Ontario Review Board
Re: Brian Drepaul
ORB File No: 5845
Hearing held on: Monday, March 24, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code
Before:
Alternate Chairperson: Ms. M. Labrosse Members: Dr. P. Prendergast Dr. L.O. Lightfoot Ms. L. Banks Mr. A. Bouvier
Parties Appearing:
Accused: Brian Drepaul Counsel: Mr. A. Rai
The person in charge of hospital: Counsel: Mr. J. McIntyre
Attorney General of Ontario: Counsel: Mr. C. Waite
REASONS FOR DECISION AND DISPOSITION
(Dated May 6, 2025)
Introduction
On April 11, 2011, Brian Drepaul was found not criminally responsible on account of mental disorder on charges of mischief - endangering life (x2), assault with a weapon (x2), and possession of weapon for a dangerous purpose, all contrary to the Criminal Code of Canada.
Mr. Drepaul is currently subject to an Ontario Review Board (“ORB”) Disposition dated April 18, 2024, which detains him at the General Forensic Unit of the Centre for Addiction and Mental Health, Toronto (“CAMH”), hereinafter referred to as the hospital, and which includes community living in the community of the Greater Toronto Area (“GTA”) in accommodation approved by the person in charge.
By way of letter dated March 5, 2025, the hospital notified the ORB under s. 672.56(2) of the Criminal Code that Mr. Drepaul had been readmitted to hospital on February 25, 2025, thereby constituting a significant increase in the restriction of his liberty.
On March 24, 2025, the ORB convened a hearing at CAMH for the annual review of Mr. Drepaul’s Disposition and to review the restriction of liberty. Mr. Drepaul did not attend his hearing but had given his counsel, Mr. Rai, instructions to attend the hearing on his behalf. At the request of Mr. Rai, the Board granted Mr. Drepaul an order excusing him from attending his hearing under s. 672.5(10)(a) of the Criminal Code.
A Hospital Report dated March 4, 2025, was entered as Exhibit 1 for the hearing.
The issues for the hearing are whether Mr. Drepaul continues to pose a significant threat to the safety of the public and, if so, to determine the necessary and appropriate Disposition having regard to the factors set out at s. 672.54. The Board was also tasked with reviewing the restriction of liberty in order to determine whether it was reasonable and warranted and represented the least onerous and least restrictive course of action available to the hospital.
For the reasons set out below the Board finds that Mr. Drepaul continues to pose a significant threat to the safety of the public and that the maintenance of the current Disposition, namely a detention order, on the same terms and conditions, with the addition of a condition granting the hospital oversight of the contact between Mr. Drepaul and his daughter Monica, remains the necessary and appropriate Disposition.
With respect to the hospital’s decision to readmit Mr. Drepaul to hospital on February 25, 2025, thereby significantly increasing the restriction of his liberty, the Board finds that that decision was reasonable and warranted, and in the circumstances, represented the least onerous and least restrictive course of action available to the hospital to manage the heightened risk presented by Mr. Drepaul at that time. The Board also finds that the ongoing restriction remains reasonable and warranted and least onerous and least restrictive at this time.
Index Offences
- The details of the index offences are extracted from last year’s Reasons for Disposition, as follows:
“In June of 2010, Mr. Drepaul threw two air conditioner units from the seventh floor of an apartment building to the ground. These did not strike anyone. When police arrived to investigate this incident, they found Mr. Drepaul wielding a hammer and making threats. He was in a very agitated state. He refused orders from police to drop the hammer and a metal pole, ran away, and challenged officers to shoot him. When closer, he lunged at officers. Two officers were struck by the metal pole, and received minor injuries. Mr. Drepaul was arrested.”
Background History
Mr. Drepaul’s personal, legal and psychiatric history is set out in detail in the Hospital Report. Briefly summarized, Mr. Drepaul is currently 51 years of age and was born in Guyana. He came to Canada in 1983 when he was 9 years old. He lived with both of his parents throughout his childhood.
Mr. Drepaul has two brothers and a sister. One of his brothers has schizophrenia and resides in the GTA. His other brother has been deported to Guyana, apparently on account of not having Canadian citizenship and having accrued a significant criminal record involving break and enters and drug dealing.
