Ontario Review Board
Re: Sara Eves
ORB File No: 6728
Hearing held on: Tuesday, May 13, 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. R. Chandrasena Dr. S. Wiseman Mr. E. Siebenmorgen Ms. R. Chopra
Parties Appearing: Accused: Sara Eves Counsel: Ms. C. Whillier
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION (Dated June 9, 2025)
Introduction
On April 1, 2015, Sara Eves, now 32 years old, was found not criminally responsible on account of mental disorder (NCR) on charges of assault with a weapon (x2), mischief not exceeding $5,000.00, and failing to comply with probation, all contrary to the Criminal Code. Ms. Eves was most recently subject to a Disposition of the Ontario Review Board (“ORB” or “the Board”) dated May 22, 2024 pursuant to which she was ordered detained at the Southwest Centre for Mental Health Care (“Southwest” or “the Hospital”) subject to several conditions, including that she be permitted to live in the community in approved accommodations.
On Tuesday, May 13, 2025, a panel of the Board convened in person at Southwest Centre for Forensic Mental Health (“Southwest Centre” or “the Hospital”) to conduct a review of Ms. Eves” Disposition and to make a new Disposition pursuant to section 672.81 (1) of the Criminal Code. Ms. Eves was present and represented by her counsel, Ms. Whillier. The issues to be determined at the hearing were whether Ms. Eves continued to represent a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, what was the necessary and appropriate Disposition that was also the least onerous and least restrictive taking into account the factors set out in 672.54 of the Criminal Code.
Positions of the Parties
- At the commencement of the hearing the parties were requested to provide their initial and “without prejudice” positions with respect to the issues before the Board. The parties jointly submitted that Ms. Eves should continue to be subject to a Detention Order on the same terms and conditions as those contained in her existing Disposition, with minor changes to reflect that the Hospital is unable to provide staff-escorted privileges, to specify community living within Southwestern Ontario, and to provide that Ms. Eves’ indirectly supervised passes be limited to Southwestern Ontario. On behalf of her client, Ms. Whillier stated that Ms. Eves was not contesting the issue of significant threat. The parties maintained their positions at the conclusion of the evidence.
Evidence at the Hearing
- The evidence at the hearing consisted of the Hospital Report dated April 7, 2025 and the oral evidence of Dr. N. Mokhber, Ms. Eves’ attending psychiatrist.
Findings
- The Board accepted the parties’ joint recommendation and found, independently on the evidence, that Ms. Eves represents a significant threat to the safety of the public. A new Disposition, in the form of a Detention Order reflecting the agreed-upon changes, was issued. Ms. Eves was advised that Reasons for the Board’s findings would be provided at a later date. These are those Reasons.
Index Offences
- The index offences occurred when Ms. Eves was 21 years old. The synopsis of the circumstances surrounding those offences is contained within the Hospital Report and is reproduced as follows:
On May 9, 2012 the accused entered into a Probation Order for a period of 3 years in a Guelph Court in regard to the charge of Break of Probation. Two of the conditions of this order was the accused, “Keep the peace and be of good behavior.” And that she, “Not own, possess, carry or control an offensive weapon, firearm, ammunition or explosive substance or any firearms certificate/registration/licence as defined in the Criminal Code.”
On June 23, 2014 the accused entered into a Probation Order for a period of 2 years in a Guelph Court in regard to the charges of Breach Probation and Arson Damage Property. Two conditions of this order was the accused, Keep the peace and be of good behavior.” And, “do not possess any weapon(s) or incendiary devices as defined by the Criminal Code (for example, a BB gun, pellet gun, firearm, imitation firearm, cross-bow, prohibited or restricted weapon or device, ammunition or explosive substance or anything designed to be used or intended for use to cause death or injury or to threaten or intimidate any person).”
On November 3, 2014 at approximately 7:40 pm the accused – Sara EVES attended to her mother’s residence of 226 Terraview Crescent in Guelph. Once inside the accused started to argue with her mother Lori EVES, about why she won’t allow the accused to live there. The accused became very upset grabbed a 6-inch steak knife from the drawer in the kitchen, then held the knife up above her head pointing it at her mother and saying numerous times that, “I’m going to kill you!”. Lori fearing for her safety told the accused her brother was outside wanting to have a smoke with her, so the accused then left the house, still keeping possession of the knife.
