Re: Stuart Charles
ORB File No: 8163
Hearing held on: Tuesday, February 18, 2025
Place of hearing: Centre for Addiction and Mental Health, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M. Segal
Members: The Hon. B. Allen
Dr. B. Bordoff
Dr. J. Kis
Mr. J. Cyr
Parties Appearing:
Accused: Stuart Charles
Counsel: Ms. C. Francis
The Person in charge of Hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION
(Dated April 10, 2025)
Introduction
Mr. Stuart Charles was charged with criminal harassment (x 2), uttering a death threat, assault and aggravated assault contrary to the Criminal Code and was found not criminally responsible on account of mental disorder on August 31, 2022.
A panel of the Ontario Review Board (Board) was convened, under s. 672.81(1) of the Criminal Code, on February 18, 2025 at the Centre for Addiction and Mental Health (CAMH or the Hospital) to review Mr. Charles’s existing disposition as to his risk to public safety.
Mr. Charles’s existing disposition dated February 23, 2024 ordered detention at CAMH Forensic Services with privileges up to living in the community in an approved accommodation with a recommendation that he be transferred to the Quebec Review Board.
At the start of the hearing the parties provided the Board with their respective positions on disposition and significant risk. The parties took the joint position that Mr. Charles remains a significant threat to the safety of the public. All parties agree with Mr. Charles's request to be transferred to the authority of the Quebec Review Board. The parties maintained their positions at the completion of the evidence.
Disposition
- For the reasons set out below the Board concludes under s. 672.54 of the Criminal Code that Mr. Charles continues to pose a significant threat to public safety and that the necessary and appropriate disposition is for Mr. Charles to be subject to a conditional discharge. The Board supports Mr. Charles’s request to be transferred to the jurisdiction of the Quebec Review Board.
Evidence Before the Board
- Before the Board is the Hospital Report dated January 23, 2025, authored by Dr. Robert McMaster which contains an account of Mr. Charles’s personal and medical histories, the details of which need not be repeated in detail here. The Board also received a letter dated July 2, 2024 from the Douglas Mental Health University Institute in Montreal providing consent to the transfer of Mr. Charles to its mental health care facility.
Index Offences
A summary of the index offence is as follows:
On September 9, 2020 Mr. Charles was walking on a Toronto street and came across the victim. Without apparent cause, Mr. Charles yelled at the victim and aggressively approached her. She tried to run away but he continued to chase her. A witness in a wheelchair saw the incident and heard Mr. Charles say, "I am going to kill you". When the witness attempted to intervene Mr. Charles punched him four or five times resulting in the witness sustaining lacerations to his face and neck.
Mr. Charles proceeded on and walked past another victim and suddenly punched the second victim in the head several times. The victim fell to the ground and Mr. Charles continued to punch him in the head and then got on top of him and gouged him in his eye. The victim yelled for someone to call the police. The second victim sustained cuts to his knees and elbows and was bleeding from the left eye. He was taken to the hospital to be treated for his injuries. He lost the vision in his left eye. Police arrived and Mr. Charles was arrested.
Current Diagnoses
- Mr. Charles’s current diagnoses are schizophrenia and cannabis use disorder, moderate, in sustained remission.
Criminal History
- In June 2006 Mr. Charles was charged with assaulting a peace officer, the outcome of which charge is not clear from the records. In August 2013 he was charged with assault causing bodily harm for an incident that occurred in January 2011 for which he was found guilty on March 4, 2013. He was convicted of a probation violation in November 2014.
Substance Use
- The evidence is that Mr. Charles has abused marijuana. There is no evidence of the use of other substances or alcohol.
Mr. Charles’s Personal and Psychiatric History
Before the Current Reporting Year
Personal History
Mr. Charles is a 48-year-old man born in Montreal to parents of Haitian descent. He is one of eight children in his family and reported a good relationship with his parents. His mother passed away in 2012. Mr. Charles indicates that he has an adult son born in 1993. The son currently resides in Montreal with his birth mother. It appears that Mr. Charles completed high school and may have attended some college courses. He indicates that he worked off and on in construction from 1995 to 2020.
