Ontario Review Board
Re: Richard P. Pillar
ORB File No: 7345
Hearing held on: Thursday, March 6, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care St. Thomas Ontario
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Weinstein Members: Dr. R.D. Chandrasena Dr. B. Sheppard Ms. K. Tomaszewski Ms. C. Plyley
Parties Appearing:
Accused: Richard P. Pillar Counsel: Ms. L. M. Carnelos
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DISPOSITION
(Dated April 14, 2025)
Introduction
On April 24, 2018, Mr. Richard Pillar was found not criminally responsible on account of mental disorder, on charges of aggravated assault and failure to comply with a probation order, contrary to the Criminal Code of Canada (the “Criminal Code”).
Under his current Disposition, dated February 9, 2024, Mr. Pillar is subject to the terms and conditions of a Disposition of the Ontario Review Board (the “Board”). Pursuant to this Disposition, he is detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Healthcare London (the “Hospital”). This Disposition provides him with various privileges, including living in the community of Southwestern Ontario, in accommodation approved by the person in charge.
On March 6, 2025, the Board convened a hearing at the Hospital to conduct the annual review of the current Disposition. Mr. Pillar was present at the hearing and represented by counsel, Ms. Carnelos. Mr. Pillar’s mother also attended the hearing.
A hospital report dated January 2, 2025 (the “Hospital Report”) was entered as Exhibit 1.
The issue at this hearing is whether Mr. Pillar is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate Disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that Mr. Pillar continues to present a significant threat to the safety of the public. The Board further ordered that Mr. Pillar be discharged on conditions as set out in our formal Disposition.
Current Psychiatric Diagnoses
- Schizophrenia
Social Anxiety Disorder
Substance Used Disorder in Sustained remission
Antisocial Personality Disorder by history
Specific Learning Disability
Borderline Intellectual Functioning
Index Offences
- The circumstance giving rise to the Index Offences are extracted from last year’s Board Reasons, as follows:
"On Wednesday, September 28, 2016, at approximately 11 a.m., 83-year-old Rina Campagna was walking alone to the bank. Suddenly and without warning, she was accosted from behind and taken to the ground by Mr. Pillar. Mr. Pillar grabbed Ms. Campagna's head and stabbed her in the eye with a knife. Ms. Campagna suffered severe injuries as a result of the attack, including the loss of one of her eyes.
Ms. Campagna and Mr. Pillar had never met before and there was no provocation. Further, Mr. Pillar made no attempt to rob Ms. Campagna. As Mr. Pillar fled the scene, witnesses observed him discarding his clothing. Mr. Pillar was arrested later the same day. He was identified by surveillance footage, and the knife and his clothing were recovered. At the time of the attack, Mr. Pillar was bound by two separate probation orders, both of which prohibited him from possessing any weapons."
Course Since Last Disposition
Mr. Pillar has resided in the community since November 11, 2021, with no readmissions.
On July 31, 2023, Mr. Pillar moved from Steele Street to Indwell’s transitional supportive housing building in St. Thomas, Ontario where he remained for the entire reporting period. Tenants are able to reside there for up to four years.
Mr. Pillar has not experienced any form of positive symptoms this reporting period. His thoughts were consistently logical and goal-oriented, with no apparent delusional or paranoid content.
The treatment team noticed an overall increase in the frequency of his brightening affect this year, as well as an increase in spontaneous and reciprocal conversations he had with his team. Staff at Mr. Pillar’s boxing gym also noticed positive changes, such as increased smiling and engagement with other gym members.
Early in the reporting year Mr. Pillar shared a concern that he was feeling very fatigued in the evening while attending his boxing sessions. His attending psychiatrist, Dr. Prakash, moved his supper time medication (clozapine) to bedtime (April 2024). Following this adjustment, he reported a significant improvement and increased energy. He shared that he “used to wait for [boxing] to be over and now never wants it to end”.
