Ontario Review Board
Re: B. (B.)
ORB File No: 7266
Hearing held on: Thursday, April 10, 2025
Place of Hearing: Southwest Centre for Forensic Mental Health Care
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. R. Bigelow Members: Ms. S. Clapp Dr. S. Swaminath Dr. M. Green Ms. C. Plyley
Parties Appearing:
Accused: B. (B.) Counsel: Mr. C. Dobson
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DISPOSITION
(Dated May 5, 2025)
Introduction
On November 29, 2017, B. (B.) was found not criminally responsible on account of mental disorder (NCR) on charges of invitation to sexual touching and break and enter contrary to the Criminal Code. He is currently subject to a disposition of the Ontario Review Board (the Board) dated April 23, 2024, ordering his detention at the Southwest Centre for Forensic Mental Health Care (the Hospital) with privileges up to and including residence in the community of Elgin or Middlesex County in supervised accommodations approved by the person in charge.
On Thursday April 10, 2025, the Board convened a hearing to review Mr. B. (B.)’s disposition pursuant to section 672.81(1) of the Criminal Code. Mr. B. (B.) was present at the hearing and represented by Counsel, Mr. Dobson. The issues to be determined at the hearing were whether Mr. B. (B.) continued to constitute a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, to determine the necessary and appropriate disposition that was also the least onerous and least restrictive taking into account the factors set out in section 672.54 of the Criminal Code.
Initial Positions of the Parties
At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. Counsel for the Hospital indicated that it was the Hospital’s position that Mr. B. (B.) continued to represent a significant threat to the public and that the necessary and appropriate disposition was a continuation of the current detention order without change.
Counsel for the Attorney General supported the Hospital position.
Counsel for Mr. B. (B.) indicated that he would not be contesting the issue of significant threat but would be submitting that, given his client’s progress, a detention order was no longer required and that his risk could be managed under the terms of a discharge on conditions. In the alternative, should the Board find that a discharge on conditions would not be appropriate, he would not be opposed to the terms being recommended by the Hospital for a detention order.
Evidence at the hearing
- The evidence at the hearing consisted of the Hospital Report dated February 4, 2025, a Psychology Assessment Report dated April 7, 2025, and the oral evidence of Dr. Arun Prakash, Mr. B. (B.)’s treating psychiatrist.
Findings:
- For the Reasons that follow, the Board finds that Mr. B. (B.) continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is a detention order without change to the terms and conditions of the current order.
Index Offences:
- The circumstances surrounding the index offences as summarized in last year’s Reasons for Disposition are as follows:
Briefly stated the index offences occurred when on July 26, 2017, the 12-year-old female victim was in her bed when she heard a knock on her bedroom door. The door then opened and she observed the accused standing at her bedroom door. He was not wearing a shirt. The victim asked him if he knew her mother and he replied yes. He then sat down on her bed, rubbed her thigh and her left leg and asked her do you want to have sex with me. The victim immediately rose from her bed, ran past the accused out of her bedroom and into that of her mother. Police were called.
Police found the accused shortly thereafter in the area. He unsuccessfully attempted to enter the door of another building when approached by the police and was arrested for the index offences. When interviewed by the police Mr. B. (B.) admitted the offences and stated that he initially broke into the residence for lodging and to satisfy his fetish for women's underwear. He further advised he had taken a pair of grey underwear from the victim's laundry hamper but dropped them at the bottom of the stairs as he was fleeing.
Background Information Regarding the Accused
- Mr. B. (B.) is currently 61 years of age and was born when his mother was 18 years old. His father left during his son’s first year of life and thereafter there was no contact until his father reconnected during Mr. B. (B.)’s teenage years. Mr. B. (B.) dropped out of school in grade 9 and has a limited employment history. Mr. B. (B.) and his mother advise that he suffered significant sexual trauma in his adolescence.
Substance Use History
- Mr. B. (B.) began using substances particularly PCP and methamphetamines at age 15. His substance use has had a significant impact on his life. He has been admitted to a number of treatment facilities over the years. He has also been admitted to hospital on numerous occasions where a significant contributing factor to the admission was substance use.
Legal History
- Mr. B. (B.) has a criminal record commencing in 1980 including convictions for break and enter, possession of narcotics for the purpose of trafficking, assault causing bodily harm, assault and being unlawfully in a dwelling house.
