Re: Tara Noble
ORB File No: 7622
Hearing held on: Thursday, February 20, 2025
Place of hearing: St. Joseph’s Healthcare Hamilton West 5th Campus, Hamilton
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Maunder
Members: Dr. S. Simpson Dr. M. Kalia Mr. R. Bigelow Mr. S. Doherty
Parties Appearing:
Accused: Ms. Tara Noble
Counsel for the Accused: Mr. A. Rai
Counsel for the Person in charge of Hospital: Mr. S. O’Brien
Counsel for the Attorney General of Ontario: Ms. J. McKenzie
REASONS FOR DISPOSITION
(Dated: March 31, 2025)
Introduction
On October 31, 2019, Tara Noble was found not criminally responsible on Criminal Code charges of harassing communications and criminal harassment. At the time of the hearing, Ms. Noble was subject to a conditional discharge that required her to report to St. Joseph’s Healthcare Hamilton (SJHH) not less than once a month, refrain from contacting the victim of the index offences, and submit samples for analysis re: use of substances. On February 20, 2025, the Board convened a hearing to conduct an annual review of Ms. Noble’s disposition.
The parties jointly submitted that we should maintain the conditional discharge with the same conditions as last year. It was conceded that the significant threat threshold was met. For the reasons set out below, the panel agreed that significant threat was made out and accepted the joint submission.
The Index Offences
Between January 1, 2019, and September 8, 2019, Ms. Noble called the Hamilton Police 52 times to report domestic assaults, noise complaints, suspicious people, neighbour troubles, and to ask for wellness checks. Many of these calls pertained to the apartment directly above Ms. Noble’s. The Police concluded most of these calls with false and warned Ms. Noble “numerous” times not to abuse the 911 system.
On September 8, 2019, Ms. Noble called 911 and reported that someone had just been shot in the head. She gave the address of her upstairs neighbour. When emergency services arrived, her upstairs neighbour was found “fearful and visibly distraught”. No one had been shot. The neighbour reported that she had been harassed by Ms. Noble for three months – Ms. Noble regularly banged on her door for as long as an hour and attempted on multiple occasions to enter the apartment. Ms. Noble also yelled threats.
Background / Context
Ms. Noble is a 50-year-old single woman. She is diagnosed with schizoaffective disorder, bipolar type, as well as amphetamine use disorder, and dependent personality disorder.
Ms. Noble had a somewhat chaotic early life. Her father drank and her mother experienced mental illness (bipolar disorder) and substance abuse. They separated when Ms. Noble was a child. She and her brother lived with her mother and Ms. Noble recalls having to care for her brother at times.
Ms. Noble started experimenting with drugs as a teenager. By the time she was 20, she was diagnosed with bipolar disorder and was on Ontario Disabilities Support Program (ODSP).
Ms. Noble had a 10-year relationship with a man who was in and out of custody. They had a daughter together when Ms. Noble was 25. Her daughter was born with developmental disabilities and when her daughter was five years old, Ms. Noble realized she was not able to care for her and she was put in foster care. Before long, Ms. Noble’s relationship ended. She began to use substances more frequently. At times she was homeless.
When Ms. Noble was 27 years old, her mother died by suicide. Historically, she had contact with her father, but they are not close. She is close with her brother, who has schizophrenia and lives in a group home. She also remains in contact with her daughter.
Ms. Noble has 30 entries on her criminal record, beginning when she was 25 years old and ending when she was 37 years old. The vast majority of entries are property offences or breaches of court orders. She was also convicted of assault twice, assault peace officer once and assault resist arrest once. Usually, she received sentences of time served, but a few times was sentenced to short periods of extra jail time.
Ms. Noble had ten psychiatric admissions to hospital before the index offences. During her early admissions, her mental state was notable for mood (mania and depression) and substance use. She attempted suicide in 2008. Closer to the index offences, Ms. Noble began to present with symptoms of psychosis. She experienced paranoid and somatic delusions that emerged around 2017. In 2019, she began to use crystal methamphetamine, and it appears to have aggravated her psychosis.
During the six weeks before her arrest for the index offence, Ms. Noble was admitted to hospital twice. She was disorganized and irritable. She believed someone in her building had put a curse on her and that she had “a pig in her abdomen”. As was typical, Ms. Noble improved in hospital with treatment but used substances at the first opportunity. During her second stay she eloped and she was subject to a Form 9 (police to apprehend and return her for assessment) at the time of the index offences.
Cognitive and neuropsychological testing conducted in 2019 indicated that Ms. Noble was functioning within the borderline range of intelligence.
Under the jurisdiction of the Board, initially in hospital, Ms. Noble endorsed derogatory auditory hallucinations and some paranoia. She accepted medications and her symptoms improved although she experienced anxiety. She engaged with substance use services as well as several programs facilitated by occupational therapy and worked collaboratively with social work. She was cooperative and pleasant and polite. She was not aggressive or violent.
