Re: Mikhail Pismerov, 2025 CanLII 31424

Ontario Review Board

Re: Mikhail Pismerov

ORB File No: 5917

Hearing held on: Wednesday, February 26, 2025

Place of hearing: Waypoint Centre for Mental Health Care 500 Church Street, Penetanguishene

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. C. MacIntyre, K.C. Members: Dr. C. Krasnik Dr. G. Stones Ms. A. La Viola Ms. D. Smith

Parties Appearing:

Accused: Mikhail Pismerov Counsel: Mr. A. Rai

The person in charge of hospital: Counsel: Ms. J. Lefebvre

Attorney General of Ontario: Counsel: Ms. J. Armenise

REASONS FOR DISPOSITION

(Dated April 11, 2025)

Introduction

1On June 23, 2011, Mikhail Pismerov was found not criminally responsible on account of mental disorder on a charge of aggravated assault, contrary to the Criminal Code.

2Mr. Pismerov is subject to an Ontario Review Board Disposition of March 8, 2023, which detains him at the Waypoint Centre for Mental Health Care - High Secure Provincial Forensic Programs. Mr. Pismerov is placed in the hospital’s Awenda Program which provides privileges up to living in the community in supervised accommodation approved by the person in charge. He has no indirectly supervised privileges.

3On February 26, 2025, the Ontario Review Board convened at Waypoint Centre for Mental Health Care (“Waypoint”) to conduct Mr. Pismerov’s annual review and to make a disposition further to s. 672.81(1) of the Criminal Code. Mr. Pismerov’s current Disposition of March 8, 2023, allowed for an extension of his review to 24 months rather than 12 months. Accordingly, it has been two years since Mr. Pismerov’s last review.

4At the outset of the hearing, all parties jointly agreed that Mr. Pismerov remained a significant threat to the safety of the public. The hospital and counsel for Mr. Pismerov agreed that a continuation of the same Disposition with a change to hold the hearings annually, rather than two years, was necessary and appropriate. Crown counsel expected to join this position and indeed at the conclusion of the evidence, did so.

5Based on the evidence presented and the joint position of the parties, the Board concluded that Mr. Pismerov remained a significant threat to the safety of the public and that the terms and conditions of his current Disposition continue with the deletion of the clause requiring a two-year review.

Index Offence

6The Reasons for Disposition of April 6, 2023 outline the circumstances of the index offence, as follows:

“The accused, Mikhail Pismerov (1988.12.17) has been a resident of Kerry’s Place at 20 First Avenue in Orangeville for at least three years. The accused is suffering from autism and obsessive compulsive disorder and, as such, resides at Kerry’s Place, which is a group home caring for young adults like the accused.

The victim, [female victim’s name and date of birth], resides across the street from 20 First Avenue at [street address] in Orangeville.

Synopsis

On Monday, 9 May 2011, at or about 4:00 p.m., the accused was outside at the rear of 20 First Avenue in Orangeville, where he was in the care of a Kerry’s Place group home worker…. The accused was becoming upset and requested his medication from the worker, who agreed to issue the medication, which would mean that the pair would enter the 20 First Avenue residence.

Walking to the street entrance of 20 First Avenue, the accused bolted across First Avenue to [the female victim’s address], where the accused encountered the victim. The accused lunged at the victim’s car and when the victim approached, the accused bit the left hand middle finger of the victim at the first knuckle severing the finger. [Information from Crown Attorney, received from victim, indicates that this information is incorrect. The digit affected is actually the right index finger.]

On Monday, 9 May 2011, at approximately 4:12 p.m., the accused was located … and arrested for the offence of Aggravated Assault, contrary to Section 268(1) CC. He was read his right to counsel and caution, which he verbally indicated he understood. The accused did not exercise his right to counsel.

The accused did not give a statement. The accused will be held for Show Cause for public safety and his safety. Kerry’s Place staff is aware of the accused being held and advised of Bail Court timings, location, and date.”

Background

7A Hospital Report of February 3, 2025, is filed as Exhibit 1 to this hearing. It should be referred to for detail regarding Mr. Pismerov’s circumstances. Mr. Pismerov was born in December 1988 in Russia. He and his parents and two siblings immigrated to Canada from Russia in 1998. At the age of five or six while residing in Russia, he was diagnosed with autistic disorder resulting in significant behavioural problems and agitation and aggression and compulsive behaviours during his teenage years and which have continued to this day.

8Very soon after their arrival in Canada, Mr. Pismerov’s family placed him in a residential treatment program as they could not manage his behaviours in their home.

9When the index offence took place Mr. Pismerov had been a resident at Kerry’s Place, a 24-hour supervised group home in Orangeville for the previous four-year period. Since 2007 he had been followed in the community by a psychiatrist and he was connected with the Bayview Dual-Diagnosis Program in Penetanguishene. A support plan was in place which included hospitalization when his behaviours escalated to an unmanageable level. He often required only a few days in hospital to settle without any further intervention required. It was reported by Kerry’s Place that hospitalization seemed to interrupt his behavioural cycle. Following the index offence, Mr. Pismerov was assessed at the Oak Ridge Secure Forensic Program (now Waypoint). It was noted that over the years, despite treatment on a variety of psychotropic medications, he continued to be significantly behaviourally disturbed. Following the index offence and pursuant to a Disposition of the Review Board, Mr. Pismerov was detained at Waypoint’s High Secure Program and discharged back to Kerry’s Place in December of 2011.

