Re: Thomas F. Brailsford
ORB File No: 5896
Hearing held on: Wednesday, March 26, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(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: Thomas F. Brailsford Counsel: Mr. J.R. Collins
The person in charge of hospital: Counsel: Ms. A. Marshall
Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION
(Dated May 7, 2025)
Introduction
On June 15, 2011, Thomas Brailsford was found not criminally responsible on account of mental disorder on a charge of first-degree murder, contrary to the Criminal Code of Canada.
Mr. Brailsford is currently subject to a Disposition of the Ontario Review Board dated April 24, 2024, which detains him at the Forensic Service of the Centre for Addiction and Mental Health with permission to live in 24 hour a day supervised accommodation approved by the person in charge.
On March 26, 2025, the Ontario Review Board convened a hearing at the Centre for Addiction and Mental Health, Toronto, hereinafter referred to as “CAMH” and/or the hospital, to review Mr. Brailsford's Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Brailsford was present for his hearing, represented by counsel, Mr. John Richard Collins. A Hospital Report dated March 7, 2025, was entered as Exhibit 1 for the hearing.
The issues for this hearing are whether Mr. Brailsford 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 enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below, the Board finds that Mr. Brailsford continues to pose a significant threat to the safety of the public and that the maintenance of the current Disposition remains necessary and appropriate at this time.
Index Offence
- The index offence is summarized in last year's Reasons for Disposition at paragraph 5 and reads as follows:
“On June 30, 2010, Mr. Brailsford, who had a long history of illness and treatment for schizophrenia, with symptoms including paranoia, killed his mother in a delusional belief that she was a follower of Lucifer. He called the police, and they arrived to find his mother dead, and her head severed from her body. Mr. Brailsford was arrested and was noted to be extremely compliant. He told the police what he had done and why. He also expressed an apparent delusional belief that a man in a neighbouring apartment had killed two individuals and was armed with a laser.”
Background History
Mr. Brailsford's personal, legal, and psychiatric history are set out in detail in the Hospital Report. Briefly summarized, Mr. Brailsford is 64 years of age and was born in Toronto and raised in Clarkson, Ontario. He is the youngest in a sibline of three and has two older sisters. His parents separated when he was approximately five years old, after which he lived primarily with his mother and saw his father alternate weekends and one night per week.
Mr. Brailsford did not complete high school and stopped attending in grade 12 to take a job at Goodyear Tire where he worked for less than a year.
Mr. Brailsford reports having used hashish and/or cannabis regularly during his teens. He also experimented with harder drugs but does not appear to have had substances use issues as an adult. There have been no concerns regarding the use of alcohol or drugs since Mr. Brailsford has been under the purview of the ORB.
The Hospital Report sets out Mr. Brailsford's criminal history which includes charges of false alarm of fire mischief in 2009 and charges of assault and utter threats of death in 2010.
Psychiatric History
Mr. Brailsford’s psychiatric history goes back to 1981, after his eldest sister noticed changes in him and took him to see their family doctor. He was subsequently admitted to the Etobicoke General Hospital and continued with a day program after his discharge. He was diagnosed with schizophrenia, paranoid subtype. He was initially treated with depot fluphenazine and oral chlorpromazine. His medications were changed several times under different doctors. Mr. Brailsford claims not to have been hospitalized again until 2005, when he was admitted to St. Joseph’s Hospital.
The Hospital Reports sets out the details of a number of subsequent admissions to St. Joseph’s Hospital and Toronto Western Hospital, leading up to the index offence in 2010.
Mr. Brailsford's current diagnoses include Schizophrenia in partial remission and Cannabis Use Disorder in full sustained remission.
Evidence at the Hearing
The hospital's evidence was presented through its report and through the oral testimony of Dr. Roland Jones who has been Mr. Brailsford’s attending psychiatrist on Unit 3-2.
Dr. Jones has been Mr. Brailsford’s attending psychiatrist since January of 2024. Dr. Jones adopted the contents of the Hospital Report and corrected the information on page 2 of the Hospital Report that Mr. Brailsford is currently on a secure forensic unit not on a general forensic unit. Dr. Jones advised that there were no material updates to the report.
