Ontario Review Board
Re: Seth C. Woelke
ORB File No. 8142
Hearing Date: March 3, 2025
Hearing Location: St. Joseph’s Healthcare, Hamilton, West 5^th^ Campus
Pursuant to: Sections 672.81(2) and 672.81(2.1) of the Criminal Code of Canada;
Before:
Alternate Chairperson: Mr. C. Flanagan
Members: Dr. K. Hand
Dr. A. Kerry
Ms. M. McKinnon
Mr. K. McKenna
Parties Appearing:
Accused: Seth C. Woelke Counsel: Ms. M. Perez
The Person in charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. C. Gzik
REASONS FOR DISPOSITION
(Dated April 7, 2025)
Introduction
Mr. Woelke was found not criminally responsible on September 7, 2022, for the Criminal Code offence of assault with a weapon.
He was initially detained at the Waypoint Centre for Mental Health Care (Waypoint.) He was transferred to St. Joseph’s Healthcare, Hamilton (St. Joseph’s) on June 25, 2024.
Mr. Woelke is currently subject to a Disposition dated March 18, 2024, which provides for his detention in hospital with privileges extending to hospital and grounds indirectly supervised and entering the community of Hamilton escorted by staff.
St. Joseph’s notified the Board by letter dated December 10, 2024, that on November 28, 2024, Mr. Woelke knocked a patient to the floor and struck the patient with several punches. He was taken to seclusion until December 2, 2024, and then moved to a locked pod. His privileges were gradually increased reaching level 2, escorted passes on the secure side of the building. Prior to November 28^th^ he was exercising level 3 passes, indirectly supervised passes to the public side of the building, and level 4, escorted passes into the community for the purpose of attending therapeutic programs.
On January 20, 2025, St. Joseph’s notified the Board that Mr. Woelke assaulted various staff on January 11, 2025, by punching, kicking, and spitting. He was immediately moved to seclusion then to a locked pod.
The restriction of liberties hearing regarding the restrictions imposed after the November 28^th^ incident was scheduled for January 14, 2025. It was adjourned to accommodate a hearing for both the restrictions following November 28^th^ and the restrictions that followed the assaults on staff on January 11, 2025.
St. Joseph’s also advised the Board that it was requesting an early annual hearing to request a transfer of Mr. Woelke to Waypoint pursuant to s. 672.81(2) of the Criminal Code. St. Joseph’s did not believe it could safely manage the risk to the safety of patients or staff at their facility.
A panel of the Ontario Review Board (the panel) convened this hearing on March 3, 2025, at St. Joseph’s to consider the appropriateness of the restrictions to his liberty on November 28, 2024 and January 11, 2025, and to conduct an early annual review with one of the issues being the transfer of Mr. Woelke to Waypoint as requested by St. Joseph’s.
At the commencement of the hearing counsel for Mr. Woelke raised a concern with regard to the contents of the victim impact statement (VIS) of Mr. Gary Coles, the victim of the index offence. She referred to various comments in the VIS which she argued went beyond the scope of what is permissible under s. 672.5(14) of the Criminal Code. Neither Crown Counsel nor the Hospital’s counsel strongly opposed Ms. Perez’s position.
The panel reviewed the VIS, and agreed with Ms. Perez that certain comments made by the victim are beyond what is permitted in s. 672.5(14). The panel, applying one of the options provided in R v Klem 2016 ONCA 119, admitted the document into evidence and only considered the portions that comply with the requirements of the Criminal Code.
At the commencement of the hearing the Hospital advised the panel that it was recommending that Mr. Woelke be transferred to Waypoint under a detention order with privileges that extend to hospital and grounds beyond the secure perimeter escorted by staff. Until such time that the transfer occurs the Hospital was recommending that St. Joseph’s have residual authority to provide privileges that extend to hospital and grounds accompanied by staff or person approved by the person in charge. The Hospital also submitted that the restrictions to Mr. Woelke’s liberty interests on the above mentioned two occasions were necessary and warranted.
Crown Counsel supported the position taken by the Hospital.
Counsel for Mr. Woelke took no position with respect to the restriction of liberties. She supported a detention order with the terms and conditions recommended by the Hospital. She opposed, however, the transfer to Waypoint.
