Ontario Review Board
Re: Taegan Urquhart
ORB File No: 3557
Hearing held on: Monday, March 3, 2025
Place of Hearing: Providence Care Hospital, Kingston
Pursuant to: Section 672.81 (1) of the Criminal Code
Before: Alternate Chairperson: Mr. J. Hanbidge Members: Dr. J. Watts Dr. J. Cheston Mr. E. Siebenmorgen Mr. R. Rainboth
Parties Appearing: Accused: Taegan Urquhart Counsel: Ms. E. Holder The Person in Charge Counsel: Ms. T. Tom Attorney-General of Ontario: Counsel: Ms. J. Ferguson
REASONS FOR DISPOSITION (Dated May 5, 2025)
Introduction
[1]. On April 22, 2002, Taegan Urquhart was found not criminally responsible on account of mental disorder (NCR) on charges of assault and assault peace officer (x3) contrary to the Criminal Code. Ms. Urquhart has been subject to the jurisdiction of the Ontario Review Board (“ORB” or “the Board”) since that time. She was most recently subject to a Disposition dated April 25, 2024 pursuant to which she was ordered detained at the Secure Forensic Unit of Providence Care Hospital (“PCH” or “the Hospital”) with privileges and conditions extending to community living in approved accommodation.
[2]. On Monday, March 3, 2025, a panel of the Board convened in person at Providence Care Hospital to conduct a review of Ms. Urquhart’s Disposition and to make a new Disposition pursuant to section 672.81 (1) of the Criminal Code. Ms. Urquhart was present and represented by her counsel, Ms. Holder. The issues to be determined at the hearing were whether Ms. Urquhart continues to represent a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, what was the necessary and appropriate Disposition that was also the least onerous and least restrictive taking into account the factors set out in 672.54 of the Criminal Code.
Positions of the Parties
[3]. At the commencement of the hearing the parties were requested to provide their initial and “without prejudice” positions with respect to the issues before the Board. Counsel for the Hospital confirmed the Hospital’s position, stated at pp. 88-90 of its Report, that Ms. Urquhart represented a significant threat to the safety of the public and that the necessary and appropriate Disposition was a Detention Order with the same privileges and restrictions as contained in the existing Disposition.
[4]. Counsel for the Attorney General and counsel for Ms. Urquhart both supported the Hospital’s recommendation, and the panel was thus presented with a joint position, which was maintained at the conclusion of the evidence.
Evidence at the Hearing
[5]. The evidence at the hearing consisted of the Hospital Report dated February 3, 2025, and the oral evidence of Dr. Z. Selhi, Ms. Urquhart’s treating psychiatrist.
Findings
[6]. For the Reasons that follow, the Board accepted the parties’ joint recommendation and found, independently on the evidence, that Ms. Urquhart continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Detention Order with the same terms as contained in the Disposition dated April 25, 2024.
Index Offences
[7]. The circumstances surrounding the index offences are contained within the Hospital Report and were conveniently summarized in last year’s Reasons for Disposition. That summary, as slightly augmented from the Hospital Report, is as follows:
“On March 2, 2002, Ms. Urquhart got into an argument with her mother at home. Ms. Urquhart grabbed her mother by the hair and twisted her head around. Ms. Urquhart was later arrested. At the police station, she tried to grab at an officer’s firearm while she was being escorted to the washroom. As two officers tried to subdue her, she bit one officer on the hand twice and kicked and attempted to bite the other. About fifteen minutes later, Ms. Urquhart kicked another officer in the forearm.”
Background Information
[8]. Ms. Urquhart is currently 42 years of age. She was born in Vancouver and moved to Cobourg, Ontario with her family when she was six years old. She was raised by both her parents and has a younger brother. The Hospital Report states that her childhood was unremarkable until behavioural issues surfaced, in the form of substance use and antisocial behaviours, while she was in grade seven. In grade nine, she was diagnosed with a learning disability. She did not complete high school. Ms. Urquhart’s mother, Carol Urquhart, identified the transition from grade eight to grade nine as the period that marked her daughter’s “descent into chaotic existence, peer group issues, antisocial behaviours and most of all physical aggression” (Hospital Report, p. 43). She also has a significant history of self-harm behaviours during her teen and early adult years prior to the index offences.
