Re: Jeremiah Gryciuk
ORB File No: 7765
Hearing held on: Tuesday, February 25, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Fraser
Members: Dr. R. Wood Hill Dr. W. Johnston Mr. D. D’Intino Mr. J. Cyr
Parties Appearing:
Accused: Jeremiah Gryciuk Counsel: Mr. D. Medd
The person in charge of hospital: Representative: Ms. M. Warner
Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION
(Dated April 10, 2025)
Introduction
On August 10, 2020, Mr. Jeremiah Gryciuk was found not criminally responsible (“NCR”) on Criminal Code charges of theft under $5,000, possession of property obtained by crime, robbery, and uttering threats. Mr. Gryciuk is currently subject to a Disposition of the Ontario Review Board (“ORB”) detaining him at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH”) in Toronto with a number of privileges up to and including to live in accommodation approved by the person in charge.
On February 25, 2025, a panel convened in person and a hearing was held at CAMH. The purpose of the hearing was to determine if Mr. Gryciuk represents a significant threat to the safety of the public as defined in the Criminal Code of Canada, and if so, the necessary and appropriate disposition.
For the reasons set out below, the Board unanimously finds that Mr. Gryciuk continues to pose a significant threat to the safety of the public and that the necessary and appropriate disposition to manage that risk while meeting his needs is that he be detained in hospital on the terms set out in his current disposition.
Current Psychiatric Diagnoses:
Schizoaffective Disorder, Bipolar Type; Substance Use Disorder
Differential Diagnosis – Unspecified Personality Disorder (Cluster B) vs. Traits.
Index Offences:
- The details of the index offences are extracted from the Hospital Report, which are as follows:
Charges: Theft Under, Utter Threat & Possession of Property Obtained by Crime (14 November 2018)
On Wednesday, November 14, 2018, at approximately 3:45 pm the accused, Jeremiah GRYCIUK entered the Tim Horton's restaurant, bought a donut and left the store. The accused then approached the victim, Alondra MONTERO who was working behind the counter. The accused indicated that he was armed with a weapon and made a demand for money. The victim fearing for her safety handed over $125.00 to the accused who then fled the store.
The accused was located a short distance away by police and was arrested without incident. Prior to the search incident to arrest the accused advised the arresting officers that the money he obtained was in his left jacket pocket. The $125.00 was located and seized from the accused.
The accused was transported to 31 Division and was held pending a show cause hearing.
Arrest Report from Peel Regional Police Service
Charges: Robbery (20 November 2018)
At 8:31 pm on November 20, 2018, the accused entered the JH convenience store at 585 Lakeshore Road East in Mississauga and confronted the victim while armed with a knife. The accused made a demand for money. The victim complied and surrendered approximately $400.00 in cash from the register. The accused fled the store and the victim immediately contacted police. The victim sustained no injuries.
On November 21, 2018, the accused returned to JH convenience with his mother to give back the stolen money and turn himself in to police. The victim called police and at 1:53pm the accused was arrested for robbery, read his rights to counsel and caution which he indicated he understood. The accused was transported to 12 division where he was held pending a bail hearing.
The accused's brown leather jacket and silver knife was seized.
The accused provided a taped confession to police.
The money was recovered and returned to the victim.
Without Prejudice Position of the Parties:
At the commencement of the hearing, the parties were canvassed for their initial positions.
Counsel for the Hospital took the position that the necessary and appropriate disposition was continuation of the existing Detention Order with no changes to the conditions.
Counsel for the Attorney General supported the Hospital’s position.
Counsel for the accused took the position that Mr. Gryciuk does not meet the test for significant threat to the safety of the public, as per Winko1, and therefore advocated for an Absolute Discharge.
Evidence at the Hearing:
The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Jaiswal.
Dr. Jaiswal testified that in January and February of this year, Mr. Gryciuk’s urine drug screens (UDS) tested positive for ephedrine or pseudoephedrine. Based on discussions with Mr. Gryciuk, the team believes that these positive results came from the use of over-the-counter decongestants with pseudoephedrine in them. Subsequent UDS were negative for ephedrine and pseudoephedrine.
Dr. Jaiswal further testified that Mr. Gryciuk has expressed a desire to gradually reduce his Clozapine dosage, with a view toward getting off the medication entirely. Dr. Jaiswal stated that Mr. Gryciuk suffers from a severe persistent mental illness that likely warrants indefinite treatment with antipsychotic medications, particularly Clozapine, and so the doctor and the accused have “agreed to disagree”.
Part of this disagreement stems from Mr. Gryciuk’s belief that his historical experiences with psychosis have been substance induced. He has partial insight in the sense that he recognizes he has experienced psychosis in the past and medication prevents that, while also acknowledging that substance use has led to psychosis in the past. Despite his partial insight, Mr. Gryciuk continues to accept treatment and takes his medication.