After considering the evidence, the panel concluded that Mr. Woelke remains a significant threat to the safety of the public, and that a detention order is necessary and appropriate. The panel also concluded that the restrictions to his liberty beginning November 28, 2024, and then on January 11, 2025, were both necessary and appropriate. Furthermore, the panel accepted that St. Joseph’s could not properly manage the risk that Mr. Woelke posed to the safety of patients and staff, and that it is necessary for him to be transferred to the high security Waypoint Centre for Mental Health.
Index Offence
- The facts pertaining to the index offence are taken from the Hospital Report dated February 18, 2025, which was filed as an exhibit. Mr. Woelke was initially charged with Assault with a Weapon, Possession of a Weapon, Escape Lawful Custody, Assault Peace Officer x 2, Disarming a Peace Officer, and Resist Arrest. He was found not criminally responsible for the Assault with a Weapon charge and the balance were stayed.
Assault with a Weapon
On April 5, 2022, the victim attended a local mailbox near his home. As he left the mail- box, Mr. Woelke aggressively rushed toward the victim brandishing a 6-inch steak knife yelling, “You’re an American.” The victim feared for his safety, but was able to converse with Mr. Woelke and calm him down, and Mr. Woelke eventually returned to his residence without any further assault on the victim.
Escape Lawful Custody, Assault Peace Officer x 2, Disarming Peace Officer, and Resist Arrest.
On April 5, 2022, members of the Niagara Regional Police Service arrived on the scene. One of the officers advised Mr. Woelke that he was under arrest while holding on to his arm. Mr. Woelke broke free of the officer’s grasp and fled. Two officers caught Mr. Woelke and when trying to effect the arrest, Mr. Woelke struck one officer in the face and kicked the second officer in the stomach. Mr. Woelke attempted to grab the first officer’s CEW stun gun.
Evidence
In addition to the Hospital Report, Dr. Wu, who has been treating Mr. Woelke since September 2024, testified. Mr. Woelke and his mother, Ms. Kim Elltoft, also testified.
The Hospital Report was prepared for this hearing and provides significant information regarding Mr. Woelke’s personal background and psychiatric history.
His current psychiatric diagnoses are:
Other Specified Schizophrenia Spectrum and other Psychotic Disorder;
Cannabis Use Disorder, Moderate, in sustained remission in a controlled environment;
Obsessive-Compulsive Disorder (OCD);
Intellectual Developmental Disorder, Moderate; and
Autism Spectrum Disorder.
Mr. Woelke was formally diagnosed with an autism spectrum disorder at the age of seven, at which time he developed both motor and vocal tics. He completed grade 11. It is reported that he had difficulty making friends, reading social cues, and completing school work. He was bullied at school and had an individualized education plan (IEP) for reading and arithmetic. There were difficulties with his behaviour and he was suspended periodically from school for fighting and substance use.
Mr. Woelke’s history includes significant use of cannabis and alcohol from the age of 14, and then later, crystal methamphetamine and cocaine. In early 2022, he acknowledged the daily use of crystal methamphetamine by intravenous. He has also used magic mushrooms, fentanyl, and has abused prescription medications including Seroquel, Ritalin, Wellbutrin, and benzodiazepines. Mr. Woelke had never attended a substance abuse treatment program prior to the index offence.
Mr. Woelke had resided on his own since the age of 17. While living in the community, he has received support from Mainstream-Options Niagara Transitional Program, Person-Centered Care of Niagara Inc., and Bethesda/Twin Lakes Clinical Services. He has also been supported by the Niagara Region Mental Health-Assertive Community Treatment Team, and Willowbridge Community Services
With respect to his psychiatric history, Mr. Woelke has had several admissions to various hospitals in the Niagara and Hamilton area. He is diagnosed with intractable obsessive-compulsive disorder symptoms. This is displayed with significant repetitive rituals, especially involving the use of the washroom and hand washing.
Mr. Woelke has had extensive involvement with the police and the criminal justice system. He has been charged and convicted of assault, uttering threats, numerous failure to comply with court order charges, assault peace officer, assault with a weapon, aggravated assault, possession of a weapon dangerous, and robbery. It is reported that Mr. Woelke has had 75 documented interactions with the Niagara Police Service.