Throughout the reporting period, Mr. Pillar’s mood remained stable with some heightened anxiety during context-specific situations (e.g., the presence of dogs in his building). He was previously bitten by a dog which causes him to feel unsettled when encountering a dog in public. Despite this, Mr. Pillar has demonstrated positive and appropriate coping skills in the community when faced with other dogs. He has also demonstrated appropriate coping skills when confronted with the inappropriate behaviour of another tenant in the building.
Mr. Pillar’s cognitive and adaptive functioning was assessed to support an application for potential Development Services Ontario (DSO) eligibility. The psychology report indicated that Mr. Pillar’s cognitive functioning falls in the borderline range relative to his same-aged peers. As a result of his assessment, he qualifies for DSO support and is awaiting an intake appointment.
Mr. Pillar is typically organized for his appointments. He is responsible for independently taking his morning and supper time medications. He continues to receive support from Indwell staff for his bedtime medications.
Mr. Pillar requires some support with organizing and planning, particularly more difficult tasks. For example, when he travelled to Windsor independently for the first time to visit his family, taking multiple forms of transit (bus, cab, train) along the way, his mother supported him in creating the plan and organizing the times. With that, he was able to execute the plan without issue.
Mr. Pillar demonstrates rule adherence. In April 2024, while attending Celebrate Recovery (CR), he saw an inpatient against whom he had a no-contact order. He shared with the treatment team that when he noticed the peer he immediately left the group. He shared his disappointment in the situation as he had been attending CR for a long time and the peer had not. He asked for the treatment team’s support in navigating this situation and what options there could be to support him in still attending. Fortunately for Mr. Pillar, the peer moved out of St. Thomas.
Mr. Pillar attends Championship City Boxing on Monday, Wednesday, Thursday, and Saturday each week for 90 minutes and walks to the gym independently. The boxing gym has positively impacted his life in various ways, such as network building and community belonging.
Mr. Pillar participated in two volunteer opportunities: Mission Thrift Store and Harvest Hands. He continues to volunteer for one hour twice weekly at the Mission Thrift Store where he is responsible for duties such as sweeping, taking out the garbage, and organizing the shelves. Mr. Pillar continues to have the goal of obtaining part-time employment but has not yet secured a position. He continues to work with LEADS staff to help achieve this goal and meets with them monthly.
Mr. Pillar demonstrates good insight into the index offence, his substance use history and need for abstinence. He is both internally and externally motivated to remain abstinent from any future use of substances. He has reasonable/good insight into his risk for violence. When asked to assess his future risk of reoffending, he voiced that he does not believe he would become violent again because he consistently takes his medication and remains abstinent from substances.
He demonstrates reasonable insight into his illness and his need for treatment.
Position of the Parties
At the beginning of the hearing the Hospital took the position that Mr. Pillar continues to represent a significant threat to safety of the public, and that he should be discharged on conditions as set out on page 163 of the Hospital Report with the addition of a no-contact clause as it appears in the Disposition dated February 9, 2024.
Counsel for the Attorney-General agreed with the Hospital’s position, provided that the victim protections remained the same as in previous dispositions.
Ms. Carnelos, counsel for Mr. Pillar, advised that, for the purposes of this hearing, significant threat was not in dispute. Counsel took the position that Mr. Pillar should be subject to a conditional discharge with the conditions recommended by the Hospital in its submissions.
The Board had before it a joint position.
Evidence at the Hearing
Dr. Arun Prakash is Mr. Pillar’s treating psychiatrist. He testified on behalf of the Hospital and adopted the Hospital Report.
Mr. Pillar is doing very well at his residence at Indwell and has made significant progress this year.
He is now confident, travels on his own, and his life is structured. He boxes about five times per week, and volunteers at Mission Thrift Store twice a week. All boxing tournaments have gone very well.