Dr. Jaiswal testified that given Mr. Gryciuk’s history of medication non-compliance, his return to substance use, and mental status decompensation leading to psychosis, Mr. Gryciuk is receiving a high degree of supervision and follow up in the community. For example, he is coming to CAMH for outpatient services rather frequently and is subject to frequent UDS several times per week. Furthermore, his medication compliance is being monitored in the community by Shoppers Drug Mart staff and regular bloodwork is done to ensure that his blood Clozapine and Valproic Acid levels are in the therapeutic range.
Mr. Gryciuk was in the past year discharged from CAMH to reside in the community with his mother. The Hospital and Mr. Gryciuk have an agreement where he is to notify the team if his brother spends the night in the family home, or if Mr. Gryciuk stays overnight at his brother’s residence. The team views Mr. Gryciuk’s brother as a destabilizing factor that would prompt his return to substance use.
As it concerns Mr. Gryciuk’s mother, Dr. Jaiswal testified that while in some sense she is able to inform the Hospital if there are any concerns about the accused’s mental state, she shares some of his views surrounding medication and the long-term need for treatment.
In the coming reporting year, Dr. Jaiswal testified that they wish to see Mr. Gryciuk engaging in prosocial, structured activities outside of CAMH, and depending on how he does with those activities, the team would then look to reducing the level or frequency of supervision. Mr. Gryciuk has been encouraged to engage in some volunteering in the community and Mr. Gryciuk has expressed a desire to return to school, which the team feels would be a positive choice for him.
Dr. Jaiswal expressed the opinion that Mr. Gryciuk is in the early stages of his transition to the community and therefore there are many factors that have not yet been tested. The doctor felt that if Mr. Gryciuk were to be discharged absolutely that he would fall away from treatment and discontinue medication, leading to an episode of psychosis. He would then likely return to substance use which may be precipitated by or lead to further involvement with his brother, who is seen as a destabilizing person.
Dr. Jaiswal testified that in the past when acutely psychotic, Mr. Gryciuk has engaged in acts of violence in the past, and thus for those reasons he continues to meet the threshold for significant threat to the safety of the public. The doctor continued on to say that Mr. Gryciuk has previously had some issues with housing stability, and so it is important for the Hospital to be in a position to approve his housing, and it is also important that the Hospital has the means to return him to CAMH should he return to substance use and/or experience mental status decompensation. Dr. Jaiswal felt that the provisions of the civil Mental Health Act would be insufficient to achieve this.
In response to questions from the Attorney General, Dr. Jaiswal endorsed passages from the Hospital Report at page 27, where it was explained that Mr. Gryciuk does not accept that he has a mental illness and believes that substance use is what triggered his prior episodes of psychosis. However, he continues to take his medication.
Dr. Jaiswal testified that the Cluster B traits referred to in the differential diagnosis includes antisocial personality traits, borderline personality traits, histrionic personality traits and narcissistic personality traits. Generally, individuals who have such personality traits may have difficulties with interpersonal relations. There might be history of difficulties with rule violation and impulsivity. This relates to Mr. Gryciuk because he has a history of duplicity with respect to medication adherence and challenges with being open with the treatment team as well as with substance use.
Dr. Jaiswal was also asked to elaborate on findings in the Hospital Report at page 24 which mentioned that Mr. Gryciuk exhibited highly rigid thinking patterns. The doctor explained that when Mr. Gryciuk was on the general forensic unit, he was trying to engage the accused with discussions around structured vocational or educational programming and also housing supports. There was a discussion around applications to supported and supervised housing. But as it is indicated in the report, Mr. Gryciuk was described as shutting down when inconsistencies with respect to the need for support and engagements around housing supports were challenged and also shutting down with respect to when there's encouragement to partake in an educational programming approach.
Dr. Jaiswal agreed with Mr. Feindel’s suggestion that Mr. Gryciuk accepts the team’s guidance with some difficulty. This point was illustrated in the Hospital Report by the accused’s unwillingness to consider housing options that the team was presenting to him.
In response to questions by Mr. Medd, Dr. Jaiswal agreed that over the last year, to his credit, Mr. Gryciuk has engaged in some group therapy. He further agreed that Mr. Gryciuk has not expressed an intention to imminently cease all medication, but that he wanted to reduce his dosage with a view toward eventually being off all medication entirely.
In response to a suggestion from Mr. Medd that, based on his past willingness to self-present to Trillium Health Partners when he feels unwell, and the Board should have confidence in his willingness to admit himself for medical attention if he were to decompensate, Dr. Jaiswal did not agree. Dr. Jaiswal responded that in the past, there was evidence that Mr. Gryciuk had ceased taking his medication at least a week prior to committing the index offences and that he did not have confidence that he would present himself to Hospital each time he experiences psychotic symptoms, if not under the purview of the Board.
