Ontario Review Board
Re: Brennan G. Anderson
ORB File No: 8092
Hearing held on: Tuesday, February 25, 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: Brennan Anderson (via Zoom) Counsel: Mr. U. Agostino (via Zoom)
The person in charge of hospital: Counsel: Mr. J. Thomson
Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DISPOSITION
(Dated April 11, 2025)
Introduction
On June 15, 2022, Brennan Anderson was found not criminally responsible on account of mental disorder on charges of assault with a weapon, aggravated assault (x2), failure to appear or comply with appearance notice (x3), failure to comply with probation order (x3), all contrary to the Criminal Code.
Mr. Anderson is currently subject to a Decision and Disposition of the Ontario Review Board of March 18, 2024, which orders him detained at Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs, with privileges up to and including hospital and grounds, beyond the secure perimeter, escorted by staff.
On February 25, 2025, the Ontario Review Board convened at Waypoint Centre for Mental Health Care (“Waypoint”) to conduct Mr. Anderson’s annual review and to make a disposition further to s. 672.81(1) of the Criminal Code.
At the commencement of the hearing the Board was advised that the accused was in a disturbed mental state that morning. He was threatening staff and spitting at them. In those circumstances, and with his counsel’s help (Mr. Agostino), Mr. Anderson agreed to participate in the hearing by Zoom technology and a monitor was set up in his room enabling him to audio- visually participate in the hearing. Mr. Agostino was also permitted to proceed virtually from his office in Thunder Bay, Ontario.
The hospital proposed that there be no change in Mr. Anderson’s Disposition. This was supported by the Crown Attorney. Mr. Agostino had no specific instructions from his client.
At the conclusion of the hearing, the Board agreed with the recommendation of the hospital and ordered a continuation of Mr. Anderson’s Disposition with no change in the terms and conditions.
Index Offences
- A summary of the index offences was outlined in Reasons for Decision and Disposition of March 18, 2024, as follows:
“The facts refer to events which occurred on August 17, 2021, in the early morning hours. Allan Anderson (“Allan”), the father to Brennan, returned home after spending the evening with friends and consuming alcohol. As Allan entered his residence Brennan attacked him with a knife. Allan was stabbed 3 times in the back of the neck. Allan was able to push Brennan out the door with the help of two other family members. Brennan was arrested and released on bail.
On August 31, 2021, police became aware that Allan was at the hospital being treated for stab wounds. Allan would not cooperate with the police, but other family members informed the police that Brennan had entered Allan’s home and the two of them began to fight. During this altercation, Brennan stabbed Allan twice in the neck area with a knife and also cut his brother’s arm.”
- A more detailed description of the index offences is contained in the Hospital Report of January 27, 2025, filed as Exhibit 1 to this hearing.
Background
The January 27, 2025, Hospital Report contains considerable information about Mr. Anderson’s personal, criminal, psychiatric and medical background and should be referred to for detail.
Mr. Anderson is a 29-year-old Indigenous man born at Kasabonika, Ontario. Both parents abused substances and Mr. Anderson was subjected to physical abuse by his father and has been described as receiving inconsistency of care throughout his childhood. It is reported that Mr. Anderson suffered a serious injury around the age of 17 when he was violently attacked by his father. There appears to have been a loss of consciousness and a fractured collarbone and some injury to his back from which he has suffered pain ever since.
In the context of substance use in his family, Mr. Anderson began using substances early, including alcohol and marijuana and eventually using Percocet and oxycontin products.
Although he seemed to do well in elementary school, his mother has reported episodes of physical violence and verbal outbursts in school leading to him being suspended on multiple occasions. This culminated in an incident when Mr. Anderson brought an axe to school while under the influence of substances.
Mr. Anderson has a history of attempted suicide during his teenage years. His family had observed him experiencing auditory hallucinations and bizarre thoughts and responses.
At some point Mr. Anderson was connected with a Dr. Haggarty who arranged for home visits from time-to-time. Attempts were made to have Mr. Anderson accept Abilify but he refused, fearing that medication would “change” him forever. Mr. Anderson was also unwilling to engage in treatment. In 2016 he was placed on a Form 1 and admitted to the Lake of the Woods Hospital. He was described as being “in a psychotic state, catatonic and disorganized”. He was given Fluanxol intramuscularly, but during this admission he attacked another patient. A provisional diagnosis was Schizophrenia and Substance Induced Psychotic Disorder.
