Ontario Review Board
Re: Mathieu Thibeault
ORB File No: 7943
Hearing held on: Wednesday, February 26, 2024
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Section 672.81(1) the Criminal Code
Before:
Alternate Chairperson: Ms. M. Labrosse
Members: Dr. S. Lessard
Mr. D. Sandor
Ms. K. Brisson
Parties Appearing:
Accused: Mathieu Thibeault
Counsel: Ms. M. Lord
Person in charge of hospital: Representative: Dr. M. Strike
Attorney-General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated May 1, 2025)
Introduction
On September 13, 2021, Mathieu Thibeault, was found not criminally responsible on account of mental disorder on charges of assault with a weapon, performing an indecent act in a public place and failure to comply with an undertaking to appear for fingerprints, contrary to the provisions of the Criminal Code of Canada. He is current subject to a disposition of the Ontario Review Board, dated February 29, 2024, detaining him at the Secure Forensic Unit, Royal Ottawa Mental Health Centre (hereinafter referred to as “the Hospital”) with privileges to live in the Hospital’s catchment area in accommodations approved by the person in charge and with conditions that include that of abstaining from the non-medical use of alcohol or drugs and that of submitting samples for the purpose of monitoring his level of compliance with the abstention provision.
On February 26th, 2025, the Ontario Review Board convened a hearing at the Hospital to conduct an annual review of that disposition. The proceedings took place in the French language with a bilingual panel. Mr. Thibeault attended his hearing and was represented by his lawyer, Ms. M. Lord.
The record for the hearing included the Notice of Hearing, the most recent Disposition mentioned above and the Reasons for that Disposition. On the consent of all parties, a Hospital Report dated February 3rd, 2025, was entered into evidence as an exhibit.
The parties were canvassed for their without prejudice positions at the beginning of the hearing. The Hospital took the position that Mr. Thibeault continued to represent a significant threat to the safety of the public as that term is defined in section 672.5401 of the Criminal Code and as it is further explained by the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), [1990] 2 S.C.R. 625. It further took the position that a continuation of the reigning detention disposition, with some increase of privileges was necessary and appropriate having regard to the objectives set out in section 672.54 of the Criminal Code.
The representative of the Attorney General joined the Hospital in that initial position. Counsel for Mr. Thibeault conceded the threshold issue of significant threat subject to the Board’s independent determination but expressed initial concern that a detention disposition was not minimally intrusive and that any risk posed by Mr. Thibeault could be appropriately managed under the terms of a conditional discharge.
For the reasons set out below, the Board agrees that Mr. Thibeault continues to represent a significant threat to the safety of the public. It has further concluded that a detention disposition is necessary to manage that threat but that he has made such progress over the course of the last reporting period that it is appropriate to grant him extended privileges within the body of that detention disposition.
Evidence at the hearing
The evidence at the hearing came in the form of the Hospital Report mentioned above and the live evidence offered by Dr M. Strike and by Mr. Thibeault himself.
Turning first to the Hospital Report, it is cumulative in nature and includes a summary of the index offences as set out in last year’s Reasons for Disposition.
“August 3, 2021, Incident
On Tuesday, August 3, 2021, the accused entered the Loblaws Supermarket located at 363 Rideau Street, in the City of Ottawa. Having been banned by security the previous day for allegedly stealing a1coho~, the accused was immediately recognized by Loss Prevention Officer Jared FINLEY. The accused proceeded to walk through the store to a display of beer in the northwest corner of the store. The accused began selecting numerous cans of 473 mL Laker ice beer and concealing these items in his pant pockets. The accused was confronted by FINLEY, who removed the cans of beer from his hands. The accused was instructed to leave and escorted towards the front entrance of the store while still in possession of two cans. of 473 ml Laker ice beer in his pants pockets. The accused proceeded down the front steps towards the exit, while FINELY and a female security officer monitored from the top of the stairs. The accused reached the bottom of the stairs, turned towards FINLEY, and intentionally removed his genitals from his pants with his right hand. He then intentionally exposed his genitals to FINLEY the female security officer, and two adult customers entering the store. The accused proceeded to shake his genitals for approximately 2 seconds while staring at FINLEY in a blatant attempt to insult and offend him before leaving the store. This offence took place in broad daylight and at a time when the store was heavily populated with families and customers of all ages, who had to both enter and exit the store through this main entry point leading on to Rideau Street. Rideau Street is a major artery for vehicular and pedestrian traffic within Ottawa coming in and out of the Byward Market area and was heavily populated at the time of the offence.