10Since then, a number of admissions to Waypoint have been necessary arising from self-harming behaviour, environmental aggression and assaults on staff.

11In 2016, it was discovered that Mr. Pismerov suffered from an autoimmune disorder of Idiopathic Thrombocytopenia. This disorder causes a decrease in the number of his blood platelets. Due to this condition, Mr. Pismerov’s clozapine and other antipsychotic medications then had to be discontinued with the result being a significant deterioration in his behaviour and mental state. An admission to Waypoint was necessary as Kerry’s Place could not sufficiently manage Mr. Pismerov’s risk to staff and other residents or to himself.

12At Mr. Pismerov’s last Board review it was learned that Kerry’s Place planned to build a separate and suitable residence for Mr. Pismerov at the Kerry’s Place location. This residence will be specifically for Mr. Pismerov and would be appropriately staffed on a 24-hour basis.

13In the meantime, while a resident at Waypoint, Mr. Pismerov’s behaviour has required a number of seclusions to manage his behaviour. It was felt at his last review that his approaching annual reviews increased his anxiety and agitation. A two-year review period was then proposed.

14Mr. Pismerov suffers from:

Intellectual Disability, mild to moderate

Autism Spectrum Disorder

Obsessive Compulsive Disorder

Generalized Anxiety Disorder

His current medical diagnosis includes the autoimmune disorder, Immune Thrombocytopenic Purpura (IPT).

Evidence at Hearing

15Dr. Ismail is Mr. Pismerov’s treating psychiatrist. Dr. Ismail testified that Mr. Pismerov resides in the hospital’s Awenda Program, a specialized Dual Diagnosis Program for individuals who suffer from a cognitive impairment as well as a mental illness.

16Since his last review period, not much has changed in Mr. Pismerov’s pattern of behaviour. A crisis prevention plan is utilized to manage his maladaptive behaviours and is regularly reviewed and updated. The plan identifies those triggers and behaviours known to be early warning signs or signs of decompensation and strategies to be employed by staff to deal with the situations as they arise.

17Notwithstanding these strategies, seclusions were necessary from time-to-time due to escalating verbal or physical aggression. The Hospital Report outlines a great number of the significant incidents involving threats or harm to staff and self-injurious behaviour.

18Medication changes or adjustments in dosage were made over the review period to stabilize his mental status and behaviour, all of this conducted with an awareness of his blood disorder which is monitored regularly to ensure his platelet levels remain stable.

19Mr. Pismerov’s security levels fluctuate depending on his mental status at the time. When seclusions are necessary, they are usually short and he settles down with the use of calming prn medication.

20The latest seclusion took place between February 11 and 17, 2025. This followed a pattern of escalating anxiety with threats to staff and trying to injure himself as a way of expressing his frustration.

21Dr. Ismail explains that Mr. Pismerov is likely frustrated about the fact that he has not been able to be discharged back to Kerry’s Place. Mr. Pismerov believes he is going to be discharged and when staff try to disabuse him of the immediacy of this, he reacts behaviourally.

22Unfortunately, Kerry’s Place is still working on the financing to provide for the proposed home for Mr. Pismerov. Dr. Ismail has been given no timelines as to when this can be completed. The hospital meets with Kerry’s Place staff on a quarterly basis to provide updates on Mr. Pismerov’s housing status. The hospital team acknowledges that the delay is impacting Mr. Pismerov’s liberty and reintegration into society.

23The hospital is now recommending that Mr. Pismerov’s hearings be held annually. Dr. Ismail explained that when Mr. Pismerov was at Kerry’s Place, he would worry about the Board hearings coming up and that he might be returned to hospital afterwards. Now that he has been in hospital and can be managed there, there is no reason why the hearings cannot take place annually.

24Furthermore, the Hospital Report notes that “...the clinical team hopes that the reduced timeline will apply some pressure to Kerry’s Place, as well as the MCCSS, to obtain/provide the necessary funding to create Mr. Pismerov suitable housing”.

Decision

25The Board accepts the evidence provided by the hospital and as contained in the Hospital Report to support that Mr. Pismerov remains a significant threat to the safety of the public. It is clear that the hospital is doing all that it can to manage Mr. Pismerov’s quite problematic behaviour while in hospital.

26It is encouraging that Kerry’s Place wishes to have Mr. Pismerov return there with the appropriate environmental structure that would afford Mr. Pismerov round-the-clock 1:1, or better, supervised care, to best ensure his consistent treatment and others’ safety. The Board supports all efforts to speed up the process of building a special unit for Mr. Pismerov.