Ontario Review Board
Re: Edmond Clarence Pinsonneault
ORB File No: 4562
Hearing held on: Tuesday, April 8, 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: Ms. S. Clapp Members: Dr. S. Swaminath, Dr. M. Green, Mr. R. Bigelow, Ms. C. Plyley
Parties Appearing: Accused: Edmond Clarence Pinsonneault Counsel: Ms. C. Whillier
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated May 8, 2025)
Introduction:
1. On September 11, 2006, Edmond Clarence Pinsonneault was found not criminally responsible on account of mental disorder (“NCR”) on two charges each of possession of weapons dangerous, utter threats, and breach of probation, contrary to the Criminal Code. Since that time, he has been subject to Dispositions of the Ontario Review Board (“ORB” or the “Board”). He is currently subject to a Disposition dated April 24, 2024, whereby he is detained at the Southwest Centre for Forensic Mental Health Care (“Southwest” or the “hospital”) with privileges up to and including community living in Elgin or Middlesex County in supervised accommodation approved by the person in charge. He is also required to refrain from having weapons in his possession.
2. On April 8, 2025, a panel of the Board convened at Southwest to conduct Mr. Pinsonneault’s annual review pursuant to section 672.81(1) of the Criminal Code. Mr. Pinsonneault attended the hearing and was represented by counsel.
3. The Hospital Report dated February 6, 2025, was marked as Exhibit 1. In addition to the documentary evidence, Mr. Pinsonneault’s attending psychiatrist, Dr. Arun Prakash, gave evidence.
4. The issues to be decided at the hearing were whether Mr. Pinsonneault continues to meet the test of posing a significant threat to the safety of the public as set out in section 672.5401 of the Criminal Code, and if so, what is the necessary and appropriate Disposition, taking into account the four factors set out in section 672.54 of the Criminal Code.
Position of the Parties:
5. At the outset of the hearing the parties were asked for their initial without prejudice positions. On behalf of the hospital, Ms. Zamprogna took the position that Mr. Pinsonneault continues to represent a significant threat to the safety of the public and that a Detention Order remains necessary and appropriate. The hospital was not recommending any change to the existing Detention Order except for the addition of the word “delegate” in clause 2(d). Ms. Zamprogna explained that this language is used in all of the hospital’s newer Dispositions and would allow for people from outside agencies to supervise Mr. Pinsonneault in the community.
6. Mr. Rows adopted the position of the hospital on behalf of the Attorney General. Ms. Whillier advised that Mr. Pinsonneault takes the position that he is not a significant threat to the safety of the public and should therefore be absolutely discharged.
Findings:
7. For the reasons that follow, the panel found that Mr. Pinsonneault continues to pose a significant threat to public safety. The panel concluded that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a continuation of the Detention Order as recommended by the hospital.
Index Offences:
8. The circumstances of the index offences are stated as follows in the Hospital Report (at page 2):
“Mr. Pinsonneault was an involuntary patient at Regional Mental Health Care St. Thomas on May 28, 2005. He went out of hospital on a day pass and when he returned he had a wooden handled pocketknife. When staff asked him about it he stated “It beats a .38”. He advised staff that he had purchased the knife at a yard sale. It was taken away from him.
On May 30, 2005 Mr. Pinsonneault again returned from a day pass and was approached by two nurses and asked if they could check his duffle bag and fanny pack. He complied with the request and found six silver-pointed butter knives wrapped in paper in the fanny pack. The knives were taken away and Mr. Pinsonneault became very upset and began yelling at the nurses. He was asked why he had the knives and he said something to the effect of “Fuck you cunts up. You fucking bitches will pay.” His behaviour escalated and while he was being assessed by Dr. Chandrasena he again stated to the two female nurses “You fucking bitches I will get you and I won’t forget who you are, you fucking cunts”. He was placed in seclusion, but continued yelling and screaming. At the time of the alleged index offences Mr. Pinsonneault was on the 45th Certificate of Renewal under The Mental Health Act. He had also been placed on Probation on February 8, 2005 for a conviction for assault cause bodily harm. One of the conditions of his Probation Order was to not have any weapons. On May 31, 2005 police attended at the hospital and Mr. Pinsonneault was arrested and charged with the alleged index offences.”
