Re: Andrew Brazier
ORB File No: 6859
Hearing held on: Friday, May 30, 2025
Place of hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus Hamilton, Ontario
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. S. Clapp Members: Dr. M. Attia Dr. T. Stirpe Mr. E. Siebenmorgen Ms. R. Chopra
Parties Appearing: Accused: Andrew Brazier Counsel: Ms. C. Whillier The person in charge of hospital: Counsel: Mr. S. O’Brien Attorney General of Ontario: Counsel: Mr. I. Shaikh
REASONS FOR DISPOSITION
(Dated July 2, 2025)
Introduction:
On November 20, 2015, Andrew Brazier was found not criminally responsible on account of mental disorder (“NCR”) on a charge of uttering threats to cause death or bodily harm, contrary to the Criminal Code. He is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated February 13, 2024, whereby he is discharged from St. Joseph’s Healthcare Hamilton, West 5th Campus (“SJHCH” or the “hospital”) with minimal conditions, the most significant of which are a weapons prohibition and reporting to the person in charge of SJHCH not less than once per month.
On May 30, 2025, a panel of the Board convened at SJHCH to conduct Mr. Brazier’s annual review pursuant to section 672.81(1) of the Criminal Code. The hearing had been administratively adjourned from a date scheduled in February. Mr. Brazier attended the hearing and was represented by counsel, Ms. Whillier.
An Updated Hospital Report dated May 26, 2025, was marked as Exhibit 1. In addition to the documentary evidence, the panel heard evidence from two witnesses: Dr. Peter Sheridan, Psychologist; and Dr. Satyadev Nagari, Attending Psychiatrist.
The issues to be decided at the hearing were whether Mr. Brazier continues to meet the test of posing a significant threat to the safety of the public as set out in section 672.5401 of the Criminal Code, and if so, what is the necessary and appropriate Disposition, taking into account the four factors set out in section 672.54 of the Criminal Code.
Position of the Parties:
At the outset of the hearing the parties were asked for their initial without prejudice positions. On behalf of the hospital, Mr. O’Brien took the position that Mr. Brazier continues to represent a significant threat to the safety of the public, and that a continuation of the existing Conditional Discharge remains necessary and appropriate, with a reduction in the reporting requirement to not less than once every two months.
Mr. Shaikh supported the position of the hospital on behalf of the Attorney General.
Ms. Whillier stated that Mr. Brazier takes the position that he no longer represents a significant threat to the public, and therefore requested an Absolute Discharge.
Findings:
- After carefully considering the evidence in this somewhat unusual case, which involved a disagreement between Dr. Sheridan and Dr. Nagari as to whether Mr. Brazier continued to represent a significant threat, the panel concluded that there was sufficient evidence to find that Mr. Brazier continues to meet the threshold of significant threat to public safety. The panel concluded that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a continuation of the existing Conditional Discharge, with a decrease in reporting to not less than once every two months.
Index Offence:
- The circumstances of the index offence are taken from an Arrest Report/Synopsis which is set out in the Hospital Report at page 4 as follows:
“On Wednesday August 5, 2015, Andrew BRAZIER attended St. Joseph’s Hospital within the City of Hamilton for the purpose of being assessed for a decline in state of mental health. Upon attending this location, BRAZIER was assessed and released from that facility unconditionally.
On the same date at approximately 4 p.m., the accused engaged in a conversation by way of text with his father, and the victim, Darrell COWAN (1971-09-02). During the conversation that followed, Andrew BRAZIER stated to his father ‘Come pick me up. It’s you that wanted me here. At least get me back to town. I got released and I’m fucking homeless. I fucking hate you right now, but I get it.’ BRAZIER went on to state. ‘If you show up, expect a punch in the fucking head. I hate you! Delete my number. Two hospitals say I’m fine. I’m not doing another fucking this [sic] to appease you, you fucking cunt mouth piece of shit. I despise the thought of you. Fucking go die. You ruined my life. Hate is all that is left. Please show up so I can knock your fucking teeth out.’
The conversation depicted above took place between the hours of 4:00 p.m. and 8:13 p.m.
Andrew BRAZIER has a history of mental health, specifically schizophrenia and on one previous occasion, had acted out violently towards a family member by way of cutting that individual’s throat and ultimately ending his life. Darrell COWAN perceives the threats made by his son to be real and indicated that he is of the belief that Mr. BRAZIER is capable of carrying these threats out.”
