Ontario Review Board
Re: Chad A. Fraser
ORB File No. 8624
Hearing Date: May 29, 2025
Hearing Location: Southwest Centre for Forensic Mental Health Care
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before: Alternate Chairperson: Mr. M. D. Segal Members: Dr. B. Sheppard Dr. G. Nexhipi Ms. R. MacIntyre Mr. K. McKenna
Parties Appearing: Accused: Chad A Fraser Counsel: Mr. W. Glover
The Person in charge of Hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. D. Rows
REASONS FOR DECISION
(Dated June 13, 2025)
Introduction
Mr. Fraser, age 43, was found not criminally responsible (NCR) on September 4, 2024, for the criminal code offence of breaking and entering. He is subject to a detention order under a Disposition dated January 29, 2025, with privileges that extend to living in the community of Southwestern Ontario in accommodation approved by the person in charge.
The index offence occurred on August 12, 2022.
Mr. Fraser was released out of custody by the court at the time of the NCR finding, and he remained living in the community until February 26, 2025, when he was admitted to the Southwest Centre for Forensic Mental Health Care. He remained hospitalized at the time of this hearing.
A panel of the Ontario Review Board (the panel) convened a restriction of liberties hearing concerning the February 26th admission to hospital and the continuing hospitalization, on May 29, 2025, by videoconferencing at Southwest Centre for Forensic Mental Health Care.
At the commencement of the hearing, the Hospital submitted that the Restriction of Liberty was necessary and appropriate, and the least restrictive and onerous procedure that could be taken in the circumstances. The Hospital also requested that a Residential Treatment Clause be added to the Disposition. The Crown agreed with the Hospital’s recommendation. Counsel for Mr. Fraser indicated that he would not take a position at this time.
Evidence
The evidence at the hearing consisted of the Restriction of Liberties Report (ROL Report) dated May 7, 2025, the Hospital Report dated September 23, 2024, the Disposition and Reasons for Disposition, and the testimony of Mr. Fraser and Dr. Prakash. Dr. Prakash is the author of the risk assessment for the initial ORB hearing. He was the psychiatrist for Mr. Fraser in the community for one day before Mr. Fraser was admitted to hospital. As of March 5, 2025, Dr. Ashley Malka is Mr. Fraser’s Most Responsible Physician.
Mr. Fraser is diagnosed with schizophrenia, and with substance use disorder, with a history of using crystal methamphetamine, cannabis and alcohol. He has a criminal record that includes convictions in 2023 for forcible confinement, attempting to obstruct justice and fail to comply with recognizance.
Mr. Fraser has been under the care of a community psychiatrist since 2010. Following the index offence, Mr. Fraser had been admitted to the hospital for psychiatric care on 4 occasions.
Following the initial hearing before the ORB on January 29, 2025, the outreach team scheduled an initial intake meeting for February 25, 2025, in Blenheim, Ontario, where Mr. Fraser resides. The outreach team had difficulty contacting Mr. Fraser, but a personal friend was able to transport Mr. Fraser to the meeting with the outreach team on February 26, 2025.
Since May 2024, Mr. Fraser has been living at a friend’s home in Blenheim. Dr. Prakash testified that alcohol and crystal methamphetamine are available at this residence. According to Dr. Prakash, Mr. Fraser has only consumed alcohol.
During this initial intake meeting, Mr. Fraser advised that he had recently consumed alcohol, which is in contravention of his Disposition. He further indicated that he was becoming angry. He was observed to express paranoid ideation, and threatened litigious action. Mr. Fraser also refused to attend the hospital for a more fulsome assessment. His behaviour escalated to the point where the outreach staff became concerned for their safety. On February 26, 2025, the police transported Mr. Fraser to the Hospital for an assessment at the Hospital’s request.
On admission to hospital, it was difficult for the staff to conduct a thorough interview with Mr. Fraser. His thought content was bizarre, and he expressed paranoid delusions involving conspiracies and cameras persecuting him. He accused Dr. Quinn of having intelligence on him.
Mr. Fraser’s insight and judgment were described as grossly impaired.
Dr. Prakash referred to inadequate housing as one of the issues the Hospital is trying to address. Not only are substances available, but Mr. Fraser does not receive the support that is necessary, such as meals and ensuring medication compliance. The homeowner, where Mr. Fraser has been residing, also indicated that he may not be in a position to take Mr. Fraser back in any event.
