are his friends. He takes them out and pays for lunches. Some of the inappropriate hugging and kissing has arisen from these relationships.
Responding to questions from Ms. Perez, Dr. Ali confirmed that her patient was discharged to LOFT housing in March 2021and subsequently moved to his current Dowling Avenue residence. Both are highly supported 24/7 supervised residences. Dr. Ali agreed that Mr. Jacob has not required hospital readmission since March of 2021.
Since October of 2020, Mr. Jacob has been treatment capable and grasps the ongoing need for medication and medication compliance. He has responded to efforts to try to make him more self-sufficient in this regard. He has been sleeping well and no issues with his prescribed medications have been noted. Responding to questions from Ms. Perez, Dr. Ali conceded that her patient is out and about in the community, volunteering, and meeting with friends for most of the day.
In December 2021, Mr. Jacob agreed to a voluntary trusteeship with regard to payment of rent although he retains the ability to dismiss the trustee at any time. There have been ongoing issues with borrowing money, recently brought to the attention of housing staff and the outpatient team by a co-patient. In May of 2024, Mr. Jacob’s sister paid off all of his outstanding debts. He stated at that time that he would desist from borrowing money and continued to state this until hospitalized for medical reasons in the month preceding this hearing. Therefore, the concern remains that he continues to hide information from the treatment team.
Dr. Ali testified that her patient has made housing applications independently, without the knowledge of his treatment team, both for subsidized and market rate housing. She added that he will need to be interviewed for less supportive housing if and when that opportunity arises. Dr. Ali opined that in less supportive housing, the borrowing of money, as set out in the preceding paragraph, could lead to verbal or physical altercations.
Appropriate future programming for Mr. Jacob should address activities of daily living as well as an understanding of physical boundaries. Regrettably the number of medical hospitalizations Mr. Jacob has required in the past year have impeded his ability to participate in programming. A panel member noted that Mr. Jacob appeared to be falling asleep at different times throughout the hearing. Dr. Ali advised that over the past year Mr. Jacob has been medically unwell and presents as weak.
According to Dr. Ali, a detention order is still necessary and appropriate because the hospital continues to require the ability to approve his accommodation. He continues to need a great deal of support and there are ongoing concerns vis-à-vis his ability to manage his finances.
Questioned with regard to the possible lengthening of the current reporting requirements, Dr. Ali advised that in previous years Mr. Jacob has had trouble keeping appointments and she would therefore prefer to keep the reporting requirements as they are.
Responding to questions from a panel member, Dr. Ali confirmed that the targeted group of her patient’s inappropriate behaviours are females around his own age.
In response to another panel member, Dr. Ali indicated that omission of the abstain provision would be appropriate given Mr. Jacob’s history but if this were to occur she would want to maintain the testing provision at least for the reporting year ahead.
Evidence of Mr. Jacob:
Mr. Jacob was called to testify by his counsel. He stated that if he receives a conditional discharge he will continue to take clozapine as he needs it to help his schizophrenia. He would also continue to keep all his appointments. He plans to live where he is until other subsidized housing with supports is identified. He stated he could not go out and find his own housing as to do so is too expensive. He has no plans to stop the voluntary trusteeship that pays his rent.
Mr. Jacob testified that if he receives a conditional discharge he would return voluntarily to hospital for assessment and readmission.
Over the past year Mr. Jacob has volunteered at Progress Place, for one hour per day and also worked as a dishwasher, janitor and as a hospital screener at CAMH during COVID. He added that he can work harder now in his 50s than he did in his 20s and 30s. He recently applied for a dishwasher position at the Out of This World Café.
Questioned by a panel member Mr. Jacob initially stated that he could live on his own quite well but subsequently agreed that he continues to require some supports with staff on site in the event he relapses and with ongoing medication compliance.
Mr. Jacob reiterated that he attends his appointments on time, takes his medications on time and that his rent is paid on time. Asked about the feedback he receives from females with regard to hugging and kissing, he responded that this only occurs with people who say it is okay on the basis of mutual consent.
Closing Observations
Ms. Senko submitted that it remains necessary for the hospital to approve Mr. Jacob’s accommodation as he requires supervised housing to ensure the administration of medications. He also requires onsite supervision particularly given his medical issues over the past year. Naming a residence is insufficient to manage Mr. Jacob’s risk and it was noted that his current housing is of a temporary nature.
Provisions of the MHA are insufficient and a committal warrant continues to be needed to return him to hospital in the event he decompensates and his behaviours escalate. Ms. Senko submitted that the hospital is prepared to remove the abstain provision but wished to retain the testing provision in this patient’s disposition.
Mr. Coughlan advised that he was in support of the hospital recommendation including the above noted removal of the abstention provision.
Ms. Perez submitted that a conditional discharge with residence specified and a consent to treatment clause is appropriate for the upcoming year. This is because Mr. Jacob’s degree of significant risk has diminished over time. He has resided in the community for the past four years absent an admission. He can function with supports regarding medication compliance and food preparation.
Ms. Perez submitted that the issues identified by Dr. Ali are not particularly relevant as regard to significant threat, such as the borrowing of money.
With regard to interactions with women, Ms. Perez submitted that these are now characterized as socially rather than sexually inappropriate behaviours. This goes to the degree of significant threat that Mr. Jacob presents.
In the alternative, if a conditional discharge is determined to be inappropriate, then Mr. Jacob would agree to the removal of the current 4(a) abstain provision pertaining to substances. Further, it is requested that the reporting requirement be reduced to allow him to progress.