Mr. Drepaul is a Canadian citizen. He enjoys a close relationship with his mother who has been actively involved with him and ensures that he makes it to his medical appointments and attends at the Brampton outpatient clinic for his long-acting antipsychotic injection. His father passed away in 2003.
Mr. Drepaul dropped out of high school in Grade 9. From the time he was 17, he worked as a hardwood floor sander/varnisher. He also worked at a Chrysler Plant as an industrial cleaner. More recently, while residing in the community, Mr. Drepaul worked as a furniture mover on occasion. He is now financially supported by ODSP.
Mr. Drepaul was married in March 1993. He has two teenaged daughters from this union. In addition, his wife had a daughter from a previous relationship who Mr. Drepaul helped raise from infancy. After he and his wife separated in approximately 2002, he played an active role in rearing all three children. At the time of his arrest for the index offences, two of the children were living with him.
Mr. Drepaul’s relationship with his wife became negatively affected by his experiences of paranoia. He was always suspicious that his wife was having an affair. The relationship ended after Mr. Drepaul picked up a knife and demanded to know whether his wife was cheating on him. Mr. Drepaul maintains relationships with his ex-wife and his three children.
With respect to substance use, Mr. Drepaul has used cannabis since he was 15 years old and continues to use to this day. The frequency of his use is unclear as his own accounts will vary. He has previously failed to follow through with substance use programming. He does not regard his cannabis use as problematic; he has identified it as being an important element in his adherence to Rastafarianism.
Criminal History
- Mr. Depaul’s criminal history is set out in the Hospital Report as follows:
1992-06-03 Brampton ONT
Conspiracy to commit break & enter sec 465(1)(C) CC
Susp Sent & Probation 12 Mos
1992-09-10 Toronto ONT
Fail to Appear (Metro Toronto PF 3571-92)
Susp Sent & Probation 1 yr
2000-01-31 Brampton ONT
Poss of a weapon Sec 88(1) CC (Peel Reg PF OCC 174710- 99)
Time served (98 days) & Probation 2 yrs & Discretionary Prohibition Order Sec 110 CC for 10 yrs
2007-07-27 Brampton ONT
Uttering Threats Sec 264.1(1) (A) CC (Peel Reg PF 134381-07)
Time served (13 days) & Probation 1 yr & Discretionary Prohibition order Sec 110 CC for 5 yrs
2011-04-11
Assault
Suspended Sentence 6 mos probation
Psychiatric History
Mr. Drepaul was diagnosed with schizophrenia, paranoid subtype in 1996. Early symptoms of illness emerged in 1995: these included persecutory ideation, suspicions that his wife was cheating on him, suspecting that people could see him through the television, thought broadcasting and a belief that life forces were being transmitted through light in the form of rays similar to x-rays and that these rays were influencing his mind and body. Later in his illness, he went on to hear voices which did not tell him to hurt himself or anyone else, but which were critical of him.
Following the incident where Mr. Drepaul grabbed a knife in front of his wife and accused her of infidelity, he was admitted to METFORS in 1999 and was psychotic at the time. When police arrived on the scene, he refused to drop the knife, a refusal he later said was driven by the hope that the police would shoot him. They in fact did shoot him in the leg. As a result of the ensuing admission to METFORS, he appears to have developed the paranoid belief that the METFORS staff caused permanent alteration to his facial features.
Mr. Drepaul was treated with Risperidone from the outset of his illness with good effect. He has been admitted to hospital approximately five times with care on most occasions provided by the Peel Memorial Hospital in Brampton. From the outset of his illness, outpatient care has been provided by community psychiatrist, Dr. Acharyya.
Mr. Drepaul’s mother reported past instances of noncompliance with medication, estimating that he has stopped his Risperidone on about “five or six occasions”. She explained that he unplugs everything in his apartment and turns off all the lights whenever he has stopped his medication. She also said that he would turn furniture upside down and break mirrors because he did not want to look at himself. She recalled that he had stopped his medication in 2010, prior to the index offences.
Mr. Drepaul’s current diagnoses are:
Schizophrenia, in partial remission; and
Cannabis Use Disorder.
