Re Troy Warner, 2025 CanLII 31422

Re: Troy Warner

ORB File No: 6069/6349

Hearing held on: Wednesday, February 26, 2025

Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto

Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code

Before:

Alternate Chairperson: Mr. C. Fraser

Members: Dr. W. Johnston Dr. H. Moulden Ms. C. Murray Mr. J. Cyr

Parties Appearing:

Accused: Troy Warner Counsel: Mr. T. Whillier

The Person in charge of Hospital: Counsel: Ms. M. Warner

Attorney General of Ontario: Counsel: Ms. V. Culp

REASONS FOR DECISION AND DISPOSITION

(Dated April 10, 2025)

Introduction

1. On March 7, 2012, Troy Warner was found not criminally responsible on account of mental disorder (“NCR”) on three charges of assault with a weapon and one charge of assaulting a peace officer, all contrary to the Criminal Code of Canada (the “Criminal Code”).

2. On May 28, 2013, Troy Warner was found NCR on account of mental disorder on three charges of assault, all contrary to the Criminal Code.

3. By letter dated August 28, 2024, Centre for Addiction and Mental Health (the “hospital” or “CAMH”) notified the Board pursuant to s. 672.56(2)(b) of the Criminal Code that Mr. Warner’s liberty had been significantly restricted for a period exceeding seven days as follows:

“CAMH writes in advance of Mr. Warner’s upcoming annual hearing to alert the Board and parties of Mr. Warner’s recent episode of seclusion exceeding seven days.

On August 21, 2024, Mr. Warner was placed in locked emergency seclusion due to increased uninvited touching of co-clients and a refusal to follow staff direction. Prior to placement in seclusion he assaulted one CAMH staff member. As of the date of this letter, Mr. Warner has been in seclusion consistently since August 21, 2024.

On August 28, 2024, the clinical team attempted to trial Mr. Warner out of locked seclusion. Unfortunately, this trial resulted in a Code White. In the circumstances, Mr. Warner remains in seclusion.”

4. By letter dated September 17, 2024, CAMH notified the Board pursuant to s 672.56(2)(b) of the Criminal Code that Mr. Warner’s liberty continues and had been significantly restricted for a period exceeding seven days as follows:

“Mr. Warner is subject to a Forensic Service Detention Order at CAMH with privileges up to living in approved accommodation within the community (dated December 27, 2023).

On August 21, 2024, Mr. Warner was placed in locked emergency seclusion due to increased uninvited touching of co-clients and a refusal to follow staff direction. Prior to placement in seclusion he assaulted one CAMH staff member.

On August 28, 2024, Mr. Warner was trialed out of locked seclusion. However, on that date he physically assaulted co-patients and was placed back in locked seclusion.

Mr. Warner remains in locked seclusion as of the date of this letter. However, it is important to note that on September 12, 2024, Mr. Warner was placed on a Protective Devices Plan – a form of treatment consented to by Mr. Warner’s Substitute Decision Maker– which includes the use of locked seclusion.

Prior to his seclusion episode, beginning on August 21, 2024, Mr. Warner had access to indirectly supervised passes on hospital grounds and accompanied passes on hospital grounds and the community.

At the time of this letter, Mr. Warner does not have access to off ward passes.” …

The letter further went on to state as follows:

“CAMH takes the position that a reasonable person aware of the circumstances of Mr. Warner’s case would believe the hospital’s decision to seclude and suspend passes, for the reasons set out above, resulted in a loss of liberty so significant that the Board must convene a hearing. In coming to our position CAMH considers Mr. Warner’s privileges prior to his episode of seclusion, the conduct resulting in seclusion, and the length of seclusion episode.

Although CAMH concedes that a significant restriction of liberty occurred in this particular case, CAMH notes that the factual matrix of each seclusion episode exceeding 7 days is unique and will require an individualized assessment (meaning CAMH may well come to a different conclusion in future cases depending on the specific circumstances).”

5. On February 4, 2024, the Board (differently constituted) ruled that the Board has jurisdiction to review the placement of the accused in locked seclusion in Mr. Warner’s circumstances, which included the seclusion continuing from August 21, 2024 through December 9, 2024.

6. On February 26, 2025, a panel of the Ontario Review Board (“Board” or “panel”) convened for two reasons:

a. to review Mr. Warner’s current Disposition pursuant to s. 672.81(1) of the Criminal Code. At the time of the hearing, Mr. Warner was ordered detained at the Forensic Service of CAMH with privileges up to and including living in the community of the Greater Toronto Area in accommodation approved by the person in charge; and

b. to conduct a restriction of liberty (“ROL”) hearing.

