Ontario Review Board
Re: Michael Lawrence
ORB File No: 6838
Hearing held on: Monday, May 5, 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 of Canada
Before:
Alternate Chairperson: Ms. L. Banks
Members: Dr. T. Verny Dr. S. Wiseman Mr. K. McKenna Mr. W. Apted
Parties Appearing:
Accused: Michael Lawrence Counsel: Ms. C. Whillier
Person in charge of hospital: Counsel: Ms. M. Warner
Attorney-General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated June 18, 2025)
Introduction:
On October 7, 2015, Mr. Michael Lawrence was found not criminally responsible on account of mental disorder (“NCR”) on two charges of aggravated assault contrary to the Criminal Code of Canada (“Criminal Code”). Since his NCR finding, Mr. Lawrence has been subject to Dispositions of the Ontario Review Board (“ORB” or the “Board”), most recently a Disposition dated May 1, 2024, discharging him subject to a variety of terms and conditions, including that he reside at a specified address, report to the person in charge of the Centre for Addiction and Mental Health (“CAMH” or the “hospital”) not less than once every four weeks, consent to take treatment pursuant to s. 672.55(1) of the Criminal Code, refrain from being in possession of a weapon, and abstain from the non-medical use of alcohol and other intoxicants.
On May 5, 2025, a panel of the ORB a hearing at CAMH to review Mr. Lawrence’s current Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Lawrence attended the hearing with his counsel, Ms. Whillier.
The issues for the Board to decide at the hearing were first whether Mr. Lawrence is a significant threat to the safety of the public, and if so, what is the necessary and appropriate Disposition for the coming year based on a consideration of the factors in s. 672.54 of the Criminal Code.
For the reasons which follow, the Board finds Mr. Lawrence is a significant threat to the safety of the public and the necessary and appropriate Disposition is a continuation of the current Conditional Discharge but for the addition of two-week international travel pass subject to an itinerary approved by the person in charge of the hospital, all as set forth in his formal Disposition.
Initial Positions:
At the outset of the hearing, the parties were asked for their initial positions. Hospital counsel recommended a continuation of the current Disposition with no changes but for the addition of a two-week international travel subject to an itinerary approved by the person in charge of the hospital.
Crown counsel supported the hospital's position.
Ms. Whillier, on behalf of Mr. Lawrence, indicated that her client was requesting an Absolute Discharge. Alternatively, counsel advised that if the Board made a finding of significant threat, then her client would support a continuation of his existing Disposition with the addition of the travel privilege, as proposed. However, counsel advised that Mr. Lawrence was withdrawing his consent to the s.672.55(1) Criminal Code treatment condition.
After the hospital’s evidence was concluded, Mr. Lawrence met privately with his counsel and, upon returning to the hearing, Ms. Whillier advised that Mr. Lawrence had reconsidered his position and he now was in agreement with the inclusion of a consent to treatment condition should the Board find that he continued to represent a significant threat to public safety.
Both the hospital and the Crown maintained their joint recommendation in closing submissions.
Index Offences:
- The circumstances giving rise to the Index Offences taken from last year’s Reasons for Disposition dated May 23, 2024, as follows:
“The accused in this matter, Michael Lawrence is related to the victims…. His mother (victim #1) is one of the victims and the brother (victim #2) is the other. They all reside at the same address….
On Friday October the 5th, 2012… the accused’s mother was asleep in her bedroom when she woke to find the accused standing in her room. When asked what he was doing, the accused left the room. The victim got up to use the bathroom and she saw the accused, who asked her to talk and to come to his bedroom. The victim refused.
As they stood in the hallway near the bathroom, the victim saw that the accused was carrying a knife in his right hand and a large wooden sword in his left. The victim tried to take the knife away from the accused. The accused and the victim began to struggle as the victim yelled for her son, the other victim, to help her.
The daughter of the victim (sister of the accused) woke up and the victim yelled at her to call 911. The second victim woke as well and assisted in helping his mother fend off the accused.
The accused used the large wooden sword to push the victim away and then proceeded to stab both victims several times. The victims continued to struggle with the accused down the stairs to the main floor, where the accused fled out the front door."