In response to Mr. Medd’s suggestion that, if Mr. Gryciuk were to be re-hospitalized that he would stay as a voluntary patient, Dr. Jaiswal testified that it would depend on the circumstances.
In response to questions by the Board, when confronted with the fact that the existing disposition does not contain a term prohibiting the possession of weapons, Dr. Jaiswal responded that he was not opposed to the inclusion of that term in the disposition.
The Board inadvertently failed to canvass the positions of the parties on the inclusion of a weapons prohibition term in the disposition before the end of the hearing, and so the Chair contacted all parties after the hearing to allow for submissions on this discrete issue.
The Hospital and counsel for the Attorney General both supported the inclusion of that term, while Mr. Medd opposed it given his primary position that an Absolute Discharge was the necessary and appropriate disposition.
Returning to the evidence of Dr. Jaiswal in response to questions from the Board, Dr. Jaiswal adopted the contents of the Hospital Report which mentions that Mr. Gryciuk’s mother holds certain beliefs about “psychiatry without Hospitals” and that antipsychotic medications were not meant for long-term use. This has not been further explored with her since his discharge from Hospital.
Dr. Jaiswal further indicated that, as noted in the Hospital Report, the team remains concerned that Mr. Gryciuk is underestimating the impact of stressors on his mental status and overestimating his coping skills. This remains a concern because Mr. Gryciuk insists on returning to school in the Fall with a full course load, even when presented with evidence that in the past he has had to withdraw from full-time schooling. The team has been encouraging him to consider part-time studies, but it appears that Mr. Gryciuk has resisted that suggestion.
Dr. Jaiswal also agreed that Mr. Gryciuk’s insight into his mental illness and his need for medication remains a concern. In the past, he has made statements that he didn’t believe he would suffer an episode of mania if he ceased his medications and that he maintains his prior psychotic episodes were the result of substance use and a lack of sleep.
The Board also raised the fact that in 2024, Mr. Gryciuk mislead the treatment team about being on a waitlist for subsidized housing, and further, that he made some comments suggesting that the treatment team was pushing an idea of group home living on him because they derived some sort of benefit from doing so. Dr. Jaiswal has not discussed those beliefs with Mr. Gryciuk recently but is willing to do so moving forward.
Lastly, Dr. Jaiswal adopted the composite assessment of risk that is included at page 42 of the Hospital Report, which assessed Mr. Gryciuk as posing a moderate risk of violent reoffending in the context of a Detention Order, but a high risk on a Conditional or Absolute Discharge. Dr. Jaiswal further confirmed that this assessment of risk remains valid.
Next, the Board heard evidence from Mr. Gryciuk himself. He read a short, prepared statement at the hearing and then was examined by Mr. Medd, whereby he testified that he wanted to pursue a career as a personal support worker, that he wishes to complete schooling and find a job, and that he intends to continue residing with his mother.
Mr. Gryciuk expressed that he feels “genuinely happy” at present and has no plans to resume alcohol or substance use.
When asked to discuss his mental condition by Mr. Medd, Mr. Gryciuk testified that he does not believe he has a “genetical mental health problem” or a “mental health disorder”. He attributes his prior psychosis to abusing Vyvanse and cannabis. He again denied ever having a mental health disorder.
Mr. Gryciuk exhibited some difficulty discussing his past mental state. When asked by Mr. Medd to explain what being unwell meant to him, he testified that it meant that he needed to be hospitalized and that, “it doesn’t necessarily mean I had psychosis”.
When asked by his counsel whether he would consider going back to Hospital if he felt unwell, Mr. Gryciuk testified that he doesn’t have intentions on returning to Hospital and he doesn’t want to return.
In response to questions from Mr. Feindel about what steps he has taken in the community to prepare for an Absolute Discharge, Mr. Gryciuk testified that he did not have a psychiatrist in the community at this juncture, and that he would speak to Mr. Medd about the best course of action, including “taking that step away from CAMH”.
Mr. Gryciuk also characterized being under the jurisdiction of the Board as being a “limiting factor” and that he wanted his freedom.
Mr. Gryciuk was then questioned by the Board. He had some significant difficulty in answering the questions posed of him.
The first question asked by a panel member was whether he believed that the reason why he was “genuinely happy” right now was in part because of the care he received from the forensic program at CAMH. Mr. Gryciuk’s response was that he, “would have to think about that, sir”.
Next, he was asked whether it was fair to say that when the index offences were committed, that Mr. Gryciuk was unwell. Mr. Gryciuk was given time to consider the question and provide an answer, but he did not respond.
