Ontario Review Board
Re: Dylan Gilbert
ORB File No: 8697
Hearing held on: Wednesday, April 2, 2025
Place of hearing: Brockville Mental Health Centre
Pursuant to: Section 672.47(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. T. Mann
Dr. R. Kunjukrishnan
Dr. A. Gibas
Ms. M. den Haan
Mr. M. Hajek
Parties Appearing:
Accused: Dylan Gilbert
Counsel: Ms. K. Irwin
The person in charge of hospital: Representative: Dr. J. Gray
Attorney General of Ontario: Counsel: Ms. C. Breault
REASONS FOR DISPOSITION
(Dated May 27, 2025)
Introduction:
On December 20, 2024, Dylan Gilbert was found not criminally responsible on account of mental disorder on charges of Uttering Threats and Breach of Probation, contrary to the Criminal Code of Canada (“Criminal Code”).
The Court ordered that the matter of a disposition be referred to the Ontario Review Board (“the Board”) for an initial hearing.
On April 2, 2025, the Board convened a hearing at the Brockville Mental Health Centre (“the Hospital”) to conduct Mr. Gilbert’s initial hearing pursuant to s. 672.47(1) of the Criminal Code. Mr. Gilbert was present at the hearing and represented by his counsel, Ms. K. Irwin. Ms. C. Breault was present on behalf of the Attorney General and Dr. J. Gray was present on behalf of the Hospital. Also present at the hearing was Ms. A. Leeming, a psychometrist and PhD candidate who conducted a risk assessment of Mr. Gilbert.
The issue for determination at this hearing is whether Mr. Gilbert represents a significant threat to the safety of the public as defined in s. 672.5401 of the Criminal Code. If Mr. Gilbert is so found, the necessary and appropriate disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
Counsel for the Hospital, the Attorney General and Mr. Gilbert were joined in recommending that Mr. Gilbert be found to represent a significant threat to the safety of the public and that a detention disposition order upon the terms set out in the Hospital Report was necessary and appropriate. All parties maintained their original positions in their closing submissions.
For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that Mr. Gilbert represents a significant threat to the safety of the public, and that the necessary and appropriate, least onerous and least restrictive disposition is that of a detention disposition order upon the terms and conditions set forth in its formal disposition.
Index Offences:
- The circumstances giving rise to the index offences are set out in the Hospital Report dated March 17, 2025 and made Exhibit 1 at the hearing, as follows:
Synopsis:
On the evening of March 4, 2024, the victim, Edward GILBERT, received two phone calls on his personal cellular phone. The caller name was displayed as Providence Care Hospital.
The victim was aware that his estranged son, the accused, Dylan GILBERT, had been secured in the facility due to various criminal acts, including offences against himself as well as his wife, Janet GILBERT.
The victim ignored both calls, as he and his wife had ceased any and all communication with the accused due to his historical aggressive and violent behaviour. When the victim returned home, he had two voicemails on his cellular phone. Both voice messages were from the accused who made mention of cocaine, and the threat to return to their home and kill them both. The accused mentioned stabbing them both to death before going to sleep afterwards.
Both victims, Janet and Edward GILBERT were extremely upset and disturbed by the threats adding that they live in constant fear of the accused and routinely barricade their front and back door with large pieces of lumber as the accused had forced his way into their home on more than one occasion.
The accused was also on two separate Probation Orders, including the condition to Keep the Peace and be of Good Behaviour.
The accused was charged with two counts of Uttering Death Threats as well as two counts of Failing to Comply with his Probation Order.
Background:
The Hospital Report provides detailed information concerning Mr. Gilbert’s personal and mental health history, and his course in hospital following his admission. As such, it is not necessary to reproduce it in full in these Reasons. Some relevant factual findings are provided below for context in the making of the panel’s decision. It should however be noted that Mr. Gilbert was assessed as being an unreliable historian due to the pervasiveness of his delusional thought content. As such, the veracity of information elicited from him in clinical interviews is uncertain.
Mr. Gilbert is currently 29 years old and is the youngest of three siblings. He resided with his parents until that relationship broke down due to his mental health issues and substance use. He was unable to access shelters due to being banned for having caused extensive property damage and was homeless for approximately two years prior to the index offences. Currently his parents have ceased all contact with Mr. Gilbert due to his aggressive behaviour, uttering threats and destruction of property. He is estranged from his siblings.
