Re: Eustace Bernard Rackett
ORB File No: 2198
Hearing held on: Monday, April 28, 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. Finley Members: Dr. P.E. Cook Dr. H. Moulden Mr. B. Garrow Mr. S. Duffy
Parties Appearing:
Accused: Eustace Bernard Rackett Counsel: Ms. M. Perez
The person in charge of hospital: Counsel: Ms. A. Marshall
Attorney General of Ontario: Counsel: Ms. R. Weinberg
REASONS FOR DISPOSITION
(Dated June 10, 2025)
Introduction
On December 15, 1995, Eustace Bernard Rackett was found not criminally responsible (“NCR”) on account of mental disorder on charges of assault (x2), contrary to the Criminal Code, (the “Code”).
Mr. Rackett is detained at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH” and/or the “hospital”) under terms of a Disposition dated May 21, 2024 with discretionary privileges up to and including community living in the Greater Toronto Area in supervised accommodation approved by the person in charge. He currently resides in the community in LOFT 24-hour high support housing.
On April 28, 2024, the Board convened a hearing, pursuant to s. 672.81(1) of the Code to conduct the annual review of the current Disposition. Mr. Rackett was present at the hearing and represented by counsel. Mr. Rackett’s mother and three of his siblings also attended the hearing.
The issues before the Board are whether Mr. Rackett continues to pose a significant risk to the safety of the public, and if so, what is the necessary and appropriate disposition to manage that risk having regard to the criteria set out in s. 672. 54 of the Code.
At the outset of the hearing, the Crown joined the hospital in recommending that apart from a reduction in the minimum reporting requirements, there be no change to the current Disposition. Counsel for Mr. Rackett advocated for a conditional discharge. The issue of significant threat was not contested.
For the reasons that follow the Board finds that Mr. Rackett continues to pose a significant threat to the safety of the public and that his care should continue on the same terms as his current Disposition, amended to reduce minimum reporting to every two weeks.
Evidentiary Record
- Dr. Meng co-authored the Hospital Report dated, April 8, 2025, Exhibit 1, and testified on behalf of the hospital. No further evidence was adduced at the hearing.
Background
Mr. Rackett’s personal and psychiatric history, including the details of his mental disorder and treatment since being found NCR, are described in detail in the Hospital Report. Briefly, Mr. Rackett is 57 years of age, single with no dependents. He arrived in Canada from Jamaica in 1987 and is currently subject to a removal order.
Mr. Rackett has been under the Board’s jurisdiction for almost 30 years. He has previously been granted conditional discharges and last lived in the community in 2012. In June 2024 he moved from CAMH into LOFT 24 hour-high support transitional housing. He is unemployed and financially supported by Ontario Disability Support Program (ODSP).
Mr. Rackett is incapable of consenting to psychiatric treatment. However, he is capable of managing his financial affairs. Treatment decisions are made by his brother, in his capacity as substitute decision maker. Mr. Rackett is followed by the Expanded FOPS team under the care of Dr. Meng.
Mr. Rackett’s current diagnoses are Schizophrenia vs. Schizoaffective Disorder, Bipolar Type, Cannabis Use Disorder, and Severe Unspecified Personality Disorder.
As noted in the Board’s Reasons for Decision last year, Mr. Rackett has a criminal history that extends from 1991 to 1996 and includes a charge of assault causing bodily harm, a charge of assault, five charges of possession of narcotics, two charges of trafficking in narcotics, three charges of uttering threats and one charge of failure to comply with a recognizance.
The circumstances surrounding the index offence are also set out in last year’s Reasons as follows:
“On August 4, 1995 Mr. Rackett entered a store and the owner asked him to leave because he had caused a disturbance in the store previously. He punched the owner in nose breaking his glasses and causing a small cut on his nose.
On Aug 7, 1995 a woman and her niece had left a restaurant when they were approached by Mr. Rackett who started yelling at them for no apparent reason. They got into their car and he spat at the woman through the open door of the car. The woman got out of the car and told him to get away. The accused picked up a glass bottle and threw it at the woman’s face, striking her wrist and knuckle when she was defending herself. She required seven stitches. The accused was arrested by nearby police officers.”
Course Since Last Annual Review
As noted Mr. Rackett’s discharge into the community in June 2024 was his first discharge since 2012. He exhibited some increased affective instability in the days leading up to discharge. He was more dysregulated, loud, and argumentative. He is also reported to have uncharacteristically focused on the legality of cannabis and his right to use it. Overall, he required a high level of clinical support with his transition to the community. However, his mental state stabilized rapidly upon discharge.
