Ontario Review Board
Re: Carlos M. Martinez
ORB File No: 5639
Hearing held on: Tuesday, April 8, 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. C. Fromstein Members: Dr. L.E. Cappe Dr. C. Young Hon. C. Nelson Ms. B. Naegele
Parties Appearing: Accused: Carlos M. Martinez Counsel: Ms. M. Addie
The Person in charge of Hospital: Counsel: Mr. J. McIntyre
Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION
(Dated June 2, 2025)
Introduction
1On June 17, 2010 Carlos Martinez was found not criminally responsible (NCR) on account of mental disorder on charges of possession of a weapon and assault with a weapon, both contrary to Criminal Code of Canada. He is currently subject to a disposition dated May 1, 2024, discharging him on conditions that include that he submit samples of urine for analysis, possess no weapons and report to the hospital not less than once every two weeks.
2On April 8, 2025, the Board convened at Centre for Addiction and Mental Health (CAMH or Hospital) to review that disposition. Mr. Martinez was not present. He was represented by Ms. Addie. She explained that Mr. Martinez was not willing to attend the hearing but that she had spoken with him and received instructions to appear on his behalf and to represent him. We note that Mr. Martinez similarly had not attended his hearing last year. None of the parties took issue with this and an order was made permitting Mr. Martinez to remain absent.
3At the outset of the hearing, the parties were canvassed as to their initial positions. Mr. McIntyre, on behalf of the hospital, submitted that Mr. Martinez remains a significant threat to the safety of the public and the continuation of the current conditional discharge is that which is necessary and appropriate. Mr. Feindel, on behalf of the Crown, joined the hospital position. Ms. Addie conceded the issue of significant threat and also joined the hospital position.
4The issues to be decided at the hearing were whether Mr. Martinez continues to represent a significant threat to the safety of the public, and if so, what is the necessary and appropriate disposition.
Index Offence
5The details of the index offence are as follows:
"On the afternoon of August 7, 2008, Mr. Martinez was observed standing in front of a store on Wellesley Street in Toronto. He was in possession of a four-foot-long, thin cardboard box. The victim, Ronald Patten, exited the store on his lunch break. He was informed by a customer that Mr. Martinez was in the rear lane spilling garbage all over the ground. Mr. Patten requested that Mr. Martinez refrain from doing so, but Mr. Martinez did not respond.
As Mr. Patten began to pick up the garbage, Mr. Martinez went to a garbage bin and pulled out a 36½ inch black samurai sword. Another witness exited the store and observed Mr. Martinez raise the sword above Mr. Patten. The witness called out to Mr. Patten and warned him of the imminent attack. Fearing for his life, Mr. Patten fled the laneway and returned to the store. He locked the door and called the police. Mr. Martinez walked to another local business where he was located and arrested by the police. The officers investigated the laneway and found that the sheath of the sword contained two smaller knives and at the base of the sheath also concealed a knife."
Evidence at Hearing
6Mr. Martinez’s background is set out in detail in the Hospital Report, exhibit 1 so it need not be repeated. Briefly summarized, Mr. Martinez is presently 38 years of age. He immigrated to Canada with his family at age 4 from Uruguay. It is noted that by age 12 he exhibited behavioural issues including those that resulted in his being suspended from school as well as setting fire to his stepbrother’s clothes. At age 16/17, he punched and verbally abused his father. His mother asked him then to leave the home and he resided thereafter in a shelter and, later, with his father.
7Mr. Martinez’s diagnosis is schizophrenia.
8His first hospital admission took place when he was 29 years of age, after he destroyed his father's basement and was also found in possession of a knife. Mr. Martinez has had multiple admissions under the Mental Health Act due to threatening other people and his inconsistent medication compliance. In 2008, he was admitted after threatening his parents and presented as being very paranoid and having hallucinations. The index offence took place shortly after his release from hospital in August 2008.
9Mr. Martinez was discharged from hospital to an independent CMHA apartment in 2019.
10Mr. Martinez suffers from significant social withdrawal and interpersonal sensitivity that bars his progress towards receiving an absolute discharge. He refuses to engage with a community psychiatrist. He has a strong relationship with the Forensic Outpatient Team and it is hopeful that he will be able to develop relationships with other clinicians in the community in the future. He experienced a deterioration in his mental health in 2023 despite medication compliance. His mental health stabilized but his functioning deteriorated with him since being more isolative. He requires the establishment of community supports before he can be recommended for an absolute discharge, of which he is apprehensive.
11The Hospital Report notes that in the past treatment year Mr. Martinez has met with his forensic outpatient psychiatrist monthly but all of these visits are virtual due to his refusal to attend the hospital and his resistance to traveling by vehicle. There has been no meaningful progress in transitioning into civil care. His social withdrawal, resistance to change and interpersonal sensitivity towards care providers has impeded his prospects of success absent the support of his current forensic interventions.