Psychiatric History
- Mr. B. (B.) has a history of involvement with community mental health clinics but had difficulty following through with treatment. He has also had several acute crisis psychiatric admissions to Bluewater Hospital in Sarnia.
Current Diagnosis
- Mr. B. (B.)’s current diagnoses are:
Schizoaffective Disorder
Substance Use Disorder
Sexual Disorder – Paraphilia
Intellectual Disability
Evidence of Dr. Arun Prakash
Dr. Prakash indicated that he was Mr. B. (B.)’s attending physician and had read and adopted the contents of the Hospital Report. He advised the panel that he had just received a Psychological Assessment Report which was marked as Exhibit 2 at the hearing. That assessment confirmed a diagnosis of paraphilia but indicated that he did not meet the criteria for a formal diagnosis of a sexual or paraphilic disorder although he does display a fetishistic sexual interest towards women’s underwear.
Dr. Prakash noted that there had been a recent incident where Mr. B. (B.) admitted to having used female underwear to masturbate. However, his admission was only after the matter came to the attention of staff. This incident conflicts with his assertions of having no sexual urges.
Dr. Prakash indicated there had been an improvement in Mr. B. (B.)’s mental health after increasing his clozapine in June 2024 and he was now relatively stable and experiencing minimal delusions. He had also made progress in terms of involvement in activities on the unit as well as DSO (Developmental Services Ontario) funded activities. He noted that Mr. B. (B.)’s last admission to hospital was from January to May 2022 when he used substances and relapsed quickly. It took a number of months in the hospital for Mr. B. (B.) to stabilize, and he had remained in the community subsequently.
Dr. Prakash indicated that while in the community Mr. B. (B.) needed 24/7 supervision due to his cognitive issues and the number of medications prescribed to him which he would have great difficulty managing on his own. He noted that Mr. B. (B.) is content at his current group home and trusts the home operator.
Dr. Prakash indicated that although in 2022 Mr. B. (B.) returned to hospital voluntarily, he was not sure that he would return voluntarily if experiencing a significant decompensation.
In response to questions from panel members Dr. Prakash indicated that before Mr. B. (B.)’s risk could be managed on a conditional discharge there would have to be an increase in his insight into the need for medication, the index offences, and his understanding of his risk of further offence.
Analysis and Conclusion, Significant Threat:
Although the issue of significant threat was not contested at the hearing, the Board nevertheless makes an independent finding that Mr. B. (B.) continues to represent a significant threat to the safety of the public. He suffers from a major mental illness, schizoaffective disorder, and is also diagnosed with a substance use disorder, paraphilia and suffers from an intellectual disability. Despite adherence to medication, underlying symptoms (delusions of sexual nature) continued to surface although to a lesser extent this reporting year. He is prescribed numerous medications both psychiatric and medical and would be unlikely to be able to manage medications on his own resulting in noncompliance, decompensation and violent ideation. His cognitive deficits limit his understanding of his need for treatment increasing the likelihood of future noncompliance unless closely supervised.
Absent the supervision of the Board there is a substantial likelihood that Mr. B. (B.) would fall away from treatment. This would result in a return to the use of substances and the development of symptoms of his illness similar to those present at the time of the index offences.
Analysis and Conclusion, Necessary and Appropriate Disposition
The Board finds that the evidence amply supports the conclusion that the necessary and appropriate disposition is a continuation of the current detention order without change to the terms and conditions. There is no air of reality to consideration of a discharge on conditions. In order to manage risk, the Hospital clearly needs the authority to approve accommodation in order to ensure that Mr. B. (B.) continues to be closely supervised, and the evidence is equivocal with respect to whether he would likely return to hospital voluntarily.
The Board notes that in prior reasons for disposition the importance of having a structural professional judgement assessment. This has not yet been done although the Hospital Report indicates that Mr. B. (B.) is currently on the waiting list for such an assessment. The Board encourages the hospital to prioritize this assessment which could have an impact on the assessment of his risk.
DATED this 5^th^ day of May 2025, at the City of Toronto, in the Toronto Region.
Robert Bigelow Alternate Chairperson
Office of the Registrar Ontario Review Board