Ontario Review Board
Re: Ann-Marie Applewaithe
ORB File No: 7888
Hearing held on: Tuesday, May 27, 2025
Place of Hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus
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: Ann-Marie Applewaithe Counsel: Mr. B. Hurst
The Person in Charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Mr. S. Kim
REASONS FOR DISPOSITION (Dated July 7, 2025)
Introduction
On May 5, 2021, Ann-Marie Applewaithe, now 60 years of age, was found not criminally responsible on account of mental disorder (“NCR”) on charges of mischief under $5,000 (x3), failure to appear, and assault with a weapon, all contrary to the Criminal Code. She has most recently been subject to a Disposition of the Ontario Review Board (”ORB” or “the Board”) dated May 15, 2024 pursuant to which she is ordered detained at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“SJHCH” or “the Hospital”), subject to various conditions and privileges, up to and including living in the community in accommodation approved by the person in charge.
On Tuesday, May 27, 2025, a panel of the Board convened in person at the Hospital to conduct the annual review of Ms. Applewaithe’s Disposition and to make a new Disposition. Ms. Applewaithe was present and represented by her counsel, Mr. Hurst. The issues to be decided at the hearing were whether Ms. Applewaithe continues to represent a significant threat to the safety of the public as defined by 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 Code.
The evidence for the hearing consisted of the Hospital Report, dated April 14, 2025, and the oral evidence of Dr. W. Sutton, Ms. Applewaithe’s attending psychiatrist.
Positions of the Parties
At the commencement of the hearing the parties were invited to provide their initial, without prejudice, positions with respect to the issues before the Board. Counsel for the Hospital, supported by counsel for the Attorney General, submitted that Ms. Applewaithe continued to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition was a Detention Order with no changes from the previous Disposition.
Counsel for Ms. Applewaithe took the position that the evidence did not establish that his client is a significant threat to the safety of the public and that accordingly, she must be absolutely discharged.
The parties maintained their respective positions at the conclusion of the evidence.
Findings
- For the following reasons, the panel found that Ms. Applewaithe continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition, which is the least onerous and least restrictive in the circumstances, is a Detention Order containing terms that are unchanged from the previous Disposition.
Index Offences
- The circumstances surrounding the index offences, which occurred in Niagara Falls, are taken from the Reasons for Disposition dated June 25, 2024, and are reproduced as follows:
For a six-week period between September 2, 2020 and October 13, 2020 Ms. Applewaithe repeatedly attended at the complainant’s residence and entered his detached garage. They are strangers to one other. On occasion the complainant even found Ms. Applewaithe’s belongings in his garage. He contacted the police on eight occasions and made attempts to secure the garage by boarding up the doors. On October 12, 2020, the complainant found Ms. Applewaithe laying on a couch that she had brought inside the garage. He called police. Ms. Applewaithe was charged and released on bail with a condition that she not be within 100m of the complainant’s address. The next day she returned and tried to gain entry into the garage by using a two foot long piece of wood to pry open the boarded up doors. When confronted by the complainant, she waived the piece of wood and, on one occasion, struck him on the hand.
- During her criminal responsibility assessment in early 2021, Ms. Applewaithe was interviewed and provided her self-report of the index offences. Dr. Moulden, who conducted the psychological portion of the assessment, provided the following summary:
When asked more directly about the index offences Ms. Applewaithe indicated that she doesn’t understand why the “landlord wants me out”, and stated that she pays $500 in rent. She then referred to police attending her residence when she is in the shower, and leaving boots on the steps, which she interpreted to be “bad”, but would not explain why. She indicated that the landlord “took the keys…so I left a note”. She expressed confusion, stating “I don’t have a problem with anyone…I don’t need the police to protect me…what do they want with me?”. She added that she wore her white scrubs on the peace bridge to show that she is a peaceful person. Ms. Applewaithe was queried about returning to the location of the offences despite being directed not to. She denied that this was the case, and stated that she would have left if she had been asked. She stated “they (referring to the landlord) have to let me live my life…they don’t want me to have a place to live…they have to finish with me by telling me what they are doing, not just jail”. She went on to say “I’m not supposed to know what I know”, but declined to explain what she meant by this statement. Ms. Applewaithe commented “his mouth is in everything” and “he’s a spokesman for me”, which she explained meant that the “landlord speaks and makes decisions for me…being the one in authority…they’re not caring for me”. She went on to express fear for her safety, and stated that he has taken her belongings, had her arrested, doesn’t want her to live anywhere, and will try to kill her. Ms. Applewaithe maintained her innocence, and expressed her entitlement to live at the location. She explained that her actions (which she would not describe or acknowledge) were in self-defence because the “landlord wants to fight”. She again described feeling fearful, and stated “I’d defend myself again…they’re trying to fight me.”