Mr. Woelke underwent a psychological assessment in 2017. The conclusion from the assessment was that Mr. Woelke met the criteria for an intellectual disability and a developmental disability. His cognitive abilities fell in the extremely low range. The assessor noted that he had extreme difficulty using his learned knowledge in any functional way in daily life. He could repeat what he had learned, but was unable to apply that information to abstract situations. The assessment revealed that Mr. Woelke has difficulty processing information and problem solving. Although he may be able to resolve a situation after the fact, in the moment, he is not able to consider consequences of his actions and apply any problem-solving skills.
From November 18 to 19, 2018, Mr. Woelke was admitted to Niagara Health System, St. Catharine’s General Site. He had initially been placed on a Form 1 under the Mental Health Act. Mr. Woelke was brought to the hospital after being violent to staff at his group home when they tried to get him out of the bathtub. It was noted that he could become violent when anyone interfered with his bathroom rituals. He was chemically and physically restrained in the emergency department of the Niagara General Site. He managed to free himself from the physical restraints and proceeded to injure two staff members.
One of the treating physicians at the time expressed his belief that Mr. Woelke had a neurodevelopmental diagnosis of Autism Spectrum Disorder, and experienced significant anxiety with an Obsessive-Compulsive Disorder since the age of 8. The physician commented that the intense obsessions and rituals became worse over time.
From January 28 to March 28, 2022, Mr. Woelke was admitted to St. Joseph’s pursuant to a treatment order. He was admitted in five-point restraints as a result of self-harm behaviour while at Halton Healthcare in Oakville. This involved hitting and scratching himself. His thought content was bizarre, and he had grandiose delusions of being royalty. While in hospital Mr. Woelke presented as unpredictable, impulsive, and dysregulated. Restraints were often required, and there were multiple instances where a Code White was called, including one occasion when he kicked and smashed the glass on a door. There was an incident where he assaulted staff members. His presentation improved with medication and he was discharged back to Maplehurst Correctional Centre.
Following the index offence on April 5, 2022, Mr. Woelke was admitted to Waypoint on June 21, 2022, and then returned to Niagara Detention Centre on August 22, 2022 to await his not criminally responsible hearing. He was found not criminally responsible on September 7, 2022, and readmitted to Waypoint on November 22, 2022.
The Hospital Report indicates that Mr. Woelke progressed well at Waypoint. He was polite and cooperative with others on his unit, he followed staff direction, and was compliant with his medication. He participated in activities both on and off his unit, including use of the courtyard, recreation centre, and the pool.
Prior to his annual hearing in 2023, Mr. Woelke advised Waypoint that he would like to be transferred to St. Joseph’s. He was familiar with St. Joseph’s, and his family lived in the Niagara Region which is much closer to St. Joseph’s than Waypoint. The Board ordered his transfer to St. Joseph’s, but St. Joseph’s was not able to accommodate the transfer until June 25, 2024.
Prior to the transfer, the Hospital Report indicates that Mr. Woelke remained stable at Waypoint. There were no signs of a formal thought disorder, but his thought content involved obsessive themes and compulsive behaviour. The report does indicate that there were ongoing issues with following rules, antagonizing others, and not following direction from staff. He continued to experience intrusive thoughts and compulsive behaviour related to washroom activities and cleanliness. The unit’s psychometrist described a history of the obsessive thoughts and compulsive behaviour being a catalyst to violent behaviour, but that the violent behaviour appeared to have significantly diminished over the past several years.
During his time at Waypoint Mr. Woelke made several comments to staff about wanting to smoke weed, and his intention to ask his doctor at St. Joseph’s if the prohibition against alcohol use could be removed.
There were also a number of incidents at Waypoint which were documented. Most of the issues concerned being dismissive of staff direction, and not following the rules. However, there were various episodes of significant agitation and aggression. On March 6, 2023, Mr. Woelke was upset and shouting, and he was encouraged to return to his room to calm down. He refused and began swearing at staff with closed fists yelling, “I’m not going back to my fucking room, you can’t tell me what to do.” On June 5, 2023, Mr. Woelke became angry at staff in the dining room. As he left the area, he kicked over a food tray cart, picked up a garbage can and threw it at the staff member. He called staff “bitches” and said they deserved it. He was placed in seclusion and was heard repeatedly throwing a chair against his door.