Mr. Brailsford was first admitted to CAMH on July 5, 2011, and has remained in hospital since then. He has been transferred between general and secure units and has a history of elopements, the last of which occurred November 26 to 28, 2022.
Mr. Brailsford currently has Level 4 passes (being escorted passes in to the community) which he was not using much until recently. He is moving towards Level 5. Level 5 would allow for indirectly supervised hospital grounds access to attend programming throughout the hospital. Mr. Brailsford is currently completing the training offered to him on how to utilize that pass level. Dr. Jones indicated that the treatment team is aware that ORB hearings are stressful for Mr. Brailsford and that they wanted to wait until after the hearing to have him start exercising the Level 5 privileges, to ensure that he is in a good state when he starts using them.
The next move for Mr. Brailsford would be a transfer to a general unit and this will be possible once he is deemed to be using his level 5 and level 6 privileges appropriately. Once on a general unit, the treatment team would start to plan his discharge to the community.
Dr. Jones stated that though Mr. Brailsford is ready for transfer to a general unit, he is somewhat reluctant to make that move as transitions are difficult for him. It has been difficult for the treatment team to motivate Mr. Brailsford to attend programming and to avail himself of his privileges.
Dr. Jones added that the treatment team is very aware of Mr. Brailsford's history of elopements and that they are preparing him very carefully for this transition.
With respect to the history of elopements, Dr. Jones explained that these incidents happened out of the blue and there were no indications that this was going to happen. With respect to the last elopement in 2022, Mr. Brailsford was on a general unit getting ready for discharge and that the incident of elopement may have been caused by the anxiety that he was experiencing regarding the upcoming discharge. Hospital staff are alerted to watch out for signs of possible planned elopements, which can include a patient taking out more cash than usual or preparing a change of clothes.
With respect to participation in programming, Mr. Brailsford has attended some recreational programming including music and cooking-related unit-based programs. Mr. Brailsford has demonstrated some improvement in better participating in the unit-based programs in the last few weeks.
In response to questions posed to him by counsel for the Attorney General, Mr. Feindel, Dr. Jones stated that Mr. Brailsford does not use computers and does not tend to spend time reading. He will go into the community 1:1, mostly to Tim Horton's or Shoppers Drug Mart and has also attended some group outings. In the last month, Mr. Brailsford exercised seven 1:1 passes in the community and nine passes on hospital grounds. Mr. Brailsford does not participate in any of the group outings. Dr. Jones acknowledged that it may be helpful to give Mr. Brailsford an AWOL protocol in the event that he elopes again.
In response to questions posed to him by counsel for Mr. Brailsford, Mr. Collins, Dr. Jones responded as follows:
a) He confirmed that relapse prevention programs are not indicated for Mr. Brailsford at this time, given the remoteness of his substance use history.
b) With respect to Mr. Brailsford's unauthorized leaves from the hospital, the last one having occurred in 2022, Dr. Jones indicated that it is difficult to access Mr. Brailsford thought content at that time. Though he is prepared to sit down and talk, he has never really given an explanation as to why he eloped. Dr. Jones does not believe that Mr. Brailsford was feeling discouragement around his lack of progress but rather that the AWOL may have been intended to slow down the discharge.
c) Dr. Jones does not believe that Mr. Brailsford's reluctance to take opportunities to move forward is rooted in a problem of institutionalization, as he has stated that he is content with being in hospital and is grateful for the support, preparation of meals and structured living arrangements.
d) Dr. Jones acknowledged that the goal of forensic rehabilitation is that of reintegration into the community. The hospital has always maintained that goal for Mr. Brailsford; however given the very serious index offence, Mr. Brailsford’s serious mental illness, and persistent negative symptoms that have manifested themselves by a lack of motivation have delayed achieving the goal of community reintegration.
e) The hospital hopes that the move from a secure unit to a general unit will motivate Mr. Brailsford to work towards his discharge from the hospital. The fact that he remains to this day on a secure unit is due to his lack of motivation and not necessarily a sign of his institutionalization.
f) A move to the general unit will be dependent on his use of level 5 and level 6 privileges which he is poised to start as he has utilized escorted passes without any problems and has just completed the level 5 training.
g) There exist multiple housing options which will be explored once he gets on the general unit. Though he is currently on a generalized list for supportive housing Mr. Brailsford has not had his needs evaluated to the point where he is ready to be added to specific housing waitlists.