[9]. Ms. Urquhart self-reported a history of substance use dating to when she was 17 years old. She consumed cannabis, heroin, cocaine, and PCP, and was a frequent consumer of alcohol.
[10]. Ms. Urquhart has a criminal record. The record reproduced in the Hospital Report is current only to August 9, 2008 (Hospital Report, p. 7). Her record commenced in 1999, with four youth court convictions registered that year. As an adult, she was convicted on two occasions for assaulting a peace officer and once for common assault, prior to the commission of the index offences. She also had convictions for various offences against the administration of justice, mischief, and committing a common nuisance. After coming under the Board’s jurisdiction, she was convicted of assault in 2003 and again in 2005, as noted below at para. 12 of these Reasons.
[11]. The Hospital Report, as indicated at para. 13 of these Reasons, indicates that in 2010 or 2011, Ms. Urquhart was also convicted of further offences arising out of serious attacks upon staff members at PCH. There is no information as to the precise nature of these convictions.
Brief Summary of Course Under the Board’s Jurisdiction
[12]. After being found NCR, Ms. Urquhart spent seven years at Ontario Shores before being moved to Providence Care. From 2002 until 2015 (about half these years at Ontario Shores and half at Providence Care), Ms. Urquhart was very challenging in her behaviour. She dismissed staff attempts to get her to comply with unit rules and limits. She was both verbally and physically assaultive toward both peers and staff, at times exhibiting uncontrolled rage. Her verbal abuse included death threats. She was regularly secluded and spent time in physical restraints. She was convicted in 2003 of assaulting a peer and in 2005 of assaults on two staff members. Her behaviour also included frequent self-harm as well as threats to commit suicide. Her diagnoses included “severe personality pathology” with borderline and antisocial traits, schizoaffective disorder, substance use disorder, autism spectrum disorder and learning disabilities. During her first year at Providence Care, a “working diagnosis” of ADHD (Attention Deficit Hyperactivity Disorder) was added.
[13]. Following several serious assaults by Ms. Urquhart on nursing staff at Providence Care (noted in the Hospital Report, p. 62, as having resulted in “serious bodily harm”), Ms. Urquhart was charged criminally and spent some 37 days in pre-sentence custody, ultimately receiving a further probationary sentence. Upon her return to the Hospital in April of 2011, she was placed on a restrictive behavioural management program that included the use of physical restraint devices. In his note prepared in advance of the 2012 ORB hearing, Dr. Michael Chan (Ms. Urquhart’s attending psychiatrist at the time) characterized her as being managed in a “maximum security way” in a medium secure institution (Hospital Report, p. 48). In 2013, her level of risk was assessed as high in all domains and her treatment team expressed pessimism about her clinical management.
[14]. In April of 2014, following receipt by the Hospital of recommendations from an independent psychiatric consultation (which included consideration of a diagnosis of schizophrenia and a trial of clozapine, Ms. Urquhart began to receive clozapine as her antipsychotic medication. Lithium carbonate was added to her medications in January of 2015, and by March of that year, significant improvements in her emotional regulation were observed. By April, her outbursts and abuse of staff had “dramatically” reduced. Ms. Urquhart’s behavioural management plan was modified to make it less restrictive. In 2017, she began to exercise indirectly supervised privileges, including limited privileges off the hospital grounds. She also had her first visit to her parents’ home, accompanied by her mother as her Approved Person.