Analysis and Decision
(a) Significant Threat
Ongoing significant threat to the safety of the public cannot be speculative. It must entail a real risk of serious physical or psychological harm arising from conduct that is both serious and criminal in nature.
In determining whether continues to represent a significant threat to the safety of the public the Board has carefully analyzed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
The Board unanimously finds that Mr. Jacob continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the position of the parties and accepted the uncontroverted evidence of Dr. Ali that Mr. Jacob continues to pose a significant threat. The Board relies on the Hospital Report and the Composite Risk Assessment contained therein at page 47 in determining that Mr. Jacob represents a significant threat to the safety of the public. Mr. Jacob suffers from Schizophrenia; a major mental illness, complicated by Paraphilia, not otherwise specified and previously complicated by Substance Use Disorder, in remission. The specific rationale addressing the existence of significant threat is reproduced below for ease of reference:
Given Mr. Jacob’s history of violence and sexually inappropriate behaviour, psychotic illness, affective and behavioural instability, paraphilic interests, significant history of non-compliance with remediation attempts, and risk assessment scores, he continues to meet the threshold for significant threat as defined in Section 672.5401 of the Criminal Code.
The Board therefore accepts that absent an ORB Disposition, Mr. Jacob would likely become non-compliant with prescribed medications which would lead to decompensation and the re-emergence of behaviours similar to those seen at the time of the index offences. We are satisfied that absent an ORB Disposition, it is likely that Mr. Jacob will cause serious physical or psychological harm to members of the public and such conduct will likely be criminal in nature.
(b) Disposition
Flowing from the Board’s finding that Mr. Jacob continues to pose a significant threat to the safety of the public it must shape a disposition for the year ahead. Its paramount consideration in doing so must be the safety of the public while also considering Mr. Jacob’s needs pursuant to s. 672.54 of the Criminal Code.
The necessary and appropriate disposition for Mr. Jacob provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.
In considering Mr. Jacob needs, the Board was attentive to his ongoing need for supports within a highly supported 24/7 staffed living environment since his discharge into the community four years ago. Specifically, with regard to ongoing medication compliance, monitoring for the possibility of relapse, activities of daily living and attendance at appointments. This contradicts his assertion that he could live quite well on his own and has, according to Dr. Ali made housing applications independently, absent the knowledge of the treatment team for both subsidized and market rate housing. Neither subsidized or market rate housing can provide the elevated degree of support he continues to require.
To his credit, in December of 2021 Mr. Jacob agreed to a voluntary trusteeship for the payment of his subsidized rent which continues to the present and speaks to a recognition of ongoing financial responsibilities. This contrasts markedly however with Mr. Jacob’s ongoing pattern of incurring debts. His sister paid off whatever debts he owed in May of 2024 with an understanding that he would no longer borrow money. However, it was recently learned that his pattern of borrowing continues and was not disclosed to his treatment team.
Overall, the circumstances described in the two preceding paragraphs speak to Mr. Jacob’s inability to reside in less supportive housing.
The panel finds that Mr. Jacob’s desire for visitors is symptomatic of the increase in inappropriate behaviours that have occurred during the past reporting year. Specifically, the inappropriate hugging and kissing of females and his resistance to engage in programming to augment his understanding of physical boundaries. A paragraph extracted from Page 41 of the Hospital Report merits reproduction:
In regards to social interactions, in February 2024, it was reported that Mr. Jacob had been asking female clients for their phone numbers while he was working at a warming shelter. Mr. Jacob confirmed this was true and he was reminded of professional boundaries and responsibilities, as well as potential discomfort to other people. Following this conversation, Mr. Jacob stated that he “promises” to not ask clients for their numbers again. In September 2024, Mr. Jacob’s FOPS case manager received a report that Mr. Jacob “hugged [female peer] tightly and deeply kissed the cheek of [female peer], as she struggled under his embrace”. The note indicated that the female was relieved when the hug ended. This was discussed with Mr. Jacob and he was reminded about consent and boundaries. In December 2024, Mr. Jacob’s FOPS case manager received communication about Mr. Jacob inappropriately hugging and kissing the cheek of various Progress Place members. Mr. Jacob advised that he does this to be “friendly”, and he was reminded by Progress Place and the FOPS team about consent and boundaries again. Mr. Jacob does socialize with friends and has a friend that he visits on weekends in Oshawa. He has contact with his sister.
This extract contradicts Mr. Jacob’s testimony that the feedback he receives from females he hugs and kisses is okay on the basis of mutual consent. Clearly, it is not.
Accordingly, a detention order remains necessary and appropriate in order for the hospital to continue to have the ability to approve Mr. Jacob’s accommodation. His current housing is of a temporary nature and the naming a residence is insufficient to manage Mr. Jacob’s risk
Finally, in light of Mr. Jacob’s lengthy history of abstinence from substances, removal of the current 4(a) abstain provision together with retention of the current 4(b) test provision are necessary appropriate. The Panel is also prepared to reduce Mr. Jacob’s current 4(c) reporting requirement from not less than once per week to not less than once every two weeks.
Conclusion
Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Jacob poses to the safety of the public while still meeting his needs, remains a Detention Disposition.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Ali and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Jacob’s mental condition, his reintegration into society and other needs.
DATED this 3^rd^ day of April, 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Capelle Legal Member
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Office of the Registrar Ontario Review Board