Mr. Gilbert attended school until Grade 10 before leaving, reportedly due in part, to having been bullied. While at school he was diagnosed with a learning disability and auditory processing challenges. Records indicate he had an Individualized Education Plan and was involved in a Speech Language Program. Mr. Gilbert was also diagnosed with ADHD and took Adderall. Information in the Hospital Report indicates that Mr. Gilbert may have been on risperidone for many years as originally prescribed by a paediatrician but this has not yet been independently verified.
Mr. Gilbert began using substances at a young age, reporting that he would binge drink by consuming 12 tall cans of beer or a “mickey” of vodka in a short time. Mr. Gilbert endorsed using cocaine, speed, fentanyl, methamphetamine and heroin. Urine drug screens completed during multiple hospital contacts as an adult indicated that Mr. Gilbert often tests positive for cannabis. Hospital records indicate that Mr. Gilbert has reported experiencing shakes when abstaining from alcohol use but did not follow through with a referral to “rehab” made in 2021.
Mr. Gilbert’s criminal record is outlined on pages 25- 26 of the Hospital Report. It shows many convictions for mischief under $5000 and failure to comply with probation orders.
Mr. Gilbert has a significant psychiatric history including numerous mental health hospitalizations beginning in 2021, the chronology of which is outlined in part on pages 5-12 and 27-29 of the Hospital Report. Mr. Gilbert, when unwell, is described in the Hospital Report (page28) as follows:
When actively psychotic and experiencing auditory hallucinations and/or delusional thoughts, Mr. Gilbert appears to express somatic delusions and believes that his parents were poisoning and/or harming him throughout his life and intended to kill him. These have resulted in repeated instances of impulsive aggression and threats towards his parents and others whom he has reported mean to harm him.
Mr. Gilbert’s more recent psychiatric history prior to the NCR finding includes his being hospitalized at Brockville General Hospital on September 8, 2021 after expressing a number of delusional beliefs including having a microchip in his brain which allowed others to communicate and control him. His diagnosis at that time was “Psychosis NYD” and “rule out Schizophrenia, Alcohol Hallucinosis, Drug-Induced Psychosis”.
Mr. Gilbert was again hospitalized at Brockville General Hospital on October 23, 2021 after being placed on a Form 1 by the emergency room physician. Police had transported him to hospital after he had been found on a park bench drinking alcohol and yelling at people. While at hospital he became agitated, caused property damage and was charged criminally as a result. He had been homeless for several months after conflict with his parents over his substance use.
By March 2022 Mr. Gilbert was incarcerated and the attending psychiatrist had diagnosed him with Schizophrenia-spectrum disorder. Following further assessment by Dr. A. Corona, Mr. Gilbert was diagnosed with “Unspecified Schizophrenia Spectrum and other Psychotic Disorder” within the context of “intellectual disability and substance use”.
On April 14, 2022, Mr. Gilbert had a third presentation at Brockville General Hospital. He was brought there by his worker from the Court Diversion Program of Lanark Leeds Grenville Addiction and Mental Health who had found him disorganized, agitated, exhibiting signs of auditory and visual hallucinations and talking about wanting to die. On that occasion he was treated and permitted to leave without admission to the hospital as he was not opined to be a violence risk at the time nor was he thought to have any sustained psychosis when not under the influence of drugs or alcohol.
In addition to these hospital attendances, a number of reports were prepared by Dr. T. Hassan of Providence Care in Kingston in 2023 and 2024 on the issues of Mr. Gilbert’s fitness to stand trial and his eligibility for a defense of not criminally responsible on various charges including five counts of mischief and failure to comply with probation order. In his report dated July 17, 2023, Dr. Hassan diagnosed Mr. Gilbert with Schizophrenia and Substance Use Disorder (crystal methamphetamine).
Mr. Gilbert was discharged from Providence after the July 17, 2023 assessment but on July 21, 2023 was transported by police to Kingston General Hospital after being found on the roof of a building and indicating he was planning to commit suicide. He was admitted to the psychiatric unit and, after further assessment by Dr. Hassan, readmitted to Providence Care.