The accused then walked up the street to 242 Terraview Crescent where she located the second victim – Ben DUNN (who is not known to the accused). He was seated in his vehicle in the driveway waiting for a friend. DUNN had the window of the vehicle down when the accused grabbed him through the window by his shirt and said to, “get out of the car”, DUNN began to get out of the vehicle when the accused said, “you think I’m fucking joking” and raised the knife above her head and pointed it at DUNN. DUNN was partially out of the car when the accused let him go. He got back into his car, closed the window and locked the doors. The accused began stabbing at the driver’s side window and roof of DUNN’s car, then down the side of the car and eventually stabbing/slashing the front driver’s side tire causing it to deflate. The damage to the vehicle is estimated at approx. $400.
The accused then fled the area on foot. At 7:54 pm the accused was located by Police K9 a short distance away. She dropped the knife when approached by Police and was placed under arrest, for the abovementioned charges.
Diagnoses
- Ms. Eves’ psychiatric diagnoses are listed in the Hospital Report as follows:
(i) schizoaffective disorder;
(ii) substance use disorder (in remission in a controlled environment);
(iii) social anxiety disorder;
(iv) antisocial personality disorder, by history; and
(v) acquired brain injury, by history.
Background Information
Ms. Eves’ personal history, psychiatric background and course under the Board’s jurisdiction are extensively detailed in the Hospital Report. As the Report was entered as an Exhibit and forms part of the evidence, its contents need not be extensively summarized in these Reasons. In summary, Ms. Eves currently lives in a 24/7 supervised group home in St. Thomas, where she has been since her discharge from the Hospital in May of 2022. She has been under the care of the Hospital’s Forensic Outreach Team and Dr. Arun Prakash until Dr. Mokhber took over her care in February of 2025. At the group home, Ms. Eves is supported by a worker from the Community Homes for Opportunity (CHO) program, offered through Canadian Mental Health Association (CMHA). She also reportedly has a very good relationship with the owner/operator of the group home.
Ms. Eves is the elder of two siblings (she has a younger brother who was reportedly living in London at the time of the hearing). Her parents reportedly separated in 2003 and were divorced in 2005. Her father was reportedly a binge drinker who was verbally and sometimes physically abusive to her mother when on these binges.
Ms. Eves’ medical history includes reports of concussions and loss of consciousness from playing football as well as from falling off her bicycle.
Ms. Eves has a substance use history dating to her grade 10 year, when she started consuming cannabis and alcohol. She did not complete school beyond grade 10. Her drug use became heavier over time. Her first psychiatric admission occurred from late March to May of 2009 when she was 16 years old. Her discharge diagnosis was bipolar affective disorder with psychotic symptoms, along with substance abuse, mainly marijuana and alcohol. Later in 2009, she underwent an assessment that revealed cognitive difficulties. Further psychiatric admissions followed in 2009, 2010, and 2011. Some admissions followed reports of suicide attempts, aggressive behaviour in her father’s home, and an assault upon her father. She also was previously admitted for a fitness to stand trial and a criminal responsibility assessment in 2011.
In addition to her substance use and psychiatric history, Ms. Eves has an extensive criminal record spanning the years from 2010 to 2014. Her convictions include killing or injuring an animal, assaults on both her father and brother, arson, and numerous failures to comply with probation. She has been mostly noncompliant with medications on leaving hospital in the past and, prior to her NCR finding, regularly failed to follow up with psychiatric care. She also had a history of homelessness. She stated that she has never had a job. Her self-report of having a difficult relationship with her family and friends is confirmed by her criminal and psychiatric history.
Brief Summary of Course Under the Board’s Jurisdiction
During Ms. Eves’ initial course in the Hospital, it was noted that she became easily agitated, angry and verbally abusive to staff when she did not receive the responses she desired. On one occasion in 2016, she assaulted a staff member after being asked to wait until a nursing shift change was completed before she could receive her PRN medication.
