Tianna Campbell (Re), 2025 CanLII 28973

Ontario Review Board

Re: Tianna Campbell

ORB File No: 8704

Hearing held on: Monday, February 24, 2025

Place of Hearing: Brockville Mental Health Centre

Pursuant to: Section 672.47(1) of the Criminal Code

Before: Alternate Chairperson: Mr. M. Segal Members:

• Dr. R. Kunjukrishnan
• Dr. T. Stirpe
• Ms. M. Chamberlain
• Mr. A. Mete

Parties Appearing:

• Accused: Tianna Campbell
  • Counsel: Ms. N. Calvinho
• Person in charge of hospital:
  • Representative: Dr. J. Gray
• Attorney-General of Ontario:
  • Counsel: Mr. K. Schultz

REASONS FOR DISPOSITION

(Dated April 3, 2025)

Introduction

1Tianna Campbell, aged 21, was found not guilty by reason of mental disorder on January 15th, 2025, on a charge of assault, that arose on March 10, 2024. The court declined to make a disposition and referred the matter to the Ontario Review Board (the Board) to make an initial disposition.

2On February 24, 2025, Ms. Campbell made her initial appearance from the Brockville Mental Health Centre (the hospital). The Board had before it the hospital report dated November 18th, 2024.

3By way of background, the Board also had before it the Criminal Court file that included charging documents, police reports and earlier assessments.

4In preliminary positions, the hospital, represented by Dr. J. Gray, reiterated what was in the report. The hospital position was there may be a question as to whether the patient’s risk meets the Winko threshold, but if the Board thought otherwise, Ms. Campbell should be on a detention order with liberal privileges. Defense counsel agreed. Crown counsel was of the view that the significant threshold would be met.

Current Diagnosis

• Bipolar Affective Disorder, most recent episode manic
• Intellectual Disability, mild severity.

Background

5Ms. Campbell is single. She was residing with her maternal grandmother at the time of the index offence. She is unemployed and receives Ontario Works. Ms. Campbell had recently come to Brockville to live with her grandmother interspersed with periods of previous homelessness and residing in shelters.

Index Offences

6The facts are set out in the hospital report and are summarized as follows:

"On Saturday March 9 2024 Tianna Campbell was apprehended under the Mental Health Act by the Brockville Police Service where she was place on a Form 1. At this point Tianna stayed in the care of the Brockville General Hospital. On Sunday March 10 2024 Tianna assaulted a nurse, Lise Laframboise, in the In-patient Mental Health area of the hospital. Tianna grabbed Lise a nurse at the hospital by the hair and proceeded to hit her face off the side of the stretcher she was sitting on.

Lise suffered bruising to her face and a cut to the inside of her lip. Lise attended the Emergency Room for medical attention and received X-rays on her face and back. Tianna pulled out some of Lise's hair. Brockville Police were contacted and Lise would like Tianna to be criminally charged. An Undertaking has been prepared and is in the D Platoon slot. Lise was advised to tell her supervisors to notify Police when Tianna is going to be released so Brockville Police can arrest Tianna at that time.

On March 20th 2024 at approximately 1630hrs, the accused, Tianna CAMPBELL was located and arrested for the offence of Assault. She was read her rights to counsel and cautioned, which she indicated she understood. The accused did not exercise her rights to speak to counsel. The accused was released on scene via an Undertaking with a future Court date of April 26th, 2024, at 9:00 a.m., with a future fingerprint date of April 23rd at 8:45 a.m.

The following is culled from the Case File Synopsis authored by #118 Branco, Ian, dated March 20, 2024:

On March 20th 2024 at approximately 1609hrs, PC BRANCO (myself) and SGT CHICOINE were dispatched to Brockville General Hospital at 75 Charles Street in Brockville. Information received from Brockville Police Service dispatch was that a patient, Tianna CAMPBELL was being released from BGH custody. Further information from BPS dispatch was that BPS had grounds for the arrest of CAMPBELL. from an incident that happened on March 10th, 2024. CAMPBELL had assaulted an emergency room nurse that had wanted to proceed with Criminal Charges. Additionally, CAMPBELL was being cared for at the BGH Mental Health unit and was awaiting to be released.

SGT. CHICOINE and I arrived on scene at approximately 1620hrs. We then attended the Mental Health ward where we were greeted by multiple nurses. These nurses advised Police that CAMPBELL was going to have her grandmother present as a support while she was arrested.

Police were then brought to the secure area for mental health clientele where we were introduced to CAMPBELL. At approximately 1630, I advised CAMPBELL she was under arrest for Assault under the grounds formulated by CST. MCINROY While CAMPBELL had her grandmother as support, Police did not handcuff her as we believed this would escalate tension and was unnecessary. CAMPBELL was then provided her Rights to Counsel. CAMPBELL indicated she understood her rights to counsel, and then advised she wanted to call a lawyer. CAMPBELL was then provided her Caution, to which she indicated she understood. I released CAMPBELL on scene at Brockville General hospital via Undertaking. This document was explained to CAMPBELL, and her future court date and fingerprint appointment were explained to her. She indicated she understood and then signed the requested document. Police gave CAMPBELL her copy of the document and this ends my involvement with this file.

End of report.

The following is culled from the Case File Synopsis authored by #118 Branco, Ian, dated March 25, 2024:

On March 24th 2024 at approximately 2030hrs the accused, Tianna CAMPBELL was at 25 Edgewood Avenue where the accused was refusing to take her prescribed medications. The accused behaviours began to escalate, and she then threatened the victim that she would burn her with a cigarette. The Police were notified.

