Ontario Review Board
Re: Terrance G. Williams
ORB File No: 8065/8074
Hearing held on: Friday, June 6, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks
Members: Dr. S. Chatterjee Dr. M. Kalia Mr. D. D’Intio Mr. S. Duffy
Parties Appearing:
Accused: Terrance G. Williams Counsel: Mr. C. Hynes
Person in charge of the Hospital: Counsel: Mr. S. Dow
Attorney General of Ontario: Counsel: Ms. N. MacDonald
AMENDED REASONS FOR DISPOSITION
(Dated June 19, 2025)
Please see underlined changes at paragraphs 23, 30 and 35. The last sentence at paragraph 36 has been deleted.
Introduction:
On March 28, 2022, Terrance Williams was found not criminally responsible on account of mental disorder (“NCR”) on a charge of aggravated assault contrary to the Criminal Code of Canada. On May 4, 2022, he was again found NCR on a charge of assault, contrary to the Criminal Code.
Mr. Williams is currently subject to a Disposition of the Ontario Review Board (the Board), dated June 14, 2024, detaining him within the Forensic Program at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores” or the “hospital”) with discretionary privileges up to and including the ability to live in the community in accommodation approved by the person in charge.
On June 6, 2025, the Board convened a hearing to determine whether Mr. Williams continues to represent a significant threat to the safety of the public, and, if so, the necessary and appropriate disposition having regard to the criteria in s. 672.54 of the Criminal Code. Mr. Williams was present and represented by Ms. Dubb.
For the reasons that follow, the Board unanimously finds that Mr. Williams continues to pose a significant threat to the safety of the public and that the necessary and appropriate Disposition is his existing Detention Order.
Initial Positions:
At the outset of the proceedings, the parties were canvassed as to their positions. Counsel for the hospital submitted that Mr. Williams continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition is a continuation of the current Detention Order.
Counsel for the Ministry of the Attorney General supported the hospital’s recommendations.
Ms. Dubb was also supportive of the hospital’s recommendation and she conceded the issue of significant threat for the purposes of this hearing.
All parties maintained their joint recommendation in closing submissions.
Index Offences:
- The following summary of the index offences was taken from last year’s Reasons for Disposition dated July 3, 2024, as follows:
Finding of NCR for Assault on May 4, 2022
On November 19, 2020, at 8:15 p.m., Mr. Williams was present in a bank vestibule in possession of a knife. The police seized the knife but chose not to arrest him. At 10:30 p.m. that same evening, Mr. Williams boarded a bus and immediately began pacing up and down the aisle, cursing and swearing. He approached a stranger and without warning or provocation punched him twice on his left cheek. Mr. Williams then left the bus and fled. At 11:25 p.m., while still in the same general area, he approached a woman putting her child into a car seat. He struck her with a bottle that he was carrying.
Mr. Williams was charged with assault in respect of the 10:30 p.m. incident, and assault with a weapon in respect of the 11:25 p.m. incident. He was found NCR in respect of first charge. The Crown withdrew the second charge.
Finding of NCR for Aggravated Assault on March 28, 2022
Mr. Williams was charged with nine offences as a result of incidents that took place on December 5, 2020, but he was only found NCR on the charge of aggravated assault. The other charges he faced were attempt murder, possessing a weapon, carrying a concealed weapon, theft under $5,000, assault, disobeying a court order (two counts) and failing to comply with a release order. These charges were all withdrawn.
The sequence of events surrounding the second index offence began while Mr. Williams was waiting for a bus at a bus stop. Mr. Williams tried to engage the victim, a stranger to him, in a conversation about Vikings and God. The victim attempted to ignore Mr. Williams. They both boarded the bus when it arrived. Mr. Williams then stabbed the victim in the head and the hands causing him to fall to the ground. This assault was unprovoked and gave rise to both the offence of aggravated assault and a charge of attempted murder.