Prior Experience under the ORB:
This is Mr. Brazier’s second time under the jurisdiction of the Board. He was found NCR on an earlier index offence of second-degree murder on October 7, 2008, and was granted an Absolute Discharge on September 17, 2013. While in a paranoid and delusional state, Mr. Brazier stabbed his step-grandfather to death as he lay in bed beside his wife.
The detailed circumstances of this offence, and Mr. Brazier’s course under the ORB at that time, are outlined in the Hospital Report and will not be repeated here. However, the following summary of what happened after Mr. Brazier’s Absolute Discharge in 2013 from last year’s Reasons is relevant (at paragraphs 13-15):
“Mr. Brazier was found NCR on October 7, 2008, on a charge of second-degree murder. He was 21 years old at the time. He was hospitalized at SJHH until 2010, when he was discharged to community living. He received an Absolute Discharge from the Board on September 17, 2013. The Hospital’s Clinical Risk Assessment prepared for Mr. Brazier’s
September 2013 Board hearing includes the following statement:
“On medications and away from drugs and alcohol Mr. Brazier presents with a full and well-rounded personality. He is warm, caring, kind and sensitive. He has deep remorse for his actions and has insight not only into his illness but also into how another illness episode might translate into violence. He independently is able to say that he believes he needs to stay on medication for the rest of his life.”
Thereafter, he quickly stopped his medication and began smoking marijuana daily, despite remaining abstinent for almost five years while subject to ORB oversight.
Mr. Brazier had been employed following his Absolute Discharge but lost his position. He became unwell and in February of 2014, attended at SJHH and sought voluntary admission. Although no longer a forensic patient, he was accepted for voluntary admission at the Forensic Psychiatry Program from February 11-26, 2014. He was discharged for voluntary follow-up with the Forensic Outpatient Program and the Brantford Assertive Community Treatment Team (Brant ACTT). He again stopped taking his medications in approximately April of 2014. In January of 2015, Mr. Brazier requested a discharge from the Forensic Psychiatry Outpatient Program and apparently also terminated his involvement with Brant ACTT.”
Background:
Mr. Brazier’s personal history is outlined in the Hospital Report in detail and will not be repeated here. In summary, Mr. Brazier is now 37 years old. He lives with his common law wife, recently welcomed an infant son, and has a full time job.
Mr. Brazier’s parents were 15 years old and not in a committed relationship when he was born. While he lived intermittently with each of his parents for periods of time, he eventually lived with his father’s family. He left school in grade 11, and had various jobs after that. He had no criminal record or psychiatric history before the onset of his symptoms in January 2008, which ultimately resulted in the first index offence.
Mr. Brazier has a significant history of cannabis use. The Hospital Report stated that he reported beginning to smoke marijuana in grade 10, which gradually increased to daily use in grade 11. He was suspended from school for smoking marijuana, and then quit using for almost two years. He started using again in November 2006 when he was employed at a shop where his boss smoked marijuana. He gradually increased his use to half an ounce per week by the time of the first index offence. Mr. Brazier abstained from cannabis use for five years when first under the jurisdiction of the ORB, however he stopped taking his medication and smoked marijuana regularly soon after his Absolute Discharge in 2013. He used on an almost daily basis after his employment ended in 2014, smoking up to five joints per day. He did not believe that cannabis use affected his mental state.
Between January 2015 and the time of the current index offence, several of Mr. Brazier’s personal supports observed deterioration in his mental state and suggested that he attend the hospital for a psychiatric assessment. He attended the emergency departments of two hospitals in order to appease his father, but was not found to be certifiable under the Mental Health Act (“MHA”) and was discharged.
Psychiatric History:
As was noted above, Ms. Brazier’s first contact with psychiatric services was following his first index offence when he was under the jurisdiction of the Board from 2008 to 2013. The Hospital Report outlined Mr. Brazier’s course under the ORB and stated that he exhibited significant improvement in his mental status after a year of treatment, and then had high engagement in programs and community reintegration.
After his Absolute Discharge in 2013, Mr. Brazier had a voluntary admission to SJHCH from February 10-16, 2014 when he presented with deterioration in his mental status and bizarre behavior. The Hospital Report stated that he stabilized within a short time and was cooperative with plans for follow-up.