A Crisis Prevention Plan was created on March 17, 2023, in an effort to ensure a consistent approach was employed to manage Mr. Woelke’s behaviour, including his ritualistic behaviour. The plan cautioned staff to not interrupt his rituals once they had started because this could trigger a physically aggressive response.
A Risk Assessment was completed on January 8, 2024. It indicates that when Mr. Woelke is unwell, he can present with disorganized behaviour, delusions, hallucinations, incoherent thought process, and violent behaviour. His delusions often have themes of violence and aggression. The Assessment referred to Mr. Woelke having assaulted various people who have interfered with his rituals, which is particularly disturbing given his rituals can last from 5-7 hours.
He has a history of medication non-compliance, and has misused psychotropic medications to attain a high. Prior to the index offence, he did not participate in any treatment program that was arranged for him, which resulted in many readmissions to hospital.
Mr. Woelke was admitted to St. Joseph’s on June 25, 2024. The Hospital Report indicates that during his time at St. Joseph’s he has been usually calm and cooperative with routine care, but is sensitive to perceived provocation, and can be easily angered when his requests are denied or limits have to be set. It refers to Mr. Woelke having limited coping skills, and having great difficulty calming down once he has become upset. This has resulted in him becoming verbally and physically aggressive, and destructive towards property on numerous occasions.
There has been no difficulty with Mr. Woelke accepting his medication, and there has been no evidence of psychosis. The Hospital Report refers to Mr. Woelke having limited insight into his illness, believing that he suffers from a drug-induced psychosis. His urine samples, which are provided regularly, have all been negative for illicit substances.
The ritualistic behaviours, which are a reflection of the Obsessive-Compulsive Disorder and the Autism Spectrum Disorder, continue. Various plans were implemented to encourage Mr. Woelke to use the bathroom less often.
There were a number of incidents recorded by the hospital this past year. Apart from the occurrences on November 28 and January 11, which are the subject of the restriction of liberties hearing, they were essentially Mr. Woelke being agitated and verbally aggressive to staff and patients when angered by some event or simple direction from staff. This would often result in intimidating behaviour, such as, yelling and swearing at the patient or staff member, and on one occasion, spitting on a patient.
The November 28, 2024 incident, which resulted in a loss of his privileges, was an assault by Mr. Woelke on a patient. Other patients have been accusing Mr. Woelke of having sex with a 13-year-old since August. Apparently, Mr. Woelke overheard the patient talking to another patient about Mr. Woelke having a relationship with a 13-year-old girl. Mr. Woelke chased the patient, knocked the patient to the ground and proceeded to punch him several times in the head area. With the support of extra staff, they were able to stop the assault and remove Mr. Woelke from the area. He was assessed an acute risk and placed in seclusion in environmental restraints.
He was removed from seclusion on December 2, 2024, and transferred to a locked pod until December 16^th^. Prior to November 28 he was exercising level 3 privileges, indirectly supervised hospital grounds.
On January 10, 2025, Mr. Woelke was taken on a staff accompanied pass into the community. Mr. Woelke was permitted to bring his cell phone to purchase a coffee, but was told he could not use it for any other purpose. He was observed to use the phone to send text messages and refused to stop when directed by staff. When they returned to the unit, Mr. Woelke was advised that he would lose his privileges for 24 hours. He became argumentative with staff, threw furniture in his room and kicked a closet door off its hinges. As a result of this escalation of violence Mr. Woelke was asked to remain in a locked pod over the weekend.
On January 11, 2025, a staff member allowed Mr. Woelke to leave his pod to attend the dining room. The charge nurse reminded Mr. Woelke that he agreed to remain in the locked pod over the weekend and re-directed him back to his room. Once in his room he became angry, shouted “fuck you,” and ran towards the staff member punching him numerous times in the face and spitting on him. Other members of staff intervened and attempted to gain control of Mr. Woelke. He kicked another member of staff in the chest, and pinned a third staff member between his legs and slammed him into the ground. During these assaults he was yelling, “I don’t care if I go back to Waypoint.” It took 5 staff members to control Mr. Woelke, and 3 were physically injured. The police were contacted and Mr. Woelke has been charged with an assault. This charge is still before the court. He was placed into 5-point restraints for approximately 72 hours and then transferred to seclusion. On January 27 he was transferred to the Mountain 3 unit which has locked bedrooms. At this point all his off-unit passes were cancelled.