Incident August 21, 2021
On Saturday, August 21st, 2021, the accused was lying in the road. A concerned citizen called Ottawa Paramedics, as the accused appeared to be malnourished and unwell. Paramedics arrived at the intersection of Queen Mary Street and North River Road. The victim, Natalie GRAHAM, in the role of a paramedic, attempted to speak to the accused to assess him and provide aid if necessary. The accused provided his name to paramedics, and that he had missed his bus this morning to Quebec. Paramedics asked the accused where he resided, at which point he began shouting and getting upset. The accused began shouting in French and repeating his name multiple times. The accused began gathering his belongings on the street, one of them being a large pair of orange handled scissors. The victim immediately upon noticing the scissors, stepped back and avoided the first stabbing motion from the accused, however, the accused was successful with a second stabbing motion and struck the victim on the right thigh. The accused attempted to throw the scissors down a street drain, however, he was unsuccessful, and the scissors were. later recovered by Ottawa Police Services. The accused then ran away northbound on North River Road.”
Mr. Thibeault’s personal history is set out in detail in the Hospital Report and was outlined in last year’s Reasons for Disposition. He is 33 years of age and is from La Malbaie, Quebec. He grew up with a supportive family though he reportedly struggled with behavioral issues as a child that led to some difficulties with his schooling. He has struggled with homelessness since the age of fifteen and has a lengthy history of substance use that includes cannabis and speed. In addition to having a reportedly lengthy criminal record, Mr. Thibeault has indicated that he has “practically tried every drug,” including cannabis, stimulants, crystal meth, Fentanyl, heroin, LSD, and ecstasy.
Mr. Thibeault has also suffered difficulties associated with at least two traumatic injuries. In 2014 he suffered head trauma after being hit by a bus. A few years later, in Brampton, he was hit by a car, resulting in further injury. Complications led to infections and further surgeries on his left leg. Even so, he has attempted over the years to maintain some employment income, working in construction, delivery and kitchen work.
In terms of mental illness, Mr. Thibeault received his first diagnosis of psychosis when he was nineteen. According to the Hospital Report, he has reported that he “always” suffered from hallucinations and had been prescribed several antipsychotic medications, including injectables, over the years. He reported several hospitalizations in Quebec and Toronto. The Hospital Report sets out a long and concerning history of major mental illness.
Mr. Thibeault’s current diagnoses are:
Bipolar disorder unspecified or related to consumption
Attention deficit hyperactivity disorder (ADHD)
Mild neurocognitive disorder resulting from traumatic brain injury
Cannabis, alcohol, opiate, and amphetamine use disorder.
The Hospital Report’s update for the purposes of this hearing begins at page 58. In positive terms it explains that Mr. Thibeault has done very well abstaining from the use of substances over the course of this reporting period. Urine screenings have consistently come back negative for all substances and there have been no reports of suspected substance use from either the treatment team or staff at the group home where he now resides. Mr. Thibeault has also expressed a desire to maintain compliance with his treatment regime though he does still require reminders and prompting in this regard. While for the first half of this review period he struggled with conflict with other residents at the group home, the Case Management Study beginning at page 63 of the Hospital Report explains that he has been working with the treatment team to avoid conflict and cope more effectively with issues involving his family. He has followed the recommendations of the treatment team regarding balancing his work schedule with his mental health and other needs and has, particularly over the last half of the review period, been punctual and dependable with weekly meetings.
The Hospital Report explains that Mr. Thibeault has been making good effort regarding the pursuit of his General Education Diploma. He has engaged in volunteering and, in terms of employment, has woken up as early as 4 AM to get himself to “day labour jobs”. His case manager explains through the Hospital Report what the goals are for the next review period. They include continued abstinence from substances, the development of a larger network of natural, positive social relationships, increased time with employment and career planning, the development of skills needed for daily independent living (Mr. Thibeault yet resides in a group home that provides a measure of supervision and support), physical activity and increasing insight into his mental health and need for medications.
The Hospital Report also provides a Psychotherapy Summary at page 65. It says that Mr. Thibeault still struggles with attention and emotional regulation. His sense of urgency is often heightened by emotional distress leading to impulsive reactions on his part. His psychotherapy to this point has sought to help him acquire new strategies to recognize, challenge and manage his anger and anger-related cognitive distortions so as to restructure them in more constructive ways. To his credit, Mr. Thibeault has begun incorporating relaxation strategies that include aspects of mindfulness. This has helped him to pause and regulate himself before reacting. He is being strengthened in his awareness of boundaries so as to avoid frustrations and in the short period prior to the hearing had implemented cognitive diffusion strategies. Throughout this, Mr. Thibeault has remained actively engaged and appreciative of the guidance and instruction being given. His attendance has greatly improved compared to the last reporting period, and he has been manifesting less irritability and difficulty with collaborating.
