Ontario Review Board
Re: Phillip Bettencourt
ORB File No: 7315
Hearing held on: Thursday, April 3, 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: Phillip Bettencourt
Counsel: Mr. P. Lewandowski
The person in charge of hospital: Counsel: Ms. P. Miltenburg
Attorney-General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated May 5, 2025)
Introduction
On February 26, 2018, Phillip Bettencourt was found not criminally responsible on account of mental disorder (NCR) on charges of aggravated assault, failure to comply with probation order, failure to attend court, and failure to comply with condition of judicial release, all contrary to the Criminal Code of Canada. He is currently subject to a disposition of the Ontario Review Board (ORB/the Board) dated September 5, 2024, detaining him at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre (ROH/the hospital) with discretionary privileges up to and including the ability to reside in the community in approved accommodation. The disposition also recommended a transfer of Mr. Bettencourt to the Tribunal Administratif du Quebec (TAQ), Province of Quebec, to be detained at the Centre Hospitalier Pierre-Janet, Gatineau, for the purpose of his reintegration into society and the recovery and treatment of the accused.
On April 3, 2025, the Board convened a panel to review Mr. Bettencourt’s disposition pursuant to s.672.81(1) of the Criminal Code. 1 Mr Bettencourt was present and represented by his counsel Mr. Lewandowski, who was appointed pursuant to s,672.5(8) of the Criminal Code.
At the outset of the proceedings, all parties were canvassed as to their positions on the two issues to be determined by the Board: whether Mr. Bettencourt continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition having regard to the criteria set out in s. 672.54 of the Criminal Code.
Ms. Miltenburg, on behalf of the hospital, submitted that Mr. Bettencourt remains a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order. Further, the hospital recommended that the conditions be modified to allow Mr. Bettencourt indirectly supervised passes to travel to Gatineau, Quebec and the ability to reside in approved accommodation there. The hospital also recommended a condition allowing Mr. Bettencourt to travel up to 14 days within Ontario and Quebec with an itinerary approved in advance.
Ms. Dufort, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions. Mr. Lewandowki specifically conceded that Mr. Bettencourt remains a significant threat to the safety of the public and ultimately agreed with the hospital’s positions.
Findings
- For the reasons that follow the Board finds that Mr. Bettencourt remains a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current detention order with the expansion of privileges as recommended by the parties.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated February 13, 2025 (ex, 1), the Consent of the Attorney General of Ontario, dated January 28, 2025 (ex.2), the Consent of the Attorney General of Ontario, dated March 20, 2025 (ex.3), and correspondence from Dr, Labelle, of the Pierre-Janet Hospital in Gatineau, dated October 28, 2024 (ex.4).
The Index Offences
- A summary of the index offences is taken from the Reasons for Disposition, dated October 16, 2024:
Aggravated Assault and Failure to Comply with terms of a Probation Order (May 24, 2017)
“On May 24, 2017, at around 11:30 a.m., Mr. Bettencourt approached Mr. Geoffrey Piché, an individual unknown to the accused, outside of the Shepherds of Good Hope in Ottawa…[In video surveillance capturing the offence], Mr. Bettencourt is seen walking on the sidewalk towards the parking lot area near the sidewalk where Mr. Piché was standing. Mr. Bettencourt is seen waving his arms and clapping his hands as if upset about something and he appeared to be looking at Mr. Piché the entire time. According to the police repot Mr. Bettencourt was yelling at Mr. Piché as he approached him. In the police report, it is reported that Mr. Bettencourt threw the victim to the ground, causing him to land on his head.
Officers followed up with Montfort Hospital staff about the condition of Mr. Piché. He had suffered from a cut below his right eye, as well as bleeding and swelling. The emergency room physician advised officers that she was concerned that Mr. Piché might have some kind of internal bleeding or possibly even a facial fracture.”
Mr. Bettencourt is also before the Ontario Review Board on three counts of failing to comply with a court order. On June 12, 2017, he failed to attend court. On August 4, 2017, he failed to report to his bail supervisor, and on August 15, 0217, he breached a condition to reside at the Ottawa Mission.”
Background Information
The Hospital Report contains detailed information about Mr. Bettencourt’s background and psychiatric history and need not be reviewed here but for the following material points. Mr. Bettencourt resided in Gatineau with his parents and younger brother. According to his mother, her husband was an alcoholic and would become abusive towards her when intoxicated, often in the presence of her sons. Mr. Bettencourt’s brother also suffers from Schizophrenia.
According to his mother, Mr. Bettencourt was diagnosed with Attention Deficit and Hyperactivity Disorder (ADHD) when he was in Grade 2 and was prescribed Ritalin. He began to experience difficulties in school around the age of 14 and, when he was 16, he quit school. He had several brief manual labour jobs. He continues to be supported by the Ontario Disability Support Program.