As a result of his difficulties, Mr. Anderson has had numerous hospital admissions. Limited insight and noncompliance with medication and treatment were common themes. Use of substances continued throughout.
While in custody following the index offences, Mr. Anderson reported a decrease in auditory hallucinations since beginning Invega Sustenna medication.
After his admission to Thunder Bay Regional Health Sciences Centre, he attacked co-patients, nurses and other staff, usually without warning, and it is believed that these were in response to delusions that others were intending to harm or kill him. Command auditory hallucinations instructed him to attack them.
Clozapine medication began on January 23, 2023; however, these auditory hallucinations did not change.
A violent attack on a peer support worker took place on January 11, 2023, and again on January 7, 2023. On February 6, 2023, Mr. Anderson attacked a nurse and aggressively charged at other staff on February 16, 2023.
As a result of the above-noted behaviour, a request to transfer Mr. Anderson to Waypoint was made. He was ultimately transferred to the High Secure Provincial Forensic Programs Division at Waypoint on April 6, 2023, where his auditory hallucinations and paranoid delusions continued with the general belief that staff and co-patients were gang rivals who intended to harm him. Further assaults on staff took place requiring numerous seclusions.
At last year’s hearing his treating doctor, Dr. Komer, indicated that the accused had incorporated hospital staff into his delusions and thus has become a high risk to assault staff. He continued to take injectable antipsychotic medication and clozapine. At last year’s Board it was determined that Mr. Anderson had been in seclusion more often than not since April of 2023. On many occasions Mr. Anderson refused seclusion relief fearing that he would feel unsafe out of seclusion and that he would hurt someone.
Evidence at Hearing
Dr. William Komer has been Mr. Anderson’s treating psychiatrist for the past reporting year, however, on November 14, 2024, Mr. Anderson was transferred from the hospital’s Forensic Assessment Program to the Beckwith Program and he will now continue under the care of Dr. Bouskill.
Most notably, Mr. Anderson has been in seclusion for over a year since January 7, 2024. Throughout this period of time the hospital applied its seclusion protocol requiring that secluded patients be reviewed daily and seen by a psychiatrist, other than the treating psychiatrist, for review and assessment every 72 hours and at seven days and every 28 days thereafter. In Mr. Anderson’s case, he has been assessed and offered and often provided with seclusion relief at least daily. During seclusion relief he requires the use of wrist/waist pinel restraints. He has required a minimum of four staff to be present while on seclusion relief.
The pattern throughout the year has been a number of instances of physical aggression against staff, many of which took place suddenly and just following Mr. Anderson’s denial of any thoughts of harm towards others. The Hospital Report outlines these instances. Mr. Anderson has said that auditory hallucinations direct him to assault staff as he believes that staff were trying to kill him and that they were rival gang members.
Further complicating matters, Mr. Anderson has expressed thoughts of suicide and has engaged in attempts of self-harm. Two significant self-harm attempts were made on June 4, 2024, when he tried to choke himself with an apple and on June 17, 2024, when he attempted to swallow a paper spoon.
Dr. Komer testified that Mr. Anderson has told him that he has schizophrenia and that medication helps him, however the voices keep telling him to assault others. The assaults seem to flow from Mr. Anderson’s continuing perception that his personal safety is threatened by those he assaults.
In addition to the incidents outlined in the Hospital Report, Dr. Komer testified that on February 9, 2025, Mr. Anderson tried to punch a staff member on the way back to his room following seclusion relief. Three days ago, he attempted to spit on a nurse. He has had no seclusion relief nor asked for relief from seclusion in the past eight days. Dr. Komer met Mr. Anderson on the morning of the hearing and reported that he continues to hear voices which tell him to hurt people. Mr. Anderson claims that his spitting is really his technique to get fresh air. In the past few weeks Dr. Komer has seen an increase in Mr. Anderson’s aggression.