Currently Mr. Rackett resides in his own unit which is equipped with a bathroom and a kitchenette. He is provided with cooked meals. However, he is able to warm up his own purchased food using the microwave in his kitchenette. He is responsible for keeping the unit tidy. Housing staff clean his washroom and floors, take out the trash and do his laundry. LOFT staff are on site 24 hours per day to administer medications, complete mental status assessments, and assist with any issues that may arise. A geriatric psychiatrist, family physician, and a nurse practitioner attend the residence on a regular basis and provide care on site. Although Mr. Rackett is also to be followed by the forensic outpatient service team, his psychiatric medications were managed by the LOFT geriatric psychiatrist.
Recently Mr. Rackett has expressed increased dissatisfaction with his housing. He would prefer less supportive housing. He does not believe that he requires the intensity of services being provided and considers himself higher functioning than the other residents. As noted in the Hospital Report, in February, he expressed vague paranoid ideation about food contamination at the residence, which he queried was possibly intentionally done to him selectively.
Dr. Meng stated that Mr. Rackett would be visiting St. Anne’s Place, a seniors’ apartment complex operated by LOFT, following the hearing today, to see the residence and meet the staff. The services provided at St. Anne’s include personal care, meal preparation, essential housekeeping, laundry, medication support, escorts to appointments, activation and socialization, emergency response and 24-hour on-site staffing.
If Mr. Rackett is accepted as a resident, it is expected that St. Anne’s will become his permanent home. However, transitioning to St. Anne’s will undoubtedly be stressful in Dr. Meng’s opinion.
As noted in the Hospital Report, between June and December 2024 Mr. Rackett received cognitive adaptation therapy interventions from the FOPS occupational therapist to support his early transition to the community. Dr. Meng noted that while Mr. Rackett was successful in developing skills to adapt to his current living environment, he may experience difficulties in the event he moves to St. Anne’s which offers less supported accommodation.
St. Anne’s will provide Mr. Rackett with his own apartment. He will continue to have meals provided and receive assistance with medication administration. However, he will be responsible for maintaining his own unit and other activities of daily living, including his unit upkeep and laundry. The staff to patient ratio is lower at St. Anne’s. Help is available but the staff may not be as responsive, or be able to offer the level of support that Mr. Rackett is accustomed to. The overall reduction in support may increase Mr. Rackett’s stress level. There could be some stability issues attributable to increased stress, at least in the initial stages of the transition. Thus, the hospital’s ongoing ability to approve housing will assist in ensuring he remains suitably housed.
The uncertainty surrounding Mr. Rackett’s immigration status is also believed to be an added stressor in his life. Dr. Meng stated that Mr. Rackett says that he is not seeking an absolute discharge due to the risk that he may be deported.
Dr. Meng confirmed Mr. Rackett’s insight into his mental illness, the need for medication, and risk for violent reoffending remained limited. As noted in the Hospital Report, he continued to attribute his historically agitated and aggressive behaviors when unwell to justifiable responses to actual persecution. He was unable to appreciate the instability that he demonstrated when he was inadequately treated, and continued to press for changes back to medications that have proven ineffective. Similarly, he rejected feedback about the detrimental impact that repeated medication changes had on his long-term stability. Moreover, Mr. Rackett continues to characterize his index offense as “a simple little crime”. And, he attributes his extended course under the Board to possible discrimination based on his race.
Importantly, Mr. Rackett does not recognize that his appreciation of reality and emotional/behavioral control can be substantially impaired by symptoms of his mental illness. Dr. Meng confirmed that as a result of such lack of insight, Mr. Rackett’s compliance with psychotropic medications, the utmost important factor in maintaining his clinical stability, and the conditions of his Disposition, has been largely externally driven. In Dr. Meng’s opinion, it is highly unlikely that Mr. Rackett would continue with ongoing psychiatric treatment if not under the auspices of the Board.
As noted in the Hospital Report, another important concern is Mr. Rackett’s substance use, when not under appropriate supervision. He struggled with substance use earlier in his tenure under the Board. Even when he was in an inpatient setting he managed to get hold of substances.
To his credit, however, Mr. Rackett has not engaged in substance use in the past several years. Dr. Meng confirmed that Mr. Rackett has remained abstinent from substances since his recent discharge. Currently he provides samples once per week. Furthermore, notwithstanding Mr. Rackett’s recent more argumentative attitude about his right to use cannabis, he denies any intention to use in the future, recognizing that it could lead to his readmission to the hospital. He also expressed the opinion that cannabis no longer produced the same positive effect as he aged.
