Ontario Review Board
Re: Aaron Mayers
ORB File No: 7677
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: Aaron Mayers Counsel: Ms. M. Perez The person in charge of hospital: Representative: Ms. T. Murdock Attorney General of Ontario: Counsel: Ms. J. Armenise
REASONS FOR DISPOSITION
(Dated April 11, 2025)
Introduction
[1]. On January 17, 2020, Aaron Mayers was found not criminally responsible on account of mental disorder on a charge of assault causing bodily harm, contrary to the Criminal Code.
[2]. Mr. Mayers is currently subject to an Ontario Review Board Decision and Disposition of April 2, 2024, which ordered him detained at Waypoint Centre for Mental Health Care in its High Secure Provincial Forensic Programs, with privileges up to and including hospital and grounds privileges, beyond the secure perimeter, escorted by staff.
[3]. On February 26, 2025, the Ontario Review Board convened at Waypoint Centre for Mental Health Care (“Waypoint”) to conduct Mr. Mayers’ annual review and to make a disposition further to s. 672.81(1) of the Criminal Code. Mr. Mayers did initially attend his hearing, however very soon afterwards he elected to leave. Mr. Mayers’ counsel, Ms. Perez, had received instructions from him. Accordingly, an order to proceed with the hearing in Mr. Mayers’ absence was made pursuant to s. 672.5(10)(a) of the Criminal Code.
[4]. At the outset of the hearing, the parties were asked to provide their preliminary positions. All parties agreed to a continuation of Mr. Mayers’ Detention Order with no change in the terms and conditions. It was conceded that Mr. Mayers remains a significant threat to the safety of the public.
[5]. Ms. Perez commented that although her client agrees with the hospital’s recommendation, he wished the Board to know that he would like to move to three other hospitals as a goal, but at the present time he wishes to stay at Waypoint.
Index Offence
[6]. A Hospital Report of January 22, 2025, was filed as Exhibit 1 to this hearing. It contains a description of the index offence, as follows:
“On January 12, 2019, the victim [male nurse’s / victim’s name] was working in his capacity as a nurse at [the] Psychiatric Intensive Care Unit at Sunnybrook Health Sciences Centre in the City of Toronto. The victim was taking care of a patient in Room C of the F2 Wing (Psychiatric Intensive Care Unit) when the accused before the Court attended in the room and blitzed the victim by punching him three to four times on the left side of his face. The victim was able to grab the accused and gain slight control over him. A nurse who was nearby activated a Code White and numerous nurses were able to attend into the area and assist with restraining him and assisting the victim.”
Background
[7]. The Hospital Report should be referred to for details regarding the accused’s personal, criminal and psychiatric background. Mr. Mayers is 37 years of age. He suffers from Schizophrenia-continuous, Substance Use Disorder (alcohol, cannabis, opioids, amphetamines), and Antisocial Personality Disorder.
[8]. Mr. Mayers has a criminal record beginning in Youth Court in 2003 and spanning the years between 2003 and 2020. The charges over these years included assault, assault causing bodily harm and possession of weapon. A number of Youth Court charges were withdrawn and after 2009 charges of assault were either withdrawn or stayed.
[9]. On January 17, 2020, the same day he was found not criminally responsible with respect to the index offence, Mr. Mayers was convicted of utter threat, possession of weapon for dangerous purpose, and two charges of failure to comply with recognizance. He was given a suspended sentence and placed on probation for six months. Any remaining charges were withdrawn.
[10]. Mr. Mayers displayed some behavioural problems in his youth. These included lying, truancy, stealing and substance abuse.
[11]. By grade 8 he was dealing drugs on the grounds of his school and began using street drugs and alcohol himself. He has reported using cocaine, LSD, ecstasy, cannabis, narcotics and magic mushrooms in the past. It has been recorded that he also abused Ritalin and oxycodone. He was involved in the Adolescence Substance Abuse Outreach Program at the Hospital for Sick Children between April 2001 and March 2003.
[12]. In the six years before the index offence Mr. Mayers was often homeless, spending many periods of time in hospital or living on the streets or in shelters.
[13]. The Hospital Report records the many hospital admissions and psychiatric assessments required of Mr. Mayers since the age of 18. Following the finding of not criminally responsible Mr. Mayers was detained at Waypoint on January 17, 2020.