The Hospital Report indicates that Mr. Bettencourt started using drugs in his late teens, in particular, cocaine and then amphetamines. He has a criminal record that includes convictions for theft, break and enter, drug related offences, including trafficking, uttering threats and multiple convictions for failing to comply with court orders.
According to hospital records, Mr. Bettencourt had a psychiatric assessment at the Centre
Hospitalier Pierre-Janet (CHPJ), in November 2010. At the time, he exhibited symptoms of depression, paranoia and self-harming behaviours. His brother and parents were worried about him and had called for police to bring him to the emergency room. Upon admission, Mr. Bettencourt was talking about seeing visions, masks and reported feeling watched and followed. He believed that people wanted to beat him up. Mr. Bettencourt was treated with antipsychotic medication and eventually discharged with a diagnosis of Amphetamine Use Disorder and Amphetamine-Induced Psychosis.
Mr. Bettencourt’s next admission to hospital was in late 2017. He had been found unfit to stand trial on the index offences and was admitted pursuant to a Treatment Order. He had not been taking his prescribed medication for some time and was exhibiting significantly disorganized thinking and paranoid delusions. He remained quite psychotic and thought disordered even after several weeks of high doses of antipsychotic medication.
Following his NCR finding, Mr. Bettencourt remained in hospital. He was engaged in programming and groups and began to set realistic goals for himself. He also was able to gain some perspective and appreciated the impact of cannabis use on the deterioration in his brother’s mental status and increased presence of psychotic symptoms. It appeared to motivate Mr. Bettencourt to achieve abstinence.
Mr. Bettencourt was discharged to reside in the Grove Transitional Residence in January 2019. He continued to be compliant with medication and participated well in activities at the residence. He also continued to be abstinent from any drugs, and all of his urine drug screens were negative. In September he found a job as a dishwasher at a local bakery. In October, he moved into an independent apartment that was within the Grove program.
In November 2020, Mr. Bettencourt told the treatment team that he had consumed cocaine when visiting an old friend. He demonstrated no symptoms of psychosis. In December he tested positive for cocaine. He was warned of the risk of relapse of psychosis and that a further relapse could result in him losing housing or being readmitted to hospital. Unfortunately, Mr. Bettencourt’s drug use increased. His urine drug screens were positive for cocaine and cannabis.
In April 2021, Mr. Bettencourt’s mother contacted the treatment team to express concern about a deterioration in her son’s mental health resulting from substance use. She reported that he would spend his ODSP money on drugs, sometimes within three days. Attempts by the team to contact Mr. Bettencourt were unsuccessful and information from his pharmacy indicated that he had not been filling his prescription.
By early 2022, Mr. Bettencourt moved on from the Grove satellite program and was
accepted to the Forensic Supportive Housing Program (FSHP) operated by the Salus
corporation. The rent supplement that he had for his apartment as a participant of the Grove program would be continued under the FSHP program.
All the 11 urine samples that Mr. Bettencourt provided in 2022 tested positive for methamphetamine, cocaine metabolites and cannabis. There was concern that his financial situation was being impacted. Although he continued to have his funded apartment in Ottawa, he spent most of the year residing with his mother in Gatineau. This was in breach of his disposition as his mother’s residence had not been determined to be an approved accommodation.
In anticipation of a transfer of his care to CHPJ, Mr. Bettencourt began to receive shared psychiatric care in that hospital in Gatineau, in cooperation with his treatment team in Ottawa. That arrangement stopped in June 2023 when Mr. Bettencourt was no longer able to reside with his mother. The treating psychiatrist at CHPJ shared concerns about Mr. Bettencourt’s presentation with his treatment team.
The treatment team found it very challenging to assess Mr. Bettencourt’s mental status as there was little contact between his appointments for his long-acting injectable antipsychotic medications. However, he was appropriate and pleasant with nursing staff and would deny experiencing any psychiatric symptoms.
Over the course of the year Mr. Bettencourt continued to be in breach of his disposition and the treatment team experienced difficulty in monitoring his risk in the community. There were several Form 49’s issued for Mr. Bettencourt to be brought to hospital for an assessment. He remained on the waitlist for admission to the forensic inpatient unit for much of the year. Unfortunately, bed shortages prevented his admission.
In the Hospital Report, Dr. Strike made the following observation at p.53:
At every encounter, I assessed his ability meet criteria for involuntary admission under the Mental Health Act, hoping to admit him to another hospital. However, he never even came close to meeting criteria to be certified. He therefore remained on the very long forensic admission waitlist, while the outpatient team worked hard to motivate him to attend his appointments, follow his disposition, abstain from substances, and increase his antipsychotic medication.
