Ontario Review Board
Re: Trey Thomas
ORB File No. 7475
Hearing Date: March 5, 2025
Place of hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus
Pursuant to: Sections 672.81(1) 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: Trey Thomas
Counsel Mr. A. Rai
The Person in charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. K. Malkovich
REASONS FOR DISPOSITION AND DECISION
(Dated April 9, 2025)
Introduction
Mr. Thomas was charged under the Criminal Code of Canada with assault with a weapon. He was found not criminally responsible (NCR) for this offence on December 21, 2018.
He is currently subject to a detention order under a Disposition dated March 27, 2024, with privileges that extend to living in the community of Southern Ontario in accommodation approved by the person in charge.
A panel of the Ontario Review Board convened this annual hearing and a restriction of liberties hearing on March 5, 2025, at St. Joseph’s Healthcare, Hamilton, West 5th Campus (St. Joseph’s,) to review the current Disposition, and to determine if the restriction to Mr. Thomas’ liberty was warranted.
At the commencement of the hearing, the Hospital submitted that Mr. Thomas remained a significant threat to the safety of the public, and that a continuation of the exiting detention order with the same terms and conditions was necessary. The Hospital further submitted that the restriction to Mr. Thomas’ liberty was warranted in the circumstances.
Counsel for the Attorney-General and for Mr. Thomas supported the Hospital’s position with respect to both the annual hearing and the restriction of liberties.
After considering the evidence, the panel agreed with the position taken by the parties. Mr. Thomas remains a significant threat to the safety of the public, and a continuation of the current Disposition is necessary. The panel also accepts that the restriction to his liberty was necessary and warranted.
Index Offence
- The following is a synopsis of the facts pertaining to the index offence.
The Index Offence occurred on August 6, 2018. Mr. Thomas attended the home of his sister and her boyfriend (Janet Thomas and Jordan Hill), and asked for his passport. He was told they did not have his passport. Mr. Thomas became upset, he went outside and grabbed a shovel, which he used to strike Ms. Thomas’ vehicle numerous times. Mr. Thomas then swung the shovel at Jordon Hill and Brody Thomas, who were attempting to take the shovel away from him. The police arrived and arrested Mr. Thomas. The police report indicates that in the six weeks prior to the index offence they received 15 mental health related calls concerning Mr. Thomas.
Evidence
On April 19, 2024, St. Joseph’s advised the Board that Mr. Thomas had been readmitted to the hospital on April 5, 2024. He had disclosed significant suicidal thoughts to his outpatient team. On April 17, 2024, the Hospital was advised by his community residence, Emmaus Place, that they were terminating his tenancy following numerous readmissions to hospital in the past couple of years, and the limited progress being made with their rehabilitation programs.
A hearing was scheduled for July 25, 2024, to consider the restriction to his liberty. The hearing was adjourned at the request of the Hospital after they learned that Mr. Thomas no longer had community housing available. Mr. Thomas remains in the hospital as of the date of this hearing.
The evidence at this hearing consisted of the Hospital Report dated February 21, 2025, and the testimony of Dr. Prat, Mr. Thomas’ treating psychiatrist. The Hospital Report was prepared for this hearing, and contains a detailed review of Mr. Thomas’ personal and mental health history.
Mr. Thomas is diagnosed with Schizophrenia and Substance Use Disorder (in remission.)
Mr. Thomas’ mother was originally from Florida and part of the Seminole Tribe. His father was a member of the Six Nations. When Mr. Thomas was 9 years of age his mother returned to Florida. She was killed in a motor vehicle accident in 2015. In October 2017, his father committed suicide.
Prior to the index offence, Mr. Thomas lived with his sister Janet. She indicated that he started to become withdrawn at the age of 15, and she began to notice psychotic symptoms at the age of 17, following the death of his father. He completed High School, but has no work history.
He has had numerous admissions to the hospital for psychiatric care prior to the NCR finding. He attempted suicide in January 2018, and was observed to be responding to command hallucinations.
In April 2018, he was hospitalized after telling police that he had abused children and that he was considering suicide. He was hospitalized in August 2018, after telling police that he had thoughts of harming his sister.
During this time, he was not taking his prescribed medication, and was consuming marijuana. The hospital notes, prior to the index offence, refer to Mr. Thomas being psychotic, having no insight into his condition, and responding to auditory hallucinations.