7. The issues to be determined are whether Mr. Warner continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate Disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code. A further issue to be determined is whether the hospital’s decision to increase the restrictions of Mr. Warner’s liberty was warranted, necessary and appropriate at the time of onset, August 21, 2024, and whether it continued to be so through December 9, 2024.

8. Mr. Warner was present for his hearing and was represented by counsel, Mr. Thomas Whillier, throughout the proceedings.

9. A Hospital Report dated December 4, 2024, was entered as Exhibit 1.

10. For the reasons set out below and based on the evidence and opinions before us, the Board found that Mr. Warner continues to represent a significant threat to the safety of the public. The Board finds that a Detention Disposition with detention at the Forensic Service of CAMH is the necessary and appropriate Order on the terms set out in our formal Disposition having regard to the safety of the public, which is the paramount concern, and also having regard to Mr. Warner’s mental health, reintegration into society, and other needs.

11. Additionally, the panel found that the restriction of Mr. Warner’s liberty on August 21, 2024, was significant and it represented the least onerous, and least restrictive measure at the time it was imposed, and it continued to be through to December 9, 2024.

Current Psychiatric Diagnosis

12. Schizophrenia

Position of the Parties

13. At the commencement of the hearing, the parties were canvassed for their without prejudice positions. The hospital, supported by the Attorney General, took the position that the necessary and appropriate Disposition is a Detention Order at the Forensic Service of CAMH on the same terms as last year. They further submitted that the restriction of liberty of August 21, 2024, was necessary and appropriate through to December 9, 2024.

14. Mr. Whillier, counsel for Mr. Warner, conceded the issue of significant threat to the safety of the public. Mr. Whillier agreed with the recommendations of the hospital with respect to the Disposition. He also agreed that the restriction of liberty of August 21, 2024, through to December 9, 2024, was warranted, necessary and appropriate under the circumstances.

15. Therefore, there was a joint submission on all issues.

Index Offence

16. The index offences are summarized as follows:

“Index Offences 1 – Assault with a Weapon (three counts) and Assault Peace Officer

These offences occurred on December 12, 2011. Mr. Warner and the victims were known to each other. The incident occurred at the London Psychiatric Hospital where Mr. Warner was an involuntary patient. On December 12, 2011, a nurse noticed Mr. Warner attempting to exit the dining room with a fork in his right hand and a butter knife in his other hand. He was asked to leave the utensils in the dining room. He then walked towards a nurse, swung his right arm in a stabbing motion in the direction of this person. The fork that was in Mr. Warner's hand struck the nurse in the left shoulder area. Other staff responded to assist. When Mr. Warner began swinging his left arm in a stabbing motion towards the other staff, the knife in the left hand of Mr. Warner struck another nurse several times in her back area. A third staff member responded, and Mr. Warner was taken to the ground in a struggle. While on the ground he was able to break his hand free and continued to attempt to stab staff who were present. He was eventually restrained and placed in seclusion. On December 13, 2012, Mr. Warner attempted to assault a police officer after being transported to the London Police Headquarters Detention Unit.

Index Offences 2 – November 7, 2012

Mr. Warner and both victims were known to each other as involuntary patients at the Regional Mental Health Centre in southwestern Ontario. On November 7, 2012, a co-patient was speaking on the phone when Mr. Warner ran towards him, jumped up and did a flying kick in the direction of this person's head. The co-patient moved out of the way, dropped the phone and stood up when Mr. Warner began punching and kicking while yelling at this person. Mr. Warner then turned his attention towards the second victim who was in the hallway, and he punched him in the back of the head yelling “repent, repent, repent”. Staff members responded and Mr. Warner was seen attempting to go out a window. They were able to restrain Mr. Warner physically and with medication to calm him down. On December 15, 2012, a developmentally delayed patient at the Regional Mental Health Centre in southwestern Ontario contacted the police to report that she had been assaulted by Mr. Warner. On this date Mr. Warner was in the common television room wearing wrist restraints. He walked out into the hallway as the victim was walking past the door. Mr. Warner reached out with his hands waist high and grabbed hold of her around the waist, lifted her and pushed her into the room. He dropped her down onto her mattress and fell on top of her. Several staff members witnessed the incident and pulled Mr. Warner off the victim. She was uninjured physically.”

Background and History

17. The Hospital Report contains extensive information regarding Mr. Warner’s background, mental health history, criminal history and his course in hospital subsequent to his NCR finding, the entirety of which need not be repeated here in detail. However, the following particulars are noteworthy.