Ultimately, Dr. Hassan opined that Mr. Gilbert was both fit to stand trial and criminally responsible in connection with his charges. Dr. Hassan’s impression at the time was that Mr. Gilbert’s main issue was the lack of a place to live and that he destroyed property or engaged in “some sort of crime” to get arrested and have shelter in jail.
On September 12, 2024, Mr. Gilbert saw Dr. K. Mascioli through the Secure Treatment Unit Outpatient OTN clinic. Mr. Gilbert told Dr. Mascioli there was a chip in his brain and that his parents were out to get him but was uncertain as to why. He voiced not feeling in control of his thoughts. Dr. Mascioli endorsed the diagnoses made by Dr. Corona in March 2022 of “Unspecified Schizophrenia Spectrum and other Psychotic Disorder in [the] context of an intellectual disability and substance use”. At that time, Mr. Gilbert was on an injectable antipsychotic medication, paliperidone (Invega) Sustenna, with his next dose due at the end of September also on sertraline (an antidepressant which has anxiolytic properties).
Overall, Mr. Gilbert’s psychiatric and substance use history reflects a pattern which is described on page 28 of the Hospital Report as follows:
“Mr. Gilbert's history of offending and admission to hospital appears to follow a pattern of substance use and decompensation of mental health symptoms, increased suicidality and psychotic symptoms [including delusional thinking and auditory hallucinations], then admission to hospital where he engages in destruction of property and mischief. It appears that Mr. Gilbert has been repeatedly prescribed antipsychotic medication but that this has not been followed through adequately upon discharge in the community, resulting in a cessation of medication use and an eventual resurgence of symptoms, [thus] repeating the pattern.
- When mentally stable, Mr. Gilbert presents as a pleasant and cooperative individual. He has acknowledged being addicted to substances and worries about ending up in the same cycle of substance use and crime. He voices a strong desire to abstain from substances and would like help with this. However, he does not believe that he threatened his parents and continues to harbour many delusional and persecutory beliefs about them Additionally, Mr. Gilbert has expressed some concerning violent ideation and desires especially with respect to gun culture and targeting his parents with deadly force (see pp 29-30 and 36 of the Hospital Report for further particulars).
Progress in Hospital after NCR Finding:
Mr. Gilbert’s course in hospital following his admission to the Forensic Treatment Unit on November 18, 2024 and subsequent NCR finding on December 18, 2024, has not been without incident as outlined on pages 22 and 23 of the Hospital Report.
On December 14, 2024, Mr. Gilbert pushed an elderly resident from behind causing the resident to fall to the floor and sustain some minor injuries. Mr. Gilbert presented as acutely agitated by his psychotic symptoms, shouting “get them out of my head” while banging on the wall. He was unable to settle even with staff intervention and had to be secluded for a short period of time. He asked for and received medication to help him settle. Prior to settling, he kicked holes in the seclusion room walls.
Mr. Gilbert was also secluded on December 21, 2024 and then again on January 2, 2025 after he destroyed property in the common room. He was shouting and flipping tables; he ripped the phone off the wall, shattering it. He lunged at a staff member. Physical intervention and chemical restraints were required to control his behaviour. Several staff members were needed to carry him to a locked seclusion room and to provide an intramuscular injection to help him settle.
Since that time, Mr. Gilbert has not exhibited any management problems, nor has he been physically or verbally aggressive.
Overall, Mr. Gilbert has been compliant with medications since the NCR finding but continues to experience symptoms. The Hospital Report notes that he has on many occasions asked for increases in his medication and is open about reporting hallucinations. He recognizes the hallucinations as symptoms of his mental illness but his insight into his illness is only partial at this time as he continues to believe that his family works for the mafia and that various people are out to get him.
Because of the lack of improvement in his paranoid ideation and reports of hallucinations despite full compliance with his medication regimen, a trial of clozapine was proposed. Mr. Gilbert consented and received his first dose on January 29, 2025. Thus far, Mr. Gilbert has not reported any side effects and is happy to continue to take it. However, as of the date of the Hospital Report, he had not experienced any reduction in the frequency or intensity of the voices. There has more recently been an absence of volatile behaviours by Mr. Gilbert which might be a result of being switched to clozapine. Mr. Gilbert will continue to be monitored for any positive effects of this medication on his psychotic symptoms.
