Re: Jacques Jean Plante
ORB File No: 2266
Hearing held on: Wednesday, January 29, 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. G.A. Chaimowitz Dr. K. Hand Mr. J. Goldenberg Mr. S. Duffy
Parties Appearing: Accused: Jacques Jean Plante Counsel: Ms. C. Francis
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated April 7, 2025)
Introduction
On March 12, 1996, Jacques Plante was found not criminally responsible by reason of mental disorder (NCR) on a charge of assault, contrary to the Criminal Code of Canada (Criminal Code). He is currently subject to a disposition of the Ontario Review Board (the Board/ORB), dated February 22, 2024, discharging him on conditions, including that he reside at his current residence.
On January 29, 2025, the Board convened a hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Plante was not present. He was at South Lake Hospital as a result of injuries sustained after a fall. He was represented by Ms. Francis who had instructions to proceed in his absence. On consent of all parties, Mr. Plante was excused from the proceedings pursuant to s. 672.5(10) of the Criminal Code.
At the outset of the proceedings, all parties were canvassed as to their positions on the two issues to be determined by the Board: whether Mr. Plante continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition having regard to the criteria set out in s. 672.54 of the Criminal Code.
Ms. Warner, on behalf of the hospital, submitted that Mr. Plante continues to represent a significant threat and the necessary and appropriate disposition is a continuation of the current conditional discharge. Ms. Culp, on behalf of the Ministry of the Attorney General, and Ms. Francis concurred in the hospital’s positions. Ms. Francis indicated that her client wished to stay at his present residence and wanted to remain under the jurisdiction of the Board. Thus, a joint recommendation was put before the Board.
Findings
- For the reasons that follow, the Board finds that Mr. Plante continues to represent a significant threat and the necessary and appropriate disposition is a discharge with conditions that he reside at his current residence, not be in possession of any weapon and he report not less than once every three months.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated January 8, 2025, (ex. 1), and the viva voce evidence of Dr. Ugwunze, Mr. Plante’s treating psychiatrist.
The Index Offence
- On March 12, 1996, the victim was sitting in a parkette in Toronto. The accused walked over to the victim and said nothing to her. He immediately began to punch her about the head until they both fell to the ground. The accused continued to assault her until an unknown person intervened. The victim sustained minor injuries to the nose and a sore forehead.
Background Information
The Hospital Report contains detailed information about Mr. Plante’s background and psychiatric history and need not be reviewed here but for the following material points. Mr. Plante is a 67-year-old man who currently resides in a single room in a group home run by Community Homes for Opportunity (CHO), at Cedarlane Residence, Holland Landing Road, Ontario. He is financially supported by the Ontario Disability Support Program (ODSP).
Mr. Plante’s first psychiatric admission was in 1974. At that time, he was diagnosed with a psychotic disorder, likely schizophrenia, and treated with the oral antipsychotic, Haloperidol. Before the commission of the index offence, Mr. Plante had had 17 inpatient admissions over the course of 17 years. These admissions were generally precipitated by threatening or aggressive behaviours in the community, often in the context of medication noncompliance and/or substance use.
Mr. Plante reported that he started consuming alcohol at the age of twelve. His alcohol use has continued while under the jurisdiction of the Board, notwithstanding a requirement that he abstain from substances. This has tended to occur when Mr. Plante has eloped and engaged in binge consumption of alcohol and/or other substances of abuse.
Mr. Plante’s criminal record is quite dated and contains four convictions, three of which are for assault. More recently in August, 2020, Mr. Plante assaulted a co-resident at his housing and on May 24, 2021, he assaulted a staff member. Impulsivity is a significant factor in his violence.
Course Since the Last Disposition
Mr. Plante’s current diagnoses are Schizophrenia and Polysubstance Use Disorder (alcohol, cocaine and cannabis). He has a number of physical health issues and is under the care of the home’s visiting family doctor, Dr. Sarang, who also prescribes all his medical medication. Additionally, he has remained under the care of the Stroke Prevention Clinic at South Lake Regional Health Centre (SRHC), specifically under the care of stroke neurologist Dr. Bebedjian, for ongoing management and monitoring.
Mr. Plante has continued to reside at Cedarlane Residence, and did not require readmission into a psychiatric hospital this reporting period. He has remained compliant with this medication, albeit administered under staff supervision. He did not access alcohol or other prohibited substances and there were no instances of aggression or behavioural dysregulation. He has acknowledged experiencing auditory hallucinations on at least three occasions.
Mr. Plante remains incapable of making treatment decisions and his sister continues to act as his Substitute Decision Maker. His insight remains limited. While he is able to acknowledge his diagnosis of Schizophrenia, he is not able to make a connection between his treatment with clozapine and his improved mental status. He requires supervised medication administration. Further, he minimizes the impact of substances, in particular alcohol, on his mental state and his risk for violence.