Mr. Charles moved from Montreal to Vancouver in 2011, back to Montreal in 2019 and then to Toronto. He has been living in shelters in Toronto since 2019/2020 until his arrest on September 9, 2020. Mr. Charles is financially supported by ODSP.
Psychiatric History
It appears that Mr. Charles's first encounter with the psychiatric system was in 2006 which began with an admission to a hospital in Vancouver where he received diagnoses of schizophrenia, cannabis use and paranoid psychosis. Again in 2006, 2009, 2011, 2012 and 2013, he was admitted to various hospitals in Vancouver consequent to criminal charges with one admission to a hospital in Ottawa. He was treated in 2012 with long-acting intramuscular injections.
In 2020 following the index offence Mr. Charles was detained at the Toronto South Detention Centre (TSDC) where he was referred for a psychiatric consultation. He was not taking his medications and was experiencing psychosis. From December 22, 2020 to January 3, 2021 Mr. Charles was admitted to CAMH after being transferred from the TSDC on a Form 1 completed by the psychiatrist at TSDC. He was noted to be hostile, paranoid, guarded, disorganized and presenting with hallucinatory behaviour in jail. His symptoms settled with anti-psychotic medication and he was re-detained at TSDC.
Then in April 2021 he was subsequently re-admitted eventually on an involuntary basis to CAMH in locked seclusion presenting as grandiose and threatening. From June to September 2021 Mr. Charles was again re-detained at TSDC where he was treated with long-acting intramuscular anti-psychotic medication. Mr. Charles was found to be cooperative and compliant with his medications.
As noted Mr. Charles was found not criminally responsible on August 31, 2022 and was transferred to the Forensic Assessment Triage Unit (FATU) at CAMH on November 7, 2022.
Upon admission to CAMH Mr. Charles denied ever experiencing any psychotic symptoms. He reported that he was previously diagnosed with schizophrenia but that he does not agree with that diagnosis. Mr. Charles was agreeable to continue taking his long-acting injectable anti-psychotic medication once every three months in the hospital. With the medication, he was noted to be calm and cooperative.
Mr. Charles’s presentation and mental status remained positive displaying no episodes of aggression or violence, requiring no locked seclusion or any chemical/physical restraints. He remained compliant with his medications and with programming on the unit and maintained good hygiene. However Mr. Charles continued to deny psychotic symptoms and thoughts of self-harm or harm to others.
During the reporting period from January 2023 to January 2024, Mr. Charles had a relatively stable year apart from a brief period of mental decompensation that resolved quickly. He was transferred from FATU to a secure forensic unit on March 31, 2023. On July 25, 2023 Mr. Charles was transferred to a general forensic unit where there were no critical incidents including absconding events, self-harm or violence. His urine drug screens remained negative for prohibited substances.
Mr. Charles's schizophrenia continued to be treated with long-acting intramuscular anti-psychotic injections every three months. He generally denied positive symptoms of psychosis which included hallucinations or delusions. Mr. Charles's insight into his diagnosis and treatment of his major mental disorder and his insight into the index offence remained limited. However there were no significant negative symptoms that interfered with Mr. Charles’s functionality.
Mr. Charles denied any intention of returning to the use of prohibited substances and his urine drug screens were negative for prohibited substances. He provided urine samples without issue and he participated in a substance relapse prevention course. By December 2023 Mr. Charles had attained level 8 passes whereby he had access to indirectly supervised passes to the community for recreation and socialization purposes and committed no breaches of his pass privileges. By late 2023 Mr. Charles was engaging actively in five CAMH programs including cognitive behavioural therapy, illness management and recovery and art programs at the library. He was amicable with co-patients and staff and made contact with his son in Quebec. Mr. Charles’s goal for the upcoming year was for a transfer to Quebec.