Ms. Eves was started on clozapine in 2016. After the initiation of clozapine, Ms. Eves reported that the voices she was hearing were not as mean to her or as bothering to her as before. Moreover, she appeared to be thinking more clearly and was no longer presenting with disorganized or nonsensical thoughts. Her mood became more stable, and many of her complaints and aggressive behaviours significantly decreased. However, she continued to voice delusional and paranoid thought content at times, believing that staff will murder her or abandon her if she were to get into a car with them. She has also voiced the belief that staff members are going to hurt her, kill her, or rape her. However, she often admitted that she does not truly believe these things and that it is the auditory hallucinations that are telling her this information.
Ms. Eves’ mother died in June of 2017. Her father, despite having his own struggles with substance use, was her main source of family support. In November of 2017, Ms. Eves experienced a tonic-clonic seizure. As a result, her clozapine dose had to be decreased. This resulted in a significant decompensation of her mental status, lasting a several weeks. The clozapine dose was gradually increased again. By July of 2018, Ms. Eves was able to take a major step forward in her ability to trust staff with her personal safety, as she got into a vehicle with her therapeutic recreation specialist and a nurse for a community outing. Initially, she was agreeable to only occasional outings and for very short distances (to a nearby Tim Horton’s) but eventually entered the community with staff on a weekly basis.
By 2021, Ms. Eves was able, despite experiencing anxiety around living in the community, to complete an application for supervised housing with Community Homes for Opportunity (CHO). She was formally discharged to a supervised group home in June of 2022. Ms. Eves’ level of wellness and stability fluctuated. However, these fluctuations were generally short-lived, and she managed these changes through medication adjustments, smoking reductions, PRN use, and support from her Outreach Team members and group home staff. She continued to experience positive symptoms, including auditory hallucinations, paranoia, and delusions. The frequency and intensity of each appeared to fluctuate and were directly related to the level of stress she was experiencing or due to lower blood clozapine levels related to increased smoking.
During the initial period following her discharge to the group home, Ms. Eves' paranoia prevented her from participating in many CMHA community-based activities, as she feared for her safety. For example, she initially refused to go to the YMCA with her CHO worker because she was afraid the lights would go out, and someone would kill her. She denied this being something her auditory hallucinations told her and stated it was "just an impression.”
Ms. Eves visited regularly at her father’s apartment in St. Thomas following his move there from London in 2022, exercising four-hour passes three times per week. Her participation in structured programming slowly increased after she started to live at the group home, but over time, she became preoccupied with her father’s situation and her desire to eventually live with him. Her father also voiced this desire and wanted her to be able to leave the group home. It was opined by Ms. Eves’ outreach team that her father’s desire to have her spend all her time with her was interfering with her move towards independence and the achievement of her treatment goals.
During the 2023-2024 reporting period, Ms. Eves began to spend a portion of Tuesdays, Thursdays, Saturdays, and Sundays at her father’s apartment, with the frequency gradually increasing over the reporting period. She reported spending her time there with her father, brother, and their new dog, doing errands and cooking meals together. Unfortunately, this period of relative stability ended, as noted in last year’s Reasons, on May 1 of 2024 as a result of her father being evicted from his apartment. Her brother had to find alternative accommodation, the dog had to be given up to a shelter, and for some time, Ms. Eves became preoccupied with finding new accommodation for her father.
The Most Recent Reporting Period
During the past reporting year, Ms. Eves has continued to experience positive symptoms of her major mental illness, including auditory hallucinations. There has been some improvement in her willingness to discuss her symptoms with the treatment team and the group home’s manager but would not disclose what the voices were saying, other than to say that they gave her headaches and to deny that they were commanding to her. During acute times, the group home manager would note occasionally hearing Ms. Eves responding to the voices when she was alone and pacing. During these acute times, Ms. Eves was also more guarded with the Hospital’s outreach team. Overall, Ms. Eves became less guarded and paranoid about her relationship with outreach team members since her father’s eviction from his apartment in the spring of 2024, as she allowed team members to provide her with emotional support during this time.
The main source of stress for Ms. Eves has been her father’s instability, and this is expected to continue over the next reporting period. Ms. Eves reportedly witnessed her father being intoxicated and in a decompensated mental state on many occasions, being erratic and unkind to her, and making violent suicidal threats. Despite her father’s situation having worsened, Ms. Eves’ mental state did not decompensate, and she reportedly demonstrated “tremendous resilience and growth” while receiving significant support from the group home staff, her outreach team, and from her aunts and grandmother who live in Guelph.