Following this event, Mr. Williams tried to steal a bottle of Crown Royal from an LCBO store, punched a second person without provocation, was arrested in possession of two large knives, all while subject to a peace bond that included conditions that he keep the peace and be of good behavior and not possess weapons, and while also subject to a judicial release order that included a provision that he not possess weapons.”
Personal Background:
The Hospital Report, dated May 20, 2025 (the “Hospital Report”), was made an exhibit and need not be reviewed beyond the following highlights. Mr. Williams is a 24-year-old man who was born in Jamaica and immigrated with some of his family in 2010. They joined their father who had been residing in Canada. His mother remained in Jamaica with some of his siblings. He maintained a good relationship with all of his family members. There is some suggestion that Mr. Williams was sexually abused by some male cousins when he lived in Jamaica.
Mr. Williams reported that when he was a child, other children would bully him and that he would “bully them back” and get into fights. In high school, he skipped classes to smoke cannabis and fought with others who he said were trying to rob him of the proceeds he had made from selling cannabis. He was expelled from school and ultimately dropped out completely. He had difficulty maintaining employment. He is currently supported by the Ontario Disability Support Program.
Mr. Williams was living with his father until he was asked to leave by the landlord as a result of his disruptive behaviour. He lived with an aunt in Ajax but left over arguments over his consumption of cannabis. His father and sister tried to place him in various shelters but apparently, he declined any housing or any funding associated with the government.
Criminal History:
- He has two entries on his criminal record including possession of a weapon in 2016, for which he received two years’ probation, and uttering threats, assault with a weapon and causing a disturbance in 2019, for which he was ordered to enter into a recognizance to keep the peace and be of good behaviour.
Psychiatric History:
Mr. Williams’ first psychiatric admission was in March 2017 when he was admitted briefly to the Rouge Valley Centenary Hospital – Child and Adolescent Unit. He was 16 at the time and had been brought to the hospital because of increasingly bizarre behaviour. He had been chanting and reading Bible verses into the night and not sleeping well. Over the course of the admission, he presented with delusional thinking and he was extremely religiously preoccupied. At the time he was using cannabis frequently. He was treated with antipsychotic medication and discharged with a diagnosis of first episode of psychosis, rule out schizophrenia, rule out substance use psychosis, marijuana use disorder and rule out learning disability.
Over the next three years Mr. Williams had a number of admissions to the Rouge Valley Centenary Hospital, sometimes brought to the emergency department by his father, and sometimes by police. Upon admission, he reported paranoia and auditory hallucinations, often in the context of medication noncompliance and regularly using cannabis. He reported that by 2019 he was using cannabis daily.
Shortly after the index offence in November 2020, Mr. Williams was brought by police to the emergency department. His father had obtained a Form 2 under the Mental Health Act (“MHA”). Mr. Williams had engaged in a verbal argument with a stranger, believing that the stranger had provoked him by staring at him. His father reported that since Mr. Williams had stopped taking his Invega injection some 8 months earlier and switched to oral olanzapine, his mental state had deteriorated. He had been homeless for the previous two months and had only taken his medication when he was feeling overwhelmed and needed sleep. He was admitted to hospital and treated with olanzapine. When he was no longer certifiable, he was discharged against medical advice.
Mr. Williams was admitted to Ontario Shores in the Forensic Assessment Unit (“FAU”) on September 13, 2021, pursuant to an Assessment Order. He had two seizures within a two-week period. His father advised that Mr. Williams last had a seizure three years prior. He was prescribed anticonvulsant medication valproic acid and referred to neurologist.
Current Diagnoses:
- His current diagnoses are:
Schizophrenia;
Cannabis Use Disorder, in sustained remission in a controlled setting; and
Seizure Disorder, in remission (which carries a risk of seizure-induced psychosis).
Evidence at the Hearing:
Dr. B. Chuong testified at the hearing to supplement the documentary evidence before the Board. She has been Mr. Williams’ in-patient psychiatrist from January 2024 until June 2, 2025. Dr. Chuong endorsed the contents of the Hospital Report.