Personal Background:
The details of Mr. Lawrence’s personal, psychiatric and criminal history are set out in the Hospital Report dated March 22, 2025 (the “Hospital Report”) which was entered as an Exhibit at the hearing and need not be repeated in detail here. Briefly stated, Mr. Lawrence was 36 years old at the time of the hearing. He is the youngest of three siblings. His parents separated when he was young.
He reported that his father was involved in ministering in the Revival Church. In his work, his father would give ‘spiritual baths”. This practice eventually led to charges of sexual assault which resulted in a four-year prison sentence.
There was also economic hardship in his childhood and at one point the Children's Aid Society was involved for a few months after Mr. Lawrence told his teacher that he had been hit by his mother. He dropped out of school at the age of 16, but returned sporadically for the next seven years, completing grade 11 at the age of 23.
Mr. Lawrence held a variety of jobs over the years but had a pattern of quitting after a few months.
Mr. Lawrence reportedly began using marijuana at the age of 14 or 15, and he consumed it regularly. He also drank alcohol. Prior to the commission of the index offences, he had been smoking 2-3 marijuana cigarettes on a daily basis.
Mr. Lawrence has never married and has no children.
Criminal History:
- Prior to the index offences, Mr. Lawrence had criminal convictions for aggravated assault (2005), possession of a weapon, failure to comply with a probation order and robbery (2008), and trafficking in cocaine (2010). Both the robbery and trafficking convictions resulted in significant jail sentences.
Psychiatric History:
Mr. Lawrence has a long and significant history of mental health issues commencing in 2005, when he was admitted to the Child and Adolescent Unit of the Humber River Regional Hospital. He did not maintain follow up and was inconsistent with medication compliance.
Since coming under the jurisdiction of the ORB, Mr. Lawrence has had no admissions to hospital. After being found NCR, he remained in the community and was followed by the CAMH downtown East ACT team from February to April 2016. He was then transferred to the EFOPS team under the care of Dr. Duff. He was declared incapable of consenting to psychiatric treatment on April 5, 2017. His mother is his substitute decision maker (“SDM”). Since 2017, he has cooperated in receiving monthly intramuscular injections at the FOPS clinic.
Mr. Lawrence lived in a one-bedroom apartment in a supported housing residence through HouseLinks before electing to return to the family home in July 2018, where he was living at the time of this hearing. Since living in the community, he has supported by the Forensic Outpatient Service (“FOP”).
On April 30, 2020, Mr. Lawrence was granted a Conditional Discharge with conditions including, among others, that he resides at his parents’ home and that he consent to treatment pursuant to s. 672.55(1) of the Criminal Code.
Since November 2023, Mr. Lawrence has reported regular use of cannabis and, by his self-report, he smokes one joint a day at the conclusion of his workday. This is in contravention of the requirement that he abstain from use of intoxicants as set forth in his existing ORB Disposition.
Current Diagnosis:
- Mr. Lawrence’s current diagnoses are:
Schizophrenia; and
Cannabis Use Disorder, moderate.
Evidence at the Hearing:
In addition to the Hospital Report, the Board heard oral testimony from Dr. D. Jaiswal who has been Mr. Lawrence’s treating forensic psychiatrist over the past reporting year.
The doctor advised that Mr. Lawrence continues to be assessed as incapable to consent to psychiatric treatment and his mother or the Office of the Public Guardian and Trustee acts as his substitute decision maker (“SDM”). Mr. Lawrence is currently treated with a long-acting injection (“LAI”) of an antipsychotic medication which he has been consistently compliant with. Despite treatment compliance, he has continued to intermittently report the presence of a spirit–based entity, which he described as a “poltergeist thing”. Dr. Jaiswal commented that this symptom was likely residual in nature and Mr. Lawrence did not appear to be behaviourally pre-occupied by it. There were no other reported perceptual disturbances over the year in review. Dr. Jaiswal commented that Mr. Lawrence continues to experience these intermittent tactile hallucinations (which Mr. Lawrence attributes to a “spiritual presence”) approximately less than five times a year. In the doctor’s opinion, Mr. Lawrence is presently optimally treated.