[14]. Throughout his time at Waypoint Mr. Mayers has demonstrated environmental, physical and verbally aggressive behaviour requiring many seclusion periods, sometimes with the use of Pinel restraints and staff donning personal protective equipment.
[15]. The 2023 to 2024 reporting year was no exception to Mr. Mayers’ behaviour and the necessity for seclusions, although the number of seclusions were fewer than the previous year. This was attributable to adjustments and changes in Mr. Mayers’ medication; in particular, he had a positive response to Haloperidol.
Evidence at Hearing
[16]. Dr. Mishra continues to be Mr. Mayers’ treating psychiatrist. Mr. Mayers is now incapable of both consenting to treatment and to managing property and the Public Guardian and Trustee acts as his substitute decision maker.
[17]. As is typical, Mr. Mayers’ mental status has fluctuated over the year, largely attributable to his repeated discontinuance of medications. Mr. Mayers responded favourably to a combination of Haloperidol and valproic acid and between March and July of 2024, there were no significant incidents of aggression and an observed reduction in his agitation, irritability and aggression.
[18]. Beginning in April, Mr. Mayers experienced paranoid thoughts that he was being injected with plastic and began to insist on stopping his long-acting medication. By July 19 he had stopped his oral medication, worsening his mental state. In August of 2024, he regularly refused Divalproex Sodium but then agreed to restart it again in September. By the end of October, he stopped it again.
[19]. Consent was sought from the Public Guardian and Trustee to adjust his medication and to start ECT treatment as Mr. Mayers was, at best inconsistent, and at worst, not compliant with any oral medications and was becoming increasingly disorganized and agitated.
[20]. Mr. Mayers’ behaviour resulted in three seclusions between September 16 and 19, December 19 to 22, 2024 and January 14 to 20, 2025. The Hospital Report describes the behaviour that resulted in these seclusions, environmental aggression in his room and assault on staff and threats towards staff.
[21]. The hospital has identified that there is a real need to optimize Mr. Mayers’ medication to manage his risk of violence attributable to symptoms of psychosis. This will be done in combination with the use of periods of seclusion.
[22]. In Dr. Mishra’s risk summary in the Hospital Report he states:
“It is my opinion that Mr. Mayers continues to meet the threshold for significant threat to the safety of the public. Over the course of this review period, Mr. Mayers has continued to engage in assaultive behaviour, has required frequent seclusion, has remained highly psychotic, and has demonstrated recurrent antisociality and substance-seeking behaviours. Mr. Mayers’ psychosis, antisociality, and substance use all inform his violence risk.”
[23]. Attached to the Hospital Report are photographs of Mr. Mayers’ room. They show walls and ceiling with barely any space that is not covered with drawings which Dr. Mishra says are all part of Mr. Mayers’ delusional system and make sense to him. In response to Ms. Perez’s questions, Dr. Mishra confirmed that Mr. Mayers has hurt himself when he is “donkey kicking” in his room. His level of aggression is quite severe. Dr. Mishra suspects that the reported incidents of his environmental aggression are fewer than what actually happen. He confirms that Mr. Mayers often chooses to stay in one of the seclusion rooms as he feels calmer there.
Decision
[24]. The Board accepts the evidence of Dr. Mishra and as contained in the Hospital Report regarding the factors that support that Mr. Mayers remains a significant threat to the safety of the public and that he continue to be detained at Waypoint with no change in the terms and conditions of his current Disposition.
[25]. Treatment for Mr. Mayers has been challenging and continues to be so. Dr. Mishra has noted that his illness would not be that difficult to deal with if Mr. Mayers would be compliant and cooperative with his medications. Dr. Mishra suspects that Mr. Mayers takes some pleasure out of his fantasy thoughts and would miss them if he took medication as otherwise his life would be boring. Accordingly, Dr. Mishra does not think Mr. Mayers has much motivation to take medication.
[26]. It is clear from the evidence that Dr. Mishra and the hospital team have been trying to optimize the dose and type of medication to be prescribed for Mr. Mayers and at the same time find a means or method to sustain that medication given Mr. Mayers’ inconsistent compliance. These efforts will continue.
[27]. In all the circumstances, the necessary and appropriate Disposition for Mr. Mayers is a continuation of his current Disposition with no change in the terms and conditions.
DATED thids 11^th^ 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