Ontario Review Board
Re: Mitch Coursolle
ORB File No: 8544
Hearing held on: Wednesday, May 14, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. M.D. Segal Members: Dr. A.D. Jones Dr. S. Wiseman Mr. E. Siebenmorgen Ms. M. McKinnon
Parties Appearing: Accused: Mitch Coursolle Counsel: Mr. C. Dobson
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated June 4, 2025)
Introduction
[1]. Mitch Coursolle, age 31, was found not criminally responsible by reason of mental disorder on March 6, 2024, on a charge of arson causing damage to property, contrary to the Criminal Code. At present he is on a conditional discharge, living in the community.
[2]. On May 14, 2025, Mr. Coursolle appeared before the Ontario Review Board (the "Board") at the Southwest Centre for Forensic Mental Health Care (the "hospital") for his annual hearing. The Board had before it as Exhibit 1, a Hospital Report dated April 20, 2025, and the current Disposition and most recent Reasons for Disposition.
[3]. In preliminary positions, the hospital, supported by Crown counsel, advanced that significant threat to the public was present and that the current Disposition sufficiently managed the risk. However, reporting was to be reduced to just twice a month. Mr. C. Dobson, for the patient, put forward an absolute discharge as the desired result, or in the alternative, agreed with the conditional discharge with the change noted above. At the conclusion of the hearing, the Board found that significant threat continues to be present and that the current Disposition was appropriate and represented the least onerous and least restrictive Disposition. Reporting should be reduced as recommended. The requirement to submit samples and the consent to treatment clauses were to be removed.
Index Offence
[4]. The details of the index offence are as follows:
"On January 7, 2023, at 4:40 am, emergency services were contacted by the accused in relation to a fire inside his residence. Multiple police officers arrived on scene and were met at the door by the accused. The accused advised that he believed others were inside the residence as he had heard voices. At this time, firefighters arrived on scene and observed a Christmas tree on fire at the rear of the residence.
Constable Buckle removed the accused from the residence for safety reasons and spoke with him about the fire. At this time, the accused stated: "I started it to get help." As a result of this comment, Constable Buckle arrested the accused at 4:49 am for Arson. The accused was read his right to counsel and caution which he understood.
The accused was then transported to the London Police Service Headquarters
Detention Unit where he was paraded in front of Sergeant Adamovich at 5:11 am.
Once the fire was extinguished at the accused's address, members of the London Police Service secured the residence pending a search warrant.
The investigation was turned over to Detective Constable Norman of the Street Crime Unit.
At 2:58 pm, Detective Constable Norman interviewed the accused who admitted to starting the fire in his unit.
As a result of this investigation, the accused is charged with one count of Arson contrary to Section 434 of the Criminal Code."
[5]. The fire caused $200,000 in damages. Mr. Coursolle is being sued by the landlord.
Diagnoses
[6]. Schizophrenia Spectrum Disorder Avoidant Personality Traits Anxiety Disorder (NOS)
Background
[7]. This was well stated in last year's Reasons at paragraphs 5 to 11:
"Mr. Coursolle is presently 30(31) years of age. At the time of the index offence, he was living in a residence in London, Ontario. He had previously been employed at the Studio Arts Music Academy in St. Thomas. He is a skilled musician and taught guitar. That employment had ended in October 2022. Evidence contained in the Hospital Report suggests that Mr. Coursolle may have been having prodromal symptoms of paranoia that impacted the loss of employment.
On New Year's Eve 2022, Mr. Coursolle attended at the hospital in London. His father had taken him there. Mr. Coursolle was exhibiting symptoms of paranoia. He had been put on a Form 1 for a 72-hour observation but the psychiatrist on duty felt that he did not satisfy the criteria on the basis that Mr. Coursolle was saying that he wanted to leave the hospital that doctor felt it was his duty to discharge him. The hospital released him in the middle of the night without informing Mr. Coursolle's family The index offence took place a week later.