Background Information
The Hospital Report contains information concerning Ms. Applewaithe’s personal background, brief criminal history, psychiatric history prior to the index offences, and her course in the Hospital following the NCR verdict. As the Report is in evidence at the hearing, the information need not be summarized for the purpose of these Reasons. Some portions that pertain to the issues are highlighted below.
Ms. Applewaithe was born in Guyana and moved to Canada with her family in 1967. She is single, has no children, was never married, and has had no significant partners in her life. She lived with her parents (now both deceased) until 2000. After completing high school, she attended Centennial College for a computer course for one year before attending “nursing school”. She reportedly graduated from the nursing assistant program and worked for a temporary employment agency as a personal support worker until the summer of 2004. She has not worked since then and has been supported by ODSP. She has, however, expressed a desire to return to work.
Ms. Applewaithe’s mother was still living at the time of the NCR assessment (she passed away in 2023) and provided collateral information. She reported that at one point, the family had made plans to move to the Niagara Region, but ultimately did not do so. However, Ms. Applewaithe chose to live there herself.
Ms. Applewaithe has no history of substance use.
Her mother reported that Ms. Applewaithe began to “act funny”, say odd things, and had paranoid beliefs starting around the age of 30. Ms. Applewaithe isolated from her friends and siblings and became very secretive about her life, including where she was living. According to her mother, she was diagnosed with Schizophrenia but would not take medication for it. Over the 10 years leading up to the index offences, Ms. Applewaithe stayed in the Niagara Region for the summer months but returned to her parents’ home in Toronto during the winter. While living with them, she would go missing for days at a time and would not say where she was going or where she had been. Her father passed away in May 2020, and according to her mother, she last saw her at his funeral.
Ms. Applewaithe has a somewhat dated criminal record, with the latest entries (in the Hospital Report at p. 5) being several withdrawn charges for failing to appear and fraudulently obtaining transportation in 2011. There are only two convictions, one for failing to appear and another for assault with a weapon, both in 2009. At the hearing, counsel for the Hospital advised that there was no information available concerning the circumstances of these offences, other than that they were Toronto matters.
With respect to Ms. Applewaithe’s formal psychiatric history, past medical records document a diagnosis of Delusional Disorder in 1997; however, additional details pertaining to this diagnosis are no longer available. She was first declared incapable of managing her finances during an admission in December 2004, and again during another admission in January 2005.
Following brief hospital admissions in the summer of 2000 and early January of 2001, Ms. Applewaithe was followed by an outpatient psychiatrist, Dr. Morton Rapp, at Scarborough General Hospital between the years 2001 and 2004. According to a note from Sunnybrook Health Sciences Centre, she was also a client of Scarborough General Hospital’s Assertive Community Treatment Team around this time. Unfortunately, these records have reportedly been purged. The available information does not disclose the frequency of Ms. Applewaithe’s appointments with Dr. Rapp or the medication, if any, that she was receiving. There were two hospital admissions during this period, in October of 2001, and a lengthier, two-week admission in April of 2004, when it appeared that she was very symptomatic and homeless.
Hospital notes from 2001 record that Ms. Applewaithe had made homicidal threats against her father and against two residents at a shelter where she was staying at the time. She reportedly stabilized rapidly on two medications, with decreased agitation, improvement in her mood, and no further homicidal threats.
Ms. Applewaithe had further psychiatric admissions in Toronto during the period between December of 2004 and early February 2005, and then a two-week admission at SJHCH in November of 2005 before being discharged and taken to a “lodging home” in Toronto. Years later, in 2014 and 2015, she had several brief visits to general hospital emergency departments. The Hospital Report stated that Ms. Applewaithe’s longstanding history of untreated schizophrenia had resulted in threats, physical violence and functional decline.