Dr. Prakash testified that the symptoms observed at the time of the recent admission were similar to the symptoms of schizophrenia observed at the time of the initial ORB hearing. He was referring to resistance to supervision, behavioural and affective instability, and a brief period of aggression and anger.
Dr. Prakash further testified, that although Mr. Fraser has not required seclusion or restraints, he is argumentative and requires constant verbal redirection.
At the time of this hearing, there was no plan to discharge Mr. Fraser into the community, and he did not have access to any privileges.
Dr. Prakash testified that the delusional beliefs continue, and one of his aims is to optimize the medication including mood stabilizing medication. Mr. Fraser experiences mood symptoms that need to be addressed. Dr. Prakash indicated that schizoaffective disorder may be an appropriate diagnosis. In addition to optimizing the medication, Dr. Prakash suggested that a behavioural plan should be developed with 1:1 counselling. He believes the 1:1 counselling should be done before group programming which Mr. Fraser may find overwhelming. Dr. Prakash indicated that it is just in the last two weeks that Mr. Fraser is capable of attending programming.
Dr. Prakash also suggested in his testimony that Mr. Fraser would likely benefit from a residential treatment facility. He recommended a term be included in the Disposition to permit Mr. Fraser to attend a residential treatment facility anywhere in Ontario for up to 90 days. Dr. Prakash again suggested that the 1:1 counselling be undertaken before Mr. Fraser attends a residential treatment facility to avoid anxiety that may arise in a group setting.
Mr. Fraser’s mother reported to hospital staff on December 10, 2024, that her son’s delusions and anger were worse the past year. He was argumentative and displayed aggressive behaviour. Mr. Fraser’s mother is his substitute decision maker for medical treatment.
Dr. Prakash testified that the risk factors listed in the Hospital Report dated December 23, 2024, are still present. Mr. Fraser continues to experience psychotic symptoms, he lacks insight into his mental disorder and its presentations, and he has a history of violence. In Dr. Prakash’s opinion, it was necessary to admit Mr. Fraser to stabilize his condition and control the risk to public safety.
Mr. Fraser testified and advised the hearing that he would like to go to the Westover Treatment Centre which is local and close to his family. Mr. Fraser indicated a desire to participate in programming for drug and alcohol abuse.
Submissions
The Hospital took the position that the initial admission to hospital on February 26, 2025, and the continuing hospitalization were warranted and necessary. Mr. Fraser was experiencing a decline in his mental condition and needed to be assessed in the hospital to determine the appropriate treatment. The Hospital also referred to a lack of stable housing for Mr. Fraser in the community. The Crown supported the submissions of the Hospital.
Counsel for Mr. Fraser indicated that Mr. Fraser thought he was doing well but now recognizes the period of instability, which resulted in aggression. Counsel acknowledged that the restriction of Mr. Fraser’s liberty was warranted, and that being in hospital and treated with the appropriate medication is positive. Counsel referred to the Westover Centre as being an excellent facility for a short-term stay, and that Mr. Fraser appears to embrace their programming.
Analysis
It is very clear from the evidence that Mr. Fraser was becoming mentally unstable as of February 26, 2025, and required hospitalization and an assessment of his condition. It is also the evidence that Mr. Fraser has a history of violence when unwell, and according to his mother, his delusions, anger, and aggression had become worse this past year.
Mr. Fraser advised hospital staff that he had consumed alcohol just prior to the February 26, 2025 meeting with the outreach team, and it appears that other substances are available at the friend’s home where Mr. Fraser was residing. It is appropriate for the Hospital to be concerned with this housing and to be looking for more supportive housing for Mr. Fraser when he returns to the community.
Substance abuse has been an issue for Mr. Fraser for quite some time, and substance use undoubtedly has a negative impact on his mental health. The recommendation of adding a residential treatment clause to the Disposition, anywhere in Ontario for up to 90 days, is very reasonable.
In conclusion, the decision to admit Mr. Fraser to hospital on February 26, 2025, and the continuing hospitalization was warranted and appropriate in the circumstances. It is also reasonable to add the treatment clause requested by the Hospital to the Disposition.
Dated this 13th day of June 2025, at the City of Toronto, in the Toronto Region.
Kevin McKenna Legal Member
Office of the Registrar Ontario Review Board