Following the second NCR finding, Mr. Brazier was admitted to SJHCH. He was not taking any psychotropic medications and did not believe that he was suffering from ongoing psychiatric symptoms or that any kind of intervention was required. He initially did not want the treatment team to share information with his family. Mr. Brazier admitted that he had lied to the forensic outpatient team about taking medication, and said that he felt guilty about it. He explained that he had discontinued his medication in the community because he felt he needed to try being off medication. He questioned his diagnosis and disliked the “grogginess” he experienced. He eventually agreed to take medication while in the hospital, but demonstrated underlying irritability, an entrenched delusional belief that his step-grandfather had sexually abused him, and a lack of full insight.
Mr. Brazier was discharged to the community to live in his grandparents’ home in February 2016, and received a Conditional Discharge in February 2018. He has had no readmissions to hospital. His long-acting injectable medication has been administered by his family doctor since 2019. He and his partner (to whom he became engaged) moved to a separate home on his family’s property in September 2023.
The prohibition on alcohol and cannabis use was removed from Mr. Brazier’s Disposition in 2019. He resumed alcohol and cannabis use in 2021, and while he was open with the team about it, this was a significant concern for the treatment team given Mr. Brazier’s apparent lack of insight regarding substance use and his potential for violence. His reporting requirement was increased for a period of time as a result. Mr. Brazier continued to use alcohol and cannabis recreationally with no reported change in his mental status. In the 2023 reporting year, he was using cannabis with his partner and was not adhering to the Low-Risk Cannabis Use Guidelines recommended by the treatment team.
The following excerpts from the Hospital Report are instructive with respect to Mr. Brazier’s presentation while subject to the jurisdiction of the Board, and his risk to the public.
From page 34 (November 2016):
“Notwithstanding what appeared to be a spotless rehabilitative period associated with the prior NCR, and him appearing to be an ideal candidate for an Absolute Discharge, after the Absolute Discharge it became apparent that he was using cannabis and had quickly stopped his medications. This is despite being very clear with the outpatient team about his insight into his illness, the link between his illness and the Index Offence, as well as the link between any substance use and the same consequences.
We do know that Mr. Brazier cannot be taken at his word, and that a much longer period of stability is required before there can be any assurance that we can stop the involvement of the Ontario Review Board, maintaining him in the community. Notwithstanding that experience, he presents as a kind, thoughtful and caring young man.”
- From page 46 (February 2023):
“However, we must not lose sight of the index offence and the dramatic change in what otherwise was a prosocial man, leading him to commit the original index offence. In other words, when Mr. Brazier became psychotic it overrode his normal prosocial behaviour, sufficient that he brutally murdered somebody he cared about in horrific fashion. Importantly too was that marijuana use appeared to have been part of the escalation in his symptoms.
Also, it is important to remember that Mr. Brazier remained quite unwell and quite belligerent for an extended period of time, until the appropriate medications were found to treat his psychosis.
Also, critical to consider is the fact that Mr. Brazier had received an absolute discharge in the past. Mr. Brazier convinced his treatment clinicians including myself that his insight into his illness was excellent, that he would take medications for the foreseeable future, and link between substance use and index offence/psychosis was solid. Notwithstanding the support for the absolute discharge, Mr. Brazier had immediately stopped his medications and resumed using substances of abuse.”
- The Hospital Report stated that Mr. Brazier’s diagnoses are Schizophrenia (in remission), and Substance Use Disorder – Cannabis (in remission).
Evidence at the Hearing:
The Hospital Report stated that Mr. Brazier had another good year, with continued mental stability, compliance with treatment, and attendance at all appointments without issue. He is capable of consenting to treatment and managing his finances. There were a number of significant life events for Mr. Brazier this year. He discontinued his use of cannabis following last year’s ORB hearing (with two minor slips-ups), he obtained full-time employment in June 2024, he and his partner moved to a home in Brantford in September 2024, and they welcomed a baby boy in January 2025.
The Hospital Report included an updated Psychology Risk Assessment completed by Dr. Sheridan. Taking into account Mr. Brazier’s clinical presentation, and all factors identified on the HCR-20 V3, HARM, and SAPROF, Mr. Brazier’s risk for future violence was determined to be low if granted an Absolute Discharge. Dr. Sheridan made the following concluding comments (at page 59):
“Nevertheless, at this time, it is difficult to argue that Mr. Brazier remains a significant threat to the community. His understanding of his illness, need for treatment, and potential for violence is well-developed. He has demonstrated sustained compliance with the conditions of supervision and adherence to prescribed medications with no recurrence of illness or relapse into serious substance abuse for more than a decade. Despite opportunity to do so, he has not decreased or discontinued his medications or abused cannabis. Notwithstanding the gravity of Mr. Brazier’s first index offence in 2008, he has voiced no violent ideation and there has been no concern about physically aggressive or violent behaviour since the commission of the current index offence in 2015.