In addition to failing to report to his treatment team, Mr. Bettencourt repeatedly failed to meet with his FSHP case manager, accommodate home visits, and complete the required annual paperwork to maintain his apartment. He officially lost his rent supplement and case management with the Salus corporation in November 2023, causing his housing costs to increase substantially. Notwithstanding this development, Mr. Bettencourt remained calm and pleasant when interacting with his treatment team. He stated an intention to abstain from substances but for cannabis as he found that it was helpful for his mental health. He believed he would be able to stop using stimulant drugs without the need for hospital admission or residential treatment.
In February 2024, Mr. Bettencourt was brought to hospital pursuant to a Form 2 under the Mental Health Act. He had been several weeks overdue for his injection. He presented as argumentative with psychomotor agitation. He stated that he did not want to receive his injectable antipsychotic medication. He reported that he had been using cocaine three times weekly, amphetamine (“speed”) two to three times weekly, cannabis daily, and alcohol occasionally. His urine toxicology screen was positive for cocaine, amphetamine, methamphetamine, and cannabis. He initially insisted upon stopping his antipsychotic medication, stating that he had read several books at the library and had thereby concluded that he does not have schizophrenia, nor did he ever have psychosis.
In April 2024, Mr. Bettencourt’s mother reached out to the treatment team, concerned for her son’s mental stability in the context of substance use and concerned about his aggression towards her. She reported that in February 2024, he has squeezed her wrist hard and broke her broom when he was upset and under the influence of substances. She had called police and Mr. Bettencourt had fled before they had arrived.
Mr. Bettencourt was brought to hospital pursuant to another form 49 that had been issued to Ottawa Police Services on the morning of Monday May 6, 2024. He was admitted to the secure forensic assessment unit and eventually transferred to the less secure forensic rehabilitation unit on June 17, 2024.
Course Since the Last Disposition
- Mr. Bettencourt’s current diagnoses are:
Schizophrenia, multiple episodes, currently in full remission
Antisocial personality disorder
Cocaine and amphetamine-type stimulant use disorders, severe
Cannabis use disorder, severe
He is currently receiving injections of Aripiprazole depot every 28 days.
Mr. Bettencourt remained on the Forensic Rehabilitation Unit for the latter part of 2024 and then was transferred to the Crisis Inpatient Unit in early January 2025. This transfer was required due to the forensic unit’s significant bed shortages.
Since his admission, Mr. Bettencourt has been compliant with his antipsychotic medication and no mood or psychotic symptoms have been noted. He states that he is committed to remaining on his medication indefinitely in order to keep his schizophrenia in remission.
Mr. Bettencourt has participated in a six-week virtual Concurrent Disorders Unit program. He continues to benefit from attending self-help recovery meetings. He reports that he no longer experiences cravings and plans to abstain indefinitely from substances of all kind. All his urine drug screens have been negative. In Dr. Strike’s opinion, Mr. Bettencourt is
genuinely intrinsically motivated to abstain from substances in order to maintain his recovery lifelong.
Mr. Bettencourt has been exercising 12-hour daily passes in the community, indirectly supervised. He hopes to complete his high school diploma and then pursue an apprenticeship in the trades. He also hopes to transition into an independent apartment but appreciates that he may need to transition to a semi-supervised accommodation in the interim. He hopes to achieve both of those goals in Gatineau. His mother remains very supportive and has expressed a desire for Mr. Bettencourt to exercise overnight passes to visit with her on weekends.
Dr. Strike testified before the Board. She congratulated Mr. Bettencourt for his sustained abstinence. She reiterated that it is evident that his motivation to abstain is intrinsic and not dependent on the disposition from the Board.
Unfortunately, bed shortages have again impacted on Mr. Bettencourt. He was transferred to the Secure Forensic Assessment Unit (FAU) on March 7, 2025, through no fault of his own. It was due to a lack of bed spaces. While on the FAU, patients are not able to exercise passes to the same extent as on other units. Within a few days, he was transferred to the Forensic Rehabilitation Unit (FRU) and his privileges reinstated. Mr. Bettencourt took this setback well.
Mr. Bettencourt has taken the initiative in a number of areas. He has started going through the process of obtaining his driver’s license. He has applied for the Quebec equivalent to OHIP and has taken steps to have his ODSP transferred to the Quebec social assistance program. Notably, Mr. Bettencourt has investigated appropriate accommodations in the Gatineau area and has found a transitional residence, Maison Realité, which supports people with mental health and addiction issues. Mr. Bettencourt is awaiting a disposition that will allow him to travel to Gatineau and attend adult high school classes.