Mr. Woelke remained in a locked bedroom until February 24. At the time of this hearing, Mr. Woelke remained under strict supervision and was not permitted to go off the unit. He does exercise courtyard passes escorted by staff. Prior to January 10, 2025, he was exercising accompanied passes to the public side of the hospital.
Prior to January 11^th^, Mr. Woelke was engaged in programming with occupational therapy. It became evident that he required support in the areas of self-care routines and engagement in meaningful activities. The occupational therapist identified impulsive behaviour and coping skills as needing support. Following the January 11th assaults, the therapist stated that Mr. Woelke lacks the skills for self-management and regulation of his thoughts and emotions. He is not able to utilize coping skills in the moment which leads to an impulsive reaction. The therapist suggested that Mr. Woelke would benefit from a specialized environment where individuals of similar cognitive and behavioural functioning reside, and skills for coping and self-management are taught through targeted approaches. They suggested an environment that specializes in preparing individuals with his challenges for integration into the community is recommended.
Dr. Wu testified that it has been a challenging year for Mr. Woelke. He can be polite and cooperative at times, but that his neurodevelopment disorder, OCD and emotional dysregulation present significant challenges. He currently resides on Waterfall 3 because locked rooms are available.
He explained the restrictions that have been in place since the November 28^th^ incident. Mr. Woelke was in seclusion to December 2^nd^, then a locked pod until December 19^th^. Following the January 11^th^ assaults, Mr. Woelke was initially place in 5-point restraints and then to a locked pod until January 28^th^. At this time, he was moved to a locked room with 2 days of seclusion. As of February 11, he was allowed out of his locked room to dine with co-patients. Starting on February 12^th^, he was able to exercise courtyard passes escorted by 2 staff, which was later reduced to 1 staff. On February 24 he was transferred to Harbour North 3 which has more security available.
Dr. Wu testified that Mr. Woelke is unable to cope in the moment. He is unable to access appropriate coping and problem-solving skills, and control his behaviour at the time. As a result, Dr. Wu does not believe Mr. Woelke will be able to access more privileges in the foreseeable future.
Dr. Wu testified that Mr. Woelke requires treatment for his dual diagnosis, and that this treatment involves more than simply medication. He stated that St. Joseph’s does not have specialized resources for dual diagnosis treatment.
Dr. Wu believes that the risk factors identified in the Hospital Report will remain active for the next 12 months, and that it will likely take a very long time to properly treat these illnesses. Mr. Woelke is unlikely to be able to access the resources that are available at St. Joseph’s for the foreseeable future.
Dr. Wu stated that Mr. Woelke is evaluated regularly, and that his risk to public safety is still considered high. He advised that staff have expressed a serious concern for their safety, want to be protected, and there is unanimous agreement that Mr. Woelke needs to be transferred to Waypoint. He emphasized that Mr. Woelke’s condition is quite complex.
Dr. Wu indicated that Waypoint has a higher level of security and support. He expects that Mr. Woelke would attain off-unit privileges to attend therapeutic programming and other off-unit services at Waypoint. He believes that dual diagnosis services that Mr. Woelke needs are available at Waypoint in a secure environment.
In answering questions from the Crown, Dr. Wu testified that Waypoint has more staffing, and a greater number of programs that are available in a secure environment.
In answering questions from counsel for Mr. Woelke, Dr. Wu testified that at a team meeting on February 19^th^ they discussed the reasons for transferring Mr. Woelke to Waterfall 3. He was doing well at that time, interacting appropriately with patients and following directions from staff. Dr. Wu indicated that Mr. Woelke was handling stress better, and that it was a reflection of better behaviour in the short term.
Dr. Wu agreed that Mr. Woelke was doing relatively well from June 2024, until the assault on the patient in November 2024, and that until an incident in October, he had achieved level 3 passes, hospital grounds indirectly supervised.