In my opinion, Mr. Brazier is unlikely to fall away from follow-up, discontinue his medication, and/or increase his consumption of cannabis if granted an Absolute Discharge. I believe his present circumstances are very different from what they were after he received an Absolute Discharge in 2013. In the decade since his current index offence, Mr. Brazier has matured considerably, settled down with a partner, and has started a family that is very important to him. He states unequivocally he would not jeopardize the stability of his relationship with his partner and son. Provided he continues in ongoing follow-up with his family physician and remains adherent to his LAI medication, Mr. Brazier’s risk for violent reoffending would be effectively managed on Absolute Discharge from the ORB.”
The Hospital Report stated that the treatment team was not unanimous in its recommendations to the Board. As noted above, Dr. Sheridan opined that Mr. Brazier no longer met the threshold for significant threat, however Dr. Nagari was of the opinion that the significant threat threshold continued to be met. For this reason, both Dr. Sheridan and Dr. Nagari testified at the hearing.
The Hospital Report included Dr. Nagari’s Clinical Risk Summary, which acknowledged all the positive progress and stability that Mr. Brazier has achieved. Dr. Nagari’s main concern was around the risk factor of cannabis use, and the following explanation was provided (at page 61):
“Over the past reporting year, Mr. Brazier’s mental status has remained stable. Mr. Brazier’s partner stopped smoking cannabis when she discovered she was pregnant during spring 2024, and this further bolstered Mr. Brazier’s own commitment to abstain. Neither he nor his partner have resumed cannabis use after their baby was born in January 2025. While it is commendable that Mr. Brazier remains abstinent, we believe that due to his prior history of returning to cannabis use after periods of abstinence, it is foreseeable that he will resume cannabis use. Currently, notwithstanding some intrinsic motivation, his abstinence is largely externally motivated. This is informed by the fact that his decision to abstain followed the Board’s disposition last year, and was strengthened by his partner’s own decision to quit cannabis. Although he has not engaged in cannabis use in nearly a year, given the additional stressors and responsibilities associated with his growing family, it is more likely than not, that he will seek the comfort of using cannabis. Without oversight, Mr. Brazier runs an increased risk of decompensation leading to loss of insight and discontinuation of medications, that can result in psychosis, aggression and violence. This necessitates ongoing supervision by Forensic Psychiatry, as this system has the ability to alter the level of monitoring and intervene quickly should any signs of decompensation emerge. While consistent employment, housing stability, family support, being in a committed relationship and parenthood are all protective factors, as per the literature, Mr. Brazier’s history of psychotic relapses resulting from serious cannabis use outweighs such protections.”
- Finally, the Hospital Report included the hospital’s position regarding the difference of opinion between Dr. Sheridan and Dr. Nagari on the issue of significant threat, and stated the following (at pages 61-62):
“The hospital is fully aware of Mr. Brazier’s past history and the fact that previously he had appeared deserving of an Absolute Discharge, received the Absolute Discharge, with the unfortunate recurrence of his psychotic symptoms associated with resuming drug use and stopping his medications.
It is with that in mind that the hospital strongly concurs with the opinion of Dr. Nagari and strongly recommends the continuation of the Conditional Discharge disposition. We feel that one does need to also take into account his history under the Review Board when considering future risk. Given the gravity of Mr. Brazier’s offence, the speed with which his mental status decompensated after his previous Absolute Discharge, and the difficulty in getting him stabilized, it is our opinion, that Mr. Brazier continues to pose a significant risk to the safety of the public.”
Testimony of Dr. Sheridan (Psychologist):
Dr. Sheridan testified that he is the Clinical Psychologist and the case manager on Mr. Brazier’s treatment team. He initially worked with Mr. Brazier when he was in the hospital, and has now been his case manager for approximately three to four years. Dr. Sheridan stated that it is unusual for him to be a case manager, but because Mr. Brazier had been with the team for so long, and there had been a lot of staff turnover, it made sense for him to be the case manager.