18. Mr. Warner is an unmarried 49-year-old man with no dependants.

19. Mr. Warner received a diploma in Graphic Design from Mohawk College in 1995.

20. Mr. Warner has no criminal record prior to the index offences. He was charged with Assault Peace Office on September 18, 2007, but the charges were withdrawn.

21. Records indicated that Mr. Warner had been living on the streets in Toronto for approximately two years prior to an admission to Credit Valley Hospital in June 2006. He was diagnosed with schizophrenia and treated with Epival, Risperdal, Imovane and Cogentin.

22. Mr. Warner had a further nine admissions to hospital from June 29, 2006, up to the time of his first set of index offences on November 7, 2012.

23. Mr. Warner first consumed alcohol at the age of twenty. He denies a pattern of abusive consumption of alcohol. There is no reported history of drug use.

24. In June 2014, Mr. Warner was transferred to CAMH from Waypoint Centre for Mental Health Care. Mr. Warner continues to experience auditory hallucinations and religious preoccupation. He has been in locked seclusion on many occasions, including the most recent seclusion that is the subject of his current Restriction of Liberty hearing.

25. On January 3, 2021, Mr. Warner experienced a seizure. He had a further seizure on February 5, 2021. It was suspected that the seizures were related to clozapine, which he has been receiving since 2015. He was prescribed Kepra to suppress seizures.

26. Mr. Warner is incapable to consent to treatment. His mother is his substitute decision maker.

Course Since Last Disposition

27. Mr. Warner struggled with a significant decline in his mental health in the last reporting year.

28. At the beginning of the reporting year, Mr. Warner insisted on changing his medications and expressed frustration with his clozapine treatment.

29. In October 2023, he was placed in emergency seclusion with limb restraints following a physical altercation with a co-patient.

30. Mr. Warner challenged his finding of incapacity at the Consent and Capacity Board early 2024, which upheld the finding that he is incapable to make his own treatment decisions.

31. On March 4, 2024, Mr. Warner exhibited invasive behaviours, such as placing his fingers in co-patients’ ears claiming, “God told me to do it to drive the demon out of them and install the Holy Spirit.” He demonstrated increased anger, impulsivity, and defiance of staff directions, which required seclusion.

32. By summer 2024, Mr. Warner showed an improvement in his mental health. However, he requested seclusion on June 9, 2024, to avoid acting on his impulses to touch and ‘bless’ co-patients. He was released from seclusion the following day.

33. Despite Mr. Warner’s ongoing religious preoccupations and intermittent auditory hallucinations, he was able to participate consistently in various groups and programs. He achieved a level 5 pass for off-unit programming by June 24, 2024.

34. On July 28, Mr. Warner refused clozapine, citing religious beliefs. By August 2024, Mr. Warner stopped all medications including clozapine. On August 21, 2024, Mr. Warner became increasingly religiously preoccupied and assaulted security staff, prompting a Code White and placement in seclusion. All passes were suspended. His medications were adjusted with the consent of his substitute decision maker and injectable antipsychotic medications and anxiolytics were administered. He was tested out of seclusion on August 28, 2024. However, another Code White was necessary due to kicking and punching a co-patient and attempting to kiss another. He was returned to seclusion.

35. In seclusion, Mr. Warner was seen every twelve hours by the on-call physician to assess the need for seclusion. He was also seen every five days for a further independent assessment. Mr. Warner’s condition remained unstable.

36. On September 12, 2024, a Protected Devices Protocol (PDP) seclusion protocol was approved. While in PDP seclusion, he was given a trial out of seclusion. He immediately rushed at staff aggressively prompting another Code White and a return to seclusion. In late September 2024, an ECT consult was requested due to emerging suicidality, refusal of meals, and unsuccessful attempts to stabilize him. On October 2, 2024, Mr. Warner was transferred to the Secure Observation and Treatment Unit (SOTU). ECT commenced on October 7, 2024. By November 26, 2024, Mr. Warner demonstrated significant improvements from the 18 ECT sessions and clozapine treatment. Seclusion was discontinued on December 9, 2024.

Evidence at the Hearing

37. The Board had available to it the evidence and documents forming the Record, the Exhibit, and oral evidence of Dr. Kravtsenyuk, Mr. Warner’s psychiatrist prior to his transfer to SOTU.

38. Dr. Kravtsenyuk testified that she was involved in Mr. Warner’s care from August 2023 until he was transferred to SOTU. She assessed Mr. Warner on February 25, 2025, and had the opportunity to review his case with his current psychiatrist on SOTU.