The Hospital Report explains that, moving forward, anger management will remain an important aspect of Mr. Thibeault’s therapy. This is appropriate given the significant difficulties encountered with other group-home residents over the first half of this reporting period. It is important to maintain Mr. Thibeault’s progress given the Board’s primary objective to ensure the safety of the public, and the other objectives associated with Mr. Thibeault’s mental health and other needs, including the ultimate objective of reintegration into the community.
The Hospital Report incorporates a Violence Risk Assessment at page 67. In concluding that Mr. Thibeault represents a moderate risk for future violence (a noted improvement from the Violence Risk Assessment relied upon at the time of his last annual review), the Hospital Report places the positive developments in positions of prominence. Mr. Thibeault has improved on clinical risk factors. He has not presented with primary symptoms of major mental illness. He has however continued to have difficulties with rules and with medication compliance. There is concern that his difficulties with following rules and with treatment compliance increase when Mr. Thibeault struggles with anger management or engages in the use of substances. Risk for him is still present in stressful situations that require him to adapt to circumstances. The Hospital Report goes on to specify Mr. Thibeault’s re-offence scenario:
Son scenario de risque de violence le plus probable n’a pas changé. Il pourrait proférer des menaces de mort, de santé physique ou d’agression environnementale (comme un méfait) dans un contexte de fixation de limites par des figures d’autorités ou d’un conflit interpersonnel, particulièrement lorsqu’il se sent incompris. Cela constituerait une colère affective et réactive où il devient émotionnellement dérégulé et perd le contrôle de son comportement, ce qu’il a démontré au moins une fois par semaine depuis qu’il suit le programme de médecine légale. Son autre scénario de récidive est un comportement agressif motivé par des pensées délirantes, qui pourrait survenir en raison de l’oubli de doses de médicament, d’une consommation accrue de substances ou d’une combinaison de ces deux déstabilisateurs.
Regarding housing, the Hospital Report explains that an “accommodations approved” condition remains appropriate and necessary to manage Mr. Thibeault’s risk of aggression. It describes a risk of impulsivity associated with Mr. Thibeault’s desire to move towards independent living. It highlights again in the context of approved accommodations that Mr. Thibeault requires direct support when it comes to taking his antipsychotic medication, noting that, even with supports in a group home setting there were frequent missed doses over the course of this review period. It explains plans to transition Mr. Thibeault to transitional supervised housing at the Grove, where he would benefit from increased supports to ensure that Mr. Thibeault receives his oral medications as prescribed. Staff at the Grove would also help supervise Mr. Thibeault’s efforts to abstain absolutely from the use of substances. They would help with management of his anger, impulsivity, and management of his finances.
Dr Strike’s evidence to the Board largely corresponded with the contents of the Hospital Report. She highlighted Mr. Thibeault’s participation in groups and his continued efforts to abstain from the use of substances. She expressed some concern over an occasion when Mr. Thibeault used cannabis as he dealt with stresses associated with a change in his approved accommodations. She addressed times described in the Hospital Report when Mr. Thibeault struggled with conflict with co-residents at the group home he lived in. She confirmed that Mr. Thibeault receives his antipsychotic medication orally and that he requires supervision and use of a blister pack to encourage him to remember to take his medications. She confirmed that, at this stage, Mr. Thibeault is reliant upon that support. She expressed concern that independent living would leave him without the supports necessary to ensure good compliance with Mr. Thibeault’s medication regime. Mr. Thibeault experienced side effects with long acting injectables in the past that have caused him to resist recommendations of a transition away from oral medications.
Dr Strike spoke of the efforts underway to reintegrate Mr. Thibeault into the community. This included advocating with the Grove in the hopes that Mr. Thibeault would be able to maintain some level of employment while residing there. Dr Strike explained that sufficient progress has been made such that it is no longer necessary or appropriate to provide for the potential transfer of Mr. Thibeault’s ORB file to the Tribunal Administratif du Québec. She explained that he has become integrated into the Ottawa community and has discovered that several of his contacts in his region of Charlevoix, Quebec are negative for him.