He was admitted to St. Joseph’s on September 5, 2018, and was described as acutely agitated and hearing voices. He continued to believe that he was a child molester, and did not accept that these thoughts were delusional. He was started on Clozapine which resulted in noticeable improvements. However, the auditory hallucinations continued and were at times severe. It was also indicated that he lacked motivation to engage in meaningful activities.
On March 8, 2021, he was discharged from St. Joseph’s to live in the community at a home operated by the Canadian Mental Health Association. He was readmitted March 16th after he advised the housing staff of suicidal ideation. The Hospital staff concluded that Mr. Thomas required different housing that had closer supervision and monitoring. There was no structure to his day, he was likely not taking his medication, and he complained of feeling lonely.
In August 2021, Mr. Thomas was accepted into a welding program at Mohawk College. He did not complete the necessary paper work or pursue the program. It is reported that this is indicative of his lack of motivation and reluctance to engage in activities or programming.
In January 2022 he was discharged from the hospital to reside in the community at Emmaus Place. This facility has 24-hour daily supervision.
The staff at Emmaus Place indicated that Mr. Thomas missed scheduled appointments, and would not approach staff for his medication as he was directed to do. He attended some recreational programs but required significant encouragement. He was mentally stable but his mood fluctuated. Mr. Thomas preferred to sleep in late, and as a consequence, missed his morning medication on many occasions. This was not his antipsychotic medication.
Mr. Thomas has been readmitted to the hospital numerous times since his discharge to Emmaus Place.
On April 18, 2023, he was readmitted after experiencing suicidal ideation.
He was admitted at his request on October 25, 2023, for suicidal thoughts.
On September 15, 2023, he was readmitted after advising staff that he was feeling lonely and unwell.
On October 25, 2023, he was admitted for a similar reason, and stated to staff that he felt safer in the hospital.
He was admitted on February 1, 2024, for passive suicidal ideation.
Mr. Thomas was readmitted on April 5, 2024, the subject of this restriction of liberties hearing, after disclosing significant suicidal plans to his outpatient team. He remains in the hospital.
Mr. Thomas does not have a criminal record.
He has reported to staff that social withdrawal, isolation, and increased sleep indicate that he is decompensating. These symptoms are often precipitated by feelings of loneliness or boredom.
Mr. Thomas would often report to staff that the auditory hallucinations he had experienced in the past were now fine. However, he is not typically forthcoming with information concerning these hallucinations, so it has been difficult for the treatment team to assess the frequency and intensity of the hallucinations.
Mr. Thomas is entitled to receive a monthly income from the Seminole Tribe in Florida. There have been issues with Mr. Thomas providing the Tribe with required paperwork, which has interrupted the payment. The Seminole Tribe has requested that Mr. Thomas present himself to the Tribe in Florida in person so they can confirm his identity. This has proven difficult, and staff is assisting him. A member of the Seminole Tribe attended this hearing by videoconference, which may facilitate a resolution to the outstanding issues.
The staff at Emmaus Place indicated that they were providing more extensive support for Mr. Thomas than they provided to the other tenants. They were meeting with him twice weekly for scheduled appointments, they were performing nightly telephone check-ins, and they were observing Mr. Thomas take his medication.
During this past year, Mr. Thomas has been generally cooperative with staff. Mr. Thomas indicated that he was experiencing auditory hallucinations in the form of “noise in the background,” but that they are well managed and controlled. He does not elaborate further, but rather, states that he will let staff know if they become bothersome.
He consistently adheres to the unit rules, utilizing his therapeutic passes appropriately. All urine drug screens have been negative for substances.
On October 15, 2024, Mr. Thomas attempted suicide by cutting his left forearm. He was placed on 1:1 constant observation from October 15 to October 23, 2024. His affect appeared sad at the time. Mr. Thomas refused to discuss the incident. He advised staff in November that he periodically researches medical assistance in dying when his suicidal ideation worsens.
On October 21, 2024, Mr. Thomas began Dialectical Behavioural Therapy (DBT,) and has been consistently attending all scheduled appointments with the clinician. The clinician reports, that at this early stage, the focus has been on preventing any further attempts at self-harm. As this risk decreases, the focus will shift to improving his insight and understanding of his emotions, while strengthening his capacity to tolerate stress. It is anticipated that he will continue with this therapy for the foreseeable future.
Mr. Thomas currently exercises 6 hours-per-week indirectly supervised passes into the community. These passes have been used without difficulty.
Mr. Thomas has had limited engagement with Occupation Therapy. He is generally pleasant, but displays low mood and motivation, which impacts his ability to participate in various activities.