Dr. Ugwunze testified before the Board. He reported that on January 14, 2025, Mr. Plante fell outside of the home and sustained a fractured wrist. He remains an inpatient at South Lake Hospital and cannot be discharged until he is mobile. Mr. Plante previously required a walker. This arm injury has resulted in him now requiring a wheelchair. Unfortunately, his residence in the community cannot support wheelchair access. Dr. Ugwunze indicated that Mr. Plante will require some rehabilitation and there is some question if and when he will be able to return to his residence.
Mr. Plante’s case manager has been to visit him in the hospital and reports that Mr. Plante is mentally stable and in good spirits. He is understandably anxious where he will be transferred. His wish is to return to his CHO housing.
Dr. Ugwunze noted that, notwithstanding compliance with medication, Mr. Plante continues to experience refractory symptoms of his illness. The ongoing auditory hallucinations have not appeared to cause Mr. Plante any distress.
Dr. Ugwunze testified that over the next clinical year, the treatment team will look to transition Mr. Plante to the Schizophrenia Clinic. The doctor indicated that there were a number of unknowns given Mr. Plante’s recent injury. His current residence has been critical in Mr. Plante’s stability. Any change in that regard would be stressful for Mr. Plante and would increase his risk to the safety of the public.
Dr. Ugwunze testified that there are two factors that support his recommendation for a conditional discharge at this time. The first is Mr. Plante’s rehabilitation trajectory. If his mobility does not improve, it is possible that Mr. Plante will have to move from his current residence. Secondly, since Mr. Plante has been in the hospital, Dr. Ugwunze has not been able to conduct a fulsome psychiatric assessment. The doctor is reluctant to conclude that Mr. Plante risk has decreased and that he no longer represents a significant threat absent such an assessment.
With respect to the abstain and submit requirements in Mr. Plante’s current disposition, Dr. Ugwunze testified that Mr. Plante cannot leave the house on his own due to his physical limitations. He has not accessed alcohol through the assistance of other residents this year. Unlike last year, he has not actively sought out alcohol. He has not had a urine drug screen for some time. Instead, staff at the residence have been monitoring his mental status and they have not observed any concerning behaviour suggesting substance use. Mr. Plante has stated that he does not want to drink anymore.
All parties maintained the joint submission for a conditional charge. None of the parties advocated for a continuation of the abstain and submit requirements.
Analysis and Conclusion
The Board carefully considered the Hospital Report and the evidence of Dr. Ugwunze and unanimously concluded that Mr. Plante continues to represent a significant threat to the safety of the public. Mr. Plante’s risk arises from his diagnosis of Schizophrenia with a long history of medication noncompliance and problematic substance use. Notwithstanding compliance with medication, he continues to experience auditory hallucinations.
Mr. Plante’s insight into the benefits of medication and the risk of violence in the context of substance use is limited. Absent supervision that ensures compliance with treatment, Mr. Plante has shown a history of becoming acutely psychotic, with prominent delusions and hallucinations primarily of a paranoid and persecutory nature. These have included command hallucinations, directing aggression and violence towards community members, similar to the time of the index offence.
The management of Mr. Plante’s risk is directly linked to his current residence. The Board accepts Dr. Ugwunze’s reluctance to conclude that Mr. Plante now no longer represents a significant threat given the number of unknowns, in particular whether Mr. Plante will be able to return to the CHO home.
Having found that Mr. Plante continues to represent a significant threat to the safety of the public, the panel must consider the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code, which includes the need to protect the public from dangerous persons, the mental condition of the accused, the integration of the accused into society and the other needs of the accused.
As stated earlier, Mr. Plante’s stability is directly linked to the support that he receives from the staff at his current residence. Staff monitor and administer his medication to ensure compliance. They also monitor his mental status and note any changes in his behaviour. Critically, the location of this residence makes it difficult for Mr. Plante to access substances. Staff are vigilant in maintaining a substance free environment and are mindful of any interactions between Mr. Plante and his co-residents in that regard. As such, over the past year Mr. Plante has not accessed substances and recently has stated an intention to remain abstinent.
Mr. Plante’s recent injury and admission to hospital has put his future plans in question. He is understandably anxious. It is anticipated that he will receive appropriate rehabilitative treatment in order to ensure his safe transition back to his residence. Once that occurs, efforts by the Forensic Outpatient Service and Dr. Ugwunze will focus on Mr. Plante’s care to be assumed by the Schizophrenia Clinic at the Southlake Regional Health Centre.
The Board finds that the conditions requiring that Mr. Plante abstain from the use of alcohol or drugs or any other intoxicant substances, and to submit samples of his urine and/or breath for testing are no longer necessary and appropriate. The location of Mr. Plante’s residence frustrates any attempt at obtaining alcohol. Further, the staff are vigilant in ensuring that the residence is substance free. There have been no reports of any substance use by Mr. Plante and there have been no noted changes in his behaviour suggesting he has used substances. The plan over the next year is to transition Mr. Plante’s care to a non-forensic service.
Accordingly, the Board orders that Mr. Plante be discharged subject to a condition that he continue to reside at his current residence, that he not be in possession of any weapons and that he report not less than once every three months.
DATED this 7^th^ day of April, 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Finley Alternate Chairperson
__________________ Office of the Registrar Ontario Review Board