Following the index offence Mr. Coursolle improved on antipsychotic medication. He entered the Prevention and Early Intervention for Psychosis program (PEPP) at London Health Sciences. He remained living in the community subject to bail conditions.
The Hospital Report, exhibit 6, sets out diagnoses of a 'brief psychotic disorder, rule out unspecified schizophrenia spectrum disorder and rule out substance induced psychosis'. The Hospital Report sets out that Mr. Coursolle's diagnosis requires clarification.
The Hospital Report notes that after the index offence Mr. Coursolle attended at his family doctor who prescribed him antipsychotic medication. Mr. Coursolle took this medication based on his doctor having recommended it. He remained compliant with medication but continued to experience symptoms. He was prescribed alternate medication, risperidone, to add to the olanzapine previously recommended. He experienced vomiting and the risperidone medications were stopped. Other medications were tried.
In April 2024, Mr. Coursolle, who is capable with respect to medication, following consultation with his psychiatrist, chose to stop taking all medication. The Hospital Report notes that Mr. Coursolle has indicated that he feels better off of medication. He has indicated to the treatment team that he wants to again smoke cannabis in the future. His father has indicated that Mr. Coursolle was, prior to the index offence, smoking a lot of marijuana. His father would prefer if he abstained.
Mr. Coursolle remains living at his home in St. Thomas in a reclusive fashion with his cats. His father and Mr. Coursolle are in regular bi-weekly contact and his father provides his son with groceries as well as financial support. Mr. Coursolle speaks to his mother daily. She often sees him daily after she finishes work and it is the hospital's belief that she would notice any symptoms if Mr. Coursolle's mental health was to deteriorate."
Evidence at Hearing
[8]. Dr. Ajay Prakash, the patient's psychiatrist, testified. Dr. Prakash indicated the request for an absolute discharge had actively been discussed but rejected by the treatment team.
[9]. The Board was referred to the assessment of clinical risk at page 33 of the Hospital Report. Mr. Coursolle is at low risk for violence on a conditional discharge because of protective factors.
[10]. The doctor noted that Mr. Coursolle was a prosocial individual with no criminal history before the index offence and had no history of mental disorder.
[11]. In the reporting period, there have been no hospital readmissions, crises or violence. Mr. Coursolle is not on any antipsychotic medication at his request.
[12]. Dr. Prakash noted that there is a lack of structure in Mr. Coursolle's life. He essentially stays in his apartment most of the time. Mr. Coursolle continues to believe that the persecutory thoughts that drove him to commit arson are reality based. He does not believe he has a mental disorder. The diagnosis is still being pursued. At present it is described as schizophrenia spectrum disorder. Mr. Coursolle has been off medications for over a year, but the doctor is of the view that the paranoia and suspicions remain.
[13]. Mr. Coursolle has not used cannabis this year. He has been substance abstinent for over a year. Drug screens verify that. The motivation for that choice is not so clear. Mr. Coursolle has indicated that in relation to consumption, that "it may look bad". He has indicated that absent supervision by the Board "he would probably not use".
[14]. Mr. Coursolle has a community-based treatment team that acts as the hospital delegate. It is called the Prevention and Early Intervention for Psychosis Program or PEPP. It is supervised by a psychiatrist, Dr. A. Dhaliwal. The PEPP involvement is not a forever solution. Dr. Dhaliwal has said that if PEPP stopped, she would continue to see the patient privately.
[15]. Mr. Coursolle's father, and occasionally his mother, drive him to PEPP appointments. Mr. Coursolle does not engage with the hospital's forensic team.
[16]. Prior to the index offence, Mr. Coursolle's life had shrunk. He had become reclusive. Just prior to the index offence he attended at emergency services but was unfortunately discharged.
[17]. Mr. Coursolle stopped taking all medications in April 2024. Dr. Prakash understood the reason was concerns about side effects such as weight gain and sedation.
[18]. He has taken CBT for anxiety through PEPP. He indicated that this was somewhat helpful.