The clinical team planned to prepare Mr. Charles for housing in the community. An independent living assessment determined that he could benefit from transitional housing as he was found to have a high level of functioning and skills to be able to live independently.
Current Reporting Year February 2024 to January 2025
On April 8, 2024 Mr. Charles was discharged to the Canadian Mental Health Association’s (CMHA) Transitional Rehabilitation Housing Program (TRHP2) which is located on Hospital grounds and is a 24-hour supervised, high-support program that provides on-site medication monitoring, a curfew, urine collection, case management and programming. It is reported that Mr. Charles had a positive reporting period transitioning well to THRP2. This is reflected in the absence of any critical incidents and stability in his mental state. Mr. Charles participated well in CAMH's referral process to the Douglas Hospital in Quebec in anticipation of a possible transfer.
By letter dated July 2024 Douglas Mental Health University Institute agreed to the transfer to provide Mr. Charles psychiatric care. Consents from the Ontario Attorney General and the Quebec Attorney are required to effect the transfer. The Ontario Attorney General provided its consent on February 14, 2025. The consent of the Quebec Attorney General is expected to be forthcoming shortly.
However some changes were observed in Mr. Charles's mental state after discharge to community housing, changes according to the clinical team, that required only ongoing monitoring and psycho-education since there were no concerns over aggression or violence. The concerning behaviours were Mr. Charles putting up numerous religious pictures, yelling in his room, responding to internal stimuli, mumbling during a group gathering and engaging in unusual behaviours like standing and staring at a wall.
By the end of the 2024/2025 reporting period, Mr. Charles stated that he understood that he has a diagnosis of schizophrenia and that medications help treat his symptoms. Mr. Charles has consistently had negative urine tests while in the Hospital and while living in community housing. He denies cravings for drugs and indicates substance use is something he is no longer interested in. Mr. Charles has accepted that there is a relationship between his decompensation and the risk of violence. The Hospital Report indicates that through his cooperation with the clinical team, Mr. Charles is now able to identify stressors in his life and strategies for managing them.
Mr. Charles has displayed a capacity for independent living as he manages his finances independently, cooks independently, attends appointments, takes transit independently and maintains his room to an acceptable standard. Mr. Charles also is capable of taking his medications independently. He has benefited from staff support for problem-solving around managing his medication whenever there was a change.
Mr. Charles has relatives in Quebec including his son. His goal is to transfer to the authority of the Quebec Review Board to be closer to his family. He continues to await communication from the Quebec Attorney General.
On the question of risk the Hospital Report concludes:
Mr. Charles has a history that suggests that, in the absence of a structured environment, antipsychotic treatment and significant professional supervision, he is at high risk of decompensation. Without medication, the natural course of schizophrenia would result in a deterioration of the psychotic symptoms––in the case of Mr. Charles, paranoid ideation, auditory hallucinations, disorganization and violence. Mr. Charles has a history of cannabis use, which could further worsen his symptoms. This could lead to a misinterpretation of his surroundings and violence towards others. When unwell, his insight into his illness would deteriorate, and at that point he would be unlikely to seek services. [at page 21].
The treatment team concludes in all the circumstances that the necessary and appropriate, least onerous and least restrictive, disposition is a conditional discharge. The clinical team supports Mr. Charles's request for transfer to Quebec in that he has only resided in Toronto for a short period and has no external support here.
The conditions recommended by the clinical team are that Mr. Charles: abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant; submit urine samples and/or breath to the person in charge of the Hospital; refrain from having in his possession any firearm, ammunition or other offensive weapon; and report to the person in charge of the Hospital not less than once per every two weeks.
Dr. Robert McMaster’s Evidence
Dr. Robert McMaster testified at the hearing. He emphasized the positive year Mr. Charles has enjoyed during the current year. He made a smooth transition to THRP-2 housing where he has a good relationship with FOPS and has demonstrated his capacity to live independently with the available support. Dr. McMaster informed the Board that once approved, Mr. Charles would be at the top of the waitlist for placement in Quebec and that he would not be transferred until suitable housing is secured. He pointed to the positive effect that will be offered by external support and proximity to his family in Montreal.