Since residing within the Hospital’s Forensic Program, Ms. Applewaithe’s demeanor has been consistently calm. She is described as soft-spoken. She maintains eye contact and will engage in conversation when initiated by others. She has enjoyed participating in recreational activities and utilizing the courtyard although prefers to remain seclusive to herself in these settings. Initially, she did not use her off ward privileges independently as she felt unsafe doing so by herself, however she enjoyed going out accompanied by staff. During her first reporting year from 2021-2022, she was consistently observed to be quite apprehensive and guarded around others, although she denied experiencing paranoia. She also expressed a continuing belief that he was entitled to live in the victim’s garage. Ms. Applewaithe often refused to engage in assessments or accept supportive services. Her Clinical Risk Assessment for the 2022 hearing stated that even with full medication compliance, she still suffered from residual disorganization and likely some degree of paranoia. By the time of her 2024 hearing, it was noted that with the continued administration of her antipsychotic medication, her paranoia became attenuated over time. Her antipsychotic medication was stopped, however, due to observed significant extra-pyramidal effects.
Evidence at the Hearing
Ms. Applewaithe’s current diagnosis is schizophrenia. She is incapable of consenting to treatment and of managing her finances/property. Her finances are managed by the Public Guardian and Trustee. Her brother, who lives in Toronto and occasionally visits her, is her substitute decision maker (SDM). Her sister, who also visits occasionally, lives in Florida.
The Hospital Report states that Ms. Applewaithe has remained stable over the past reporting year. She has adhered to a relatively rigid routine, which included participating in select unit and community based supervised activities and utilizing indirect passes on the hospital grounds. There have been no concerns of violent or aggressive behaviour. She continues to experience difficulty articulating her thoughts, and it is believed that this reflects residual disorganization associated with her psychiatric illness.
As indicated above, Ms. Applewaithe’s antipsychotic medication was discontinued in the fall of 2023 due to ongoing extrapyramidal symptoms (EPS) including tardive dyskinesia/dystonia, and Parkinsonian movements. These symptoms have improved with the combination of antipsychotic discontinuation and the introduction of tetrabenazine, a medication reserved for the treatment of hyperkinetic movement disorders. Due to the persistent nature of Ms. Applewaithe’s movement disorder, a Neurology consultation was obtained to assess the likelihood of underlying Parkinson’s disease. The consulting neurologist concluded that her symptoms are most likely attributable to tardive dyskinesia secondary to previous antipsychotic treatment.
The Clinical Risk Summary states that Ms. Applewaithe typically presents as a pleasant, soft-spoken woman who appears rather fragile in the context of her small stature and persistent EPS that has resulted in difficulties with ambulation, as evidenced by her slow shuffling gait, postural irregularity, and intermittent tremor. It is noted that although no evidence of paranoia or perceptual disturbance was observed over the reporting period, due to Ms. Applewaithe’s “taciturn” communication style, it is difficult to accurately discern her inner experience.
Dr. Sutton has been Ms. Applewaithe’s attending psychiatrist since 2021. He testified that she has done quite well in hospital and gets along well with both patients and staff.
Ms. Applewaithe has engaged in some recreational programs over the course of the year but has not been involved in any structured therapeutic programs. In his evidence, Dr. Sutton advised that Ms. Applewaithe has also become involved with a day program at St. Joseph’s Villa in Hamilton. She had been attending this for the three weeks prior to the hearing. The Hospital Report noted that Ms. Applewaithe was initially reluctant to attend this program. She was provided with support and encouragement to attend, and it was explained to her that attending Day Program is an important first step toward community reintegration, developing social supports and gaining some independence.
Ms. Applewaithe was also referred to the Stay Well Program at SJHCH. The purpose of this program is to maintain and improve her current level of mobility and physical capabilities. This program, along with the previously mentioned day program, would be available to Ms. Applewaithe after discharge to community living.
Ms. Applewaithe expressed ambivalence about her future plans, particularly around her housing. The following extract from the 2025 psychological risk assessment update (Hospital Report, p. 37) conducted by Dr. Mamak, summarizes part of her interview with Ms. Applewaithe on March 6, 2025, and is informative:
When asked about her goals for the upcoming year, Ms. Applewaithe noted that she would like to be discharged from hospital but had no specific plans for the same. She did assert that when living in the community, she wanted to maintain connection with the forensic psychiatry program as she finds the support to be “helpful.” It is noted that when the notion of an absolute discharge was broached with Ms. Applewaithe and the potential implications of the same (being free from FPP supports in terms of psychiatric follow-up, housing, leisure etc.) were reviewed, Ms. Applewaithe appeared visibly concerned about the same. When asked if she had thought about housing options, Ms. Applewaithe stated that while she feels that she could likely secure housing on her own, she would prefer assistance with the same. It was unclear if she desired a supported living environment or wished to reside independently. In the past, she has expressed a desire to live independently.