Evidence at the Hearing
The hospital's evidence was presented through its report dated March 4, 2025, and through the oral testimony of Dr. A. Igoumenou. This evidence is summarized below.
Dr. Igoumenou adopted the contents of the Hospital Report and stated that she has been Mr. Drepaul’s outpatient psychiatrist since January 7, 2025. By way of update, she advised that Mr. Drepaul was transferred to a forensic unit from a general psychiatry unit on March 18, 2025.
On February 24, 2025, the hospital was informed that Mr. Drepaul had been charged with choking his daughter while she was at his apartment. He was arrested, charged and taken to the station where he was processed. Mr. Drepaul contacted his case manager to report the charge and was then brought to hospital emergency.
With respect to the incident leading to the criminal charge, Dr. Igoumenou testified that Mr. Drepaul reported that he had had several calls with his daughter Monica that day, that she was irritable and verbally abusive with him and that she wanted to come to his apartment to pick up her cats which she did so at 9:00 p.m. that night. Mr. Drepaul was with his brother. After collecting her cats, Monica would not leave and Mr. Drepaul claims that there was a physical altercation to get her out, and that following this, she contacted the police.
Dr. Igoumenou maintains that the decision to bring Mr. Drepaul in was the least onerous decision to deal with the heightened risk brought about by this incident and the fact that Mr. Drepaul was presenting with some psychotic symptoms. The hospital is still trying to address those symptoms and optimize medication, as well as to assess him without cannabis use. Mr. Drepaul has been using cannabis on a very regular basis and the hospital believes that it does impact his mental health.
Dr. Igoumenou believes that it would be premature to discharge Mr. Drepaul today as he remains psychotic despite being treated with a long-acting injectable Abilify Trinza. The hospital is considering adding another antipsychotic medication but also want Mr. Drepaul to obtain psychological support to help him deal with the problematic relationship that he has with his daughter, Monica.
Mr. Drepaul has resided in the same apartment for approximately 10 years, which is paid through his ODSP. Mr. Drepaul actually left his apartment and moved in with his mother in the fall of 2024, as Monica was staying there and refused to leave, and he could no longer tolerate living with her. The treatment team feels that there should be limits to the contact between Mr. Drepaul and Monica, given their volatile relationship. In addition, the hospital must address the issue of risk to Mr. Drepaul’s daughter and granddaughter given the recent charges.
Mr. Drepaul has also disclosed that he has been using alcohol two to three times per month and that he understands that this is a breach of his Disposition. He also disclosed that he used mushrooms a few months ago. This is concerning to the treatment team given that mushrooms are hallucinogenic, and that Mr. Drepaul was experiencing hallucinations at the time of the index offences. Alcohol is also problematic due to its disinhibiting effect, and in the case of Mr. Drepaul, can lead to him acting out more quickly.
According to Dr. Igoumenou, Mr. Drepaul has no insight into the need for medication and has stated that if was no longer under an ORB Disposition, he would stop taking medications as he believes that they are physically harmful to him. On two occasions in the past calendar year, Mr. Drepaul refused to take his injection, which is given to him once every three months, meaning that he refused to take his long-acting antipsychotic 50 percent of the time in 2024.
Dr. Igoumenou is of the opinion that a detention order continues to be required in order to ensure that the hospital has the authority to approve accommodation and to assess the situation with the daughter, given their issues and the concern that she might return to the apartment. Dr. Igoumenou also believes that the Mental Health Act would not be sufficient to rapidly readmit Mr. Drepaul to hospital in the event of further decompensation. Dr. Igoumenou believes that community living continues to be appropriate and does not see Mr. Drepaul’s current admission as a lengthy one. The treatment team is focusing on optimizing medication and to encourage Mr. Drepaul to attend therapy as well as putting in safeguards against further violence.
Dr. Igoumenou also stated that stressors are a big problem for Mr. Drepaul, and that he has several in his life, including his relationship with Monica and his financial situation. The situation with Monica is currently resolved but Mr. Drepaul has been left with a considerable debt for a loan taken out by him to assist her with her consumer debt. Monica was supposed to pay back that debt but stopped making payments after several months. Mr. Drepaul has acknowledged that he will likely have to pay this debt on his own and this is a stressor for him.