Background:
9. Mr. Pinsonneault’s personal history is outlined in the Hospital Report and will not be repeated here. In summary, Mr. Pinsonneault is a 70-year-old single man who has been institutionalized for much of his life. He was a slow learner in school and left school in grade 11. He worked sporadically after that. He had a brief marriage in 1976-1977, but he was very suspicious of his wife which led to divorce.
Criminal History:
10. Mr. Pinsonneault’s criminal record before the index offences includes convictions for possession of a narcotic in 1974, two counts of assault in 1987, another assault in 1991, and a conviction of assault causing bodily harm in February 2005.
Psychiatric History:
11. The Hospital Report outlined Mr. Pinsonneault’s psychiatric history before the index offences and will not be repeated. In summary, Mr. Pinsonneault was diagnosed with paranoid schizophrenia in 1977 and had numerous hospital admissions in the following years. He frequently left hospital against medical advice and repeatedly stopped taking medications. Mr. Pinsonneault was found incapable of consenting to treatment in 1986 and his mother became his substitute decision-maker (“SDM”). He lived on and off with his mother during this time, and police were called as a result of his behaviours on several occasions. He was often described as paranoid, psychotic, and threatening. Mr. Pinsonneault was hospitalized in July 1994, and remained there until the index offences occurred in 2005.
12. Mr. Pinsonneault was admitted to Southwest on June 27, 2005 for a fitness assessment. He was initially found unfit to stand trial, but was retuned to court, deemed fit, and found NCR on September 11, 2006. Mr. Pinsonneault’s course under the jurisdiction of the Board is outlined in the Hospital Report in detail. He remained symptomatic with no insight into his illness for many years. Between March 2009 and March 2011, Mr. Pinsonneault lived at Kettle Creek Gardens Residence, with multiple admissions to hospital as a result of refusing medications and having knives in his possession. A compromise was ultimately reached such that Mr. Pinsonneault lived at the residence, but went in to the hospital every two weeks for his injection.
13. Mr. Pinsonneault was readmitted to hospital in August 2014 because he was being evicted from the Kettle Creek residence due to ongoing intimidating behaviours and non-compliance with house rules. He remained very delusional and was thought disordered, irritable, and verbally aggressive with staff. Mr. Pinsonneault remained in the hospital until he was discharged to a supervised group home in November 2019. He had a number of short admissions in October and November of 2020, and then five admissions in 2023 as a result of deterioration in his mental state and violent threats and incidents. It was believed that part of the reason for Mr. Pinsonneault’s more recent deterioration and readmissions was because the group home moved locations.
14. In the spring of 2023, Mr. Pinsonneault was discharged from Canadian Mental Health Association (“CMHA”) services because he did not meet special funding eligibility due to lack of participation in both in-house and CMHA programming. He then became responsible for paying a private rent fee and for covering the cost of other services provided at the home.
15. Mr. Pinsonneault is diagnosed with treatment resistant Schizoaffective Disorder.
Evidence at the Hearing:
16. Mr. Pinsonneault continues to live at the supervised group home that is affiliated with Community Homes for Opportunity and CMHA. It is staffed 24 hours per day and seven days a week, and administers most of his medications. The Hospital Report stated that compared to previous reporting periods, Mr. Pinsonneault demonstrated increased stability this year. There were no readmissions to hospital, no significant incidents, no violent threats, and he followed the rules at the group home. Consistent with his baseline, Mr. Pinsonneault remains significantly impacted by positive symptoms (grandiose, persecutory, and bizarre delusions, auditory hallucinations, suspiciousness, and flights of ideas) on a daily basis, as well as negative symptoms of his mental illness.