Current Psychiatric Diagnoses:
- Mr. Gilbert is diagnosed with Schizophrenia and Alcohol and Cocaine Use Disorders – in full remission in controlled environment.
Evidence at the Hearing:
The Board had the benefit of receiving information from the Hospital Report, Mr. Gilbert’s CPIC report dated March 17, 2025 (Exhibit 2) as well as oral evidence from Mr. Gilbert’s forensic psychiatrist, Dr. J. Gray. In providing his oral evidence, Dr. Gray first endorsed the contents of the Hospital Report including the risk assessments and conceptualizations contained at pp 34-39 and then provided the Board with an update as to Mr. Gilbert’s progress since March 17, 2025.
Dr. Gray noted Mr. Gilbert’s past involvement with the legal system involved offences that were not particularly violent save for the index offences which involved threats. Nevertheless, Mr. Gilbert presents with many risk factors associated with violence, as enumerated in Ms. Leeming’s risk assessment report which is reproduced in full in the Hospital Report.
Dr. Gray advised that Mr. Gilbert has continued to do quite well overall, notwithstanding some of the aggressive and destructive behaviours that occurred in December 2024 and in early January 2025, prior to the initiation of clozapine. Mr. Gilbert has been polite and cooperative with staff and never opposed taking his medication.
Dr. Gray described Mr. Gilbert’s insight into his illness as partial. While he mostly admits to having a diagnosis of Schizophrenia, vacillating only sometimes, he lacks insight that the content of his delusions are not reality-based. Dr. Gray explained that the problem with delusions is that they are encoded in the brain at a time when an individual is psychotic and as such seem real to that individual. The doctor said it takes time to revisit those old memories and to challenge them in a meaningful way, which is why he does not expect Mr. Gilbert to have full insight this early in his tenure under the Board.
Mr. Gilbert continues to take clozapine and his dose was recently increased to 400mg per day from 300mg per day, as Mr. Gilbert’s serum blood level showed a sub-therapeutic level despite full compliance. Mr. Gilbert continues to be quite happy being on clozapine and has not mentioned any side effects, which is positive. Dr. Gray feels Mr. Gilbert’s symptoms are showing some degree of amelioration, but it continues to be early days and there is room for improvement which is likely to come over time.
Dr. Gray outlined the rationale behind the Hospital’s request for a fairly broad range of privileges, including indirectly supervised access to hospital grounds and in the community as well as the possibility of living in supervised accommodation. Dr. Gray expects that Mr. Gilbert might well be ready to be discharged to the community towards the latter part of the coming year, hopefully to the FITT residence on the grounds of the Hospital, but will not be ready to live independently as there is still much work to be done to further his recovery. Dr. Gray is not worried that Mr. Gilbert will pose an elopement risk, given Mr. Gilbert’s historical aversion to being homeless and his overall level of contentment in hospital.
In view of Mr. Gilbert’s continued animosity towards his parents, Dr. Gray recommended that there be a no-contact provision with the possibility of revocation by them should their relationship with their son progress to that point over the year. Currently, Mr. Gilbert’s parents have not responded to various efforts by the treatment team to contact them and Mr. Gilbert himself has not expressed any interest reaching out to them himself. At this juncture, Mr. Gilbert’s aversion to his parents is somewhat of a protective factor as it is currently operating to keep him from trying to contact them. Dr. Gray indicated that the treatment team will continue its efforts to engage Mr. Gilbert’s parents.
Dr. Gray supported the inclusion of a condition in the disposition requiring Mr. Gilbert to abstain from substances as well as to submit samples for testing and indicated that a prohibition on possession of weapons was appropriate to mitigate risk.
No other evidence was called.
Analysis and Conclusions:
Significant Threat:
Having heard and considered the entirety of the evidence as well as the submissions of the parties, the Board finds that Mr. Gilbert’s current constellation of symptoms and behaviours is such that he poses a significant threat to the safety of the public. In coming to its conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Gray and the clinical, actuarial and structured professional judgment risk assessments set out in the Hospital Report beginning at page 34.