In response to questions posed to her by counsel for the Attorney General, Mr. Waite, Dr. Igoumenou responded as follows:
a) She believes that Mr. Drepaul can be maintained in his current accommodation with more intense supports. The hospital is trying to balance the risks with the benefits of having Mr. Drepaul remain in the housing that he has had for close to a decade.
b) Dr. Igoumenou is not able to identify an exact timeframe for discharge but states that the treatment team will have a case conference after today and will begin planning for the next steps. She does not believe that the discharge is imminent but that it could happen within a few weeks.
c) Dr. Igoumenou is not able to confirm whether drugs and alcohol played a role in the incident resulting in the new criminal charge against Mr. Drepaul as it is not clear whether his presentation was due to having consumed substances. Mr. Drepaul remains symptomatic and can exhibit symptoms shortly after receiving his injection. The hospital would consider starting treatment with clozapine but would need Mr. Drepaul’s consent and cooperation for that.
d) Mr. Drepaul has a complex delusional system whereby he believes that his body has been altered by the medical professionals in his life. He also thinks that he can counter these effects with exercise. The hospital needs to optimize medication and introduce psychological counselling to help him with this.
e) The treatment team also acknowledges that Mr. Drepaul’s freedom is important to him, that he is capable of looking after his own needs and that his family is important to him. He also provides help to his aging mother.
f) In the opinion of Dr. Igoumenou, the risk assessment is not significantly altered by the recent criminal charges as the problematic relationship with Moncia is not new and it has been taken into consideration prior to the recent charge.
In response to questions posed to her by counsel for Mr. Drepaul, Mr. Rai, Dr. Igoumenou confirmed that Mr. Drepaul’s current accommodation is an independent apartment and that it will remain available to him despite his recent admission. Dr. Igoumenou also confirmed that Mr. Drepaul has not demonstrated any problematic behaviour since being in hospital.
In response to questions posed to her by members of the panel, Dr. Igoumenou responded as follows:
a) Mr. Drepaul has been involved in problematic interactions with his daughter for approximately the last 10 years. The hospital does believe that he was provoked by her following repeated phone calls and showing up at his apartment at 9:00 p.m. and then refusing to leave. The hospital thinks that this incident occurred because of a build-up of frustration with respect to his relationship with Monica. Mr. Drepaul was not assessed as being paranoid at the time of his admission. Mr. Drepaul’s daughter has long-standing behavioural issues.
b) Dr. Igoumenou confirmed that Mr. Drepaul had previously been charged with assaulting his granddaughter in May of 2022, which charges were withdrawn in October 2023. There was also a report to the Children's Aid Society about him smoking cannabis around his granddaughter.
c) Mr. Drepaul’s next court appearance is set for March 26, 2025, and it will be a virtual appearance. Dr. Igoumenou stated that though she has not requested a specific condition to address the contact between Mr. Drepaul and his daughter, Monica. The two are quite enmeshed and it is not obvious how to regularize or prevent contact between them if necessary.
d) Cannabis use does contribute and destabilize Mr. Drepaul’s illness. He is only at the pre-contemplative stage of wanting to meaningfully address his cannabis use which he sees as part of his religion. Mr. Drepaul reports that he only buys his cannabis from a dispensary and that he only buys products with a certain percentage of THC. Dr. Igoumenou acknowledged that this currently is an unmanaged risk factor.
e) Dr. Igoumenou confirmed that supervised accommodation could assist in managing this conflict as well as Mr. Drepaul’s cannabis use but that the hospital is not seeking a change to the Disposition in that regard at this time. In any event, the current Disposition would permit the hospital to insist that housing be supervised if it felt that that was necessary.
f) Dr. Igoumenou acknowledged that it could be helpful to have a clause in the Disposition which allows the hospital to monitor, control, or even prohibit contact between Mr. Drepaul and Monica when necessary and that it could be beneficial for this to be imposed by the ORB.
g) Mr. Drepaul has had one negative test for cannabis since being in hospital and given that he has been in hospital now for three weeks, his tests should continue to be negative for cannabis use.
h) Dr. Igoumenou confirmed that she believes that Mr. Drepaul’s rent is paid directly from his ODSP such that having to continue to pay the loan provided to his daughter should not jeopardize his housing.