[19]. Consumption of cannabis was involved in the index offence and has the impact of increasing the risk for violence. There is a concern that Mr. Coursolle is engaged in impression management. Mr. Coursolle has declined substance use therapy. The doctor agreed that Mr. Coursolle may believe that life is better without cannabis. He acknowledges he was in a "dark place" at the time of the index offence.
[20]. Stress could exacerbate his risk for violence. The hospital is concerned about the impending civil lawsuit. In that regard.
[21]. This past year there has been no interest in employment or a housing change on Mr. Coursolle's part, despite some indications that he had been considering this. While Dr. Prakash believes Mr. Coursolle is capable to consent to treatment, an assessment of capacity should be undertaken.
[22]. Dr. Prakash does not have clarity of diagnoses. Dr. Prakash firmly believes that Mr. Coursolle was psychotic at the time of the index offence. There are continuing concerns about Mr. Coursolle's current mental health. It is the hospital's view that there is a real risk of relapse, even if substances were not being consumed. The lack of medication adds to this concern.
[23]. Mr. Coursolle is no longer prepared to consent to treatment.
[24]. There is merit to the deleting the submit samples clause to test the waters further.
[25]. Mr. Coursolle's relationship with the forensic team at the hospital is satisfactory. Mr. Coursolle is not perfectly forthcoming, but he is forthcoming enough. He needs to be asked before providing answers. He is not the sort to volunteer symptoms. Mr. Coursolle still represents a significant risk to the safety of the community for the reasons found in the Hospital Report.
[26]. Mr. Coursolle has occasionally engaged with vocational staff, but then his interest wains. It might be a good idea for PEPP to review the impact of the index offence with the patient.
[27]. Mr. Coursolle is frustrated by all the appointments he has. In essence, Mr. Coursolle feels he is capable of living his own life and does not feel he requires all this attention. Mr. Coursolle's insight in all three domains has not increased.
[28]. In final submissions, among other things, the hospital stressed the recency of the serious index offence and noted the imperfect insight, possible impression management and the refusal of medication. Psychosis is clear but understanding it is not complete. More stability is required to protect the public. An absolute discharge was not supported.
[29]. Mr. Dobson noted that guesswork did not satisfy the requirement that a disposition was necessary. While acknowledging that the matter was not without its complexities, Mr. Coursolle has external supports through his parents and with the PEPP team.
Analysis
[30]. In this matter, the evidence was clear to the Board that there is a likelihood of relapse. Mr. Coursolle continues to demonstrate paranoia and psychosis. Equally it is clear that Mr. Coursolle could not recognize decompensation and would be reluctant to accept assistance. The index offence was very grave and laden with danger. There is underdeveloped insight into his mental disorder, the offence, the impact of his medications and the impact of medication in relation to the risk involved. Although remaining abstinent from cannabis use this year despite the absence of a prohibition against its use, Mr. Coursolle does not have good insight into the impact on his mental health. His current abstinence form cannabis appears, on the evidence, to be somewhat externally motivated, primarily to satisfy forensic expectations, rather than driven by internalized insight into the role of substances in his mental health and the index offence.
[31]. The index offence is very fresh. Mr. Coursolle has not been in the community very long since the index offence. He continues to live independently, as he did prior to the index offence, and his housing situation is itself a source of stress. Signs of paranoia still persist, as they had prior to the index offence. Taking the evidence as a whole, the panel is satisfied that there continues to be a substantial risk of decompensation of Mr. Coursolle's mental state that would lead to a criminal act and that is likely to result in serious physical harm. He therefore presents as a significant threat to the safety of the public.
[32]. More work needs to be done on diagnosis, and therapeutic counseling including substance abuse. Stressors will increase the risk. Mr. Coursolle no longer consents to treatment and therefore we must remove that as a condition. While not inspiring practical confidence, that decision is his right and cannot be held against him. The evidence was clear that further supervision in the community is definitely warranted but with a relaxation of conditions. Accordingly, the "submit samples" clause will be removed, and reporting will be reduced to not less than twice a month. We wish Mr. Coursolle well in the upcoming year.
DATED this 4th day of June 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
Office of the Registrar Ontario Review Board