In July 2021 (about 20 months after admission to hospital), Ms. Noble was discharged to live at Baldwin House, a supportive setting run by the CMHA. She adjusted well including attending to the responsibilities of more independent living – medication administration, chores, cooking, etc.
On the other hand, although she was aware that her ex-partner (not the father of her daughter) was a negative influence, she decided to meet with him soon after her discharge. On September 20, 2021, Ms. Noble was readmitted to hospital after relapsing into crystal methamphetamine and cannabis use with her ex-partner. The team noted that she subsequently became manic and psychotic. She remained there for two months before being gradually discharged back to Baldwin House.
Ms. Noble did well following her discharge back to Baldwin House. Stress sometimes triggered some variation in mood, but she did not experience symptoms of psychosis. She remained adherent to her medications (oral supplements to a long-acting injectable antipsychotic medication) and abstained from substances. At the same time, her insight into her relapse risk was underdeveloped and she relied upon the forensic supports available.
In February 2023, Ms. Noble moved into an independent apartment (City Housing).
The Current Year
Dr. Yedishtra Naidoo, Ms. Noble’s attending psychiatrist since 2020, testified and adopted the Hospital Report.
Although it was anticipated that after four and a half years of abstinence (since September 2021), she might be ready for an absolute discharge this year, Ms. Noble relapsed during the first half of 2024. In the early Spring, she re-connected with her ex-partner. He relapsed into substances and eventually so did Ms. Noble. She used substances several times before advising the team of her contact with her ex and her relapse. She agreed to return to hospital.
After five weeks, Ms. Noble was discharged. Since then, she has had further sporadic contact with her ex. Although she planned to call the police if he showed up at her home, when he did show up she was unable to follow through. Ms. Noble is concerned about his wellbeing and has ruminated that she should be doing more for him. At the same time, she knows that their interactions have “often left her in a bad space” and that future interactions might put her at risk of relapse or losing her apartment.
Following her admission to hospital, the team increased Ms. Noble’s reporting to three times a week for several months. Ms. Noble also participated in a new substance addiction treatment program. She has been meeting with her case manager once a week. She meets with a Peer Support worker and a Behavioural Therapist, as well as seeing a counsellor once a week at the Women’s Centre.
Dr. Naidoo testified that Ms. Noble demonstrates memory difficulties likely influenced by psycho-emotional factors related to psychosis but also agreed that retesting would provide a more accurate assessment of her cognitive status.
Ms. Noble is prosocial. She cares deeply about her relationships with various family members and has put work into bettering them, even when difficult. She has also set other goals – notably, to improve her physical health and obtain employment.
Ms. Noble has insight into her illness, need for medication, and that stress and substance use exacerbate her instability. She also appreciates the role the forensic program plays in supporting her. She said that the “forensic program has saved (her) life”.
The week prior to the hearing, Ms. Noble testified positive for methadone, a result Dr. Naidoo had not had a chance to discuss with Ms. Noble. He suspected Ms. Noble thought she was taking something else. Dr. Naidoo was not concerned about the use destabilizing her.
Significant Threat
- The panel accepted the uncontradicted evidence from the hospital that Ms. Noble remains a significant threat to the safety of the public. The hospital summarized the basis for this conclusion as follows:
…Ms. Noble’s risk for violence…is considered low with the current disposition in place. However, absent forensic oversight Ms. Noble is vulnerable to stress such that her relatively newly acquired adaptive coping may be tested beyond her capacity. This could result in a return to substance abuse, as it did this year. Without an ORB disposition, Ms. Noble may not be able to avail herself of an appropriate support system and continue using, likely leading to medication noncompliance. In this case, she would likely experience a psychiatric decompensation characterized by delusional beliefs which may contribute to violent ideation and verbal or physical violence.
We would go further. Based on her history of substance use and relapse, and tendency to downplay her need for ongoing relapse prevention, we assessed the risk of her returning to substance use, absent the oversight of the Board, as likely. We also viewed it as quite unlikely, absent the forensic service, that Ms. Noble would have access to, and utilize, the supports she needs to get her back on course once she relapses. Thus, we assessed as high the likelihood that this trajectory would lead to medication non-compliance, to psychiatric decompensation, to violent ideation, and verbal or physical violence.
Necessary and Appropriate Disposition
- The panel agreed with the joint position that the necessary and appropriate disposition remained a conditional discharge on the current minimal terms. Given the key role abstinence has played in Ms. Noble’s stability, it remains necessary and appropriate to require she provide samples so the team can screen for substance use. Ms. Noble did not suggest otherwise.
DATED this 31st day of March 2025, at the City of Toronto, in the Toronto Region.
Leslie Maunder
Alternate Chairperson
Office of the Registrar
Ontario Review Board