Although Mr. Anderson is generally resistant to taking medication and medication changes, in the past year he has agreed to prn olanzapine and an increase in his clozapine dosage and has been agreeable to taking an antidepressant medication. Overall, there has therefore been an improvement in his willingness to take prescribed medication.
Dr. Komer acknowledges that ECT treatment might be a treatment consideration for Mr. Anderson. Dr. Komer also acknowledges that Mr. Anderson had suffered a number of head injuries in his younger years, including a period of unconsciousness following an assault by his father. To Dr. Komer’s knowledge there have been no CT scans or other investigation of the sequelae, if any, of these head injuries. Although he did not dismiss it outright, Dr. Komer was less than enthusiastic about the efficacy of psychotherapy to deal with Mr. Anderson’s tumultuous young years.
In their final submissions the hospital and Crown Attorney maintained their initial position that Mr. Anderson remains a significant threat to the safety of the public and that there be no change in his Disposition.
Mr. Agostino had no instructions with respect to a Disposition, however, he did point out that Mr. Anderson had been compliant with medication and following his recent cooperation with medication changes, Mr. Anderson gained some partial insight regarding his awareness of a diagnosis of schizophrenia and the benefit of antipsychotic medication. Mr. Agostino also pointed out that, although not in recent times, Mr. Anderson did develop a close relationship with his family. Mr. Anderson wishes to return to Thunder Bay to be closer to his family. (Dr. Komer supports this aspiration).
Decision
The Board accepts the evidence provided by Dr. Komer in his oral evidence and as outlined in the Hospital Report, that Mr. Anderson remains a significant threat to the safety of the public. The risks are clearly outlined in the Hospital Report and are unchallenged at this hearing. Unfortunately, Mr. Anderson suffers from a treatment resistant form of schizophrenia with chronic, ongoing positive symptoms of psychosis notwithstanding compliance with prescribed antipsychotic medication.
Mr. Anderson has acknowledged having the major mental illness of schizophrenia and he has been compliant with prescribed medication. He is capable of making his own treatment decisions, however, there is an overall lack of insight into his understanding of the illness of schizophrenia and why medication is beneficial. He has also been unable to identify any strategies that might reduce his risk to others and health teaching from staff has not been effective in this regard.
Mr. Anderson has a history of threatening and aggressive acts, and this pattern has continued in the last reporting year, with numerous assaults or attempted assaults of staff which regrettably have resulted in his seclusion since January of 2024. He has never been free of thoughts that he must act aggressively towards others, and they appear to have increased in intensity in the past few months.
Mr. Anderson’s delusions about being threatened have, in the past year, now included members of his hospital care team and this accounts for almost all of his assaults against staff in the past year and why he has had no significant periods of seclusion relief. By his own decision, he often refuses offered seclusion relief.
It is important to repeat the remarks in the second item of the clinical items of the HCR-20 assessment:
“Violent Ideation or Intent: Although Mr. Anderson has repeatedly struck out at staff, he has made it clear that these acts are in response to command hallucinations as a way to avoid being harmed. He expresses remorse for these actions and does not appear to take pleasure or satisfaction in harming others. Therefore, this factor is NOT currently present.”
The Review Board is concerned that there appears to be no clear plan for moving Mr. Anderson ahead in his treatment and rehabilitation. A major concern is that seclusion is now a norm for Mr. Anderson and when seclusion relief is available it is with restraints. This has become a permanent or semi-permanent situation for Mr. Anderson with no suggestions for change offered by the hospital.
The Board suggests that consideration should be given to a trial of ECT, that the possibility of an intellectual deficit due to Mr. Anderson’s early head injuries be investigated and that perhaps a consideration of psychotherapy could be made in due course. The Board also suggests that the hospital might consider an independent psychiatric assessment or at least an independent medication review.
For the time being, however, the evidence clearly supports the necessity for a continuation of Mr. Anderson’s Disposition with no change in its terms and conditions. Currently, given Mr. Anderson’s mental state and the resulting danger to others, particularly staff, this is the least onerous and least restrictive disposition with reservations as above noted by the Ontario Review Board.
DATED this 11th day of April 2025, at the City of Toronto, in the Toronto Region.
Mr. C. MacIntyre, K.C. Alternate Chairperson Office of the Registrar Ontario Review Board