Ontario Review Board
Re: Rio John
ORB File No: 7135
Hearing held on: Friday, June 20, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. S. Kert Members: Dr. T. Verny Dr. J.C. Rose Ms. K. Tomaszewski Ms. C. Plyley
Parties Appearing: Accused: Rio John Counsel: Ms. C. Whillier
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DISPOSITION
(Dated July 18, 2025)
Overview
On April 12, 2017, Rio John was found not criminally responsible on account of mental disorder (NCR) on charges of sexual assault (x2), indecent assault (x3), attempt to commit an indictable offence (theft), and theft under. At the time of the hearing, Mr. John was ordered detained at the Southwest Centre for Forensic Mental Health Care (Southwest Centre), with privileges extending to living in the community of Elgin or Middlesex County in accommodation approved by the person in charge.
On June 20, 2025, this panel of the Review Board convened a hearing to conduct the annual review of Mr. John’s disposition. Mr. John was present and was represented by his counsel, Ms. C. Whillier.
The issues to be decided at this hearing are whether Mr. John continues to pose a significant threat to the safety of the public and, if so, what is the necessary and appropriate disposition, considering the four factors in s. 672.54 of the Code.
The hearing proceeded on the basis of a joint submission in respect of both issues. None of the parties contested a finding of significant threat, and the parties jointly submitted that the sole change to the current disposition should be the removal of a clause that permits Mr. John 24-hour community passes, as those passes are otherwise subsumed under another clause in his disposition. Put simply, the parties were effectively recommending no substantive change to the current disposition.
For the reasons set out below, we find that Mr. John continues to represent a significant threat to public safety and that the necessary and appropriate disposition is a detention order, with the conditions and privileges set out in his current disposition, apart from the change outlined above.
The Index Offences
- The index offences can be summarized as follows. On February 10, 2016, Mr. John stole multiple chocolate bars from a variety store. Six days later, he masturbated on two occasions in a mall and once in a Starbucks. On May 26, 2016, Mr. John tried to take a woman’s cellphone and then groped her breasts and buttocks on the street. A few minutes later, he repeatedly slapped the buttocks of another woman on the street.
Background
Mr. John is 37 years of age. He was born in Barbados and came to Canada as an infant with his father and stepmother. He is a poor historian. His father, who remains a source of significant support for Mr. John, provided some background information and other details have been collected through his health records.
Mr. John was diagnosed with ADHD at an early age. He did not finish high school. He found work but had trouble keeping jobs. As a youth he was convicted of arson; by the time of the index offences, his criminal record included threats and multiple assaults (including with a weapon), as well as property offences and failures to comply with supervision orders.
Mr. John has a lengthy history of being diagnosed with substance use disorder, for the most part involving alcohol and cannabis use. Historically, substance use significantly exacerbated his psychiatric symptoms and heightened his risk for violence. He also has a lengthy history of psychiatric contacts and admissions. His first psychiatric hospitalization was in 2009, followed by several admissions before May 2016 (the last date of the index offences), most of which lasted for months. During that time, Mr. John was diagnosed with a range of psychotic disorders. His current diagnoses include schizophrenia, substance use disorder (in remission in a controlled setting), and antisocial personality traits. He is incapable of making treatment decisions and his father is his substitute decision maker.
Prior to his involvement with forensic psychiatric services, Mr. John had a history of homelessness and was engaged intermittently with community agencies such as the Elgin ACT team and the Thames Valley Addiction Services. Though there is information that as of November 2013 he had been able to live independently in his own apartment for about three years, his living situation often included the London shelter system and other unstable environments, He had difficulty independently organizing and stabilizing his life, and consistently declined mental health support and recommended treatment.
When first admitted to the Southwest Centre in 2016, Mr. John demonstrated significant positive and negative symptoms of psychosis. He exposed himself to staff and was threatening, both physically and verbally. His mental state improved with consistent treatment but it was not until 2019 when aripiprazole was stopped and clozapine started, that his sexually inappropriate behaviour abated. Mr. John’s aggressive behaviours also largely resolved. Despite this, Mr. John continued to experience both positive symptoms (hallucinations) and negative symptoms (isolation, disorganization).
In hospital, Mr. John has largely refused to participate in psychoeducational programming. He struggled with his activities of daily living, including showering. Over the years this proved to be a major impediment to his progress through the forensic system.
In July 2021, a behavioural analyst began working with Mr. John to try to improve his hygiene. They developed a rapport and, together with the addition of amisulpride to his medication regimen in January 2023, Mr. John displayed incremental progress. In the months that followed the introduction of amisulpride, Mr. John demonstrated improvements in attending programs, communicating with staff, socializing with peers and engaging with family members. There were also improvements in the symptoms of his mental illness, which were primarily attributed to the introduction of the medication.