When asked about community supports, namely contact with her family, Ms. Applewaithe admitted that she has had occasional contact with her siblings. When asked about the potential to reside with one of her siblings, Ms. Applewaithe noted that while her siblings may provide temporary accommodation, none would provide long-term accommodation. She suggested that it was likely that if placed with a sibling, they would likely ask her to leave, and she may not have sufficient time to secure housing. Again, Ms. Applewaithe appeared distressed by this prospect and so, the undersigned assured her that this was a hypothetical scenario only and that there were no current plans to discharge her to a family member’s home or to a residence without FPP supports being in place, and this seemed to assuage her concern.
Over the past reporting year, it has been observed that Ms. Applewaithe depends on staff for most ADLs (Activities of Daily Living) and IADLs (Instrumental Activities of Daily Living) and requires a 24-hour supervised care facility.
Regarding efforts to connect Ms. Applewaithe with appropriate housing, it is noted that Ms. Applewaithe has been on waitlists for the Good Shepherd Community Housing Opportunity (CHO) Program since December 9, 2021, and the Indwell, Wentworth Program since February 17, 2022. Both programs have lengthy waitlists but have staff on site 24 hours per day, which the treatment team feels is an important consideration for Ms. Applewaithe. The social worker has also referred Ms. Applewaithe to the First Place Supportive Housing Program, which consists of apartment units through City of Hamilton Housing that provide on-site support services 24 hours per day. Dr. Sutton updated the panel to state that the level of supports provided at First Place have been determined to be insufficient for Ms. Applewaithe.
Dr. Mamak used two actuarial tools to prepare her risk assessment update, namely the e-HARM-FV (Electronic-Hamilton Anatomy of Risk Management-Forensic Version), and the HCR-20 v. 3. The eHARM-FV is a structured professional judgment tool that is completed monthly by the clinical team as a means of assessing and monitoring risk, and to inform decision making. Applying this tool, it was the team’s opinion that with the safeguards currently in place, Ms. Applewaithe’s risk to act out violently fell in the low range. If these safeguards were lifted and she was released into the community without professional supports, the team estimated that her risk would increase to the low-moderate range in the immediate (days to weeks) and long term (weeks to months).
Dr. Mamak’s overall risk summary, which includes both the e-HARM assessment and the HCR-20 v. 3 assessment, includes the following formulation:
In terms of risk, the undersigned concurs with the treatment team’s opinion that her risk to act out violently falls in the low range with the structure and support currently provided within the framework of a detention order.
However, when the possibility of an absolute discharge is considered for Ms. Applewaithe, it is the undersigned's opinion that such an action would elevate her risk, meeting the threshold for “significant threat.” As stated, Ms. Applewaithe is not currently prescribed psychiatric medications. Given her lengthy and well documented history of psychiatric instability, it is highly likely that she will experience decompensation at some point. While predicting the exact timing of this is challenging, research indicates that decompensation can occur up to two years after the discontinuation of antipsychotic medication. Stress is known to accelerate this process, and it is opined that an absolute discharge without a solid discharge plan or psychiatric follow-up would be highly destabilizing for Ms. Applewaithe. It is noted that she became visibly concerned when this was proposed as a hypothetical scenario.
Dr. Sutton’s opinion was that Ms. Applewaithe’s main risk factor is her transience and homelessness in the context of untreated illness. In his opinion, she would be highly likely to experience decompensation in the context of stress, pointing out that she has experienced that kind of decompensation before. Later, in response to a question from counsel for the Attorney General, Dr. Sutton stated that in the absence of the support, structure and supervision that she has received, the likelihood of her decompensation is quite high, and a decline could happen quite rapidly.
Dr. Sutton was asked about the need for careful monitoring of Ms. Applewaithe’s mental state during her transition to community living, and how a reintroduction of antipsychotic medication would be managed in view of the extra-pyramidal symptoms she had previously experienced. Dr. Sutton stated that if her symptoms returned, in particular her paranoia and perceptual disturbances, he would consider reintroducing Quetiapine (Seroquel). It is noted that from her earlier psychiatric history, Quetiapine had been administered and appeared effective in relieving her acute symptoms.
Dr. Sutton was asked to estimate Ms. Applewaithe’s height and weight for the record, to supplement what those at the hearing could observe directly about her. He estimated her height at 5’, 2” and her weight as approximately 115-120 pounds. He was asked whether Ms. Applewaithe is capable of hurting someone, given her small and slight stature. He responded that her presentation in the Hospital, with the support she has received, is very different from how she presented in the past from the standpoint of her aggression.