Mr. Thomas has no approved person, and does not have a close relationship with his siblings. He does contact his brother periodically who lives in Florida through social media.
Mr. Thomas has consistently expressed no interest in engaging with the Hamilton Regional Indian Centre or the Aboriginal Health Centre, or becoming involved in the cultural teachings and practices offered by these services.
Mr. Thomas expressed to Dr. Prat that he experiences low mood and auditory hallucinations on a daily basis.
Dr. Prat testified that Mr. Thomas’ engagement with DBT is promising, and that he enjoys a good rapport with his psychotherapist.
He described Mr. Thomas’ mental illness as complex; particularly in the context of the persistent suicidal thoughts. He also believes that Mr. Thomas experiences more symptoms than he discloses.
With respect to future treatment, Dr. Prat stressed the importance of continuing with the DBT. He will also help Mr. Thomas become involved in some activity that he enjoys. Dr. Prat suggested that there may be a personality component to his illness in addition to the Schizophrenia.
Dr. Prat stated that if Mr. Thomas was not under the authority of the Board, he would discontinue his medication, the psychotic symptoms would intensify, and in all likelihood, he would harm himself.
In answer to questions from the Crown, Dr. Prat indicated that DBT is the proper treatment for the personality disorder component of Mr. Thomas’ illness, as well as appropriate to manage his emotions.
In answer to questions from counsel for Mr. Thomas, Dr. Prat advised that Mr. Thomas has been compliant with his medication, and has exercised his passes to the community without difficulty. He has not consumed any substances. Dr. Prat acknowledged that his main concern at this time is emotional regulation and self-harm.
In response to questions from the panel, Dr. Prat testified that Mr. Thomas has never had any connection to the Seminole Tribe in Florida, and expressed no interest in connecting with the Six Nations. The emphasis for his treatment at this time will be the DBT. He testified that Mr. Thomas experiences a sense of loss without a set of structures in place.
Submissions
The Hospital submitted that a detention order is necessary, and that the restriction to his liberty was warranted. Counsel referred to the multiple readmissions to hospital, and the recurring suicidal ideation. Mr. Thomas will decompensate quickly if supports are not provided for him, which would put the safety of the public at risk. He also referred to the fact that there is currently no available housing in the community for Mr. Thomas.
The Crown referred to the attempted suicide in October, 2024, with a razor as being of great concern. It demonstrates impulsive and concerning behaviour, and is indicative of a risk to public safety. The Crown agrees with the Hospital that the restriction of liberty was necessary and appropriate.
Counsel for Mr. Thomas expressed hope that the DBT will have a positive impact on Mr. Thomas’ mental health. He also referred to Mr. Thomas being able to exercise passes into the community without any incidents as being very positive. He also agreed that the restriction of liberty was necessary and appropriate.
Analysis
The panel agrees with the position taken by the parties that Mr. Thomas remains a significant threat to the safety of the public, and that a detention order is necessary and appropriate. The panel also finds that the restriction to his liberty, which began with a readmission to hospital on April 5, 2024, and continues, was warranted in the circumstances.
Over the past few years, Mr. Thomas has demonstrated a pattern of not doing well in the community, and requiring readmission to hospital. This has occurred on multiple occasions. It is typically a result of persistent despondency coupled with repeated episodes of suicidal ideation. It perhaps culminated with the attempt at suicide on October 15, 2024.
His lack of motivation and interest in pursuing any activities exacerbates these low-mood symptoms.
Dr. Prat suggested in his evidence that there may be a personality component to his illness together with the Schizophrenia. Mr. Thomas’ participation in DBT may be very beneficial in addressing these personality symptoms. Currently, these negative symptoms prevent Mr. Thomas from progressing and elevating his mood.
Unfortunately, Mr. Thomas lost his supervised housing at Emmaus Place, and there is no other housing available. Housing with supervision will be required for Mr. Thomas when he is discharged to live in the community. It is, therefore, necessary for the Hospital to approve his housing.
A detention order with the terms suggested by the Hospital is necessary and appropriate. It was necessary for the Hospital to readmit Mr. Thomas on April 5, 2024, after he expressed, what is described as, significant suicidal thoughts to his outpatient team.
In coming to this conclusion, the panel has applied the principles provided in s. 672.5401 of the Criminal Code.
Dated this 9th day of April 2025, at the City of Toronto, in the Toronto Region.
Kevin McKenna
Legal Member
_____________________
Office of the Registrar
Ontario Review Board