Dr. Strike testified that Mr. Bettencourt’s mother continues to be his main source of support in the community. Mr. Bettencourt’s visits to her home in Gatineau, where she continues to reside with her other son, have gone exceptionally well. She has expressed a desire to have him home more often, including overnight passes.
Dr. Strike testified that the transfer of Mr. Bettencourt’s case now has been approved by the Attorney General in Quebec. She made several efforts to contact the doctor at CHPJ who had previously treated Mr. Bettencourt. No response had been received as of the date of the hearing. Dr. Strike was unable to provide any information as to when the transfer could be effected as there could be an issue with bed availability.
Dr. Strike testified that Mr. Bettencourt’s insight into his mental illness and the need for treatment is excellent. He has remained compliant with treatment and there have been no symptoms or instability noted. Mr. Bettencourt has taken the initiative in his own recovery. He has started to attend Narcotics Anonymous meetings in the community and is using community resources to support his ongoing stability.
Dr. Strike indicated that the hospital required the ability to approve Mr. Bettencourt’s accommodation. His residence is critical to his stability. Mr. Bettencourt has shown insight into the benefit of residing in a supportive residence before transitioning to his own apartment.
In the doctor’s opinion, there continues to be a need for oversight. Should Mr. Bettencourt relapse into noncompliance with treatment or substance use, he exercises poor judgement which is directly related to his risk for violence. If a relapse occurs, the treatment team would intervene early and urgently in order to prevent a decompensation in Mr. Bettencourt’s mental status.
Dr. Strike testified that the hospital requires a detention order in order to bring Mr. Bettencourt to hospital for an assessment. Historically Mr. Bettencourt has been resistant to admissions to hospital. Further, it would take a long time before he would be certifiable under the Mental Health Act. A Form 49 would allow the hospital to bring Mr. Bettencourt to hospital if he was using substances and assess whether an admission was necessary in order to manage his risk to the safety of the public.
In response to questions from Ms. Dufort, Dr. Strike indicated that Mr. Bettencourt has started the process with Maison Realité. The treatment team will assist him in completing a full application, including obtaining the necessary reports and financial supports. Apparently, the wait list for the residence is relatively short, approximately one month from the date of acceptance.
All parties maintained the joint submission.
Analysis and Conclusion
The Board has carefully considered the Hospital Report and the evidence of Dr, Strike and unanimously concludes that Mr. Bettencourt remains a significant threat to the safety of the public. His risk flows from his diagnosis of Schizophrenia. When untreated and/or in the context of substance use, Mr. Bettencourt has experienced persecutory delusions and disorganized thinking that has led him to assault members of the public. The index offence included significant unprovoked violence perpetrated upon an innocent person. The consequences could have been much worse. More recently, Mr. Bettencourt has been aggressive, both verbally and physically, with his mother. As such he remains a significant threat.
Having found that Mr. Bettencourt 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 includes 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 finds that the necessary and appropriate disposition is a detention order. We accept that Mr. Bettencourt’s accommodation is critical to his stability in the community. Mr. Bettencourt did well when residing at the Grove supportive residence. Unfortunately, his return to substance use and his increasing detachment from the treatment team occurred when he was residing in his own apartment. At this stage in Mr Bettencourt’s recovery, the hospital requires the ability to ensure that he is residing in accommodation appropriate to his needs.
Further, the Board finds that the provisions of the Mental Health Act would not be sufficient to manage Mr. Bettencourt’s risk should he suffer a deterioration in his mental status. The detention order is needed to intervene quickly in the event of decompensation, which could be triggered by his substance use. Historically, he has been resistant to a readmission to hospital. Over the past few years, Dr. Strike has considered the availability of the MHA to bring him to hospital for an assessment and concluded that he did not meet the test. Finally, the hospital requires the ability to hold Mr. Bettencourt in hospital, should he be admitted, to ensure that he regains stability and the appropriate supports are engaged.
Mr. Bettencourt has taken significant steps in his recovery and reintegration into the community. He has started the process of transitioning his care and supports to Gatineau. It is unfortunate that the approval process for his transfer has taken so long. To that end, the Board agrees that the least onerous and least restrictive disposition that is necessary and appropriate includes the ability for Mr. Bettencourt to exercise passes in and eventually reside in the Gatineau community.
Accordingly, the Board orders that Mr. Bettencourt be subject to a detention order with the ability to exercise indirectly supervised passes in the Gatineau/Ottawa area and further that he have the ability to reside in approved accommodation, and the ability to travel up to 14 days within Ottawa and Quebec with an itinerary approved in advance so that he can have overnight visits with his mother and brother.
DATED this 5^th^ 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