Dr. Sutton testified that unlike the previous situation when Ms. Applewaithe’s restricted mobility prevented her from accepting an accommodation that required her to navigate stairs, she now tends to walk relatively easily on her own. She has a slow, shuffling gait that is likely to be permanent; however, she is currently likely able to manage living in a rsidence with stairs.
Referring to paragraph 13 of last year’s Reasons, which summarized a 2014 hospital visit resulting in a diagnostic opinion1, counsel suggested the possibility that Ms. Applewaithe does not, in fact, have schizophrenia. Dr. Sutton testified that the diagnosis of schizophrenia has been confirmed several times, and while it was possible that she does not have this major illness, that possibility is unlikely.
Counsel also asked Dr. Sutton whether the application of “Box B” criteria under the Mental Health Act (MHA), together with a Community Treatment Order (CTO), could adequately protect the public if Ms. Applewaithe were absolutely discharged. Dr. Sutton responded that since she is incapable of consenting to treatment, a substantial deterioration of her mental condition in the community would likely trigger an ability to bring Ms. Applewaithe into a hospital for an assessment, but getting her treated and stabilized would require a longer admission. Dr. Sutton noted that in the past the MHA was not sufficient to keep her in the hospital as her symptoms were not overt and she was frequently released. A CTO could also help in getting Ms. Applewaithe initially to a hospital; however, Dr. Sutton testified that neither mechanism replicates the support provided by a forensic team from the standpoint of housing, financial and community transition assistance. In this regard, Dr. Sutton referred to and adopted Dr. Mamak’s opinion about Ms. Applewaithe being in the community on her own.
Dr. Sutton agreed with counsel’s suggestion that it was possible that Ms. Applewaithe would remain in hospital voluntarily. If the Board were to order an Absolute Discharge, she would not be asked to leave the Hospital, but Dr. Sutton would be concerned for her willingness to stay. It is difficult to predict what she would do, and this uncertainty is increased because of the inconsistencies and lack of clarity in her own plans.
Counsel asked Dr. Sutton to explain the significance of the risk score, from the eHARM-FV tool, that placed Ms. Applewaithe in the low-moderate range of risk to act out violently if released to the community in the absence of any supports. Dr. Sutton explained, first, that the eHARM-FV is an assessment conducted each month for the purpose of determining the granting of privileges. Furthermore, he explained that it formed one component of the overall assessment, which he stated would be in the moderate to high range in the context of an Absolute Discharge.
In response to questions from the panel, Dr. Sutton explained a re-offence scenario that he opined was likely. He stated that in the absence of support from the Hospital, Ms. Applewaithe’s deterioration would be imminent, leading to a return of paranoia, a considerable increase in agitation, and then aggression directed to others. Violence to others would likely arise in the context of Ms. Applewaithe having no place to live.
The panel had a question concerning the nature of any psychological harm that Ms. Applewaithe could cause. Dr. Sutton referred to the situation where she had been brought to hospital (in 2014) after being seen yelling and causing a disturbance at a bus shelter in St. Catharines, and stated that if Ms. Applewaithe were to become more disorganized and paranoid, the potential for psychological harm to others would exist.
Dr. Sutton testified, in response to a panel member’s question, that Ms. Applewaithe appears to understand the assistance that she has been receiving from the treatment team around finding appropriate housing, and that in the context of an Absolute Discharge, she would not have this. However, her appreciation of the team’s support is inconsistent at best.
Dr. Sutton candidly acknowledged that a portion of the treatment team’s overall concerns for Ms. Applewaithe is “without a doubt” rooted in “best interest” considerations.
No further evidence was led following Dr. Sutton’s testimony.
Analysis and Conclusions
Having reviewed the evidence and carefully considered the submissions of counsel, the panel found that Ms. Applewaithe represents a significant threat to the safety of the public. Despite her physical limitations, she remains capable of wielding weapons that have the potential to cause serious physical or psychological harm. Absent the professional supports provided through the Hospital under the terms of a Review Board Disposition, there is every likelihood that Ms. Applewaithe would once again become unhoused, disengage from mental health supports, become overwhelmed by the stressors of essentially fending for herself, and become seriously disorganized and paranoid. In such a state, there is a real likelihood that she would engage in criminal activity, likely in the form of acts of aggression that can seriously injure other members of the public. Her acts may also cause psychological harm to members of the public, particularly if she were to enter a home not her own, or as Dr. Sutton testified, as a result of causing disturbances in the community. The panel appreciates that such harm must go beyond the mere trivial or annoying. When Ms. Applewaithe is extremely dysregulated and in the throes of a psychotic episode, a more serious degree of harm is likely.