He used multiple passes to go home to his family. His mother and brother are Approved Persons. Mr. Pillar spends time with his brother’s children. He attended a family reunion in Windsor with no issues. All passes have gone very well and all visits with his family have been positive.
Mr. Pillar has no positive symptoms of his illness. He still has a flat affect but now he is much more spontaneous.
Dr. Prakash attributes these improvements to his structured lifestyle and acknowledges the excellent support Mr. Pillar receives from his boxing coach.
One minor adjustment was made to his medications, to give all 600 mg. of clozapine at night. Mr. Pillar now has more energy and is happier.
Mr. Pillar’s insight has improved across all spheres. He now understands the connection between substance use and his illness. There have been no issues with substance use for the last four years. He is adherent to his medications.
He has developed in his coping strategies and is compliant with rules. For example, before using a nutritional supplement (which has been a concern in the past) he now asks the treatment team, and the treatment team then checks with a pharmacist. As another example, he complied with a no-contact order even though it meant he might have to stop attending Celebrate Recovery, and he took his concerns of how to manage this to the treatment team.
Mr. Pillar has developed trust with the treatment team and the Indwell staff, who are able to identify any signs of decompensation. It is Dr. Prakash’s opinion that Mr. Pillar will come to the Hospital voluntarily if requested to do so by the treatment team.
Clozapine levels (as shown by test results) are now stable for two reasons. First, Mr. Pillar limits himself to ten cigarettes per day. Second, blood level testing is now done at the Hospital rather than at Life Labs as in previous reporting years. Because the testing is done at a specific time at the Hospital, rather than at variable times at Life Labs, the test results are more stable and more accurately reflect clozapine levels.
Mr. Pillar is able to follow the treatment team’s advice to abstain from alcohol. Relapse support is not needed at present, although Mr. Pillar has contacted the Indwell staff who run the support group at Indwell.
Mr. Pillar has decided to stay in St Thomas rather than move to Windsor. He can remain at Indwell for another two years. Dr. Prakash expressed hope that DSO funding will help Mr. Pillar with his housing costs.
The Hospital does not need to approve Mr. Pillar’s accommodation because of the trust that has developed between Mr. Pillar and the treatment team, and the support of his boxing coach and his family.
In Dr. Prakash’s opinion, it is not necessary to include a travel restriction in Mr. Pillar’s Disposition, and it would be harmful to his community involvement. He travels to Windsor to visit his family; and boxing tournaments are held beyond Elgin and Middlesex counties. When Mr. Pillar travels, he is with someone and occupied in structured activities.
In response to the question of what Dr. Prakash would like to see before considering an absolute discharge, Dr. Prakash identified the following: improved insight with respect to his illness and need for treatment; continued medication adherence; assessment of how Mr. Pillar copes with the stressors of extra travel; ability to maintain abstinence when exposed to other substances when Mr. Pillar travels; and non-forensic psychiatric supports in the community.
As Mr. Pillar continues to progress in the areas identified by Dr. Prakash, Dr. Prakash expects that Mr. Pillar will be referred to a non-forensic treatment team, and once that relationship is established and Mr. Pillar becomes independent of the Hospital treatment team, the treatment team will consider an absolute discharge.
Dr. Prakash agreed that the following paragraphs from last year’s Board’s Reasons for Disposition, while not true last year, are true this year, because of Mr. Pillar’s progress:
Counsel submitted that Mr. Pillar’s behaviour indicates that he will be compliant with a request to stay in the Hospital, and that to assert otherwise is speculation. She listed as examples that: he came to the Hospital when there was an explosion at Indwell; has taken medications when he is told to; has adapted to not make plans inconsistent with his treatment needs; and uses memory aids when told to do so.
Counsel concluded that there is no evidence that Mr. Pillar will not comply with a condition to attend the Hospital for assessment and to remain at the Hospital voluntarily for an admission.
Submissions
All parties maintained their initial positions.