Dr. Sheridan confirmed his opinion that Mr. Brazier no longer represents a significant threat to public safety and should therefore be granted an Absolute Discharge. He explained that Mr. Brazier’s historical risk factors are more distant now, and his clinical and risk management factors are well managed with almost all of them being entirely in his favour. He noted that Mr. Brazier is now on a long-acting injectable medication (he was on oral medications when he received an Absolute Discharge in 2013), he has matured considerably in the last ten years, he has been in a committed common law relationship for three years, and he just welcomed a child. He testified that Mr. Brazier’s life looks very different now, he has more to lose, and what is important to him has changed since the last time he was under the Board. Dr. Sheridan testified that Mr. Brazier’s insight is sound, and he has committed to abstaining from cannabis since April 2024. Neither he nor his partner have any interest or intent in using cannabis while they raise a family.
Dr. Sheridan testified that Mr. Brazier has a supportive partner and family network, and there are currently many people coming and going from their house in light of the new baby. Dr. Sheridan believed that they would notice any changes in Mr. Brazier’s mental status, especially because a number of them were present when Mr. Brazier was unwell in the past. Mr. Brazier’s common law wife’s parents were also Mr. Brazier’s employer for a period of time and they are aware of his status under the ORB (however Dr. Sheridan did not know if they were aware of Mr. Brazier’s diagnosis and the first index offence). Dr. Sheridan noted that while Mr. Brazier’s father was the victim of the current index offence, he now has a good relationship with his father. Dr. Sheridan did not know how Mr. Brazier’s father felt about the possibility that he may receive an Absolute Discharge. Dr. Sheridan also testified that he is confident that Mr. Brazier’s common law wife would be able to recognize signs of decompensation in Mr. Brazier, and explained that they had spent almost two hours together last summer on psychoeducation.
When asked about the risk of cannabis use, Dr. Sheridan noted that Mr. Brazier had used cannabis in recent years without any change in mental status. This was different than when he was using excessively prior to the index offences. It was Dr. Sheridan’s opinion that if Mr. Brazier were to use cannabis again, it would likely be in the same manner that he had used in recent years (recreationally once or twice per week, with periods where he was using upwards of three times a week). He noted that Mr. Brazier has always been open with the treatment team about his cannabis use, and did not use excessively even when he had the opportunity to do so. He did not anticipate that Mr. Brazier would use excessively such that he would became destabilized. In terms of alcohol, he has only had the occasional drink.
Dr. Sheridan also testified about the attempts to find Mr. Brazier a psychiatrist in the community. Although Mr. Brazier had expressed a willingness to travel a fair distance for this, they have been unable to find him psychiatric follow-up despite multiple attempts. Dr. Sheridan stated that three psychiatrists had declined to take Mr. Brazier, and one program had closed. Dr. Sheridan did not necessarily think that Mr. Brazier was declined due to his forensic history (he noted that two of the psychiatrists he reached out to had forensic training), but that it was likely more due to availability. Dr. Sheridan did not think that Mr. Brazier needed psychiatric follow-up in the community before receiving an Absolute Discharge.
When asked about other professional supports in the community, including substance use programming or supports, Dr. Sheridan stated that Mr. Brazier had not asked for that, but there are counsellors and social workers who would be willing to help. While Mr. Brazier had no interest in substance use programming now, Dr. Sheridan noted that he had completed it while he was an inpatient. Dr. Sheridan also said that he could be available occasionally.
Dr. Sheridan was asked how Mr. Brazier was coping with being a new father. He responded that he was doing very well and is a doting father. He acknowledged that it was a big change for both Mr. Brazier and his common law wife, and that they were dealing with sleepless nights, however they did not seem to be overly stressed. Mr. Brazier took a short parental leave from work, and may take more leave when his common law wife goes back to work in July.
When asked about Mr. Brazier’s insight, Dr. Sheridan stated that it is “well-developed.” In terms of insight into his potential risk for violence, Dr. Sheridan stated that it was “above average.” Although Dr. Sheridan was not involved with Mr. Brazier during his first time under the Board, he stated that Mr. Brazier’s insight is better now than it was prior to his last Absolute Discharge, and added that it is greater than they often see. In response to questions from Ms. Whillier, Dr. Sheridan agreed that Mr. Brazier told him he would continue to take medication. While Mr. Brazier had complained about side effects (“grogginess”) of the medication in the past, he had not complained of any side effects since being on the long-acting injectable medication. Dr. Sheridan also agreed that while Mr. Brazier had questioned his diagnosis in the past, he now accepted it, and there has been a longer period of stability this time under the ORB.