Ms. Eves’ medication compliance became an issue because of her consuming concern for her father’s well-being. As a result, she was required to return to the group home, on days when she visited her father, to receive her medication as there was a high likelihood that she would forget to take them while out supporting him.
Occasional behavioural instability was noted with what appeared to be at times impulsive decisions to choose Ms. Eves’ father’s wellbeing over her own, such as not returning home for lunch medications, not attending her bloodwork appointment, deceiving group home staff about where she was going in town and deciding to see her father on a day that was not in line with the visiting schedule.
Matters came to a head on July 25, 2024, when the outreach team received a call from the group home CMHA worker and the homeowner regarding concerns about Ms. Eves’ capacity to make decisions about her father that were in his best interest instead of hers. At that time, she was spending most of her money on him, purchasing him cigarettes and food, and the group homeowner suspected that Ms. Eves was also taking food from the home to give to him (although there was no proof of the latter). Ms. Eves was putting herself at risk for eviction, and was readmitted to the Hospital for a few days, until August 1. She initially refused to come to the Hospital voluntarily but eventually did so, after a lengthy a lengthy conversation with outreach team members and the homeowner. During her inpatient stay, a comprehensive care plan was put in place to support her continued living in the group home.
In addition to the constant stress of dealing with her father, Ms. Eves also coped well with other stressors during this reporting period. Unfortunately, one of the new residents in the home died. Ms. Eves coped well with this event, and was noted to have demonstrated empathy towards the resident and to the group home manager, who was struggling with the death. She is described as a kind and helpful member of the group home, enjoying a good relationship with everyone. When not out spending time with her father, Ms. Eves typically spent her days at home, helping the manager in the kitchen and participating in some in-house activities.
Ms. Eves’ clozapine dose was increased over the past reporting year. She reported becoming less stressed by her auditory hallucinations, although she reported often being too busy with her father’s issues to pay attention to the voices or talk to them.
During the reporting year, Ms. Eves continued to experience paranoia related to her personal safety and refused to travel outside St. Thomas. Although she wanted to see her brother and his girlfriend in London and her grandmother and aunts in Guelph, she did not use her travel passes to do so. She would like to visit with her grandmother and aunts in the coming year but stated that they would need to come to St. Thomas for this purpose.
Evidence of Dr. Mokhber
As stated above, Dr. Mokhber assumed Ms. Eves’ care in February of 2025, taking over from Dr. Arun Prakash. She gave evidence to supplement the evidence in the Hospital Report, which she adopted. She began her evidence by stating that Ms. Eves had experienced improvements during the reporting year in her mood and stress management. She was also more settled. Dr. Mokhber said that Ms. Eves’ medications are now optimized (her daily clozapine dose is now at 475 mg) and that she is cooperating with her medication regimen.
Dr. Mokhber stated that now that Ms. Eves’ father and brother have places to live, she has allowed herself more time to focus on her own care. She is more open to discussing her symptoms and stressors, but her relationship with her treatment team needs further development. She has become willing to engage in 1:1 psychoeducation with the team’s social worker but refuses to see the psychotherapist. On the positive side, Ms. Eves continues to enjoy a very good relationship with the owner of her group home.
Noting Ms. Eves’ history of abuse at the hands of males, Dr. Mokhber pointed out that Ms. Eves now is happy that she has a female doctor.
Dr. Mokhber noted that Ms. Eves continues to demonstrate, as elaborated in the Hospital Report, limited insight across the relevant domains: her illness, her need for her medication, her need to avoid substance use, and the relationships among her illness, substance use, and risk to the community. She still expresses the belief that she is on too much medication. She has not used cannabis but expressed that she wishes to. She believes that it would be helpful to her. She has remained abstinent because she does not want to be in breach of her Disposition.