Dr. Wu believes that dual diagnosis services are available at Waypoint in a secure environment, although he acknowledged that the Hospital Report does not indicate that Mr. Woelke participated in dual diagnosis programs when he was there.
Dr. Wu acknowledged that Mr. Woelke was engaged with 1:1 counselling with a behavioural therapist at St. Joseph’s.
Dr. Wu stated that the intellectual impairment prevents Mr. Woelke from behaving rationally at times.
Mr. Woelke receives passport funding which had been transferred from Fort Erie to Hamilton, and the Anchor Rehabilitation Services had been providing a support worker to work with Mr. Woelke.
Dr. Wu acknowledged Waypoint’s response to St. Joseph’s Rule 13 transfer request and their expectation that there is a long wait-list for admission to Waypoint. Dr. Wu indicated his belief that, even if it takes a lengthy period of time to effect a transfer to Waypoint, Mr. Woelke is likely to remain on Waterfall 3, and he doesn’t expect much change to the current restrictive privileges. He acknowledged that Mr. Woelke has a good relationship with staff.
Dr. Wu was referred to the Hospital Report by a panel member and the recommendation for hospital and grounds privileges at St. Joseph’s, accompanied by staff or person approved by the person in charge, and asked whether Mr. Woelke was likely to have this privilege in the ensuing year. Dr. Wu responded that he does not anticipate it to be very likely Mr. Woelke would be able to exercise this privilege in the next year.
He was also asked if he understood the privileges available at Waypoint for Mr. Woelke to be more restrictive than the privileges that may be available for Mr. Woelke at St. Joseph’s. Dr. Wu indicated that Mr. Woelke succeeded at Waypoint with its environment and structure. He believed that Mr. Woelke had reached the upper limits of his privileges. Dr. Wu stated that he anticipated the same structure and support would be available for Mr. Woelke, and that Mr. Woelke would be able to engage in more off-unit activities than he would at St. Joseph’s.
Mr. Woelke testified that he made mistakes and felt bad about what he had done. He stated that he is trying hard to do good and would like to stay at St. Joseph’s.
Ms. Kim Elltoft, Mr. Woelke’s mother, testified. She lives in Niagara-On-The-Lake, and visits with her son every second week. She is often accompanied by other family members. She also talks by phone with her son approximately 4 times per day. She indicated that Mr. Woelke benefits from this contact.
Ms. Elltoft advised that she has a good relationship with the social work staff, and they regularly converse and share information. She expressed her appreciation for the tremendous amount of support her son receives at St. Joseph’s. She expressed her concern that the Passport funding, and the services he receives from Anchor Rehabilitation Services, would end with his transfer to Waypoint. She believes that his diet is better at St. Joseph’s, and that he benefitted from the counselling with the behavioural therapist. She also advised that Mr. Woelke was very upset with the rumour that he sexually assaulted a 13-year-old girl.
Submissions
The Hospital submitted that only after serious consideration would the Hospital request a transfer of a patient. Mr. Woelke is capable of assaulting a patient or staff at any time without any predictability. The Hospital referred to the evidence that Mr. Woelke cannot control his behaviour in the moment, and urged the panel to accept, that if Mr. Woelke remains at St. Joseph’s there will be future assaults. The Hospital further submitted that the restrictions to his liberty were warranted at the time they were initiated, and continue to be warranted to the time of the hearing.
Crown Counsel supported the recommendations of the Hospital. She urged the panel to consider Mr. Woelke’s serious criminal record for violence, and the numerous contacts with the Niagara Police Service. Counsel suggested that the emotional dysregulation was severe, and would result in future violence.
Counsel for Mr. Woelke reiterated that she is not taking a position with respect to the restrictions to Mr. Woelke’s liberty. She submitted that a transfer to Waypoint was not the least onerous and restrictive Disposition that was appropriate in the circumstances. She suggested that the November assault was a reaction by Mr. Woelke to a patient discussing Mr. Woelke having a relationship with a young woman, and the January assaults were a result of being let out of his room and then immediately being returned to his room by the charge nurse.
Counsel referred to the Rule 13 response from Waypoint, and the indication that there is a long waitlist for admission to Waypoint. She submitted that Mr. Woelke is currently doing well, and that Waypoint could only provide hospital grounds privileges escorted by staff at a 2:1 staff to patient ratio.
