Ontario Review Board
Re: Okevie Williams
ORB File No: 6780/6883
Hearing held on: Thursday, April 10, 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: Okevie Williams Counsel: Ms. S. Dubb
The Person in charge of Hospital: Counsel: Mr. J. McIntyre
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated June 3, 2025)
Introduction
On June 10, 2015, Mr. Okevie Williams was found not criminally responsible by reason of mental disorder on charges of assault and assault with a weapon. Mr. Williams was, further, on November 25, 2025 found not criminally responsible by reason of mental disorder on charges of assault with a weapon and assault causing bodily harm, all contrary to the Criminal Code of Canada.
He is currently subject to a disposition of the Ontario Review Board (ORB) dated May 15, 2024, detaining him at the general forensic unit of the Centre for Addiction and Mental Health (“CAMH” or “hospital”) with potential privileges up to and including to live in the community in approved accommodation and to travel for up to two weeks to Boston to visit family, accompanied. He is required to report to the hospital not less than once per week.
On April 10, 2025, a panel of the ORB convened a hearing at CAMH to conduct Mr. Williams’ annual review pursuant to s. 672.81(1) of the Criminal Code. Mr. Williams was present and represented by counsel, Ms. Dubb.
The issues for the Board to determine are whether Mr. Williams represents a significant threat to the safety of the public, and if so, what is the necessary and appropriate disposition for this coming year based on a consideration of the factors in s. 672.54 of the Criminal Code.
At the outset of the hearing the parties were canvassed as to their initial positions. Mr. McIntyre, counsel for the hospital, indicated the hospital’s position is that Mr. Williams is a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of his current detention order with one change: reducing his reporting to not less than once every two weeks. Ms. Culp, counsel for the Crown, joined the hospital position. Ms. Dubb, on behalf of Mr. Williams, conceded the issue of significant threat and indicated that Mr. Williams seeks a conditional discharge disposition.
Index Offences
- Full details of the index offences are set out in Exhibit 1, the Hospital Report, dated March 20, 2025. Briefly summarized:
Index Offence 1: July 21, 2014
Mr. Williams attacked a man who was using a walker for mobility. The victim was knocked down and Mr. Williams used the walker to strike him. The victim suffered injuries.
Index Offence 2: September 30, 2014
Mr. Williams pushed a person at a public library and then used a chair as a weapon to strike the victim. The victim suffered injuries.
Background
Details of Mr. Williams’ background are taken largely from the detailed reasons for disposition of last year.
Mr. Williams first exhibited signs of psychiatric illness including delusions at the age of 19. In his early twenties, he appeared to be suicidal. He was admitted to Scarborough hospitals on multiple occasions and received diagnoses including schizoaffective disorder, crack cocaine abuse, and marijuana dependence. Mr. Williams’ first hospitalization in 2007 occurred after he threatened his mother with a knife, believing that she was an imposter who had poisoned him. There were at least 3 other incidents in which Mr. Williams was admitted to hospital by police after threatening his mother. In 2012 he was admitted after he broke his television and destroyed property in his room. At that time, he believed he was ill with cancer and he was treating himself with crack cocaine and marijuana. Historically, Mr. Williams has not complied with medication and treatment providers in the community. Mr. Williams also was admitted to CAMH on four occasions once in 2012 several times in 2014 and finally in October 2014 following the index offences.