[15]. Ms. Urquhart began to participate in therapeutic programming, including groups, during the 2017-208 reporting year. As she made greater use of her indirectly supervised community privileges, she initially experienced anxiety about navigating the local public transit system but was able to reduce this anxiety with therapy and behavioural management support. While it was observed that Ms. Urquhart continued to have occasional outbursts of verbal aggression, these mainly occurred when she experienced high levels of stress or anxiety, especially when presented with situations that were new to her. She was supported in developing Cognitive Behavioural Therapy (CBT) skills to assist with this. In 2019, autism spectrum disorder was added to her list of diagnoses. This had been suspected for some years but could not be previously substantiated.
[16]. In July 2021, Ms. Urquhart was discharged to Transitional Rehabilitation Housing Program (TRHP) housing. She transitioned very well to this 24/7 supervised housing situation, exceeding her treatment team’s expectations. There were minor tensions involving co-residents and anxiety about living in the community but managed this well and worked closely with the onsite staff.
[17]. Ms. Urquhart continued to live successfully in her TRHP home throughout 2022 and 2023. She transitioned to another supportive residence in June of 2024. More is said below about this change of residence. She remained on her medications, taking them on her own but requiring some prompting at times. She also worked on developing skills for more independent living. She was said to have several friends in her apartment building. She reportedly engaged in no aggressive behaviours or verbal altercations. As of the hearing date, Ms. Urquhart had been free of aggressive behaviours for some six years.
[18]. As a result of psychological testing conducted by the Developmental Disabilities Consulting Program (DDCP) in July of 2023, Ms. Urquhart was diagnosed with Mild Intellectual Disability. Her overall score on standardized intelligence testing was in the exceptionally low range. In the Risk Assessment portion of the Hospital Report, it is stated that Ms. Urquhart’s neurodevelopmental disability and intellectual functioning impact upon her ability to appreciate complex information and communicate her experiences to others. While she demonstrates some insight into the importance of her treatment (articulating that her medications help with her mental health), it is reported that her insight into her diagnoses and their relationship to her risk remain unclear.
[19]. In June of 2024, Ms. Urquhart was transitioned from her TRHP residence to a DDTRHP home, a setting with greater supports and staff for persons living with intellectual deficits. Initially, she experienced a loss of some skills due to her reliance on the increased staff presence. However, this was temporary. The increased presence of staff also led to more opportunities for verbal conflicts, although these decreased in frequency over time. With staff support, Ms. Urquhart continued to work on her budgeting and transportation skills. She continued to self-administer her medication, with only limited need for staff prompting. It is reported that overall, she demonstrated the ability to adapt to change with support that is tailored to her needs.
[20]. A Psychological Risk Assessment prepared by Dr. Douglas noted that Ms. Urquhart has a strong need for routine and predictability. She experiences change, loss of order, and decreased predictability as stressful and anxiety-provoking. When overloaded with social and cognitive demands, she is also likely to experience anxiety, stress, and frustration. In the absence of adaptive coping strategies or supportive individuals who can prompt the use of such strategies, Ms. Urquhart is more likely to use reactive aggression, for example, verbal and/or physical aggression, to remove a distressing stimulus from her environment or to escape the situation.
[21]. The result of a structured review of Ms. Urquhart’s risk and protective factors estimated that in the shorter term, her risk was in the low-to-moderate range. Her longer-term risk, in the absence of appropriate intervention and support, is high. In Dr. Douglas’ opinion, Ms. Urquhart’s risk can be well-managed in supervised and supportive housing in the community, with continued intensive supervision.
Current Diagnoses
[22]. Ms. Urquhart’s current diagnoses are listed in the Hospital Report as follows:
- Mild intellectual development disorder;
- Autism spectrum disorder;
- Schizoaffective disorder, by history; and
- Substance use disorder, in remission in a controlled environment.
Evidence of Dr. Selhi
[23]. Dr. Selhi gave evidence to supplement the evidence in the Hospital Report, which she adopted. She has been Ms. Urquhart’s treating psychiatrist since July of 2022. She began her evidence by confirming that there had been no changes to Ms. Urquhart’s diagnoses or medications over the reporting period.