Mr. Williams has remained detained on the Forensic Community Reintegration Unit (“FCRU”) over the past reporting year.
He is assessed as incapable to consent for psychiatric treatment and under his sister’s consent, acting as his substitute decision maker (“SDM”), he is prescribed daily oral doses of the antipsychotic medications, Clozapine (since November 2024) and Aripiprazole. He also received Valproic Acid to address his seizure disorder.
The Hospital Report indicates that the treatment team has recommended Mr. Williams transition to a long-acting injectable anti-psychotic medication given his history of non-compliance and rapid decompensation; however, Mr. Williams has consistently declined, stating his fear of needles.
Despite compliance with his existing medications, Mr. Williams has continued to experience residual symptoms of his illness. At times, he has identified somatic hallucinations of something crawling all over him. He has also endorsed auditory hallucinations. Mr. Williams was not observed responding to unseen stimuli, although he tended to be quite guarded around his delusional thought content. At times, he would endorse delusions regarding angels and devils, and thoughts that he was being controlled. He denied any suicidal or violent ideation, intent, or plan. His experience of symptoms resulted in interpersonal issues.
Williams has not presented as a management challenge on the unit; however, there were some incidences related to a female co-patient who claimed she was pregnant with his child. As well, on April 11, 2025, Mr. Williams and a female co-patient were intimate. Health teaching was provided and unit rules were reviewed. Generally, Mr. Williams was sociable with select peers but, overall, he tended to spend his day using indirectly supervised privileges or resting in his room.
On two occasions over the year in review, Mr. Williams urine drug screens returned positive for cannabinoids both in September 2024. Mr. Williams explained, after being presented with the positive results, that he wanted to test the impact of cannabis on his mental state. He also disclosed that he provided the test treatment team with a cold urine sample to hide his use. Staff had observed that following his periods of use, he was more withdrawn and isolative. In response to his substance use, his privileges were held for six days before being reinstated.
Mr. Williams has been able to utilize indirectly supervised hospital and community privileges over the year in review without incident. Additionally, in October and December 2024, he went to his sister’s home over the Thanksgiving and Christmas holidays. His family members continue to be important supports and his sister is his Approved Person. Of note, she is a mental health nurse who works in another hospital.
Mr. Williams has participated in a variety of therapeutic and recreational programs and activities over the year in review. He was referred to Concurrent Disorders Services in October 2024 for individual counselling support to address his substance use and to work on relapse prevention and coping strategies. Mr. Williams completed 9 individual sessions between October 2024 and March 2025 but missed several appointments.
Mr. Williams re-engaged in individual psychotherapy in October 2024 with a Psychology Resident (under supervision of a registered Psychologist). Since then, he has completed 16 sessions to date. The primary approach to therapy has been CBT for psychosis with the incorporation of DBT skills when appropriate.
Dr. Chuong advised that Mr. Williams is awaiting a cognitive assessment with psychology given some past concerns of a possible neurodevelopmental disorder.
Mr. Williams remains on the waitlist for housing with the Community Homes for Opportunity (“CHO”) program through CMHA, Durham. A vacancy became available for him in April 2025; however, both Mr. Williams and his sister believed it was not a suitable placement for his discharge. He is currently on the waitlist for a general bed at McKay House, a 24/7 staff supported home operated through Durham Mental Health Services. Mr. Williams visited McKay House for a tour on April 4, 2025. Dr. Chuong stated that Mr. Williams was just discharged days ago, on June 2, 2025, to McKay House. This is transitional housing and the expectation is that he will over the next year or so, he will be ready to transition to less supervised housing. To date, he has managed the transition well.
Mr. Williams’ care is now supervised by Dr. Pallandi the Forensic Outpatient Service (“FOS”). He is seen more frequently than is mandated by his Disposition but if all goes well in his transition, it is expected that the frequency of his contact will be scaled back.
Dr. Chuong testified that at the present time, Mr. Williams requires significant external supervision and supports from the FOS and housing providers in order to remind him of his medical and psychiatric appointments and to closely monitor him for medication compliance.