- The hospital risk assessment is found at pages 31 to 34 of the Hospital Report and can be summarized as follows:
“If Mr. Drepaul were to re-offend, it would likely flow from some combination of ongoing use of cannabis in the context of either under-treatment or non-compliance with antipsychotic medication. If Mr. Drepaul were not subject to external controls, it is very likely that he would stop antipsychotic medication and continue to use cannabis, as has been his stated preference throughout this reporting period. He would become increasingly psychotic and agitated, resulting in an elevated risk of violent behaviour towards others, as has been the case for him in the past.”
- No other evidence was presented.
Submissions of Parties
The hospital submits that Mr. Drepaul continues to pose a significant threat to the safety of the public and that the maintenance of the current detention order, on the same terms and conditions, remains necessary and appropriate at this time. With respect to the restriction of liberty, the hospital submits that it was necessary and appropriate in the circumstances following the report that Mr. Drepaul had been charged with attempting to choke his daughter. The ongoing restriction also remains necessary and appropriate as the hospital continues to try to stabilize Mr. Drepaul and to optimize his medications and hopefully connect him with psychological counselling to assist him in dealing with the stressors in his life. Mr. McIntyre indicated that he did not have instructions from the hospital with respect to any no contact provision between Mr. Drepaul and his daughter.
Counsel for the Attorney General, Mr. Waite, submits that after hearing the hospital evidence he supports the recommendation of the hospital including that of accommodation approved given the hospital’s evidence and the fact that even under the current Disposition the hospital could decide to pursue supervised accommodation if it felt that it was required necessary.
Counsel for Mr. Drepaul, Mr. Rai, indicated his support of the hospital recommendation on both the annual and the restriction of liberty and further indicated that he was not making submissions on the addition of a non-contact provision given that he does not have instructions.
Analysis and Conclusion
Having considered all of the evidence presented at the hearing, and the submissions of the parties, the Board finds that Mr. Drepaul continues to pose a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code of Canada and as further defined by the Supreme Court of Canada in Winko v British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. This finding is based on the fact that Mr. Drepaul suffers from schizophrenia which is only in partial remission due to ongoing symptoms. He has minimal insight into his major mental illness and has clearly stated that he would stop taking treatment if he was not required to do so by his ORB Disposition. Mr. Drepaul has been involved in incidents of verbal and physical aggression since the index offences, the most recent incident with his daughter Monica having resulted in a criminal charge against him.
Mr. Drepaul was brought to hospital in order to address his violence risk and symptoms. The hospital is attempting to optimize treatment and trying to engage Mr. Drepaul in psychological counselling to assist him in better coping with the stressors in his life, including his very difficult relationship with his daughter.
The Board feels it appropriate to add a condition that permits the hospital to manage contact between Mr. Drepaul and his daughter, if needed for risk management. The hospital will have the authority to suspend that contact, when needed, which may make it easier to maintain boundaries. The Disposition shall otherwise remain unchanged, as it allows for the hospital to approve accommodation as it deems necessary. We have considered the factors set out in s. 672.54 of the Criminal Code, namely the protection of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society and his other needs, in coming to our decision that this is the necessary and appropriate, least onerous and least restrictive Disposition in all the circumstances.
With respect to the restriction of liberty, the hospital’s decision to significantly increase the restriction of Mr. Drepaul’s liberty by readmitting him to hospital following the incident with his daughter and ensuing criminal charges was reasonable and warranted, and in the circumstances, it represented the least onerous and least restrictive decision available at that time to manage the elevated risk. The ongoing restriction remains reasonable and warranted and least onerous and least restrictive to the extent that the hospital is prioritizing stabilizing Mr. Drepaul’s medication and introducing psychosocial counselling options with a view to not delaying discharge planning.
DATED this 6^th^ day of May, 2025, at the City of Toronto, in the Region of Toronto.
Ms. M. Labrosse
Alternate Chairperson
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Office of the Registrar
Ontario Review Board