Mr. Lawrence continues to reside in the community with his mother and sister at the address specified in his ORB Disposition. The team has not had communication with Mr. Lawrence’s mother over the year in review.
Over the past reporting year, Mr. Lawrence has continued to regularly use cannabis products in breach of his ORB Disposition. He reports purchasing cannabis products from a dispensary. He advises that he consumes 1 to 2 joints daily. He also reports consuming a few beers on weekends. Mr. Lawrence denies all other substance use. Urine drug screens (“UDS”) conducted on a near monthly basis consistently return positive for cannabis, and, at times, metabolites of alcohol. With one exception referred to below, the UDS have not detect the presence of other substances of abuse.
On October 16, 2024, lab results evidenced the presence of opioids in a UDS conducted. Mr. Lawrence had attended an emergency department on September 10, 2024 to address lower back pain and he was prescribed a limited course of hydromorphone, an opioid medication. This is the only incident where any substance other than alcohol or cannabis was detected.
Dr. Jaiswal commented that despite Mr. Lawrence’s regular cannabis use and intermittent alcohol use, he has remained clinical stable over the past reporting year. The doctor attributed his mental stability to Mr. Lawrence’s adherence with his LAI antipsychotic treatment. Dr. Jaiswal advised the treatment team was taking a harm reduction approach to Mr. Lawrence’s use of cannabis and alcohol. He elaborated by stating that Mr. Lawrence is fully informed of the fact that if his cannabis or alcohol use becomes problematic or if he were to suffer a decompensation, then the treatment team would react by readmitting him to the hospital. In the doctor’s assessment, this knowledge about the potential for readmission tempers Mr. Lawrence’s use of these substances.
In response to questions raised by a panel member, Dr. Jaiswal candidly acknowledged that the treatment team relies entirely on Mr. Lawrence’s self-report about his alcohol and cannabis use. The doctor acknowledged that positive UDSs indicating the presence of these substances do not provide any information about the frequency of his use, the potency of the products consumed, or the quantity of Mr. Lawrence’s consumption of same. Dr. Jaiswal
Dr. Jaiswal reiterated his testimony and that “unopposed” cannabis use poses a real risk of negatively impacting Mr. Lawrence’s mental stability. The doctor endorsed the accuracy of last year’s Reasons for Disposition regarding the doctor’s testimony as set forth in paragraphs 30 and 31 therein and advised that his opinion remains the same today and a prohibition on the use of all intoxicants remained necessary and appropriate. If the prohibition were removed, the doctor said it was more than likely that Mr. Lawrence would increase his use of cannabis and alcohol.
Of note, on March 12, 2025, an MRI of his right knee revealed a tear of his right patellar tendon. Dr. Jaiswal provided an update and advised that on March 15, 2025, Mr. Lawrence underwent surgery to repair his right knee. He was discharged from the hospital on March 16, 2025. Since his surgery he has not yet been able to return to his work, Of note, on discharge, he was prescribed 45 tablets of 5mg oxycodone and 325mg acetaminophen for pain management. In response to questions posed by a panel member, Dr. Jaiswal stated that he is not certain what Mr. Lawrence did with this medication. The doctor stated that he would follow up with Mr. Lawrence on that point. The doctor also advised that the hospital’s treatment team learned about the oxycodone prescription through shared medical records, and not from Mr. Lawrence directly. Dr. Jaiswal acknowledged that this raises concerns about transparency and the doctor stated that health teaching will be provided to Mr. Lawrence to address this type of issue from potentially happening again. Dr. Jaiswal reiterated that from the treatment team’s perspective, cannabis and alcohol use are the primary intoxicants that the hospital is concerned about in Mr. Lawrence’s case.
To his credit, Mr. Lawrence maintained full-time employment as a forklift operator at Fast Freight. Work shifts were between 6pm and 2am from Monday to Friday.
Dr. Jaiswal stated that Mr. Lawrence’s insight across all relevant domains is very underdeveloped. He does not view his symptoms as part of any mental illness but rather he believes he experiences a “spiritual entity”. He does not think that medication and/or ongoing psychiatric treatment are necessary. He has consistently told members of the treatment team that he will not engage in follow-up care if he is granted an Absolute Discharge. The doctor described Mr. Lawrence’s insight as being “stagnant” over the past several years.