39. Dr. Kravtsenyuk testified that Mr. Warner is back on clozapine (350mg daily). Mr. Warner remains on SOTU but is in the general ward milieu. He continues to get maintenance ECT every two weeks, continues to engage with the team in a meaningful way, and he shares his symptoms with the treatment team including auditory hallucinations and religious ideations.

40. Dr. Kravtsenyuk testified that Mr. Warner has not required seclusion since it was discontinued on December 9, 2024.

41. Dr. Kravtsenyuk stated that it is important to recognize Mr. Warner’s efforts to get well. The treatment team wants to see that he is able to remain committed to taking the clozapine long-term because they know that when he stops his clozapine, he deteriorates substantially. Clozapine depends on his cooperation and currently he is cooperating and is compliant with his medication regimen.

42. Mr. Warner interjected that he uses scripture to battle the voices in his head.

43. Dr. Kravtsenyuk advised that the granting of passes will be gradual and will start with escorted passes on hospital grounds. Prior to his decompensation in 2024, he was using indirectly supervised passes on hospital grounds. Mr. Warner’s ability to achieve these privileges again is contingent on his ability to remain compliant with his medications and treatment.

44. In response to questions of the Crown and the Board, Dr. Kravtsenyuk testified that the treatment team recommends community living because it is motivational and a goal for Mr. Warner to work toward, which Dr. Kravtsenyuk stated is important for his rehabilitation. He has not exercised any passes since coming out of seclusion on December 9, 2024.

45. In response to questions of the Board, Dr. Kravtsenyuk confirmed that the medication list outlined in the Hospital report is outdated. For his major mental illness Mr. Warner is taking clozapine (350mg daily), haloperidol long acting (75mg every two weeks), and valproic acid. Mr. Warner’s frustrations with clozapine included a loss of energy that interferes with his ability to work out. She stressed that Mr. Warner’s physical health is important to him.

46. Mr. Warner testified that he would like to go to unit 1-3 but he understands that this likely isn’t realistic right now.

47. In submissions, all parties agreed that it was striking how much Mr. Warner had improved since going back onto clozapine and receiving ECT treatments. All were hopeful and optimistic for his future improvement provided he remain on medication.

Analysis and Conclusions, Annual

Significant Threat

48. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Warner remains a significant threat to the safety of the public.

49. Counsel for Mr. Warner did not contest a finding of significant threat to the safety of the public. Despite this, the Board makes its own finding of significant threat based on the oral evidence, the Hospital Report, Winko and its related authorities.

50. Mr. Warner has treatment resistant schizophrenia. In this past reporting year, he experienced significant decompensation in his mental state and exhibited symptoms that led to several assaultive episodes and self-harm. He required seclusion for several months to prevent further episodes of assault.

51. The Board finds that, if not under a Disposition of the Board, Mr. Warner would likely become non-compliant with medication, decompensate significantly, and return to violent and aggressive actions comparable, at the least, to those he exhibited in the past year.

52. The Board accepts the joint submission on significant threat.

Necessary and Appropriate Disposition

53. In light of the Board’s finding of significant risk, it is charged with shaping a Disposition for the coming year.

54. The Board agrees with the joint submission of the parties. A Detention Disposition on the terms set out in the Hospital Report and agreed to by the parties is necessary and reasonable under the circumstances.

55. Mr. Warner has experienced profound decompensation in his mental state in the past reporting year. He will continue to require ECT maintenance treatments for the foreseeable future.

56. Given the recent status of Mr. Warner’s return to the general milieu of a secure unit, he will need to continue to work toward achieving privileges indirectly supervised off ward.

57. The Board commends Mr. Warner for his efforts to return to a better mental state by adhering to his medication regimen. We wish the best for him in the coming year.

58. The Board finds that that the necessary and appropriate, least onerous and least restrictive Disposition, is continuation of the Detention Order, with terms as set out in our formal Disposition.

Analysis and Conclusion, Restriction of Liberty

59. The evidence supports a finding that the initial restriction of Mr. Warner’s liberty was necessary and appropriate; this was not contested at the hearing.

60. Mr. Warner experienced a profound deterioration in his mental state this year. He became assaultive and unpredictable. Seclusion, which was a significant restriction of his liberty, was necessary and appropriate under the circumstances from the date it commenced on August 21, 2024, through to December 9, 2024.

61. The Board accepts the evidence set out in the Hospital Report, the oral evidence of Dr. Kravtsenyuk, and the submissions of the parties and finds that Mr. Warner’s restriction of liberty from August 21, 2024, to December 9, 2024, was warranted, appropriate and necessary.

DATED this 10th day of April, 2025, at the City of Toronto, in the Toronto Region.

Ms. C. Murray Legal Member

__________________ Office of the Registrar Ontario Review Board