Unfortunately, Mr. Gryciuk struggled and ultimately could not provide any response to further questions, which included the possibility that without the support of a Detention Order, he could degrade back to the state of illness he was experiencing at the time of the index offences, or why it was difficult for him to accept that he has a mental health diagnosis and saw this as a negative.
No further evidence was called by any of the parties, and all parties maintained their initial positions at the conclusion of the hearing.
Analysis and Conclusions
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Gryciuk remains a significant threat to the safety of the public and therefore a continuation of the existing Detention Order Disposition is both necessary and appropriate.
Mr. Gryciuk suffers from Schizoaffective Disorder, as well as a Substance Abuse Disorder. Mr. Gryciuk does not accept that he has a mental illness and as evidenced by his testimony at the hearing, he could not even explain the concept of being unwell.
Mr. Gryciuk has struggled with his insight into the index offences and while he has in past seemingly acknowledged that he was psychotic at the time of the index offences, he continues to insist that this was the result of substance use and not due to an underlying mental disorder.
Mr. Gryciuk has expressed an interest in reducing his dosage of prescribed medications with a view toward potentially coming off the medication altogether. This expressed viewpoint is consistent with his history of medication noncompliance, particularly in the period immediately preceding the index offences. His views on the need for medication also appear to align with those of his mother, who has expressed skepticism about the long-term use of antipsychotic medication and hospitals generally (in the context of psychiatry).
The Hospital Report at page 15 also includes a statement from the accused where he admitted that “he and his mother” had been decreasing the doses of his medication without the consent of his treating doctors.
In addition to a lack of insight into his diagnosis and need for medication, as well as a history of medication non-compliance, Mr. Gryciuk also has a history of dishonesty. For example, it was discussed at the hearing that in 2024, Mr. Gryciuk was dishonest with the team about being on a list to receive subsidized housing. The Hospital Report at page 8 further discusses the results of a psychological report from 2020 where the authors concluded that Mr. Gryciuk was attempting to appear memory impaired.
Moreover, in the past when presented with evidence of a urine drug screen that was positive for ketamine, Mr. Gryciuk initially denied using the substance, before striking a more ambivalent tone on the subject. Mr. Gryciuk at that time stated he would not use substances again, but mere weeks later tested positive for alcohol. He has struggled to remain sober from alcohol, cannabis, cocaine and other substances when in the community.
These struggles are highly probative to the issue of significant threat, because the combination of medication noncompliance and illicit substance use coincided with a psychotic episode that prompted the commission of the index offences.
The Hospital Report shows rather consistently that Mr. Gryciuk has long struggled with medication non-compliance and substance abuse. While in the past he has made statements to various doctors which suggest insight into both his mental illness and the need for medication to maintain his mental health, his recent statements as well his testimony before the Board demonstrate that any insight he may have had in the past was either superficial or no longer exists. The Hospital Report at page 21 supports this conclusion, where it notes that psychoeducation has not yielded significant changes in Mr. Gryciuk’s understanding of his illness or need for medication.
It is very clear to the Board that Mr. Gryciuk rejects his diagnoses, expresses an intention to discontinue with his medication at some point and intends to fall away from CAMH if he is discharged absolutely. Mr. Gryciuk’s oral evidence demonstrates that he views CAMH and the forensic system as a barrier to his goals, but he cannot articulate why.
Furthermore, it appears that Mr. Gryciuk has not adequately prepared for the disposition he is seeking. He does not have a psychiatrist in the community for example, and he expresses an intention to continue residing with his mother, which is problematic without the oversight of CAMH because of her views on psychiatry and medication, as well as her past complicity with reducing the dosage of Mr. Gryciuk’s medication.
As Mr. Gryciuk is assessed to be at a high risk of future violence in the context of a Conditional or Absolute Discharge, these concerns are all the more prescient.
In many respects, Mr. Gryciuk has had a very good year, and he is beginning to increase his engagement with treatment and counselling. The Board further recognizes and commends Mr. Gryciuk for his desire to pursue higher education and return to employment.
The Board hopes that Mr. Gryciuk will eventually be able to see that the structure, oversight and support of the forensic system is not a barrier to his success, but a form of support for his success. We encourage Mr. Gryciuk to continue to work with the treatment team and strongly consider their advice concerning a return to part-time studies and further engagement in group and individual programming.
In consideration of all the evidence, the submissions of the parties, and the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Gryciuk, his reintegration into society and his other needs, the necessary and appropriate Disposition is continuation of the existing Detention Order Disposition with the addition of a weapons prohibition to its terms and conditions.
DATED this 10th day of April, 2025, at the City of Toronto, in the Toronto Region.
Mr. D. D’Intino Legal Member
__________________ Office of the Registrar Ontario Review Board
Footnotes
- Winko v. British Columbia (Forensic Psychiatric Institute) 1999 CanLII 694 (SCC), [1999] 2 SCR 625