For the Hospital, Ms. Zamprogna submitted that Mr. Pillar has made progress this year. As compared to last year, clozapine levels are no longer fluctuating, and Mr. Pillar has improved in his insight. The necessary and appropriate Disposition is a conditional discharge.
Counsel for the Attorney-General adopted the Hospital’s submissions.
Counsel for Mr. Pillar agreed with the Hospital’s position and stressed that Mr. Pillar had a ‘fabulous year’. He has set and met goals; has no positive symptoms of his mental illness; curbs his cigarette use; has improved in how he deals with stressful situations; and most importantly is confident in Dr. Prakash and the treatment team and listens to them.
Analysis and Conclusion
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the parties that Mr. Pillar remains a significant threat to the safety of the public. Moreover, the Board has no difficulty in coming to an independent conclusion that Mr. Pillar’s current constellation of symptoms and behaviours supports a finding that he continues to pose a significant threat, as defined by the Supreme Court of Canada in Winko. The Board makes this finding based on Dr. Prakash’s testimony and documentary evidence available to it, and in particular the Clinical Assessment of Risk and Re-Offence Scenario set out in the Hospital Report.
Mr. Pillar has an extensive history of non-adherence to medication. Staff members have opined in the past that they are unsure whether medication adherence would continue without the presence of staff supervision. Mr. Pillar has not yet progressed to fully independent self-administration of medications.
The Board also agrees with the parties that the necessary and appropriate disposition is a conditional discharge, as recommended by the Hospital, including a no-contact clause.
Mr. Pillar’s early symptoms of decompensation are staring at people, and isolative behaviour. These symptoms are easily identifiable by the treatment team and Indwell staff. These are not symptoms which are likely to meet the criteria for involuntary detention under Box A of the MHA, but because of Mr. Pillar’s trusting relationship with the treatment team, and his willingness to comply with their suggestions, Dr. Prakash is confident that Mr. Pillar will return to the Hospital voluntarily if he is requested to do so.
This is a major improvement in Mr. Pillar’s presentation since last year. Dr. Prakash’s lack of confidence in Mr. Pillar’s willingness to return to hospital voluntarily was the major reason underlying the Hospital’s recommendation for a detention disposition last year.
The Board notes that Mr. Pillar has successfully structured his life with meaningful activities; is both internally and externally motivated to abstain from substances; has curbed his cigarette use; and has improved his coping strategies in stressful situations. His housing is stable. The Hospital Report lists several other protective factors. Most importantly, Mr. Pillar is willing to take direction from Dr. Prakash and the treatment team because he trusts them.
Mr. Pillar is now well-connected to the St. Thomas area through his structured activities, which are meaningful and important to him. He can travel to visit family and attend boxing tournaments. He is doing well in his accommodations and intends to remain in St. Thomas at this time. In these circumstances, the Hospital has no need to approve his accommodation, and travel restrictions are not necessary.
Last year (2024): the results of the current HCR-20 V-3 risk assessment suggest that Mr. Pillar presents a moderate risk of violent reoffending in the next 12 months, if he is on a detention disposition and resides in the community in a supervised setting. His risk would be higher if there was less supervision or less restrictions in his disposition.
This year the results of the integrated judgement of risk (HCR-20 and SAPROF) indicate a reduction in risk: Mr. Pillar’s risk of violence, while living in the community and under the supervision of Forensic and Indwell Home staff support, would be considered low. Should he decompensate absent forensic support, his risk would be elevated to moderate. Although he demonstrated positive internal and external motivation towards his recovery, he still requires some support and supervision to manage his overall risk.
In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Pillar, his reintegration into society and his other needs, the necessary and appropriate Disposition is a Conditional Discharge, as set out in our formal Disposition.
The Board congratulates Mr. Pillar on his successful year and wishes him continued success in the upcoming year.
DATED this 14th day of April 2025, at the City of Toronto, in the Region of Toronto.
Ms. K. Tomaszewski Legal Member
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Office of the Registrar Ontario Review Board