Ontario Review Board
Re: D’Jemima Domercant
ORB File No: 3932
Hearing held on: Monday, March 31, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley
Members: Dr. S. Lessard Dr. S. Wiseman Mr. D. Sandor Ms. N. Lemieux-McKinnon
Parties Appearing:
Accused: D’Jemima Domercant Counsel: Mr. M. Davies
Person in charge of hospital: Representative Dr. M. Strike
Attorney-General of Ontario: Counsel: Mr. J. Wright
REASONS FOR DISPOSITION
(Dated May 5, 2025)
On February 13, 2004, D’Jemima Maria Domercant was found not criminally responsible (NCR) on account of mental disorder on a charge of assault with a weapon, contrary to the Criminal Code of Canada. She is currently subject to a disposition of the Ontario Review Board (ORB/the Board), dated January 12, 2024, discharging her with conditions including that she reside at 791 Manitou Drive in Ottawa.
On March 31, 2025, the Board convened to conduct an annual hearing pursuant to s.672.81(1) of the Criminal Code to determine whether Ms. Domercant continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition. Ms. Domercant was present with her counsel, Mr. Davies. At his request, he was appointed counsel pursuant to s.672.5(8) of the Criminal Code.
At the outset of the proceedings, the parties were canvassed as to their initial positions on the issues to be determined by the Board. Dr. Strike, on behalf of the hospital, submitted that Ms. Domercant continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is an order detaining Ms. Domercant at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre with discretionary privileges up to and including the ability to reside in accommodation approved by the hospital.
Mr. Wright, on behalf of the Ministry of the Attorney-General, agreed with the hospital’s positions. Mr. Davies indicated that Ms. Domercant wished to return to her home in the community and asked that she not have any conditions that test her for the use of substances, such as urine screens. Mr. Davies advised that he would not be contesting the issue of significant threat.
Findings
- For the reasons that follow, the Board finds that Ms. Domercant remains a significant threat to the safety of the public and that the necessary and appropriate disposition is a detention order with the ability to reside in the community in approved accommodation.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated March 24, 2025 (ex. 1) and the viva voce evidence of Dr. Strike.
The Index Offence
- The circumstances of the index offence are taken from page 2 of the Hospital Report:
The offences are alleged to have taken place on November 10 and 11, 2003. The Crown Brief Synopsis indicates that initially members of the Ottawa Police responded to a call for service at 791 Manitou Drive. This call was placed by the accused. Upon arrival, she was noted to have a black left eye with minor bleeding in the area. She was alleging that she had been assaulted by her mother’s boarder, Eric Sarah. Upon further investigation, the police determined that the accused suffered the injury to her eye after she had attempted to assault Mr. Sarah with a chair. When the chair was pushed back towards her, she sustained the injury to her eye. It is reported that the accused was upset at the lack of arrest of Mr. Sarah and left the residence.
Approximately 45 minutes later, the accused is alleged to have returned to the residence. She allegedly proceeded to her mother’s bedroom where Mr. Sarah was speaking with the accused’s mother. She is alleged to have proceeded behind him and pulled a ball-peen hammer from her purse. She is alleged to have struck him at the base of his skull with this hammer. She then stated, "I got you now, call the Po-po (police)". Family members became involved and the police were called. The family took the hammer from the accused. She again departed the residence and was arrested near the residence.
The police occurrence report indicates that in further discussions with the victim, it was learned that the accused had attempted to stab him with a knife and a bottle and that she had attempted to hit him with an ax. She had further expressed intent to kill him. Further statements obtained from Mrs. Foote, the accused’s mother, indicated that the accused had been previously diagnosed as having paranoid schizophrenia. The mother also advised that her daughter was in the habit of using street drugs including marijuana and crack cocaine.