12He continues to be treated under his own consent with clozapine and has exhibited greater mental stability in this past treatment year. His psychotic symptoms have been fairly well controlled on this treatment regimen. In June 2024, he endorsed transient increased delusional thought and auditory hallucinations but indicated that he could ignore these experiences though he contemplated whether he should listen to these voices. His social withdrawal and functionality have regressed since the onset of the COVID-19 pandemic. His mother, who remains a strong support for him, concurs with this opinion noting that in the past year he has even stopped going out onto his balcony where he previously felt comfortable.
13Mr. Martinez is generally pleasant and cooperative in interactions but is susceptible to becoming irritable, antagonistic and even paranoid when canvassed on subjects outside of his narrow comfort zone. In May he agreed to meet with the CMHA ACT team psychiatrist for an additional appointment but terminated the meeting even before entering the interview room. Between May and September 2024, he was noticeably more irritable with his Forensic Outpatient Team (FOPS) during regular meetings and was especially antagonistic towards his psychiatrist. His mood appeared to improve by August 2024 but he did remain more antagonistic and suspicious of his psychiatrist. He has expressed concerns on numerous occasions that he would lose his housing and ODSP if he were no longer under the ORB and has struggled to internalize the team's attempts to clarify this misunderstanding.
14In March 2025, he agreed reluctantly to a family meeting with his mother to discuss goals for the upcoming year but abruptly terminated the meeting. He has remained without a family physician after becoming distrustful of his former provider in 2023. Throughout the year he has remained very isolated in his apartment where he spends time alone with the exception of weekly visits from his mother to bring him food and help with home maintenance. He has significant anticipatory anxiety about leaving his home.
15The hospital report sets out that Mr. Martinez has demonstrated significant strengths in recent years while residing in the community. He is commended by the team for his independent medication management and self-control and judgment with respect to avoiding potentially destabilizing influences, including substance use. He does have a significant violent antisocial history when unwell and presents a serious risk to public safety should he relapse. There are concerns about his guarded clinical engagement. There is concern Mr. Martinez will disengage from treatment if he feels challenged, particularly in the absence of ongoing access to familiar and trusted professional supports. He has shown the ability to develop therapeutic rapport over time. It is crucial that Mr. Martinez is afforded gradual and overlapping transition of care to a new civil psychiatric team so that he can develop a therapeutic alliance. Based on his current reluctance, the clinical team has not actively pursued a transfer of care, however, fortunately the relationship with the CMHA ACT team was preserved so their services could be gradually reintroduced when Mr. Martinez is ready to attempt such a transition.
16Dr. Meng, Mr. Martinez’s outpatient psychiatrist, testified at the hearing. She indicated that the team has not supported an absolute discharge for Mr. Martinez because there is not at this time any realistic community follow-up to manage his risk. He is very sensitive to changes in plan, rigid, and becomes more irritable and paranoid if there are any.
17She was asked for insight into his decompensation in May, 2024. Dr. Meng testified that Mr. Martinez was likely medication compliant as reflected in his serum levels and he was not using illicit substances. He does, however, have a very long history of fairly brittle mental illness. It took many years to get him stabilized. There were no obvious stressors to his routine but he has historically had fluctuations and the recent deterioration may just have been a factor of his illness.
18She confirmed that on a positive note that the team has maintained contact with the ACT team case manager and that they will accept him into their care if he becomes more ready. She noted protective factors that Mr. Martinez has case management supports with whom he is attached. Dr. Meng will be going on a leave and she was asked what she anticipates his reaction will be. Dr. Meng noted that essentially Mr. Martinez simply tolerates her. She has had no expectation that he would meet with her in person.
Submissions
19All parties maintained their joint positions.
Analysis and Conclusion
20The Board is unanimous in finding, based on the evidence before us and the submissions of the parties, that Mr. Martinez remains a significant threat to the safety of the public. We also agree with the joint position of the parties that his current conditional discharge disposition must be continued, without change. He requires the oversight of a treatment team to ensure that his illness is well managed by medication compliance and abstinence from substance use. In the absence of same, his mental health would likely deteriorate resulting in his posing a real threat of physical and psychological harm to persons in the community as per his history of violence.
21The team continues to make efforts to try to facilitate Mr. Martinez’s reintegration into the community and his readiness for an absolute discharge. It is the factors of his illness and his very rigidly held unwillingness to engage with other treatment providers that has recently stood in his way and continues at this time to do so. It is hoped that there will be some development moving forward wherein Mr. Martinez will be willing to engage with the community treatment team. That option remains open thanks to the maintenance of the relationship with the ACT team case management supports.
22On a positive note, Mr. Martinez has maintained his medication compliance, abstinence from substances and engagement with his treatment team. It is hoped that the continued efforts will result in movement towards being able to put in place a community treatment team so that he can become ready for an absolute discharge.
23We make this disposition in consideration of the prime factor of protection of the public, as well as Mr. Martinez’s mental condition, his reintegration into the community and his other needs.
DATED this 2nd day of June, 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Fromstein Alternate Chairperson
__________________ Office of the Registrar Ontario Review Board