Dr. Sheridan testified that while Mr. Brazier believes he can use cannabis recreationally, he is aware of the “potential trouble if he increased his cannabis use.” Dr. Sheridan did not agree that Mr. Brazier’s motivation to be abstinent was external. He testified that Mr. Brazier “took stock” of his life after the last Board hearing and demonstrated to himself and the Board that he can be abstinent. This occurred before his wife was pregnant, and Dr. Sheridan believes that he is now internally motivated to abstain for his wife and child. He also stated that Mr. Brazier felt he had more energy and improved short-term memory when not using cannabis. Dr. Sheridan acknowledged that Mr. Brazier was not saying that he would never use cannabis again, and that he also knows what he needs to show in order to be granted an Absolute Discharge.
In terms of a re-offence scenario, Dr. Sheridan testified that it would likely occur if Mr. Brazier decided he felt great after receiving an Absolute Discharge and told his family doctor that he did not want to continue with the long-acting injection. He would also likely use cannabis. However, Dr. Sheridan stated that he did not think that Mr. Brazier would stop his medication, and he was of the view that there would be many people in Mr. Brazier’s life who would pressure him not to stop the injection. He also stated that Mr. Brazier would have to use a significant amount of cannabis in order for his symptoms to return.
Testimony of Dr. Nagari (Attending Psychiatrist):
Dr. Nagari testified that he has been Mr. Brazier’s attending psychiatrist for just under three years. He reiterated his opinion that Mr. Brazier remains a significant threat to the safety of the public, and emphasized that it is somewhat atypical to have a person with a second NCR finding. Dr. Nagari stated that Mr. Brazier’s first index offence was extremely serious, and occurred despite his family noticing changes in him and encouraging him to get help. He noted that Mr. Brazier was described as an “exemplary” patient having great insight during his first time under the Board, and made great progress such that he received an Absolute Discharge after approximately five years. Within three months he had stopped all medication, was using cannabis, lost all insight, and rapidly deteriorated. Even after the Forensic Service took the unusual step of admitting him in February 2014, and setting him up with outpatient supports, he once again discontinued medications and follow-up. Despite his family trying to get him to get help, and Mr. Brazier attending at two hospitals (only to not be certified under the MHA), the current index offence occurred. Dr. Nagari added that when Mr. Brazier was assessed at SJHCH following the current index offence he wanted to be assessed while not on medication to prove that he was not experiencing psychotic symptoms. Dr. Nagari was of the opinion that this history demonstrated “tremendous resistance” to medications, and while Mr. Brazier has stated that he now accepts his diagnosis, there is a “persisting ambivalence” toward treatment.
Dr. Nagari explained that it took a longer period of time to stabilize Mr. Brazier in 2015 and numerous antipsychotic medications were trialed before he was eventually stabilized. By 2018, Mr. Brazier had maintained stability and received a Conditional Discharge. At that time, he stated that he had no intention of using cannabis again, however once the prohibition was removed from his Disposition, he was using again within two years. Dr. Nagari stated that the mere decision to return to substances given his history shows poor judgment. In any event, the treatment team developed a harm reduction approach and recommended that Mr. Brazier follow the Low-Risk Cannabis Use Guidelines, however this was not achieved. Mr. Brazier increased his use as well as the potency of the cannabis he was using.
Dr. Nagari acknowledged that Mr. Brazier has done remarkably well and his commitment to medication is very strong. He stated that Mr. Brazier’s insight into his mental illness and the need for treatment is “excellent”, and he did not think that Mr. Brazier would ever go off medication. Dr. Nagari’s concerns lay with Mr. Brazier’s cannabis use. Dr. Nagari testified that while Mr. Brazier is in a good place now, he is facing a number of stressors, including being a new parent, and it will be difficult for him to keep it all “in check.” Although Dr. Nagari acknowledged that Mr. Brazier had dealt with a lot of stressors (including “small town gossip”) and commended him for that, it was Dr. Nagari’s opinion that it was “more likely than not” that Mr. Brazier will return to cannabis use at some point and progressively increase his use. As happened in the past, this will affect his relationships, lead to mood instability and irritability, as well as loss of insight, all of which increase his risk of violence. When asked whether there was any “protection” from the effects of cannabis with the long-acting injectable medication, Dr. Nagari stated that while there may be some clinical observation to that effect, there is no neurological basis or research supporting it.
Dr. Nagari acknowledged that Mr. Brazier has developed some internal motivation to abstain from substances, but maintained his view that it is mostly externally driven. Dr. Nagari also acknowledged that Mr. Brazier has always been honest with the treatment team while under the ORB this time.