- In response to questions posed to him by members of the panel, Dr. Jones responded as follows:
a) Mr. Brailsford has recently made use of more passes which Dr. Jones believes may be in part related to the warmer weather though it is positive to see him do so.
b) Mr. Brailsford does not describe experiencing any anxiety in social situations though his negative symptoms of his illness do play a part.
c) Cognitive testing suggests that Mr. Brailsford’s cognition is somewhat impaired, but Dr. Jones does not believe that this impairs his general memory and functioning, but more so his abstract thinking.
d) Mr. Brailsford remains symptomatic at some level, but this is unlikely to change with treatment. He experiences low grade hallucinations and does not report them as being problematic. Dr. Jones believes that his current dose of clozapine is optimized though Mr. Brailsford does experience some side effects. Despite being on a low dose, his serum levels are at a therapeutic level. ECT has been ruled out because of cardiac issues.
e) Dr. Jones confirmed that strategies for preventing elopement and indicators for elopement will be communicated to the team on the general unit. Rehabilitation efforts will also be increased on the general unit.
f) Dr. Jones believes that Mr. Brailsford’s family members, including his mother's sister and her husband who were present at the hearing, are not having contact with him and are not open to having any.
g) With respect to the timing of a transfer to a general forensic unit, Dr. Jones stated that Mr. Brailsford could be ready for a move to a general unit in approximately two months or so, provided that he utilizes his passes. There is not generally a long waitlist for such a transfer.
h) Dr. Jones stated that Mr. Brailsford has not expressed much interest nor has he been forthcoming about engaging in psychological counseling or Cognitive Behavioural Testing.
In response to a question arising from counsel for the Attorney General, Mr. Feindel, Dr. Jones confirmed that discharges to the community can exceptionally be done from the secure unit, but these are usually in the case of severe intellectual disabilities or medical issues where a discharge will bypass a transfer to a general unit.
No other evidence was presented.
Submissions of the Parties
The hospital submits that Mr. Brailsford 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 the necessary and appropriate disposition for the coming year.
Counsel for the Attorney General, Mr. Feindel, adopted the hospital recommendation and added that it is positive to see some improvement in Mr. Brailsford’s presentation in the last few weeks but that it is clear that Mr. Brailsford’s lack of progress is not the result of a lack of effort on the part of the hospital.
Counsel for Mr. Brailsford, Mr. Collins, stated that the transfer to the general unit will prepare Mr. Brailsford for discharge and that it is hoped that the hospital will do everything possible to move him forward. Mr. Collins reiterated his concerns that Mr. Brailsford’s lack of motivation could be tied to institutionalization.
Analysis and Conclusion
Having considered all of the evidence presented at the hearing and the submissions of the parties, the Board finds that Mr. Brailsford meets the threshold of significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code 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.
Mr. Brailsford has a long history of major mental illness, namely paranoid schizophrenia for which he has been receiving treatment for more than forty years. His illness has been difficult to treat and while experiencing psychotic symptoms, he acted out in extreme violence and killed his mother.
Mr. Brailsford has made little rehabilitative progress over the years and has never been discharged since being first admitted in 2011. Mr. Brailsford remains symptomatic, despite being on a therapeutic dose of clozapine. The hospital has recommended that he participate in psychological counseling and CBT; however, Mr. Brailsford demonstrates no interest in pursuing any psychosocial programming but for a few recreational endeavours. His insight is described as superficial.
Mr. Brailsford has a history of eloping from hospital, most recently in 2022, when he left the hospital and was brought back after 2 days.
The hospital continues to work with Mr. Brailsford to help him progress through the forensic rehabilitation system and there some recent optimism that Mr. Brailsford may be moving towards another transfer to a general unit, where discharge planning would start.
Having considered the four 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, the Board finds that the current detention order, on the same terms and conditions, remains the necessary and appropriate and least onerous and least restrictive disposition in all of the circumstances.
DATED this 7^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