In response to questions from the representative of the Attorney General, Dr Strike addressed a concern associated with lottery winnings retrieved by Mr. Thibeault over the course of this review period. While he had won $50, 000.00, little of that money remained after only a year had passed. Dr Strike acknowledged that this was concerning given Mr. Thibeault’s historic struggles with substances and his diagnosis. She expressed concern over the level of Mr. Thibeault’s gambling in this context. When asked whether she considered it likely that Mr. Thibeault could move to independent living in the next year, her answer was in the negative. She explained that Mr. Thibeault needed significant supports around his antipsychotics and continued abstention from the use of substances. She expected that he would continue to receive those supports at the Grove group home before transitioning next to LeBreton residence. She said that those supports were necessary given Mr. Thibeault’s brain injury, struggles with bipolar disorder, ADHD, and ongoing challenges with addictions. She indicated that while Mr. Thibeault has good intentions regarding medication, he requires supports when it comes to remembering to take them.
Dr Strike expressed concern that, absent a detention disposition, there was a likelihood that Mr. Thibeault would abandon plans relative to the Grove in favor of independent living. She worried about Mr. Thibeault’s impulsivity when under stress in this regard. She also worried that, absent the supervision the Grove will provide, Mr. Thibeault would forget to take his medications, re-engage in the use of substances as a response to stressors, and suffer a decompensation that would expose the public to significant threat. She also expressed concern over the possibility of a conditional discharge naming the Grove as a place of residence, noting that this would likely prove to be more restrictive than the detention disposition being proposed, given the likelihood that Mr. Thibeault will change his residence from the Grove over the course of the next review period.
In response to questions from counsel for Mr. Thibeault, Dr Strike adopted the contents of the Hospital Report regarding positive progress in the domain of Mr. Thibeault’s engagement and involvement with the treatment team, particularly since fall, 2024. In addressing the period early in 2024 when Mr. Thibeault used cannabis to deal with the stresses associated with delay in transitioning to the Grove, Dr Strike agreed that he did not show primary symptoms of psychosis. She explained that while Mr. Thibeault appreciates the supports the Grove offers, he has repeatedly expressed a desire for independent living. She highlighted again the services offered by the Grove that made it suitable for Mr. Thibeault. This included supervision of his medications and ensuring that he has his own room to avoid conflict with co-residents.
When asked by the panel what she would need to see over the course of the next review period to recommend a conditional discharge, Dr Strike emphasized the importance of following the recommendations of the treatment team, continuing to abstain from substances, managing anger and frustrations without further admissions to the Hospital and improvement in taking his medications. She indicated an intention of working with Mr. Thibeault around accommodations and indicated that good decisions by him in that regard would also support a future request for a conditional discharge.
As mentioned, Mr. Thibeault also testified. He expressed appreciation for the services and accommodation offered by the Grove. He also expressed appreciation for Dr Strike and the Hospital, saying that they had “saved his live.” He indicated that, if asked to, he would attend at the Hospital. He acknowledged that, at this time, he was not ready for independent living.
Submissions
At the end of the hearing, the Hospital renewed its submission that Mr. Thibeault continued to represent a significant threat to the safety of the public and that a detention disposition with expanded privileges was the necessary and appropriate disposition having regard to the provisions of section 672.54 of the Criminal Code. She highlighted the good progress Mr. Thibeault has made over the last review period without taking away from the concerns noted over the course of her evidence.
The representative of the Attorney General agreed with the Hospital. While she also acknowledged the progress Mr. Thibeault has made, she argued in favor of the detention disposition with increased privileges having regard to the need to bring Mr. Thibeault into the Hospital quickly given challenges on the evidence with impulsivity and forgetfulness surrounding the taking of his medications. She addressed the importance of providing Mr. Thibeault with support given expected transitions in his accommodations.
Counsel for Mr. Thibeault conceded the issue of significant threat to the safety of the public but argued that a conditional discharge was necessary and appropriate when considering the principle of minimal intrusion and the objectives of section 672.54 of the Criminal Code. She noted Mr. Thibeault’s desire, as expressed in this hearing, to go to the Grove where he would have his own room, and the supports described by Dr Strike. She pointed to the improvements seen in attendance and punctuality over the course of this last review period and to the positive therapeutic alliance between Mr. Thibeault and the treatment team, all as factors weighing in favor of a conditional discharge.
Analysis and Conclusion
As stated, the panel agrees that Mr. Thibeault continues to represent a significant threat to the safety of the public. In arriving at this conclusion, the panel was mindful that the threshold finding of significant threat is an onerous one. It is insufficient to conclude that an individual represents a significant threat to the safety of the public simply on the basis that the individual struggles with a major mental illness. Individual factors associated with major mental illness may not be sufficient to lead to the threshold finding where there is not logical link to a real risk that the public will be exposed to significant physical or psychological harm in the absence of a disposition. A panel cannot conclude the threshold has been met where there is a low risk of occurrence, but a high risk of significant harm should something occur. Similarly, it is insufficient to ground the threshold finding on a high likelihood of offending conduct that only exposes the public to low risk of harm.