In response to questions from Ms. Whillier, Dr. Nagari agreed that Mr. Brazier has better insight now than the first time he was under the jurisdiction of the Board. However, he disagreed with Ms. Whillier’s characterization that Mr. Brazier has had ten years of stability under the Board this time. He noted that although Mr. Brazier has been subject to the jurisdiction of the Board for almost ten years, it has not been uneventful. He pointed to the period of time after Mr. Brazier was granted a Conditional Discharge and the substance use prohibition was removed, when Mr. Brazier resumed cannabis use. Dr. Nagari stated that an increase in reporting was required at that time and the treatment team had considered whether a Detention Order was required.
Dr. Nagari testified that it is a “huge limitation” that they have been unable to find a psychiatrist to follow Mr. Brazier in the community. He stated that he had written to a number of psychiatrists that he knows without any success. Further, Mr. Brazier is not eligible for an ACT team or the Hamilton Schizophrenia Program due to his stability in the community. Dr. Nagari stated that Mr. Brazier does not need to see a psychiatrist every week, but there needs to be a psychiatrist “hovering” who can respond if his risk escalates. That protection is not in place yet. Dr. Nagari added that the family physician completing a Form 1 and sending Mr. Brazier to the local emergency department would not be sufficient to manage Mr. Brazier’s risk as he likely would not meet MHA criteria for certification (as happened prior to the current index offence). For this reason, it was Dr. Nagari’s opinion that the Forensic Service needs to continue to be in the background in order to increase reporting and monitoring if necessary.
In response to questions from Ms. Whillier, Dr. Nagari acknowledged that it is unfortunate that they cannot find a psychiatrist to follow Mr. Brazier in the community and it is a major hurdle. However, it is the situation as it stands now. It may be that the treatment team will be in the same position next year, but Dr. Nagari stated that they will continue their efforts. Dr. Nagari maintained his position that just having the family doctor in the community is not enough for Mr. Brazier.
Dr. Nagari testified that in the context of Mr. Brazier’s failed treatment and supervision response in the past, extreme caution is required. It was Dr. Nagari’s opinion that Mr. Brazier’s clinical stability is because of the supports that he has had under the ORB, and without that, he remains a significant threat to the safety of the public.
Dr. Nagari stated that reducing Mr. Brazier’s reporting to not less than once every two months is “doable” at this time as a result of Mr. Brazier’s stability and recent abstinence from substances.
When asked whether Mr. Brazier will ever be eligible for an Absolute Discharge, Dr. Nagari stated that a longer period of stability is required, as well as better professional resources in the community.
Submissions:
Mr. O’Brien maintained the hospital’s position that Mr. Brazier continues to represent a significant threat to public safety. He stated that time and cannabis use are the central issues. Mr. O’Brien submitted that while it is clear that Mr. Brazier has many positives, “his history is his history”, and more time with monitoring by the forensic team is required in order to protect public safety. As such, Mr. O’Brien submitted that a continuation of the Conditional Discharge with a decrease in the reporting requirement was the necessary and appropriate, and least onerous and least restrictive Disposition given the circumstances.
Mr. Shaikh submitted that given that this is Mr. Brazier’s second index offence which involved the use of cannabis, a longer period of stability is required to ensure that history does not repeat itself. He also stated that more community supports need to be in place before an Absolute Discharge is granted this time.
Ms. Whillier stated that Mr. Brazier was requesting an Absolute Discharge, and submitted that significant threat had not been made out on the evidence. She relied on Dr. Sheridan’s evidence and the structured clinical tests that concluded that Mr. Brazier’s overall risk on an Absolute Discharge was low. She submitted that these tests included concerns about cannabis use. Ms. Whillier also submitted that even without a psychiatrist in the community, Mr. Brazier has done very well. He has excellent insight, he consistently takes his medication, and his symptoms are gone. He has the support of his family and they are aware of his mental health diagnosis and the signs of decompensation. His plans for the future are to keep doing what he is doing, grow his family, and continue to work. He is committed to health and wellness. Ms. Whillier maintained that Mr. Brazier had ten years of stability under the Board this time, and that he was currently committed to abstinence from substances. She submitted that he has better insight this time, and is unlikely to discontinue medication, fall away from follow-up, or increase his cannabis use.