On March 24th 2024 at approximately 2057hrs the accused was located and arrested for the offence of Uttering Threats to cause bodily harm. She was read her rights to counsel and cautioned, which she indicated she understood. The accused did exercise her rights and contacted the lawyer of her choosing.

The accused did not provide a statement."

7Ms. Campbell had no recollection of the index offences.

8Ms. Campbell’s parents were teenagers when she was born. Her father was not part of her life. Her mother had a series of challenges, including a cocaine addiction and was often absent. Ms. Campbell suffered sexual abuse at the age of eight. When that happened, she was sent to her paternal grandparents. She struggled in school.

9As a teenager there were behavioural problems. She attempted suicide at 16 resulting in her first hospitalization for mental health issues. At that time, she took to the streets and hooked up with a man who exploited her sexually by having her prostitute herself. She went off her antipsychotics eventually landing up in Brockville.

10While a teenager, she used cocaine, cannabis and engaged in vaping. Prior to the index offences she was not using substances according to her grandmother. Starting in 2020, there were various brief hospitalizations for mental health. She was under the care of a local mental health team in Scarborough for a few years.

Evidence at Hearing

11Dr. J. Gray was the only witness. Dr. Gray reviewed the patient’s very difficult background on how ill she was when she first entered the Brockville Mental Health Centre.

12As best as Dr. Gray could determine, Ms. Campbell did not do well in Brockville before hospitalization. There were conflicts with her grandmother. She was in and out of hospital. The Mental Health Act had been used.

13After her arrest for the index offences, she was in bad shape. She was very manic. Over some weeks things straightened out. Any signs of violence dissipated. She was compliant with her medications.

14Side effects produced weight gain and drowsiness. She is capable but declined to have her dosage of antipsychotic medication slightly reduced.

15There are lots of historical factors in her HCR-20. In Dr. Gray’s view the current risk of violence is low.

16Ms. Campbell had thrown a water bottle at her grandmother and threatened burn her with cigarettes.

17Dr. Gray, through the social worker, is actively looking for supportive housing. She is no longer eligible for entry into the Toronto Program that supervised her, as they had not heard from her in five years.

18If discharged, Dr. Gray believes Ms. Campbell may well stop taking her medications and fall away from treatment, resulting in psychosis, and a return to a risk of causing disturbances, aggressivity and potentially psychological or actual violence.

19Because of Ms. Campbell’s intellectual disability, she requires supervision and prompting and support to reliably take her medications. Her ability to perform the activities of daily living is poor.

20Dr. Gray agreed that a placement in a group home setting while beneficial, would be stressful.

21Ms. Campbell had used long-acting medications some years earlier.

22In hospital, after stabilizing, there have been no management problems.

23Dr. Gray agreed that it might be interesting to seek a transfer to the Greater Toronto Area such as to CAMH or to Ontario Shores, although he appreciates that their waiting list may be lengthy prior to admission.

24Ms. Campbell’s insight into her illness may cause her not to have the ability to inform staff of decompensation if it started to appear. As she has no memory of the index offences, she therefore has no insight into them.

25If a detention order was issued, Dr. Gray agreed that a prohibition on substances, coupled with random urine testing should be included in the disposition.

26If the Board found Ms. Campbell still represented a significant threat to the safety of the public and stable supportive housing with active community follow-up was identified, Dr. Gray agreed that an early Board could be called.

27In final submissions the parties reiterated their positions. Crown counsel stressed that significant threat was present. It was noted that Ms. Campbell has done very well in hospital.

Analysis

28Ms. Campbell has had a very difficult life for someone so young. Her history of mental health issues dates back some years. There have been times when she did better, went on an injectable and when followed by an ACT-type team led by a psychiatrist. Housing has been an issue all her life. She has been shuffled around and has few strong supports. Her intellectual disability represents an additional challenge.

29The attack on the nurse was very serious. While Ms. Campbell has no memory of it, it is illustrative of how the risk is very pronounced when Ms. Campbell is untreated, manic and psychotic.

30While Ms. Campbell is now stable in hospital, to her credit, her mental health condition appears fragile. If she were absolutely discharged, she would have no where to go, yet she requires a great deal of support, including to stay on her medications. If left to her own devices she would fall away from treatment and medication and return to mania and psychosis. In that state she would pose a real risk to the community for psychological and actual violence.

31If, on the other hand, supportive housing could be found, coupled with an active community mental health team, the risk could possibly be managed.

32While Dr. Gray has doubts about the current prospect of violence, he agrees that absent the necessary pre-conditions of good housing and community mental health care, there would be a risk to the community. Ms. Campbell has a history of non-compliance and a history of violence.

33The Board is satisfied that the significant threat threshold has been met at the present time. A Conditional Discharge is not appropriate currently. Ms. Campbell has no housing and no community psychiatric care. She has a history of being noncompliant with medications and treatment and a history of homelessness, and violence when unwell. If she began to become mentally unwell, she would not be able to obtain help, and the Mental Health Act would be ineffective to hospitalize her swiftly.

34If the protections of supportive housing and a community care team are put in place and Ms. Campbell continues to be stable, bearing in mind the stress that such a move would entail, an early Board could be called.

35The Boad also recognizes that a Rule 13 Application could also be made to possibly transfer Ms. Campbell to a GTA hospital.

36We wish Ms. Campbell well and congratulate her on her progress so far with her forensic team in a secure setting.