Dr. Jaiswal testified that Mr. Lawrence is entirely externally motivated to adhere to his LAI because he is under the Board’s jurisdiction and he wants to progress to an Absolute Discharge, at which time, he will discontinue medication and all psychiatric follow-up.
When the index offence was canvassed with him a few months ago, Mr. Lawrence stated that it occurred a long time ago and it “won’t happen again”. The doctor confirmed that Mr. Lawrence minimized the severity of the assault and its potential to have been lethal. Dr. Jaiswal stated that he considers Mr. Lawrence’s statements to be indicative of lack of insight into the nexus between his experience of symptoms of psychosis and his risk of violence.
Dr. Jaiswal advised that Mr. Lawrence was re-referred for individual therapy with FORCAT to address his deficits in insight but that Mr. Lawrence chose not to participate. Scheduling the appointments appeared to be somewhat challenging given Mr. Lawrence’s work commitments and the limited availability of FORCAT therapists. The doctor noted that virtual attendance in therapy was also an option with FORCAT but the doctor was not certain that Mr. Lawrence was interested in engaging in therapy sessions.
When asked what the rationale was for the addition of a 2-week travel privilege, the doctor stated that although Mr. Lawrence does not have any specific travel plans, he has requested that he be allowed to possibly travel to the Caribbean in the future to visit extended family members. The doctor did not see a problem with that subject to the approval of the person in charge of the hospital and an approved itinerary. Dr. Jaiswal anticipated that the travel would be likely accompanied by his mother. In addition, the doctor testified that any potential travel would be coordinated in conjunction with the administration of his LAI treatment. As well, a travel pass would require that Mr. Lawrence be required to check in with hospital during his travels. As well, a precondition to the exercise of a travel pass would be the development of a “safety plan” should Mr. Lawrence experience a decompensation while abroad. Dr. Jaiswal stated that the proposed inclusion of this travel pass is to motivate Mr. Lawrence and to further develop the team’s therapeutic rapport with Mr. Lawrence.
Dr. Jaiswal endorsed the relevance of the historical and clinical risk factors identified in the Hospital Report, including:
major mental disorder with ongoing residual symptoms;
violence other antisocial behaviours;
relationship instability;
poor treatment and supervision response;
substance use; and
underdeveloped insight
- Dr. Jaiswal stated that the treatment team would like to see improvement in the following areas before they would be likely to recommend that Mr. Lawrence be absolutely discharged from the Board’s oversight:
a continuous reduction in Mr. Lawrence’s cannabis use with the goal of total abstinence;
improvement in Mr. Lawrence’s insight across all relevant domains; and
Mr. Lawrence demonstration of a pro-active approach to maintaining his clinical stability, including, for example, his engagement in individual therapies.
In response questions from panel members regarding Mr. Lawrence’s initial position at the hearing indicating that he no longer consented to the inclusion of a treatment condition, Dr. Jaiswal stated that Mr. Lawrence is still assessed as incapable to consent to treatment and the PGT is his SDM. Dr. Jaiswal testified that the exclusion of the treatment condition would not be of critical importance in the management of Mr. Lawrence’s risk as the treatment team would likely be able to return him to hospital for a breach of his Disposition related to his ongoing use of cannabis and/or alcohol.
Dr. Jaiswal added that the team would also increase his reporting requirement to weekly contact as well so that the provisions of the Mental Health Act could be utilized to effect an involuntary readmission. The team could require that Mr. Lawrence attend at the hospital for a mental health assessment and the decision to readmit him to the hospital would be based on his clinical presentation at that time.
If Mr. Lawrence actually refused his LAI, then Dr. Jaiswal advised that under the SDM’s consent, the hospital could administer the LAI against Mr. Lawrence’s wishes. The doctor conceded that in the final analysis, the removal of the consent to treatment clause at Mr. Lawrence’s request would signify to the treatment team that Mr. Lawrence is likely considering discontinuing his prescribed treatment.