Analysis and Conclusions:
The panel carefully considered the evidence in this case. It was somewhat unusual in that there was a difference of opinion between the members of the treatment team about whether Mr. Brazier met the threshold test of being a significant threat to the safety of the public. The panel was ultimately persuaded by the evidence presented by Dr. Nagari, and concluded that Mr. Brazier continues to represent a significant threat to the safety of the public.
In coming to this conclusion, the panel carefully considered the decision of the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 (“Winko”). In that case, the Court stated that a significant threat to the safety of the public must be: more than speculative in nature and supported by the evidence; significant, in the sense of there being a “real risk of physical or psychological harm to members of the public that is serious in the sense of going beyond the merely trivial or annoying”; and the conduct giving rise to the harm must be criminal in nature. Further, the Court stated that there must be a positive finding of a significant threat to the safety of the public in order to support restrictions on an NCR accused’s liberty. Anything else, for example uncertainty, cannot suffice.
In the Winko case, the Supreme Court of Canada also stated that in coming to a conclusion on the issue of significant threat, a Review Board should closely examine a range of evidence including the circumstances of the original offence, the past and expected course of the accused’s treatment, the present state of the NCR accused’s mental condition, the NCR accused’s own plans for the future, the support services existing for the NCR accused in the community, and the recommendations provided by experts who have examined the NCR accused.
While Mr. Brazier has done very well under the jurisdiction of the Board, and he is to be commended for this, his history cannot be ignored. Without repeating the detailed history that has been discussed above, this is Mr. Brazier’s second time under the Board, and his first index offence was extremely serious and resulted in the death of a family member. Following that, Mr. Brazier did extremely well and was granted an Absolute Discharge after five years. Despite being called an “exceptional” patient, having solid insight into his mental illness, substance use, and his risk of violence, and stating that he would continue to take medication and abstain from substance use, he stopped medication and resumed cannabis use within three months. He ultimately ended up committing a crime and back under the jurisdiction of the Board.
It was particularly concerning to the panel that although Mr. Brazier appeared to be a well deserving candidate for an Absolute Discharge in 2013, he did not follow through on what he said he would do. This has been highlighted in the Hospital Report over the years, noting that since Mr. Brazier could not be taken at his word, a much longer period of stability is required before there can be any assurance that the involvement of the Ontario Review Board is no longer required.
The panel also agreed with Dr. Nagari’s concerns about Mr. Brazier’s cannabis use, and his apparent lack of appreciation for its role in the index offences and the risk of violence associated with its use. Although Mr. Brazier is clearly committed to abstinence at the current time, he has only been abstinent for one year and it is unclear how much of this is intrinsically motivated. The panel also considered that while Mr. Brazier has many meaningful and positive developments in his life, including a new baby, a new house, and a full-time job, these can also be stressors. These are all changes that occurred within the last reporting year, and it has yet to be seen how Mr. Brazier will cope over the longer term with these significant life changes. Mr. Brazier has typically turned to cannabis in times of stress, and his ability to abstain going forward remains a concern. Further, although in recent years Mr. Brazier has not used cannabis to the degree where a change in mental status was noticed, there was evidence of a progressive increase in use at times when Mr. Brazier was under stress or not working, and at least two incidents where he did use to excess and the index offences occurred thereafter.
The panel was also concerned that there is no psychiatric follow-up in the community for Mr. Brazier at this time. Given the severity of the index offences and Mr. Brazier’s history of ambivalence toward psychiatric medication, as well as his pro-cannabis attitude, the panel concurred with Dr. Nagari’s opinion that oversight by a physician with specialized expertise—beyond that of a general practitioner—is warranted to monitor Mr. Brazier in the community. The panel acknowledged that this is not something that is in Mr. Brazier’s control, and that he has been more than willing to have a psychiatrist in the community. Unfortunately this is the reality of the health care situation in our province. The panel encourages the treatment team to continue with their efforts in this regard and is hopeful that progress can be made in the coming year. Finally, the panel was also of the view that Mr. Brazier would benefit from other supports in the community, including in the area of substance use.
For all of these reasons, the panel made a positive finding that Mr. Brazier continues to meet the test of posing a significant threat to the safety of the public.
In terms of the Disposition, the panel decided that a continuation of the Conditional Discharge, with a decrease in reporting to not less than once every two months, was necessary and appropriate and the least onerous and least restrictive Disposition for Mr. Brazier at this time.
DATED this 2nd day of July 2025, at the City of Toronto, in the Toronto Region.
Suzanne Clapp Alternate Chair
Office of the Registrar Ontario Review Board