Ontario Review Board
Re: William James
ORB File No: 5660
Hearing held on: Monday, March 31, 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. M.D. Segal Members: Dr. K. Hand Dr. G. Kerry (via Zoom) Ms. M. Chamberlain (via Zoom) Mr. J. Cyr
Parties Appearing: Accused: William James Counsel: Ms. C. Francis (via Zoom) The person in charge of hospital: Representative: Ms. T. Murdock Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DISPOSITION
(Dated May 1, 2025)
On July 20, 2010, William James was found not criminally responsible on account of mental disorder on two charges of assault, contrary to the Criminal Code of Canada (the "Criminal Code").
Mr. James is subject to a Disposition of the Ontario Review Board (the "Board") dated March 18, 2024, which orders that he be detained at the Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs, Penetanguishene ("Waypoint" or the "Hospital"), with privileges up to live in the community in 24 hour-a-day specialized supervised accommodation approved by the person in charge.
On Monday, March 31, 2025, the Ontario Review Board convened a hearing at Waypoint pursuant to s. 672.81(1) of the Criminal Code.
Ms. Murdock represented the Hospital and Ms. Curry represented the Attorney General. Mr. James did not attend this hearing. Ms. Francis, counsel for Mr. James, advised the panel that it was difficult for her client to stay focused and that he did not want to attend the hearing. She stated that she had been able to meet with her client that morning and had instructions. Mr. James' presence was therefore excused per s. 672.5(10)(a) of the Criminal Code.
Position of the Parties
- Ms. Murdock, on behalf of the Hospital, submitted that Mr. James continued to represent a significant threat to the safety of the public and recommended no change to his current Disposition. This position was supported by Ms. Curry, on behalf of the Attorney General. Ms. Francis, on behalf of her client, waived this issue of significant threat and stated that her client was in agreement with the existing Disposition.
Background and Index Offences:
Mr. James was born in Windsor, Ontario, the youngest in a sibline of two. Mr. James' mother, Arlene James, worked in a factory and is now deceased. His father, Norman James, worked at odd jobs and died in his late 50s. His brother is some 15 years older. Mr. James has reported that this brother is now deceased. He has described him as an alcoholic and accountant, who resided in London, Ontario.
Mr. James had a normal birth and early physical development. During his adolescent years, Mr. James displayed various behavioural problems, including stealing, fighting, lying and truancy.
Mr. James acquired a Grade 11 education. He reported a learning disability and difficulty with spelling and math.
Mr. James worked for Chrysler from age 25 through 32. He reported leaving this job because he felt fellow workers did not want him there and were ignoring him. Mr. James began receiving financial support through the Ontario Disability Support Program in approximately 2005.
Mr. James was married at age 21 and had three children from this union. He indicated his daughter died in a road traffic accident at age 6. Mr. James has also reported that, five years later, his wife and two remaining children died in a house fire while he was visiting his mother. Mr. James reported marrying a second time. He stated he separated from this wife in approximately 2005, after hitting her.
Mr. James' current psychiatric diagnoses are listed in the Hospital Report as:
Bipolar Disorder Type I
Major Neurocognitive Disorder due to possible frontotemporal degeneration
Alcohol Use Disorder, in sustained remission, in a controlled environment
Antisocial Personality Disorder (by history)
- The circumstances of the index offences are taken from last year's Reasons for Disposition, as follows:
"On April 18, 2010, Mr. James was an inpatient at St. Thomas Regional Mental Health Centre. He assaulted a female co-patient by punching her in the face. On May 19, 2010, Mr. James assaulted a male co-patient at St. Thomas Regional Mental Health Centre by punching him in the head area several times."
Evidence at Hearing:
The evidence at the hearing consisted of the Hospital Report dated February 28, 2025, as well as the testimony of Dr. Kaggwa.