Analysis
The only contested issue at this hearing was the transfer of Mr. Woelke from St. Joseph’s to Waypoint. Crown Counsel supported the Hospital’s recommendations, and counsel for Mr. Woelke did not oppose the finding of significant threat or the imposition of a detention order. She took no position with respect to the restrictions to his liberty. She did oppose the transfer to Waypoint.
Mr. Woelke is diagnosed with multiple co-morbid persistent and severe major mental disorders, including Schizophrenia Spectrum and Other Psychotic Disorder, Substance Use Disorder, Autism Spectrum Disorder, Obsessive-Compulsive Disorder, and Intellectual Developmental Disorder. Dr. Wu described his condition as complex.
While living in the community he had many admissions to the hospital for psychiatric care. When actively psychotic, he experiences disorganized thoughts and behaviour, delusions, and hallucinations. These conditions have resulted in violence and aggression as reflected in his criminal record and his contacts with the police. The violent behaviour is particularly acute when anyone interferes with his rituals. He also has a history of non-adherence to medication and treatment. He was diagnosed with a conduct disorder when very young, and since that time, has demonstrated behaviour that has consistently violated the safety and welfare of others.
Mr. Woelke also has a significant history of illicit drug use in the community which has exacerbated his psychotic symptoms and contributed to his aggressive behaviour.
In the past year Mr. Woelke has experienced significant challenges managing his emotions and anger. In a 3-month period, he progressed from spitting on a patient to physically assaulting a patient and then physically assaulting staff. The evidence indicates that his coping skills are severely underdeveloped. When experiencing intense emotions, he does not have the ability or skills to react and respond in a less agitated and aggressive manner.
The assaults in November 2024, and January 2025, were both very serious, and resulted in physical injury to three staff members and the laying of an assault charge. It was necessary to impose the restrictions to protect patients and staff. There is also ample evidence for the panel to conclude that Mr. Woelke remains a significant threat to the safety of the public and that a detention order is necessary and appropriate.
With respect to St. Joseph’s request to transfer Mr. Woelke to Waypoint, the panel accepts that a transfer is necessary and appropriate in the circumstances. Waypoint is a high secure facility whereas St. Joseph’s is a medium secure facility. Waypoint has the structure and supports for patients who are high risk, and who require treatment in a secure environment. Waypoint has the specialized dual diagnosis services that would assist with the management of Mr. Woelke’s risk to public safety.
It is evident that St. Joseph’s does not have the resources available to properly provide treatment for Mr. Woelke, such as the dual diagnosis programming, while his privileges are restricted. Dr. Wu testified that he does not expect Mr. Woelke to increase his off-unit privileges for so long as he is at St. Joseph’s. The current restrictions are necessary to protect both co-patients and staff. The assaults were extremely violent and unpredictable. The staff have expressed a legitimate fear for their safety.
Mr. Woelke’s mother, Ms. Kim Elltoft, attended the hearing to support her son. She has maintained regular contact with him and has frequently visited with him at the hospital. She lives in the Niagara area, and a transfer to Waypoint would make visiting her son much less convenient. However, this inconvenience cannot supersede the protection of patients and staff at St. Joseph’s.
Safety of the public, which includes patients and staff, is the paramount consideration as stated in s. 672.54. When considering the other factors provided in s. 672.54, the mental condition of the accused, the reintegration of the accused into society, and the other needs of the accused, the panel concludes that a transfer to Waypoint is necessary and appropriate, as well as the least onerous and restrictive, to protect the public and to provide Mr. Woelke with the best opportunity to receive the necessary care and treatment.
The Hospital’s recommendation for accompanied passes to hospital and grounds with staff or an approved person will not be included in this Disposition. Dr. Wu testified that it is unlikely this privilege will be available to Mr. Woelke this year, and the panel does not believe that it would provide sufficient protection for the public. The privilege will be limited to hospital and grounds escorted by staff.
Dated this 7^th^ day of April 2025, at the City of Toronto, in the Toronto Region.
Kevin McKenna
Legal Member
___________________
Office of the Registrar
Ontario Review Board