[24]. Dr. Selhi described the DDTRHP residence in which Ms. Urquhart is living, stating that this is a two-bed residence that currently has no other resident. It is not intended to provide long-term housing to its residents, with the average length of stay being in the range of 18 months. In response to a question from Ms. Urquhart’s counsel, Dr. Selhi opined that Ms. Urquhart would likely be ready for independent accommodation in the fall of 2025. In re-examination, Dr. Selhi noted that Ms. Urquhart does not yet have the required funding supports for her independent housing.
[25]. After confirming that Ms. Urquhart has in general done well at her new residence, Dr. Selhi stated that the treatment team is working on preparing Ms. Urquhart for independent living, which is the next stage for her. The process includes a skills assessment that would provide information as to the supports and number of hours that Ms. Urquhart would require to position her for supported independent living, with DSO (Developmental Services Ontario) funding. Dr. Selhi acknowledged that some aspects of this funding are not yet well understood by the treatment team.
[26]. Dr. Selhi confirmed in her evidence that Ms. Urquhart continues to require the forensic team’s support for the purpose of mitigating risk. Without that support, in the context of an Absolute Discharge, Ms. Urquhart’s outbursts would escalate. She emphasized that the neurodevelopmental aspects of Ms. Urquhart’s condition caused her to be very subject to stress due to changes in her circumstances. Currently, this is demonstrated in the form of shouting or emotional outbursts.
[27]. Dr. Selhi testified that it is important for the Hospital to have the ability to determine where Ms. Urquhart lives, to ensure that she has an appropriate place to live which is affordable for her. She also said that it was important for the Hospital to be able to return Ms. Urquhart to the hospital quickly. She was not confident that Ms. Urquhart would return voluntarily. In addition, under questioning by counsel for the Attorney General, Dr. Selhi stated that the use of the Mental Health Act would likely entail police involvement, which would in turn likely escalate a return-to-hospital situation. She also opined that with a Mental Health Act admission, Ms. Urquhart would be less likely to be admitted quickly to a mental health unit and would likely need to spend time waiting in a hospital Emergency Department.
[28]. Dr. Selhi was asked by a panel member whether there were plans, in addition to preparing Ms. Urquhart for independent living, to eventually connect her to an ACT (Assertive Community Treatment) team. Dr. Selhi responded that as part of the overall care plan, the services provided by the forensic team should overlap with those of an ACT team. Dr. Selhi explained that she would expect a longer period of overlap between the services than would occur in other cases.
[29]. Asked by a panel member about the importance of Ms. Urquhart’s medication in maintaining her stability, Dr. Selhi agreed that it does play a significant role. She hastened to add, however, that she believed that the diagnosis of autism spectrum disorder and the institution of behavioural therapy also represented significant turning points in Ms. Urquhart’s trajectory. More recently, the diagnosis of neurodevelopmental disorder has also been an important development.
[30]. No further evidence was led following Dr. Selhi’s testimony.
Analysis and Conclusions, Significant Threat
[31]. Although the issue of significant threat was undisputed at the hearing, the panel nevertheless makes an independent finding that Ms. Urquhart continues to represent a significant threat to the safety of the public. In making this finding, we are of course cognizant of the fact that Ms. Urquhart has been subject to the Board’s jurisdiction for over 22 years.
[32]. Ms. Urquhart suffers from a complex constellation of conditions, some of which have only been diagnosed in the recent past. Historically, when untreated or sub-optimally treated and/or managed, Ms. Urquhart was frequently physically aggressive. Although Ms. Urquhart has been stable since she transitioned to the community and has not been physically aggressive for the past six years, her stability in the community has been maintained with medication and robust supports. Ms. Urquhart finds change stressful and struggles with adaptive functioning. She becomes anxious with uncertainty. Ms. Urquhart has in the past responded to stress and anxiety with aggression. The psychological risk assessment of Dr. Douglas, which the panel accepts, estimates that without professional intervention and support Ms. Urquhart’s risk for violence is high.