17. The Hospital Report stated that an additional antipsychotic medication was added in November 2024, which resulted in Mr. Pinsonneault being more engaged and directable, with a more stable mood. He was described as often being pleasant and polite with a good sense of humour. In addition, staff at the group home implemented a new nighttime routine in order to help Mr. Pinsonneault with sleep. Mr. Pinsonneault believes it is part of his job to supervise the parking lot, so staff now offer him a snack, sit and talk with him, and redirect him to bed if he is up past 10 p.m. Mr. Pinsonneault is also better able to self-identify when he is having a bad day, and there were no reports of angry outbursts at staff.
18. Mr. Pinsonneault continued to decline participation in any programming and enjoyed his daily routine of smoking cigarettes and listening to music. He continues to struggle with his activities of daily living and hoarding tendencies. He has accessed the community independently on passes without issue.
19. Mr. Pinsonneault remains incapable of consenting to treatment and is also incapable of managing his finances. His sister is his SDM for both treatment and property. The Hospital Report stated the following about Mr. Pinsonneault’s insight (at page 159):
“Mr. Pinsonneault continued to have poor insight into the index offence, his mental illness, and his need for treatment and this has remained unchanged for years. Any discussion about the index offence or the forensic or legal system quickly triggered his paranoid and grandiose delusions.
Mr. Pinsonneault adamantly denied having a mental illness. He did not understand the spectrum of his symptoms, had no ability to self-disclose his symptoms (other than the voices were loud), or identify warning signs of decompensation. This has remained unchanged from previous reporting periods. Attempts to provide psychoeducation about his illness and treatment were met with resistance and triggered agitation as he fully denied, disagreed with, or refuted what clinicians would try to tell him.”
20. Mr. Pinsonneault continues to have the support of his mother, sister, and brother, who have visited him more in the last year.
21. The Hospital Report states the following about the treatment plan for Mr. Pinsonneault (at page 161):
“The treatment team will continue supporting Mr. Pinsonneault at his supervised group home. Over the next six months, if Mr. Pinsonneault continues to demonstrate stability, then the treatment team plan to refer him to the Assertive Community Treatment Team (ACTT) and gradually transfer care to them in anticipation of post-forensic care. The team required a sustained period of stability prior to referring to ACTT as his previous reporting period consisted of five readmissions to hospital. Further, the team will connect him a general practitioner in the community.”
22. Dr. Prakash testified that Mr. Pinsonneault is happy and settled at his current home. He has his own room, and the staff help him out and monitor him. His symptoms of paranoia and grandiose and bizarre delusions continue, however they have impacted his behaviour less, and he has been able to cope with them such that he has not required admission to hospital in this past reporting year.
23. Dr. Prakash stated that two medication changes were made this year which have made a difference. The first was an increased dose of Olanzapine at night when Mr. Pinsonneault’s paranoia and anxiety typically increased, and the second was the addition of Quetiapine at a low dose. Mr. Pinsonneault has also been more compliant with medications this year.
24. Dr. Prakash reiterated that Mr. Pinsonneault has no insight into the index offences, his mental illness, or the need for medications for both his mental and physical illnesses (including COPD and sleep apnea).
25. If Mr. Pinsonneault were granted an Absolute Discharge, Dr. Prakash testified that he would leave the group home because he believes he owns various buildings in Alberta and Ontario, and he would not take medications. He stated that the hospital needs to be able to bring Mr. Pinsonneault back to the hospital if he deteriorates because Mr. Pinsonneault has no awareness of the early warning signs of a decompensation. Dr. Prakash also noted that at times in the past the police were required to bring Mr. Pinsonneault to hospital.
26. Dr. Prakash testified that he had spoken to Mr. Pinsonneault’s sister (who is his SDM) that morning, and she said the family was managing the increased cost of Mr. Pinsonneault’s rent and services as a result of CMHA no longer supporting him. She believes that the group home is very important to Mr. Pinsonneault.
27. When asked about physical harm by Mr. Rows, Dr. Prakash stated that the last time that Mr. Pinsonneault engaged in physical contact was pushing a worker in a group home approximately five years ago. Dr. Prakash stated that Mr. Pinsonneault made verbal threats last year, and that both physical and psychological harm remain a concern.