Prior to the index offences, Mr. Williams has a criminal record including convictions between 2005 and 2007 for offences including robbery disguise with intent, mischief and failing to comply with bail and probation orders. In addition, information in the hospital report references 2012 offences of theft and possession of stolen property,
In 2014 Mr. Williams was found unfit to stand trial on the index offences and was admitted to CAMH. At that time, Mr. Williams was markedly thought disordered, paranoid and perplexed. His mental health improved due to treatment, and he did not present a management problem. He remained in hospital and NCR findings were made in 2015. Mr. Williams showed improvement in his mental state and was able to use passes appropriately. Unfortunately, in March of 2016, a change in medication led to significant deterioration with Mr. Williams becoming overtly psychotic by the end of that month. He was sexually inappropriate. He had no insight into his actions or illness and he continued to assert that he had acted in self defence. Thereafter Mr. Williams continued to made some progress but also suffered setbacks, once due to medication error, but also due to the significant negative effect of cannabis use. In 2017 his mental health further improved and he was discharged from hospital. Unfortunately substance abuse and its negative effects led to both a lengthy readmission in October 2018 and to readmission again in 2019 within a week of discharge. Mr. Williams progressed and was transferred to high support 24-hour supervised accommodation in January 2022., where he did well. However, a missed injection due to a scheduling error affected his mental health and he and a co-resident were involved in a physical altercation. Mr. Williams was not accepted for return to the home and was readmitted to hospital in September 2022 Mr. Williams progressed in hospital but in January, 2023 there was an unexpected change in his mental state, despite him being medication compliant.. Symptoms included persecutory misperceptions, impulsivity and agitation. He was easily provoked to anger and had to enter seclusion on one occasion. He did not recognize the changes in his mental state. With treatment, he gradually improved and returned to baseline health by early February 2023.
Current Treatment Year:
Mr. Williams is treatment capable for psychiatric decisions and for property. His diagnoses include schizophrenia and cannabis use disorder (in remission in a controlled environment).
During the 2023 treatment year Mr. Williams resided on the general forensic unit under the care of Dr. Benassi. He progressed to the point that placement in the community was sought. He remained thereafter stable. He engaged well with staff and engaged in programming. Mr. Williams was able to secure a part-time cleaning position with the LCBO, up to three shifts a week and feedback from his employers was consistently positive. He was ultimately accepted for placement at Oakwood Arch, a 24/7 supervised residence.
Mr. Williams’ discharge to community living took place on May 14, 2024. The community transition went well and he is reported to enjoy his residence. He has a good relationship with the treatment team and gets along with his co-residents. Mr. Williams has continued to abstain from drugs and is highly motivated to remain abstinent to avoid rehospitalization. He continues in his employment at the LCBO with positive reports. He has close contact with his mother and regularly spends weekends at her home. Mr. Williams still has limited insight with respect to the offences and his violence risk. He maintains that he acted in self-defence. He does, however, have good insight into substance use and he indicates his plan to maintain medication compliance.
Central to this hearing was the question of what the necessary and appropriate disposition is for the upcoming year. The hospital report indicates that Mr. Williams requires ongoing intensive, consistent and reactive psychiatric intervention, supervision and follow up to manage his risk to the public. While he has had a positive reporting year, it is still early in his tenure in the community. The team must be able to act quickly and efficiently before he becomes certifiable under the Mental Health Act. Additionally, it remains necessary to approve his accommodation for risk management purposes. The hospital report risk assessment concludes that if Mr. Williams was not required to live in approved accommodation, and the team did not have the ability to quickly admit him before he reached the criteria for an involuntary admission under the Mental Health Act that his risk of future violence, including serious physical harm, would be high. Should he remain under the current disposition of a detention order with community living, his risk of future violence would be mild to moderate.
Dr. Juliette Dupré, who has been Mr. Williams’ outpatient psychiatrist since August 2024, testified and adopted the contents of the Hospital Report. She outlined that the basis of the team’s finding that Mr. Williams is a significant threat is based on the fact that he suffers from schizophrenia and can easily experience symptoms of psychosis if he engages in substance use or if he were to even miss a small dose on his medication regimen. He has been stable for the past year but remains quite fragile. His insight into his violence risk and the relationship between his symptoms and violence is quite limited. In the past year, even with full medication compliance, Mr. Williams experienced a relapse that necessitated titration of his medication. He has remained abstinent of substance use but it remains a risk factor that could destabilize him.
On the issue of disposition, she testified that a conditional discharge is not recommended for this year given the duration and the fragility of his mental state. Mr. Williams currently is happily maintained in housing but in the past he has lost several 24-hour supervised housing due to his substance use and aggression. For this reason the hospital needs to maintain the ability to bring him into the hospital if he were asked to leave his housing. Mr. Williams has a history of leaving the hospital against medical advice and not coming into hospital when unwell.