Dr. McMaster pointed to an episode that occurred on October 15, 2024 when Mr. Charles was not responding to staff. It required numerous attempts at calling his name and stomping to alert Mr. Charles. He exhibited slurred and slow speech but spoke logically. Mr. Charles could only say that he was feeling “off”. Dr. McMaster explained that the onset was rapid and opined that the episode may have had a neurological cause. He advised Mr. Charles if this occurred again that he should follow up with the Hospital.
Dr. McMaster addressed a question about THRP-2 housing accommodation not being specified in the clinical team's recommendations and whether there is a concern that on a conditional discharge, Mr. Charles might voluntarily move. Dr. Roberts responded that Mr. Charles has demonstrated that he is doing so well at THRP-2 that the team is confident he would remain there until his transfer to Montreal.
Closing Submissions
- The parties maintained their joint position that the necessary and appropriate, least onerous and least restrictive disposition, to manage Mr. Charles’s risk in the community, is a conditional discharge including the several conditions recommended by the clinical team and a term that Mr. Charles may be transferred to the authority of the Quebec Review Board once required approvals are obtained.
The Board’s Conclusions
While mindful of the parties’ joint position the Board is required to come to an independent determination.
Based on the evidence before us the Board unanimously accepts the conclusions in the Hospital Report that Mr. Charles remains a significant threat to public safety as contemplated under s. 672.54 of the Criminal Code, within the criteria outlined in Winko, and as defined in s. 672.5401. The Board considered the criteria, as set out in s. 672.54, namely, the paramount criterion of the safety of the public and Mr. Charles’s community re-integration, his mental condition and his other needs.
The Board accepts that the least onerous and least restrictive disposition that is necessary and appropriate in the circumstances is a conditional discharge with the conditions recommended in the Hospital Report including Mr. Charles's transfer to the authority of the Quebec Review Board once the approval of the Quebec Attorney General is obtained.
In keeping with the Criminal Code’s s. 672.5401 criteria the existing detention order provides for public safety and allows Mr. Charles to maintain integration in the community. As noted, satisfaction of the public safety criterion is secured by the high level of support and 24-hour supervision at THRP-2 housing.
Maintenance of Mr. Charles's integration in the community is reflected in the clinical team's observations that during his unstructured time, “Mr. Charles is often observed watching TV at TRHP2, socializing with co-residents, going for walks and meeting friends in the neighborhood.” “He also explores community resources beyond what is offered at FOPS, such as the art therapy group at a local Toronto Public Library and the Trinity Bellwoods Community Gym”.
As well any concerns that Mr. Charles might voluntarily leave his accommodation, the Board finds, are assuaged by the clinical team's observation that his transition to the housing has been uneventful and that he has acclimatized well to his new accommodation, the co-patients and staff so much so that he is regarded as a model tenant. It appears that Mr. Charles enjoys his new housing.
Concerning the episode he experienced on October 15, 2024, we strongly recommend that Mr. Charles heed the advice of Dr. McMaster and advise the Hospital of any future symptoms.
The Board wishes to acknowledge Mr. Charles’s progress in the current reporting year and we encourage him to stay on the path of progress in Toronto and on into Quebec. We wish him continued success in Quebec as he goes on to fulfill his goals for his future.
In conclusion the Board accepts the opinion of the clinical team and determines, according to s. 672.54 of the Criminal Code, that the necessary and appropriate disposition in the circumstances is a conditional discharge with the conditions recommended in the Hospital Report including Mr. Charles's transfer to the authority of the Quebec Review Board once the approval of the Quebec Attorney General is obtained.
DATED this 10th day of April, 2025, at the City of Toronto, in the Toronto Region.
The Hon. B. Allen
Legal Member
Office of the Registrar
Ontario Review Board