Mr. James' progress since his last annual review is summarized in the Hospital Report as follows:
"Mr. James continues to display aggressive behavior on an infrequent, albeit unpredictable basis. He had not endured any seclusion over the last reporting year but had a few incidents where he physically assaulted or attempted to assault staff. On August 25, 2024, he kicked a staff member in the abdomen during medication administration in the morning. On September 13, 2024, he screamed and swore at staff and attempted to strike after being given evening snack. On November 10, 2024, he attempted to strike a co-patient. All these incidents were without any warning or precursors. He continues to experience psychotic symptoms in the form of visual hallucinations at times. On February 6, 2025, he attended a dental appointment however prior to that was seeing his daughters on the ceiling. There have been other times when he can be irritable and angry for no apparent reason. He continues to lack insight into his mental disorders and their consequences, displaying ongoing cognitive impairment, impulsivity, and emotional instability. His sudden outbursts of anger necessitate careful management. His cognitive impairments, including poor memory, concentration, and orientation, hinder his ability to understand the consequences of his actions and comply with treatment."
Ms. Murdock called Dr. Kaggwa to give evidence on behalf of the Hospital. The doctor is a Forensic Fellow working under Dr. Mishra. He stated that he had reviewed the Hospital Report and was in agreement with its consents and recommendations.
Dr. Kaggwa stated that, since the date of the Report, there had been two incidents wherein Mr. James was admitted to the Georgian Bay General Hospital. The first admission was on March 12, 2025 for pneumonia. He returned to Waypoint but then had a fall and was taken to the emergency room again on March 15th. Since Mr. James' return to Waypoint for the second time, he has been quite frail and has been given a wheelchair to prevent future falls. He was also assigned a one-on-one worker to assist him with daily activities and to ensure he does not have the opportunity to fall again.
Over the past year, there has been a noticeable decline in his physical health. He now requires a lot of support and constant supervision. He currently benefits from a high level of support at Waypoint. The Hospital is looking for a placement with an appropriate level of support for Mr. James
The Hospital is trying to find a long-term care placement for Mr. James. He was accepted to one placement and a discharge date had been set, however, the service team agreed that the placement would not be appropriate for Mr. James. In this placement, Mr. James would have had a roommate, which would be problematic, and the staffing levels would not have been adequate. Mr. James continues to be on the waitlist for other long-term care facilities.
Until housing is found for Mr. James, the current Disposition remains appropriate.
Mr. James' sexual behaviours are being addressed by the Hospital staff. The staff are used to Mr. James and know him well. They are typically able to redirect him when he engages in inappropriate sexual behaviour. Staff at another facility may have a different reaction to they type of sexual acting out. Dr. Kaggwa agreed with a panel member's suggestion that this would need to be addressed in order for Mr. James to be ready to go to another placement.
Dr. Kaggwa noted that Mr. James has not used any passes into the community within the last reporting period. Even though he has not progressed to spending time in the community, Mr. James would still be able to move to a long-term facility. When a placement is found, the Hospital will implement a longer transition period for him.
Counsel for Mr. James queried whether the Hospital would be able to find a placement that would be appropriate for her client given his level of government-subsidized income. The doctor did not know the details of the placements that Mr. James is on the waitlist for.
Findings of the Board:
- The Board unanimously finds that Mr. James continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the position of the parties and accepted the uncontroverted evidence of Dr. Kaggwa that Mr. James continues to pose a significant threat. The Board also relies on the Hospital Report, which notes the following:
"Mr. James has a long history of violent behavior and antisocial actions. He has spent considerable time in hospital and is heavily reliant on the hospital staff for his day-to-day living. He is incapable of managing independent living. He continues to display impulsive and unpredictable behavior accompanied with aggression. Given the ongoing episodes of violent behavior, on the background of bipolar/schizoaffective disorder, acts of aggression remain an ever present threat. He continues to present a significant threat to the safety of the public and requires the structure and support provided under the jurisdiction of the Board to manage this risk. The current level of risk can however be managed in the community in an appropriate long-term care facility with adequate support and supervision."
The Board notes that the search for a long-term care placement for Mr. James will be difficult given the level of care required. The Board encourages the Hospital to carefully assess what placements are available to ensure that they offer the appropriate level of care for Mr. James.
The Board determines that the necessary and appropriate Disposition required to manage the threat Mr. James poses to the safety of the public while still meeting his needs, is a continuation of the existing Detention Order.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Kaggwa and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. James' mental condition, his reintegration into society and his other needs.
DATED this 1st day of May 2025, at the City of Toronto, in the Toronto Region.
Ms. M. Chamberlain Legal Member Office of the Registrar Ontario Review Board