Overall, Dr. Jaiswal stated that Mr. Lawrence’s assertion that he would no longer consent to a treatment condition was a significant concern as the doctor viewed it as a clear expression of Mr. Lawrence’s limited insight regarding the need for treatment.
Dr. Jaiswal was asked by Ms. Culp whether Mr. Lawrence had a civil psychiatric care team in place and the doctor replied in the negative and stated that Mr. Lawrence had consistently stated that he was not receptive to any follow-up professional supports should he be granted an Absolute Discharge.
Dr. Jaiswal was questioned by Ms. Whillier about the use of a Community Treatment Order to manage Mr. Lawrence’s risk. The doctor stated that he was not in favour of a CTO in the context of an Absolute Discharge because he remained of the opinion that Mr. Lawrence continues to pose a significant threat. The doctor reiterated that a CTO is not a sufficient risk management tool for Mr. Lawrence at the present juncture.
Dr. Jaiswal testified that Mr. Lawrence continues to represent a significant threat to the safety of the public. Mr. Lawrence continues to experience residual symptoms of his major mental illness. The doctor referred to the seriousness of the index offence and the fact that Mr. Lawrence continues to engage in cannabis use which was also the case at the time of the index offence.
Dr. Jaiswal opined that in the absence of an ORB Disposition, Mr. Lawrence would be highly likely to discontinue his treatment and follow-up with mental health service providers. In that context, he would be likely to continue to use alcohol, cannabis (and possibly other intoxicants) to an even greater degree. The likely result would be that Mr. Lawrence would then experience an acute decompensation in his mental state. When ill in the past, Mr. Lawrence has incorporated individuals in his proximity into his delusional beliefs and acted out with severe violence, as was the case at the time of the index offences.
The Hospital Report indicates that “...in the context of the current disposition and while residing at his current residence, Mr. Lawrence’s risk for violent offending falls in the low to moderate range. However, in the context of an absolute discharge, Mr. Lawrence’s risk for violent offending falls in the high range.”
No further evidence was called by the parties.
Analysis and Conclusions:
Based on the evidence presented, the Board finds that Mr. Lawrence represents a significant risk to the community. He suffers from a serious mental illness which is further complicated by his substance use challenges. He continues to experience residual psychotic symptoms which are likely to intensify absent treatment and/or in the context of unopposed cannabis and/or alcohol use. The evidence indicates that there is a clear historical connection between Mr. Lawrence’s drug use and mental status decompensations (as was the case at the time of the index offences) which have heightened his risk profile. Additionally, Mr. Lawrence continues to present with suboptimal insight across all domains. The Board noted the seriousness of the index offences, which could have resulted in fatalities as well as Mr. Lawrence’s past behaviour which had included a charge of aggravated assault in 2005.
The panel is mindful of the fact that the doctor’s evidence highlighted the fact that there have also been positive developments. Over the year in review Mr. Lawrence has remained medication compliant, has not engaged in any incidents of aggression or violence and has continued to reside in stable housing with his family. Unfortunately, he has continued to breach the terms of his ORB Disposition by near-daily use of cannabis and intermittent alcohol use. Despite regular cannabis use, he has not suffered a decompensation in his mental state, likely as a result of his adherence to his LAI.
Dr. Jaiswal testified that the treatment team is taking a measured, harm-reduction approach to Mr. Lawrence’s regular substance use; however, Mr. Lawrence is well aware that should his use become problematic or should he suffer a decompensation, the likely response of the hospital will be his readmission. To date, the team has not considered it necessary to readmit Mr. Lawrence.
In considering all of the evidence and the submissions of the parties, the Board orders that Mr. Lawrence shall continue to be subject to the terms of his existing Conditional Discharge Disposition subject to one amendment, being the addition of a discretionary two-week international travel subject an itinerary approved by the person in charge of the hospital.
In making this Disposition, the Board has reviewed the provisions of s. 672.54 of the Criminal Code and has carefully considered the need to protect the public from dangerous persons, the mental condition of Mr. Lawrence and his reintegration into society and other needs.
DATED this 18th day of June, 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar
Ontario Review Board