Background Information
The Hospital Report contains a great deal of information about Ms. Domercant’s background and psychiatric history and need not be reviewed in detail beyond the following material points. Ms. Domercant is a 42-year-old single woman who, until recently, resided in the family home with her mother, step-father and siblings. She is unemployed and supported by the Ontario Disability Support Program (ODSP).
Ms. Domercant first immigrated with her mother and brother to Canada from Haiti when was she was 7 years old. She and her brother had to return to Haiti due to immigration issues but permanently relocated to Canada when Ms. Domercant was eleven years of age. Ms. Domercant reports that when she returned to Haiti, she was sexually assaulted by older male family friends.
Ms. Domercant struggled academically in Canada. She reported having been expelled from two high schools because of fighting and left school in Grade 9 or 10.
Ms. Domercant has advised that she has had three long term relationships to date. She reported that she has been attracted to men who were physically violent, belonged to gangs, and flaunted with danger. She also acknowledged having been involved with an escort agency in order to obtain money and food.
Ms. Domercant has a history of significant cannabis use beginning at age 15 or 16. At one point, she was using cannabis daily, smoking 4 joints a day. Her mother reported that she also consumed crack cocaine. She has no criminal record.
Ms. Domercant reported that at about age 16 or 17, she made two overdose attempts and was seen in the Children’s Hospital Emergency Room but not kept overnight. The Hospital Report also refers to Ms. Domercant being taken to the Ottawa Hospital, Civic Campus on three occasions during the year prior to the commission of the index offence. It is reported that she did not continue with any medication treatment after her discharges from hospital. No further details were provided.
Over the years, Ms. Domercant has had a difficult relationship with her mother. There have been physical altercations, necessitating that Ms. Domercant leave the residence and reside in shelters or with friends. She has reported that her mother is verbally abusive when she is angry. Ms. Domercant also reports that she feels that her stepfather is sexually interested in her.
Ms. Domercant has expressed fears that men have been targeting her with sexual and physical violence. She experiences persecutory delusions that cause her to protect herself, such as at the time of the index offence. In 2016, she reportedly threatened a male boarder with a knife, and in October 2021, she threatened an elderly male neighbour. More recently she has feared that nursing staff might assault her while administering her injectable antipsychotic medication.
Following the NCR finding, Ms. Domercant was admitted to the Royal Ottawa Mental Health Centre (ROMHC/the hospital). She was found incapable of making treatment decisions and her mother became her Substitute Decision Maker (SDM). Over the following years there have been a number of discharges into the community. However, substance use and problematic behaviour led to readmissions. A more detailed account of her progress is contained in the Hospital Report.
Ms. Domercant was discharged from hospital to live with her family in October 2011, and since then has remained in the community but for several brief readmissions to hospital, both under the Mental Health Act and by way of a Form 49. Ms. Domercant remained on a detention order until January 2023, when she was granted a conditional discharge. She remained constantly unwell, but without any major exacerbation of her psychotic symptoms that threatened her safety or that of others. She remained incapable of consenting to treatment and her brother became her SDM.
Course Since the Last Disposition
- Ms. Domercant’s current diagnoses are:
Schizophrenia, continuous
Other specified feeding or eating disorder: Purging disorder and atypical anorexia nervosa
Antisocial Personality Disorder with Histrionic Personality Traits
Crack Cocaine Use Disorder
Cannabis Use Disorder
Over the course of the past year, Ms. Domercant has remained symptomatic with persecutory delusions and disorganized thinking. Her delusions continue to involve various male figures, believing that they are attempting to harm her, in particular her stepfather. Ms. Domercant often missed her appointments at the outpatient clinic and would attend to receive her injectable medication at random dates and times. As a result, her contact with her treating psychiatrist was significantly compromised. On occasion, she would exhibit paranoia and would be fearful and decline to have her injection administered by a certain staff member.
Ms. Domercant resisted increased contact with the treatment team and her treating psychiatrist. In order to continue to manage her risk, the team explored various services and potential referrals in the community. Ms. Domercant declined all of the suggestions.