Benefitting as it did from the helpful joint submission in this regard, the panel relies upon several factors in concluding that the threshold of significant threat has been met. Mr. Thibeault struggles with a major mental illness that was a primary factor in the commission of serious index offences. While he has made strides in abstaining from the use of substances, his history of decompensating substance use is troubling, as is his acknowledged history of involvement with the criminal justice system. He continues to struggle with medication compliance driven by his neurological difficulties and continues to struggle with impulsivity and aggressivity when responding to stressful situations. The re-offence scenario described in the Hospital Report, set out above, maintains its air of reality when one considers these factors together with problems Mr. Thibeault has had with co-residents at his place of approved accommodations, relapse into use of cannabis earlier in the review period, and repeated noncompliance with his oral antipsychotics. The Board is convinced that the joint submission that Mr. Thibeault represents a significant threat to the safety of the public is appropriate on the evidence.
Turning to the issue of disposition, it is the panel’s conclusion that it is premature to grant Mr. Thibeault a conditional discharge, but that the progress he has made does render it appropriate to grant him increased privileges in the context of a detention disposition. When considering disposition, the Board must turn its mind to the least intrusive option available to it that complies with the objectives set out in section 672.54 of the Criminal Code. These include, as a primary objective, ensuring the safety of the public, and the objectives of ensuring that Mr. Thibeault’s mental health and other needs are met, including the ultimate objective of reintegration into the community. The Board must be able to articulate why those objectives cannot be met under the auspices of a conditional discharge.
In Mr. Thibeault’s situation we have an individual that has admittedly made strides over this review period. He has shown improved engagement with the treatment team. His punctuality and reliability in keeping appointments has significantly improved. He has testified of improved appreciation for the Hospital and the treatment team, inclusive of Dr Strike. He indicates a desire to live at transitional housing made available to him at the Grove 24-hour supervised residence. He has worked over this review period at part-time employment, volunteering, and education.
The difficulty the Board has with a conditional discharge is two-fold. Firstly, in the context of a relapse to the use of cannabis in response to stressors in the initial portion of this review period, and noting the lengthy history of struggles with major mental illness and substance use that have contributed to both serious index offences and history with the criminal justice system, it is our opinion that a longer period of abstinence and engagement is required before we can conclude that the provisions of the Mental Health Act will be sufficient to manage the risk posed by Mr. Thibeault. The evidence was unchallenged that, when exposed to stressful situations that require adaptation, Mr. Thibeault struggles with aggressivity and impulsivity. The Hospital must be able to intervene quickly to manage any impulsivity that may arise as Mr. Thibeault transitions to new accommodations and from there further on his trajectory towards independent living in the community.
Secondly, Mr. Thibeault continues to struggle with treatment compliance driven by his ADHD and neurological difficulties. He requires high levels of support and supervision if he is to take his oral medications as prescribed. While it is expected that the Grove will provide this level of support, Mr. Thibeault, at the time of the hearing, had not yet taken up accommodations at that residence and the evidence is that it is expected that he will further transition from the Grove towards increased independent accommodations over the course of this review period. It will be necessary for the Hospital to be able to return him quickly to the supportive environment that he says “saved his life” should he return to inconsistency in the taking of his medications and start to demonstrate impulsivity and aggressivity towards the treatment team and others. The panel is concerned that, in that setting, Mr. Thibeault’s current therapeutic alliance will be compromised. The Hospital will require the ability to return him on a form 49. Mr. Thibeault’s insight into signs of decompensation has yet to be evaluated in an environment of increased independent living. His history to this stage does not support the conclusion that, in that state, he would accept an invitation to attend at the Hospital.
Mr. Thibeault, meanwhile, is on a positive trajectory. He has been testing negative for substances, has engaged well with groups, has identified negative influences in his home community in Quebec, has improved relations with his family, and has been able to identify how important his treatment team and the Hospital is for management of his major mental illness. This all supports an expansion of his privileges and gives hope for further progress towards a form of discharge over the course of the coming review period. It also warrants the removal of terms from the last disposition that contemplated, at that time, Mr. Thibeault’s potential transfer to Quebec and the jurisdiction of the Tribunal Administratif du Québec.
The Board congratulates Mr. Thibeault for his accomplishments to date and wishes him the best over the course of the coming year.
An order will issue accordingly.
DATED this 1st day of May 2025, at the City of Toronto, in the Toronto Region.
Mr. D. Sandor Legal Member
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Office of the Registrar
Ontario Review Board