Ontario Review Board
Re: Stefan Robinson
ORB File No: 4956
Hearing held on: Tuesday, May 20, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. S. Kert Members: Dr. S. Hucker Dr. M. Mamak Hon. B. Allen Mr. A. Bouvier
Parties Appearing:
Accused: Stefan Robinson Counsel: Mr. D. Garrick
The person in charge of hospital: Representative: Dr. P. Darby
Attorney General of Ontario: Counsel: Ms. L. Earle
REASONS FOR DISPOSITION
(Dated July 7, 2025)
Overview
On November 22, 2007, Stefan Robinson was found not criminally responsible on account of mental disorder (NCR) on Criminal Code charges including attempted arson, mischief under $5,000, and failing to comply with conditions of an undertaking or recognizance. Since the finding of NCR, Mr. Robinson has remained subject to dispositions of the Ontario Review Board, most recently a disposition dated June 17, 2024, detaining him at the General Forensic Unit of the CAMH, with privileges extending to living in the community in 24-hour supervised accommodation approved by the person in charge.
On May 20, 2025, this panel of the Review Board convened in-person at CAMH to hold a hearing and review that disposition. Mr. Robinson was present and was represented by counsel.
The issues to be decided at this hearing were whether Mr. Robinson continues to meet the threshold test of posing a significant threat to the safety of the public, and, if so, what is the necessary and appropriate disposition to be imposed in the circumstances considering the four factors set out in s. 672.54 of the Criminal Code.
None of the parties contested a finding of significant threat, and the parties jointly submitted that the current detention disposition (without any changes) remains necessary and appropriate in the circumstances. We agree. These are our reasons.
Background and Index Offences
At the time of the hearing Mr. Robinson was 62 years old, having been born in June 1962, the youngest of five siblings. According to information provided by Mr. Robinson's brother, their mother apparently abandoned the family when Mr. Robinson was one year of age (though returned when he was about 7 to reclaim the children), and he grew up in unstable and unsupported circumstances of neglect and abuse.
Mr. Robinson left school at the age of 15. In his teen years he was supported by welfare and then worked at various labour-type jobs for short periods until a workplace injury in 1987. He had a common-law partner for six years in the 1980s and has a daughter from that relationship. He was reportedly involved in another relationship in the early 1990s, which ended when he was charged with sexually assaulting his partner. Due to his delusional beliefs, he has not had recent contact with his daughter or his brother, who is his SDM for psychotropic medication. Despite this, both his daughter and brother have sought increased contact with Mr. Robinson over the last year.
Prior to the commission the index offences, Mr. Robinson had a criminal history commencing in 1983 when he was convicted of break and enter. In 1985, he was convicted of robbery and spent six months in custody. In the years that followed he was convicted on multiple charges including assault, uttering threats, assault causing bodily harm and carrying a concealed weapon. His criminal record is notable for the fact that between 1985 and 1996, a period of just over 10 years, Mr. Robinson had no criminal convictions.
According to one of his probation officers, between 1996 and 2000, Mr. Robinson was subject to several probation orders. He typically stayed at hostels and used drugs and alcohol. He often did not report to probation and when he did, he was typically hostile and agitated. He generally slept outside as he had been banned from some hostels and refused a more stable residential setting, indicating that he was not agreeable to any fixed address until the government gave him the money he believed was owed to him.
Mr. Robinson stayed intermittently at the Good Shepherd hostel in Toronto. Staff there reported that after release from hospital and jail Mr. Robinson typically did well for days to weeks, but without medication he became increasingly bizarre, insulting, aggressive and disorganized to the point where he would be asked to leave the shelter. This description is in keeping with the description of Mr. Robinson's numerous contacts with, and admissions to, psychiatric facilities prior to the index offences. Much of his history is associated with substance or alcohol abuse with delusional and paranoid symptoms. He also typically refused medication or psychiatric follow-up in the community.
In August 2007, Mr. Robinson was charged with the index offences. The circumstances underlying those charges are summarized as follows: At approximately 1:00 a.m. on August 17, 2007, Mr. Robinson was observed at the front door of a store on Queen Street West in Toronto. He set a pile of garbage on fire, then left the scene. He walked to the front door of another store and did the same thing, at one point holding the lit garbage up to the door handles in an attempt to set the building on fire. He again left the fire burning and continued up the street. Two days later, he was observed to be setting a pillow on fire in a storefront before fleeing the scene. On subsequent interview, Mr. Robinson advised that around the time of the index offences he was he was "essentially sleeping on subway vents, and spending his days panhandling."