[33]. Ms. Urquhart’s lengthy history of assaultive behaviour, which continued over the first 13 years of her course under Review Board jurisdiction, demonstrates that her assaults were unpredictable, mainly unprovoked, and at times accompanied by extreme rage, requiring physical intervention by hospital staff to prevent the infliction of serious physical harm. Even so, harm could not always be prevented. For example, the Hospital Report (p. 45) notes a “vicious attack” upon Ms. Urquhart’s prime nurse at Providence Care and another attack on another nurse (both in 2010) that damaged the latter’s ribs.
[34]. Fortunately, Ms. Urquhart’s course has undergone a dramatic change for the better over the last 10 years. The panel is satisfied that her lengthy period of stability, without aggression, is due to her having been well-treated and well-supported by the forensic team. In addition to providing medication support (which the panel finds has been foundational to Ms. Urquhart’s ability to regulate her behaviour), the Hospital’s forensic team has provided intensive support to Ms. Urquhart to prepare her for community living and during her transition, first to the TRHP home and more recently to the DDTRHP residence. Ms. Urquhart clearly requires a great deal of support to help her manage community living without experiencing elevated levels of stress and anxiety that have the potential to seriously destabilize her mental condition and result in aggression toward others. The evidence clearly establishes that absent the supervision of the Board and the Hospital’s forensic team, Ms. Urquhart’s risk to the community would be high.
Analysis and Conclusion, Necessary and Appropriate Disposition:
[35]. The panel finds, in accord with the parties’ joint position, that the necessary and appropriate Disposition is a Detention Order on the same terms as found in the previous Disposition. Ms. Urquhart has, as was expected, made a successful transition to the DDTRHP home where she is supported by both the forensic team and staff at the residence. Dr. Selhi’s evidence, supported by the Hospital Report, indicates that the treatment team is actively preparing Ms. Urquhart for living in an independent apartment, and it is anticipated that such a move could occur within the coming year. Even in an independent apartment, Ms. Urquhart will require considerable support.
[36]. At each step on her path toward community reintegration, Ms. Urquhart has experienced stresses resulting from various changes, whether due to routines of the home or due to adjustments to different staffing levels. A move to an independent residence will undoubtedly bring new adjustments. While Ms. Urquhart has been free of serious incidents of physical aggression and has not required readmission to the Hospital over the past reporting period, the panel is satisfied that the Hospital continues to require the authority of a Detention Order, both for the purpose of approving Ms. Urquhart’s community residence during the expected transition and to effect a minimally disruptive return to Hospital should this be necessary in the interests of risk mitigation. While no party suggested that a Conditional Discharge would be an appropriate Disposition, the panel is independently of the view that such a Disposition would be premature unless and until Ms. Urquhart becomes settled into a stable living situation.
Concluding Comments
[37]. As noted above in paras. 10, 11, 13 and 33 of these Reasons, the criminal record for Ms. Urquhart that appears in the Hospital Report is current only to August 9, 2008 and there appear to be additional convictions since that time. The available information is unclear in this regard, and it would help the Board to have a current criminal record available at the next hearing.
[38]. The panel wishes Ms. Urquhart the best of success as she continues on her very positive trajectory toward community reintegration in the coming year. She has worked well with her treatment team through her various transitions and is to be commended for this. We encourage her to continue to collaborate with her team as she prepares for independent living. In reaching our decisions, the panel has examined the evidence from the standpoint of a consideration of the need to protect the public, Ms. Urquhart’s mental condition and other needs, and her reintegration into the community.
DATED this 5th of May 2025, at the City of Toronto, in the Toronto Region.
Eric Siebenmorgen Legal Member
Office of the Registrar Ontario Review Board