Dr. Meng stated that the clinical team would want Mr. Rackett to be placed on a Community Treatment Order (“CTO”), before being granted a conditional discharge. However, she confirmed that Mr. Rackett became quite angry at the suggestion that a CTO would likely assist in progressing him toward a conditional discharge. He stated that this “infringed” on his human rights, as he wanted to make his own treatment decisions and not have anyone ”force” medications on him. He was dismissive when reminded that he already has a substitute decision maker for treatment decisions, such that a CTO would not reflect a significant change in his control over medications.
Dr. Meng stated that while Mr. Rackett is on a positive trajectory, possibly leading to being considered for a conditional discharge in the coming year, a detention order is necessary and appropriate at this time. Mr. Rackett continues to adjust to community living. Furthermore, Dr. Meng anticipates that Mr. Rackett will be accepted as a resident at St. Anne’s which will provide lower support, but permanent housing. While the team is optimistic that this will remain appropriate for his support needs, how he adjusts will not be known until after he has transitioned.
Dr. Meng noted that Mr. Rackett has struggled with instability during periods of transition. If the environment at St. Anne’s is insufficient to meet his needs this instability may escalate with associated elevation in his risk to the public. Without the ability to approve housing, the team would be unable to ensure that Mr. Rackett remained in suitable accommodations. Furthermore, his deteriorating judgment would also impede his ability to abide by treatment and supervision conditions, including engaging with psychiatric assessments necessary to facilitate the use of the Mental Health Act for readmission.
Dr. Meng confirmed that it is the opinion the treatment team that Mr. Rackett continues to be a significant threat to the safety of the public based on his severe psychotic disorder, with ongoing residual symptoms and clinical fragility, history of aggression with heightened psychosis, and poor insight into his need for treatment. Further, as noted he has a history of significant cannabis use with less supervision.
The re-offence scenario presented in the Hospital Report notes, that when unsupervised Mr. Rackett stops taking his antipsychotic medication, which will likely result in significant re-emergence of his psychotic symptoms. In that event he would likely become highly manic, impulsive and reckless. His grip on reality and capacity for self-control would be compromised to the point that he would be unable to refrain from acting on his psychotic symptoms and delusional beliefs. Furthermore, Mr. Rackett’s mental stability has historically been aggravated by his use of substances, the risk of which would increase with greater disinhibition and impaired judgment.
Dr. Meng confirmed that the treatment team is unanimous in its opinion that a disposition detaining Mr. Rackett at the Forensic Service at CAMH, with the provision for community living in approved supervised accommodations, remains the necessary and appropriate, least onerous and least restrictive, disposition to ensure the safety of the public.
In Dr. Meng’s opinion a conditional discharge is not appropriate at this time, as the hospital needs to be able to approve Mr. Rackett’s housing to ensure it is suitable in the context of his risk management needs. Furthermore, when residing in the community Mr. Rackett needs to be able to be readmitted expeditiously in the context of decompensation, given his history of rapid decompensation in the context of substance use, and with poor adherence to treatment.
Analysis and Conclusions
Having considered all of the evidence and the submissions presented by the parties the Board finds that Mr. Rackett continues to pose a significant threat to the safety of the public and that his care should continue on the same terms as his current Disposition amended in accordance with hospital’s recommendation to reduce the frequency of his reporting. We also agree with the hospital’s position and accept Dr. Meng’s expert opinion that a conditional discharge is premature at this time. There is no evidence upon which we can reasonably find that Mr. Rackett is in a position to self-regulate his behaviour, such that his risk can be managed under a conditional discharge at this time.
We are encouraged by Mr. Rackett’s success in adapting to community living over the past year, despite the stress accompanying the transition. We also commend that Mr. Rackett for abstaining from the use of substances based on the appreciation he has developed about the negative impact of substance use on his health in general and his mental stability in particular.
We share Dr. Meng’s optimism that Mr. Rackett is on the path to achieving a conditional discharge. We trust that a move to St. Anne’s into permanent housing, will provide Mr. Rackett with the additional stability he needs to demonstrate to the team that he is ready to be considered for a conditional discharge. Furthermore, we encourage Mr. Rackett to carefully consider Dr. Meng’s advice with respect to accepting a community treatment order as a step in progressing toward a conditional discharge.
In coming to these conclusions, the Board has considered its responsibility pursuant to s. 672.54 of the Code to make a disposition that is necessary and appropriate in the circumstances, taking in to account the safety of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society, and his other needs.
DATED this 10th day of June, 2025, at the City of Toronto, in the Region of Toronto.
Mr. B. Garrow Legal Member
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Office of the Registrar Ontario Review Board