Dr. Strike discussed medication changes with Ms. Domercant and her SDM on several occasions, including the possibility of a hospital admission to optimize her treatment. They both declined. Dr. Strike pointed to Ms. Domercant’s psychotic symptoms and the apparent distress and functional impairment that they caused, often leading her to become aggressive. Still, they both declined to make any changes, but Ms. Domercant often asked to reduce her antipsychotic medication. She stated that, should she obtain an absolute discharge, she would stop all medications.
In early September 2024, the treatment team agreed to reduce the dosage of Ms. Domercant’s antipsychotic medication. One week later, she appeared suspicious, intense and irritable. The team reached out to her SDM by phone and email to discuss her altered presentation. Four days later, he called back to report that Ms. Domercant’s mental health had deteriorated significantly after she had stopped taking all of her oral medications the week prior. She did not sleep for a few days and was very loud. When she attended the forensic outpatient clinic the following day, she expressed paranoid beliefs.
Ms. Domercant’s fluctuating mental health and periodic medication noncompliance has caused significant stress within the family home. This seemed to come to a crisis point in December 2024. Her mother had evicted her from the home three times and police were called repeatedly. Police took her to a shelter; however, she was too scared to stay there and returned home notwithstanding her mother’s position. Once again Dr. Strike raised with her SDM the possibility of transitioning Ms. Domercant to long-acting injectable medication. He remained reluctant to have her admitted to hospital and to make the recommended medication changes.
On January 7, 2025, Ms. Domercant attended the outpatient clinic and told Dr. Strike about her urgent housing issue. She reported experiencing significant stress over both her perception that her stepfather was making sexual passes at her and her mother verbally abusing her. Ms. Domercant also complained that various men were talking to her through her laptop. When contacted by Dr. Strike, her SDM did not perceive that there was an issue, although he did concede that police had been called to the residence. He further advised Dr. Strike that he believed that Ms. Domercant was not taking her medication.
Dr. Strike issued a Form 1 under the Mental Health Act, concerned for the safety of Ms. Domercant’s stepfather in particular. Ms. Domercant was admitted to the Queensway Carleton Hospital QCH) on January 7, 2025, pending an available bed and transfer to ROMHC. During her admission at QCH, Ms. Domercant demonstrated acute psychotic symptoms and had multiple incidents of physical aggression requiring chemical and mechanical restraints, and Code Whites.1 She initially refused to provide urine samples; however, the urine that she eventually provided tested positive for cannabis. Her use of both cannabis and alcohol likely contributed to the acute episode of schizophrenia.
As her aggression could not be managed at QCH, she was transferred to the Forensic Assessment Unit at ROMHC on February 6, 2025.2 Ms. Domercant had multiple aggressive incidents in February while at ROMHC, including an assault on a male co-patient, when she spit in his face. She had been preoccupied that this man supposedly was following her and trying to sexually assault her. Her agitation, aggression and delusional preoccupation decreased considerably throughout March. She is currently admitted involuntarily on a Form 4 which expires on April 10th. She has been very anxious to leave the hospital.
Based on the risk assessment tools described in the Hospital Report, Dr. Strike is of the opinion that Ms. Domercant continues to present a moderate to high risk of future violence, such as assault,
In the Hospital Report, Dr. Strike outlines the proposed treatment plan, at p. 70:
Discharge planning remains premature. The entire inpatient and outpatient team, and Mr. Howard Domercant, feel strongly that Ms. Domercant should transfer to the FRU and reintegrate gradually into the community. She has been on the waitlist for transfer to the FRU since early March. She was recently stepped down to “routine observations,” no longer requiring therapeutic engagement to prevent aggression. The family anticipate welcoming her back to the family home. This will require extensive safety planning and engagement with the family, particularly considering that there is a newborn living in the home, since Ms. Domercant’s sister had a baby around February.