Following the NCR finding in November 2007, Mr. Robinson was detained at CAMH. Over the next seven years he was transferred between different forensic units and security levels due to his recurrent absconding from hospital and from passes, and his repeated use of illicit substances, including alcohol, cocaine, cannabis and synthetic cannabinoids (Spice). After the reinitiation of treatment with clozapine in 2018, Mr. Robinson's interactions gradually improved, as did his prosocial behaviour. His delusions attenuated and did not have the same impact on his behaviour.
In January 2019, Mr. Robinson's mental state declined acutely with no sign of medication non-adherence, most likely precipitated by Spice use. His symptoms included persecutory delusions about staff and co-patients. By early February 2019 he was persistently hostile and intimidating, and unable to engage in reality-based clinical discussions. His passes were held for a short period, resulting in a rapid improvement in his mental status.
In December 2020, given his progress as an inpatient, Mr. Robinson was discharged to live in the community in high support 24-hour staffed housing operated by LOFT Community Services. He moved into a bachelor apartment with meals provided by LOFT. He adjusted well to the placement and was cooperative both with LOFT staff and the CAMH Forensic Outpatient team.
Since then, Mr. Robinson has continued to live in his LOFT apartment. However, his course in the community has not been entirely smooth. In July 2021, he returned to substance use after having abstained for approximately two years. Since that time, he has continued to use alcohol and cannabis intermittently. This has occurred despite the advice of his treatment team to avoid substance use, given the clear correlation between substance use and decompensation of his mental status.
At the time of Mr. Robinson's last ORB hearing in June 2024, Mr. Robinson had only recently been discharged from CAMH, having been readmitted on April 11, 2024. In the months prior to that admission, LOFT staff and management expressed increasing concerns about Mr. Robinson's drinking. It was well known to other residents that he was drinking on a regular basis and on occasion he returned to the residence, seemingly intoxicated. Management expressed concern about the detrimental effect this was having on other residents as they perceived that there were no consequences to his drinking, despite the fact that this was prohibited at the residence. Mr. Robinson received a formal letter indicating that at the time of the renewal of his tenancy in June 2024, it was likely that he would be evicted unless this behaviour stopped.
Given how well Mr. Robinson had done at LOFT, the plan of the CAMH clinical team was to take every step to ensure that he could maintain his residence. The team decided that a brief admission to hospital to try to break his cycle of drinking and to more assertively attempt to engage him in substance relapse prevention was necessary. While in hospital, Mr. Robinson was referred to FORCAT for substance abuse treatment. He began weekly sessions with a psychology resident supervised by Dr. Cripps, engaged well with her and planned to continue to see her on discharge from hospital.
On May 2, 2024, Mr. Robinson was discharged from CAMH and returned to live at his same LOFT housing.
Course Since Last Hearing
At the current hearing we received evidence in the form of an updated hospital report, as well as the oral testimony of Dr. Darby, Mr. Robinson's attending psychiatrist. That evidence revealed as follows: Over the past year, Mr. Robinson has continued to reside in the same high-support LOFT housing in the community. He remains incapable to consent to treatment and receives medication (clozapine) with which he is compliant under the substitute consent of his brother. Mr. Robinson also remains incapable of managing his financial affairs, which are overseen by the Public Guardian and Trustee.
As noted above, during his 2024 admission Mr. Robinson was referred to FORCAT for substance use relapse prevention programming. He met with a psychology resident from April through August 2024. According to the clinical notes from those meetings, Mr. Robinson advised that he drank beer to alleviate the flashbacks that he believes are associated with PTSD. However, Mr. Robinson was unable to identify any negative consequences of his alcohol use. Though he was pleasant and agreeable during the sessions, he appeared to lack motivation to change his substance use. He did report to the team that he found the treatment helpful as he drank less over the course of the treatment.
Despite attending the sessions, Mr. Robinson had several urine drug screens that returned positive for ethyl glucuronide (a marker for recent alcohol consumption) during the year. He was open with the team and reported he drank several beers each week at a restaurant near his residence. The team's view is that Mr. Robertson did not change his drinking habits during the year, though more recently he reported to Dr. Darby that he would be stopping his alcohol use.