Dr. Mokhber referred the panel to the list of active risk factors in the Hospital Report, which she adopted. She expressed the opinion that a Detention Order continues to be necessary in Ms. Eves’ case. Her risk can be managed very well with the supports currently in place, but not in the context of a Conditional Discharge. Dr. Mokhber also expressed the opinion that the Hospital required the authority of a Detention Order in to ensure that Ms. Eves continued to have appropriate housing. She did not believe that, without a Detention Order in place, Ms. Eves would voluntarily return to the Hospital if requested to do so.
Dr. Mokhber was asked by a panel member to comment upon the role of Ms. Eves’ acquired brain injury history. Dr. Mokhber commented that the history of investigations into this did not reveal anything of significance. She did, however, note that from her own background and studies as a neuropsychiatrist, a brain injury can affect how the brain responds to medications, potentially causing a mental illness to become more treatment resistant. In Ms. Eves’ case, however, Dr. Mokhber believed that the history of trauma was a main issue for her recovery.
No further evidence was led following Dr. Mokhber’s testimony.
Analysis and Conclusions
The panel has borne in mind the parties’ joint submission and the fact that the “significant threat” issue was uncontested. Having considered the evidence in its entirety, the panel had no difficulty in concluding that Ms. Eves represents a significant threat to the safety of the public. The panel makes this finding based upon the expert opinion evidence of Dr. Mokhber and the evidence contained in the Hospital Report.
Ms. Eves suffers from a major mental illness, schizoaffective disorder, which has historically been associated with her history of criminal conduct, including interpersonal violence inflicted upon both family members and, as demonstrated by one of the index offences, upon a total stranger. She also has an associated history of substance use. Her overall risk assessment rating on the HCR-20 tool indicates that if Ms. Eves were to be managed under a Detention Order in the community over the coming year, her risk of violence would be moderate. If she were granted a Conditional Discharge while living in the community, her risk for violence would increase to high.
Ms. Eves continues, despite the optimization of her medication, to experience auditory hallucinations. She also continues to struggle with paranoia and anxiety. In her evidence, Dr. Mokhber reminded the panel that from her history, Ms. Eves’ mental condition deteriorates very quickly.
We recognize that Ms. Eves has achieved a significant level of stability during her course in the Hospital and in the community. Adherence to prescribed medication, abstinence from substances, and the dedicated support, structure and supervision provided by her treatment teams and the staff at her group home have all contributed to this. Without all these supports, however, the panel is of the opinion that the following re-offence scenario, extracted from the Hospital Report, would all too likely become reality, with seriously harmful consequences:
Without the current level of supervision, Ms. Eves would not be able to maintain the stability that she has developed. She continues to be significantly affected by ongoing issues with her father, and if not supervised, she would spend most of her time trying to help him and neglect herself. She would likely to forget to take her medications, leading to a rapid decompensation. She has continued to voice her desire to use cannabis to deal with her ongoing stress if she was legally allowed to which would lead to an exacerbation of her symptoms, resulting in behaviours similar to the time of the index offence.
Turning to the matter of the Disposition, the panel notes that Ms. Eves lives in a supervised group home and has a very good relationship with its owner/operator. Her housing and the support that she receives there are crucial for Ms. Eves at this time in her journey toward community reintegration. Over the past reporting year, Ms. Eves was at risk for losing that residence due to lapses in judgment arising from her understandable concern for her father’s wellbeing. This required a brief readmission to the Hospital so that Ms. Eves could stabilize and, with the support of her treatment team, implement a care plan that could support continued community living in her group home. This example reinforces the soundness of Dr. Mokhber’s opinion that a Detention Order continues to be necessary.
Accordingly, the panel was satisfied that the necessary and appropriate Disposition is a Detention Order containing substantially the same terms and conditions as were included in the previous Disposition, with the minor variations as previously noted. This Disposition, the panel found, best provides for the management of Ms. Eves’ risk at this time, and therefore the protection of the public, while recognizing Ms. Eves’ mental condition and her other needs and supporting the treatment team’s continuing efforts to help her reintegrate into the community.
In closing, the panel wishes Ms. Eves the best of success over the next year and would encourage her to continue to strengthen her therapeutic relationship with Dr. Mokhber and her treatment team.
DATED this 9th day of June 2025, at the City of Toronto, in the Toronto Region.
Eric Siebenmorgen
Legal Member
Office of the Registrar
Ontario Review Board