The family indicated that Ms. Domercant’s bedroom has been converted into the baby’s room.
Dr. Strike testified before the Board. She indicated that, on March 7, 2025, Ms. Domercant was placed on the waitlist for a transfer to the less restrictive Forensic Rehabilitation Unit. Although Ms. Domercant has exhibited minor verbal aggression, she has not engaged in any physical aggression since early February.
Dr. Strike indicated that the treatment team was sensitive to the fact that this hospitalization has been distressing for Ms. Domercant. The team is working on developing a release plan that will assist Ms. Domercant to manage the stress that she experiences when residing in the family home. The team is also cognizant of the fact that there is now an infant residing in the home and Ms. Domercant has no history of being around infants.
Dr. Strike testified that there was a case conference scheduled for April 15 which will include a multi-disciplinary team and the family members. At that time a plan for the gradual transition back to the family home will be considered. Given the changes in the home, the treatment team will do an assessment to determine whether it remains an approved accommodation for Ms. Domercant.
Dr. Strike indicated that Ms. Domercant has stated an intention to drink wine when she is discharged. The doctor has voiced concerns about the negative impact of alcohol on Ms. Domercant’s mental status in the past and strongly recommends that she abstain from alcohol and cannabis.
Dr. Strike testified that the hospital requires a detention order to manage Ms. Domercant’s risk in the community. When Ms. Domercant was taken to QCH pursuant to a Form 1, the assessing psychiatrist initially did not feel that there were grounds to admit Ms. Domercant under the Mental Health Act. It was only after discussions with Dr. Strike that the decision was made to admit Ms. Domercant.
Dr. Strike reported that Ms. Domercant continues to believe that she is the subject of unwanted sexual advances by men and continues to experience stress from her mother’s verbal and physical aggression. Both were at play in December 2024 when Ms. Domercant was told to leave the family home. In the doctor’s opinion, Ms. Domercant is not yet ready to exercise passes to the family home.
When asked about whether Ms. Domercant had expressed any concerns about the process of testing for substances, Dr. Strike testified that Ms. Domercant has not provided any specific reasons to her. The doctor noted that Ms. Domercant ultimately did provide a urine sample when admitted to QCH.
Dr. Strike testified that Ms. Domercant’s brother continues to be her SDM. Communications between him and the treatment team have improved. He also has agreed to the doctor’s recommendations for optimizing Ms. Domercant’s medications. She is currently receiving injections of antipsychotic medication which will provide some protection in the short-term should she become noncompliant. In the doctor’s opinion, she is optimally medicated. Further, Ms. Domercant has given consent for the treatment team to discuss her treatment with her family, with her mother and stepfather, in particular. Dr. Strike agreed that the family would benefit from psychosocial education.
Submissions
Dr. Strike submitted that Ms. Domercant remains a significant threat to the safety of the public and the necessary and appropriate disposition is a detention order with the ability to reside in the community in approved accommodations. Ms. Domercant has a treatment resistant form of schizophrenia and, over the years, has had challenges with medication compliance. She has stated on a number of occasions that, but for the disposition of the ORB, she would cease taking all medication. In December, Ms. Domercant was engaging in cannabis use and was sub-optimally treated. When admitted to hospital she engaged in unprovoked assaults. The hospital requires a detention order as the provisions of the Mental Health Act would not be sufficient. As the admission in January demonstrated, but for the input of Dr. Strike, the assessing psychiatrist would not have admitted Ms. Domercant. In terms of testing for substances, Dr. Strike appreciated that it is an invasion of privacy. However, in the doctor’s opinion it is required to manage Ms. Domercant’s risk in the community. Without the testing provision, Ms. Domercant would not be motivated to abstain from substances.
Ms. Dufort agreed with the hospital’s submissions. She noted that with the optimization of Ms. Domercant’s medication, there is some reason to be optimistic.