Alcohol was not the only substance of concern for the team this year. In December 2024, Mr. Robinson was observed with a round object in his winter jacket. Investigation revealed a cannabis crusher and a small amount of cannabis. Mr. Robinson was advised to dispose of the device and the cannabis, and was reminded that using illicit substances is both a breach of his disposition and the terms of his lease at LOFT. At about the same time, he tested positive for cannabis on a urine drug screen. In January 2025, LOFT housing staff reported that they discovered some cannabis in Mr. Robinson's room, which he acknowledged buying impulsively from a dispensary.
In oral testimony, Dr. Darby confirmed that overall Mr. Robinson had a good year. He did not require any admissions to hospital, was quite compliant with his medications and was very pleasant to staff both at CAMH and LOFT. Apart from his ongoing substance use, there was no other concerning behaviour.
As described by Dr. Darby, Mr. Robinson exhibits chronic residual psychotic symptoms in the form of grandiose, bizarre, and paranoid delusions. He repeatedly describes that unknown people are after him, referring to this process as "lanadeering," an experience he has described for many years. On occasion he has expressed concern that a particular resident is watching him, but generally his paranoid ideation is not focused on anyone in particular in his environment.
When asked about Mr. Robinson's PCL-R score of 27.8, Dr. Darby noted that the scoring was done at a time when Mr. Robinson was very unwell, that the antisocial issues associated with that score do not currently appear to impact his relationship with the team or other people, and that in his view it is likely that were Mr. Robinson to be re-tested at this time, his score on the PCL-R would be lower.
Analysis and Conclusion
Having heard and considered all of the evidence and the joint position of the parties, we find that the test for significant threat is met, and that the current detention disposition remains necessary and appropriate.
Mr. Robinson has a long history of suffering from schizophrenia. His symptoms of psychosis have included auditory hallucinations, delusions, and agitation. While his mental state has improved since the reintroduction of clozapine in August 2018, he remains symptomatic with both positive and negative symptoms (albeit at a lesser intensity). Despite adherence with medication, Mr. Robinson has persistently evidenced deficits regarding his understanding or acceptance of his diagnosis of schizophrenia, the role his illness played in his index offences, and the impact of alcohol and illicit substance use on his mental state. He has a history of medication nonadherence in the community and his compliance while under the jurisdiction of the ORB has been contingent on external monitoring and administration. Given his poor insight he is unable to appreciate the role of medication in managing his psychosis and would likely discontinue treatment absent external supervision and enforcement. Indeed, Mr. Robinson has made clear statements to the clinical team that he would do so. In the absence of treatment his risk of rapid psychotic deterioration and associated violence is high.
We also recognize that overall, Mr. Robinson had a good clinical year. Although he is not involved in structured activities, he had no difficulties in the community and did not require readmission to hospital. Given this, Dr. Darby was asked whether a conditional discharge which named Mr. Robinson's LOFT residence and provided the ability to return him to hospital under BOX B of the Mental Health Act (given his incapacity with respect to treatment) would be sufficient to manage his risk. Dr. Darby indicated that it would not, and we agree.
As occurred last year, and given the correlation between substance use and decompensation of his mental status, there is a real possibility that Mr. Robinson will need to be brought back into hospital if his drinking again becomes more problematic. Moreover, the use of alcohol is against the rules of his housing; if Mr. Robertson continues to drink, it is foreseeable that he will have to be brought back into CAMH to avoid eviction at a time when he does not meet the criteria for the MHA. It remains essential for the team to be able to return Mr. Robinson quickly to hospital in order to maintain his housing and to be able to approve any housing in which he resides to ensure a sufficient level of supervision, including enforced provision and observation of medication. As a result, a detention disposition which allows Mr. Robinson to continue to live in the community in a home which he enjoys, but which also provides the necessary structure and supervision that he requires, remains necessary and appropriate for the coming year.
Accordingly, considering public safety (which is paramount), as well as Mr. Robinson's mental condition, his reintegration into the community and his other needs, we find that the current detention disposition should continue unchanged for the coming year.
DATED this 7th day of July, 2025, at the City of Toronto, in the Toronto Region.
Ms. S. Kert Alternate Chairperson
Office of the Registrar Ontario Review Board