Mr. Williams’ insight regarding his illness has fluctuated and the doctor described it as “superficial”. He is aware of his diagnosis but his understanding of his psychotic illness is quite limited. He has commented that he believes that medication is beneficial to him but at times he also expressed thoughts that he may not require medication in the long term. To his credit, he has remained compliant. His insight regarding substance use is also superficial and he has expressed an intention to use again when no longer under the Board’s jurisdiction. He remains abstinent because of his ORB Disposition.
The Clinical Risk Assessment contained in the. Hospital Report indicates that:
“Mr. Williams’ primary criminogenic factors are his major mental disorder, sub-optimal response to treatment, lack of insight, and substance use. Despite being started on clozapine over this reporting period, he has continued to experience active symptoms of psychosis – namely delusional thought content and auditory hallucinations. In addition, there are evident negative and cognitive symptoms of schizophrenia that have not been addressed with clozapine solely. This has been in the setting of treatment in a highly structured environment with significant oversight from professional and personal support systems that have had to intervene on multiple occasions. His history of violence has stemmed primarily from his illness, with exacerbation from cannabis use and there is a well-documented history of such. Absent appropriate support, structure, and supervision, he is likely to become non-adherent with treatment and use substances. This would likely lead to a re-emergence of his psychotic symptoms and as a result, become an acute risk of violence to others.”
Dr. Chuong testified that the existing Detention Order remains the necessary and appropriate Disposition as Mr. Williams is at the very early stage of his discharge to community living. At this time, the hospital requires the authority of a Detention Order in order to ensure that his community placement provides him with the necessary degree of structure, support, supervision and monitoring to safely manage his risk. In addition, the Detention Order allows the hospital to expeditiously readmit Mr. Williams should he experience a decompensation in his mental state weather as a result of breakthrough symptoms, relapse to substance use, or otherwise. The doctor stated that the Mental Health Act would be insufficient to safely manage his risk. Dr. Chuong added that she does not believe Mr. Williams would return to the hospital voluntarily, if requested.
The plan for the FOS team will be to continue to engage Mr. Williams in therapeutic, recreational or vocational programming.
No further evidence was called by the parties.
Analysis and Conclusions:
The Board has carefully considered the Hospital Report, the evidence of Dr. Chuong and the joint recommendation of the parties. The Board unanimously agrees that Mr. Williams continues to represent a significant threat to the safety of the public. Mr. Williams suffers from a major mental illness, schizophrenia. He continues to experience residual psychotic symptoms. He has a long history of medication non-compliance coupled with substance use. When unwell, he has acted violently, often with a weapon, towards members of the public. If not under the jurisdiction of the Board, he likely would cease taking his medication and return to cannabis use. As in the past, he would decompensate rapidly and would present a significant threat to the public.
The Board is also in agreement with the parties’ recommendation that the necessary and appropriate Disposition is a Detention Order. Notwithstanding compliance with medication, Mr. Williams continues to experience residual psychotic symptoms and he remains vulnerable to a rapid decompensation in his mental status.
Mr. Williams has just been discharged to the community four days ago and has transitioned well. However, it is still critical that the hospital retain oversight of his placement in the community in order to safely manage his risk and to cause him to be readmitted on an expeditious basis in the event he presents with a relapse to substance use or any decompensation and his mental state.
Mr. Williams has had a positive year. He has engaged in various programming and is working to develop skills that will assist in his transition into the community. He has been compliant with his treatment under his SDM’s consent.
The Board finds that his existing Detention Order is necessary and appropriate and represents the least restrictive and least onerous Disposition. In coming to this conclusion, the Board has taken into account the provisions of s. 672.54 of the Criminal Code, including the paramount factor of the safety of the public, Mr. Williams’ reintegration into the community, his mental condition and his other needs.
DATED this 19^th^ day of June 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks
Alternate Chairperson
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Office of the Registrar
Ontario Review Board