Mr. Davies reiterated Ms. Domercant’s position that she would like to return home. In his submission there is no evidence of a clear correlation between substance use and decompensation. The requirement that she provide samples of her urine or breath is a violation of her privacy. Mr. Davies further submitted that Ms. Domercant’s risk could continue to be managed with a conditional discharge and the use of the Mental Health Act. He noted that she is currently detained pursuant to a Form 4 under that act.
Analysis and Conclusion
The Board carefully considered the Hospital Report and the evidence of Dr. Strike and unanimously finds that Ms. Domercant continues to represent a significant threat to the safety of the public. Ms. Domercant has a diagnosis of schizophrenia and she continues to experience symptoms of psychosis. Compliance with treatment has been an ongoing issue, resulting in her experiencing persecutory delusions and paranoia. She has stated an intention to cease all medications once she receives an absolute discharge. Recent events have demonstrated that when Ms. Domercant stops taking her medication, she becomes aggressive, violent and paranoid and, similar to the time of the index offence, feels threatened by men in her vicinity. She would thereby present an elevated risk of violent behaviour to protect herself from perceived threats.
Having found that Ms. Domercant continues to represent a significant threat to the safety of the public, the panel must consider the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code, which include the need to protect the public from dangerous persons, the mental condition of the accused, the integration of the accused into society and the other needs of the accused.
The Board unanimously agrees that the necessary and appropriate disposition is a detention order. The Board accepts Dr. Strike’s evidence that the hospital requires the ability to admit Ms. Domercant to hospital, if necessary, and have the ability to approve her accommodation. Ms. Domercant is currently admitted under the auspices of the Mental Health Act. The Form 4 expires on April 10, 2025.
Dr. Strike has indicated that the plan going forward is to reintegrate Ms. Domercant back into the community in a slow and deliberate manner. First Ms. Domercant must be transferred to the Forensic Rehabilitation Unit. Although the family and Ms. Domercant are anticipating her return to the family home, the treatment team needs the ability to approve the accommodation. Ms. Domercant has experienced stress in the home. There is now an infant residing in what was formerly Ms. Domercant’s room. Dr. Strike has stressed that the team is mindful of the need to ensure the safety of the child and Mr. Domercant’s stepfather. Extensive safety planning and engagement with the family is critical. Further, it may well be that the Children’s Aid Society will need to be notified and could become involved.
The Board accepts Dr. Strike’s expert opinion that cannabis and alcohol have contributed to the exacerbation of Ms. Domercant’s psychotic symptoms. Historically, her use also has coincided with her becoming noncompliant with medication. Of concern to Dr. Strike is Ms. Domercant’s stated intention to consume wine when she is back residing in the community. In the circumstances Dr. Strike strongly recommends that Ms. Domercant abstain. The Board agrees that a condition to abstain from alcohol, cannabis and other intoxicants is necessary and appropriate.
The Board also agrees that the requirement that Ms. Domercant provide samples of her breath or urine is necessary and appropriate. While it is a violation of her privacy, it is minimal. The Board accepts Dr. Strike’s evidence that without the ability to test for substances, the hospital is concerned that Ms. Domercant will not have any incentive to abstain.
Finally, the Board appreciates that Ms. Domercant has been subject to a disposition for a number of years. There now are grounds for optimism. Ms. Domercant is optimally treated with injectable medication that will assist her in remaining compliant with treatment. Her family remains supportive and is engaged with the treatment team. Her reintegration into the community, most likely back to her family home, is being planned in a thoughtful manner that tries to ensure the safety of all involved.
Accordingly, the panel finds that the necessary and appropriate disposition is a detention order with the terms and conditions as recommended by the hospital. In arriving at this conclusion, the panel has considered the paramount factor of the safety of the public, Ms. Domercant’s community reintegration, her mental condition, and her other needs as required by s.672.5 of the Criminal Code.
DATED this 5th day of May 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Finley Alternate Chairperson
Office of the Registrar Ontario Review Board