Mr. Williams is capable with respect to medication decisions. The team would not be able to rely on Box B under the Mental Health Act so that even if he were brought to the hospital it would not guarantee that he would meet the criteria under the Mental Health Act for admission. His deteriorations have been rapid and where there is substance use they have been almost instantaneous.
Mr. Williams is very motivated to not return to hospital but his motivation to maintain his medication and abstinence from substances is externally motivated. His insight has, however, improved. In the past missing one dose of his injectable medication led to deterioration in his mental state. 24 hour supportive housing is necessary to manage Mr. Williams’ risk.
The past year has been the best one that he has had in his 10 years under the Ontario Review Board. Dr. Dupré testified that Mr. Williams has done this well because of the high support he has received. Mr. Williams has not indicated that he wants to move out of his residence but has discussed dissatisfaction with the frequent room checks involved in the enhanced supervision in the residence. Dr. Dupré continues to work with him on this issue. It is possible that Mr. Williams would wish to leave the residence in the future.
Dr. Dupré recognized that at last year’s hearing Dr. Benassi testified that with 12 months of stability Mr. Williams might be ready for a conditional discharge. Dr. Dupré testified that we are not yet at the 12-month mark and it is premature. Asked what he would need to see to recommend a conditional discharge in the future, Dr. Dupres indicated another year of clinical stability where Mr. Williams maintains his housing and medication compliance and reporting would give a greater indication of his readiness for a conditional discharge.
Dr. Dupré testified that to recognize the excellent year that Mr. Williams has had the hospital recommends a change in his reporting to not less than once every two weeks. He maintained his employment and worked well with the team. It is hoped that the decrease in reporting is a motivator for Mr. Williams in his gradual move towards a conditional discharge while also ensuring that his risk is managed. Dr. Dupré elaborated naming the current residence as a condition on a conditional discharge would be insufficient because the risk is that he could in the future be asked to leave. Admission under the Mental Health Act is limited further because Box A would not catch subtle signs of decompensation that would permit readmission to hospital. If Mr. Williams showed subtle signs including such as increased irritability etc. the team would want to intervene quickly for readmission. In the past Mr. Williams has benefitted from lengthier admissions to stabilize him, far longer than an involuntary admission would have permitted. Mr. Williams did not see the need for the long admission and had not wanted to remain in hospital.
Dr. Dupré was asked whether Mr. Williams was apt to experience frustration with a Board indicating that it would be yet another year until he could be considered for a conditional discharge. Dr. Dupré replied that the risk of frustration has been taken into account but Mr. Williams has a very good therapeutic alliance with his treatment team and they discussed with him the recommendation. She and Mr. Williams had a good discussion of the issue on the evening before this hearing. Mr. Williams was very appropriate indicating that he does not share the opinion of the treatment team of his risk.
It is a real strength of Mr. Williams that he is very engaged in programming which includes risk management recovery, cognitive behavioural therapy (CBT) and substance use. His employment in which he is reported to do a very good job, is also very important to his ongoing stability. A primary factor for maintaining his abstinence from substance use is that he does not want to return to hospital.
Submissions
Mr. McIntyre, on behalf of the hospital, submitted that a detention order is the necessary and appropriate disposition, with a decrease in frequency of reporting to not less than every two weeks. He submitted that on the evidence a conditional discharge was not appropriate in light of how quickly Mr. Williams has deteriorated in the past and could in the future, even after one dose of missed medication, could result in serious deterioration. Mr. Williams has a fragile mental disorder which requires ongoing intensive and consistent management and the ability to intervene quickly. In the past he lost his supportive housing. It is very important that the hospital give Mr. Williams the tools to succeed in the community. To grant him a conditional discharge would disrupt his progress under the Ontario Review Board. Dr. Benassi, who testified at last year’s hearing, is no longer involved in his care and is not in a present position to assess Mr. Williams. The evidence before the Board is from Dr. Dupré who is very involved in his care and this is the evidence that should be relied upon. He noted that Mr. Williams is considered a high risk of violence if granted a conditional discharge. He submitted it is important to highlight that the index offence was unprovoked, random and quite violent. It is important to move slowly to ensure Mr. William’s success as well as manage the risk to the public. He noted that Mr. Williams has had a great year and is working towards a future conditional discharge. He stressed that it is important that Mr. Williams recognizes that the hospital sees that and supports him in that goal.