Mr. Gilbert’s risk flows from his diagnoses of Schizophrenia and Alcohol and Cocaine Use Disorder. These illnesses, acting together or separately, make him vulnerable to acting out in a seriously criminal and violent fashion when sub-optimally treated, psychotic, and under the influence of intoxicating substances. The Board adopts the following conceptualization of risk as set out at p. 38 of the Hospital Report:
“At this time, Mr. Gilbert falls in the MODERATE/HIGH risk range for violent recidivism in the community. There are several factors which will affect Mr. Gilbert’s risk for future violence. Under his current level of supervision as an inpatient at the Forensic Treatment Unit of the Brockville Mental Health Centre, Mr. Gilbert’s risk for future violence is MODERATE…If Mr. Gilbert were to be released into the community without strict parameters in place and if these factors were to change, his risk would increase to the HIGH range. Specifically, if Mr. Gilbert were to cease his antipsychotic medication regimen (as he plans), be exposed to destabilizers such as illicit substances and homelessness, suffer decompensation in his major mental health symptoms, and come into contact with his parents, he may experience rapid affective/mental/cognitive [and] behavioural destabilization as he has in the past and return to violent behaviour including destruction of property, threatening and harassment…Given the multiple reports of violent ideations involving firearms and delusional beliefs involving his parents…there is a high likelihood that without supports in place, Mr. Gilbert’s violent behaviours may escalate to physical violence against his parents which could result in serious harm.”
- Currently, despite adherence to his medication regimen, the positive and negative symptoms of Mr. Gilbert’s major mental illness remain active. He continues to exhibit signs of affective, behavioural and cognitive instability. It is still too early in the treatment course to ascertain whether his symptoms will remit. However, the fact that he is presenting as less volatile, particularly since the initiation of clozapine, is very promising.
Least Onerous, Least Restrictive, Necessary and Appropriate Disposition:
This Board finds that Mr. Gilbert is in need of care and treatment within a forensic hospital setting and a detention disposition is the necessary and appropriate vehicle within which to provide the extrinsic legal support required for him to progress in his healing journey. Mr. Gilbert’s history includes many examples of his non-and-variable adherence to treatment and follow-up prior to the index offences. This militates towards the conclusion that he is in need of further assessment and treatment within a highly controlled environment. The Board believes that Mr. Gilbert’s risk to the safety of the public can be properly managed with a detention disposition order. There is no air of reality to a conditional discharge at this time.
Turning now to the necessary and appropriate terms, it is evident that Mr. Gilbert’s mental illness continues to be very active, and finding an effective medication regimen is a work in progress. Although he has not been physically aggressive recently, he continues to be preoccupied with firearms and with wanting to shoot people, including his parents. Mr. Gilbert is in need of psychoeducation around insight and illness management. He needs to build therapeutic relationships with his treatment team and to engage in therapeutic programming. He has not yet had the benefit of treatment for his substance use disorders and his ability to remain abstinent in a less controlled setting has yet to be assessed. Assessment is also needed to determine Mr. Gilbert’s level of need for future support when living in the community. In other words, it is still early days, and caution is warranted with respect to Mr. Gilbert’s ability to safely access the community.
This all being said, Mr. Gilbert has some strengths, including his nascent recognition that he needs to be in hospital, abstain from substance use and “get his mind straight”. He is forward looking and has identified appropriate goals such as finishing his high school education, getting his driver’s license and improving his physical and mental health. He remains in need of a high degree of support and supervision to help him remain medication compliant, shore up his insight and to develop and participate in a comprehensive treatment program.
The Board concurs with the terms and conditions proposed by the Hospital, including granting Mr. Gilbert the privilege of living in the community of Brockville in supervised, approved accommodation. Mr. Gilbert’s risk profile, including his substance use history, vulnerability to stress and preoccupation with weapons and harming his parents, informs the need for him to abstain from intoxicating substances, submit samples for testing, refrain from possessing weapons and be prohibited from contact or communication with his parents, except with their written and revocable consent.
The Board wishes Mr. Gilbert all the best over the coming year.
In arriving at our disposition, the Board has considered the paramount factor of the safety of the public, Mr. Gilbert’s community reintegration, his mental condition and his other needs, all as required by s. 672.54 of the Criminal Code.
DATED this 27^th^ day of May 2025, at the City of Toronto, in the Region of Toronto.
Ms. T. Mann
Alternate Chairperson
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Office of the Registrar
Ontario Review Board