28. The results from the risk assessment completed this year stated that Mr. Pinsonneault presents a moderate risk of violent reoffending in the next 12 months on a Detention Disposition while living in supervised accommodation. When asked by Ms. Whillier why this had been downgraded from moderate to high last year, Dr. Prakash stated that Mr. Pinsonneault is now settled in the new location of the group home, his medications have been increased, there have been some new behavioural interventions, he is sleeping better, and there is less external stimulation at the new building.
29. Ms. Whillier asked Dr. Prakash about initiating a community treatment order (“CTO”). Dr. Prakash stated Mr. Pinsonneault is on a Detention Order now so a CTO is not needed, however it will likely be considered when the treatment team believes that Mr. Pinsonneault is ready for an Absolute Discharge. He added that Mr. Pinsonneault has never had a period of stability like this before, and they want to see if they can connect him with an ACT team if this continues. Dr. Prakash stated that it takes Mr. Pinsonneault a long time to trust people, noting that he will only accept his long-acting injectable medication from one particular staff member, and he may or may not come to the hospital depending on who is making the request. He has ongoing delusions that medications are poison and are harming him. For that reason, Dr. Prakash testified that any transition to a non-forensic team would have to be in place and successful before an Absolute Discharge would be recommended.
Analysis and Conclusions:
30. Based on the Hospital Report and the evidence of Dr. Prakash, the panel concluded that there was clear evidence that Mr. Pinsonneault remains a significant threat to public safety. Although there have been some improvements this year, Mr. Pinsonneault remains highly impacted by the symptoms of his major mental illness, Schizoaffective Disorder. He continues to have fixed delusions despite being treated with three antipsychotic medications. Mr. Pinsonneault has no insight into his mental illness or the need for medication, and this has been the case since the onset of his illness many years ago. Mr. Pinsonneault is incapable of consenting to treatment and requires close supervision to ensure compliance with medication. Mr. Pinsonneault is very sensitive to change and has required hospital readmissions numerous times while under the jurisdiction of the Board. He has entered a period of relative stability at the current time (which has not been seen before), and time is needed to see if it will continue. Finally, Mr. Pinsonneault does not have any community psychiatric supports at the current time.
31. The panel accepted the re-offence scenario set out at page 164 of the Hospital Report, as well as Dr. Prakash’s evidence, that absent the supervision of the Board, Mr. Pinsonneault would stop taking medication and leave the group home. His psychotic symptoms would exacerbate and he would act on his delusions, which would lead him to feel threatened and he would respond with violence. For these reasons, given that the panel concluded that Mr. Pinsonneault remains a significant threat, an Absolute Discharge is not warranted.
32. The panel decided that a continuation of the Detention Order, with the small change in wording as recommended by the hospital, was necessary and appropriate, and the least onerous and least restrictive Disposition in the circumstances. Mr. Pinsonneault requires the close supervision provided by the group home for administration of his medications, monitoring of his behaviours, and support with his activities of daily living. This support is a significant part of his risk management. The hospital needs to maintain the ability to approve Mr. Pinsonneault’s housing.
33. Further, the panel requires the ability to bring Mr. Pinsonneault back to the hospital on a Warrant of Committal if he decompensates in the community. This has occurred on a number of occasions in the past. Mr. Pinsonneault is not able to recognize signs of decompensation in himself, and has been aggressive and threatening in the past when his symptoms worsen. The Mental Health Act would not be sufficient to prevent Mr. Pinsonneault’s risk-related behaviours. A Detention Order is required to protect the public and minimize Mr. Pinsonneault’s potential to reoffend.
34. The last year has been a more stable one for Mr. Pinsonneault, and as a result the treatment team is looking at the next steps in Mr. Pinsonneault’s recovery. If Mr. Pinsonneault continues to do well, the treatment team will move forward with a referral to an ACT team. It is expected that this transition will take some time given Mr. Pinsonneault’s history and sensitivities, but the panel is hopeful that this positive trajectory will continue for Mr. Pinsonneault.
DATED this 8th day of May 2025, at the City of Toronto, in the Toronto Region.
Suzanne Clapp Alternate Chair
Office of the Registrar Ontario Review Board