Ms. Culp, on behalf of the Crown, echoed that Mr. Williams has done very well in his current housing. There he has high support that he requires that it is necessary that the hospital remains able to approve his housing for a longer period of stability.
Ms. Dubb, on behalf of Mr. Williams, submitted that Mr. Williams has had a positive year, living in the community for almost 12 months. This has been the longest time he has been in the community since his tenure with the Ontario Review Board. He was abstinent from drug use in the past year. She submitted that his ongoing stability supports the granting of a conditional discharge She agreed that Mr. Williams’ deterioration can be very rapid even if he were to miss one dose of medication but submitted that his high supportive housing allows for close monitoring and can supervise any changes in his mental state. If he showed subtle signs of deterioration this would allow the care team to take a greater interest and move quickly so that when he met the criteria for admission he could be taken into the hospital. She noted that Mr. Williams has worked very hard and is very motivated to continue his progress.
Analysis and Conclusion
The Board is unanimous in finding that Mr. Williams continues to represent a significant threat to the safety of the public. We note that this is the joint position of the parties but we make this finding independently on the evidence before us. Mr. Williams engaged in violent index offences as recently as 2022. He assaulted another housing resident which resulted in the police being called and Mr. Williams losing his housing. Mr. Williams’ mental illness is fragile and has been susceptible to decompensation even with one missed dose of medication or in the past when his medication was changed. Were he to engage in any substance use he would be expected to deteriorate very quickly. His motivation to maintain his abstinence is external in his goal to not be returned to hospital.
The Board closely considered the issue of the necessary and appropriate disposition. Mr. Williams has had a very successful year living in the community in a highly supervised residence to which he was discharged in May of 2024. He gets along with his co-residents and enjoys the residence except for the level of supervision that includes room checks to ensure abstinence from drug use. He maintained his employment at the LCBO, working up to three shifts a week and receives very good feedback. He is in close contact with his mother and regularly spends weekends at her home. Dr. Dupré suggested that if Mr. Williams had another good year that he might be ready for a conditional discharge.
All parties commended Mr. Williams for having the most successful year he has had in his tenure before the Review Board with the longest period in a community residence.
Dr. Dupré who is Mr. Williams’ most responsible psychiatrist and has given clear and uncontroverted evidence as to the necessity for a detention order being necessary to both support Mr. Williams’ progress and protect the safety of the public. We rely on her evidence in finding that a detention order remains that which is necessary and appropriate at this time. This is supported by the evidence in the Hospital Report that Mr. Williams represents a high risk of violent reoffending on a conditional discharge. Dr. Benassi, who gave his opinion last year, has not been in a position to assess Mr. Williams currently.
On a detention order the risk is considered mild to moderate. Mr. Williams is doing very well. His main reason for abstaining from substances which would result in his rapid deterioration of aggressive behaviours, is external. Mr. Williams continues to require the very close supervision that is being afforded to him at his residence. A conditional discharge that stipulated his address would be insufficient in that the future risk is that he might be asked to leave his housing, as he was in the past due to his behaviour. He continues to have limited insight with respect to his risk of violence in the index offences. We find that it is essential that the hospital be in a position to approve his residence and to ensure that they can return Mr. Williams immediately to hospital and maintain him there for the time that is necessary to address any decompensation. To Mr. Williams’ credit, while he disagrees with the position of his treatment team, he maintains an ongoing positive relationship and it appears that he does appreciate that they have his future best interests as their goal.
The Board wishes to commend Mr. Williams for the excellent year he has had. The hospital, in recognition of this, recommends that his reporting be lessened to not less than once every two weeks. The Board unanimous accepts this recommendation and orders that the reporting be varied. It is hoped that with the excellent support that Mr. Williams has and his positive attitude that he can continue to progress towards his goal of a conditional discharge.
We make this disposition in consideration of the primary factor of protection of public safety and Mr. Williams’ mental condition, his personal needs and his reintegration into the community.
DATED this 3rd day of June, 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Fromstein Alternate Chairperson
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Office of the Registrar Ontario Review Board