Ms. Applewaithe had, for over 20 years, suffered from an untreated major mental illness, schizophrenia. We are satisfied that this has been her consistent diagnosis, particularly as provided by those who have had the best opportunities to assess her over time. Her illness resulted in loss of employment and ultimately led to a transient lifestyle, living on the street or in shelters, for most of these 20 years prior to the index offences. This long period without treatment also appears to have left her with deeply entrenched residual symptoms, including paranoia and suspiciousness. Notably, paranoia was the driving factor responsible for her actions at the time of the index offences. She struck out at the homeowner while under a delusional belief, stemming from her illness exacerbated by her homelessness, that he intended to harm her and take her home away from her.
Ms. Applewaithe’s risk to the community continues to be related to her housing situation. Indeed, this was Dr. Sutton’s opinion. The panel accepts that this opinion is founded in the evidence. While in hospital, and thus in a place where housing instability was not a concern for her, Ms. Applewaithe’s mental status has been stable, her demeanour has been calm, her paranoia and disorganization was attenuated with the assistance of antipsychotic medication, and her behaviour was free of aggression. In the context of an Absolute Discharge, since she does not yet have stable and appropriate housing, she would essentially be again placed into the same set of circumstances in which she found herself prior to the index offences.
As noted by counsel for the Hospital in his submissions, there is a certain “other needs” component to this case, to quote the language in s. 672.54 of the Criminal Code, when one considers the role of housing, or more properly the absence of housing, in Ms. Applewaithe’s life. It would clearly be in her own best interest for her search for affordable and supportive housing, where she can thrive, to be supported by the forensic team. However, this motivation, born out of health care providers’ desire to preserve and improve their patients’ health, cannot distract the Board from its task of ensuring that restrictions on an individual’s liberty are only imposed when necessary to manage a real risk to the safety of the public.
Ms. Applewaithe has clearly benefitted significantly from the structure and support of her treatment team. In the absence of such support, and especially without stable housing, it is likely that she would experience a significant increase in stress, which would quickly overwhelm her capacity to cope. This in turn, would amplify her disorganization and paranoia, thus increasing the risk of violence to others in her vicinity. The unpredictability of Ms. Applewaithe’s actions also increases this risk.
The panel is mindful of Ms. Applewaithe’s physical limitations as they may pertain to her level of risk. As was pointed out in oral evidence and was apparent to the panel from her presence in the hearing room, she is physically diminutive and slight. She has also experienced a decline in her mobility, and although she can again climb stairs, she walks slowly, with a shuffling gait.
That said, it must be recalled that one of the index offences consisted of an assault with a weapon, and although her 2009 conviction is dated, it also involved an assault with a weapon. The use of weapons is not foreign to her. In the hands of even a physically small person, the wielding of a weapon acts as essentially a force multiplier. Ms. Applewaithe believed at the time of the index offences that she was defending her home and herself when she used a piece of wood against the victim. The introduction of weapons into any confrontation clearly increases the likelihood of serious physical injury.
Before leaving this issue, the panel wishes to address the evidence, and the related submission of Ms. Applewaithe’s counsel, of the risk formulation from the application of the eHARM-FV assessment tool. That tool has a specific and limited purpose, as Dr. Sutton explained. In any event, it forms only one part of the evidence in this case. The fact that this tool revealed a “low-moderate” risk of violent conduct in the absence of Ms. Applewaithe’s professional supports instead of a “high” risk was a piece of evidence for the panel’s consideration. However, it is not, on its own, controlling on the issue of “significant threat”.
Turning to the matter of the necessary and appropriate Disposition, the panel was satisfied that the least onerous and least restrictive, and therefore necessary, Disposition is a Detention Order containing the same terms as found in the previous Disposition.
As previously discussed, the determination of an appropriate community living setting for Ms. Applewaithe, with the support that she requires to address her care needs, is crucial for the safety of the public, the maintenance of her mental health, and for her eventual successful community reintegration. To that end, the Hospital must have the ability to approve her housing and return her to the Hospital expeditiously prior to any significant deterioration of her mental condition. In any event, since specific housing has not yet been identified for her, there is simply no air of reality to a Conditional Discharge at this time.
DATED this 7th day of July 2025, at the City of Toronto, in the Toronto Region.
Eric Siebenmorgen
Legal Member
Office of the Registrar
Ontario Review Board