In October 2023, Mr. John was transferred to the rehabilitation readiness unit. He continued to respond to unseen stimuli but these occurrences were no longer disruptive and did not appear to impact his day-to-day functioning. Overall, his behaviour was generally organized. However, he continued to be significantly impacted by the negative symptoms of his illness. He often presented with limited speech and blunted affect. His hygiene was an ongoing issue. Though he demonstrated some modest improvements in this area, these were largely superficial.
Starting in February 2024, Mr. John began to use his indirectly supervised community passes more frequently. He attended programs in the area facilitated by the CMHA and enjoyed attending at the library and visiting his father weekly. Despite this progress, Mr. John had no insight into his mental illness. He disagreed with his diagnosis and stated he only took medication because the team told him to and that there would not be any negative consequences to stopping it.
Course Since the 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. Quinn, Mr. John’s attending psychiatrist. That evidence revealed as follows: During the past reporting year, Mr. John continued to demonstrate positive symptoms of his illness, including responding to unseen stimuli and voicing grandiose delusions. However, Mr. John denied these symptoms when addressed by his treatment team, and was often dismissive when asked questions related to his symptoms. Otherwise, he presented as cheerful upon approach, which was a noted improvement throughout the year.
Over the course of the year, Mr. John progressed to the extent of using indirectly supervised passes into the community on an almost daily basis. He attended Talbot House every morning during the week and generally visited with his father every weekend. There were no reported issues when he was in the community.
For much of the year, Mr. John’s hygiene continued to be an issue, and he needed reminders to perform various hygiene-related tasks. He had the opportunity to have overnight passes and possibly live with his father, but due to his son’s longstanding hygiene problems, Mr. John’s father elected to put these plans on hold. Mr. John’s hygiene also presented as a barrier to other community placements.
In oral testimony, Dr. Quinn advised that after continuous education by staff as to why his community placement had been postponed, more recently Mr. John had displayed some improvement in his hygiene. Specifically, Mr. John had been participating in a structured program of showering to try to move him forward in the forensic system. As a result of the improvement in his hygiene, as well as advocacy by the treatment team on his behalf, Mr. John has very recently been accepted to live at a CHO-run group home in St. Thomas that provides 24/7 supervision. The home has staff on site who assist with meal preparation and medication administration. Forensic outpatient staff have a close relationship with staff at the home and are frequently on site there to see other forensic clients. The current plan is that Mr. John will move to the group home in early August.
While the treatment team is hopeful about Mr. John’s return to community living, Dr. Quinn noted that they will be closely monitoring his transition as: i) he will have a roommate at the group home; and ii) the owner of the home is adamant that Mr. John must keep up his hygiene. Dr. Quinn also advised that although Mr. John continues to await a cognitive assessment (following a referral to psychology), this will not impede his transition to community living.
Analysis and Conclusion
As outlined above, the parties provided us with a joint position on the issue of significant threat and disposition. Having heard and considered all of the evidence, and taking into account the joint submission, we agree with the parties that the test for significant threat is met, and that the current disposition should continue, essentially unchanged.
Although Mr. John is compliant with medications in hospital, since his admission to the Southwest Centre, his insight has remained significantly limited across all domains, including around his mental illnesses, need for treatment and potential for violence absent treatment. As he does not believe he has any mental condition, without the close supervision and support provided under a Review Board disposition, he is not likely to remain adherent with medication to treat that condition. Additionally, even if he was inclined to remain compliant, Mr. John requires close supervision to maintain adherence with the complicated medication regimen that he is on. Given his level of disorganization, it is unlikely that he would be able to take the medications without assistance.
Moreover, while Mr. John has not used any substances since his hospitalization, he does not connect substance use to potential relapse or worsening of his psychotic symptoms. At times he asks if he can use marijuana. He remains vulnerable to substance use and absent supervision is likely to return to cannabis use. Were that to occur, particularly at a time when he was non-adherent with medication, his mental state would rapidly deteriorate, his delusions and aggressive behaviour in response to those delusions would worsen and his risk for serious criminal behaviour (including sexually inappropriate behaviours) would be high.
We also agree that a detention disposition remains necessary and appropriate in the circumstances. While it is very encouraging that Mr. John has been accepted at a group home in St. Thomas, that placement depends on him keeping up a level of hygiene that is satisfactory in the community, remaining adherent with medication and abstaining from substance use. To try to ensure the success of the proposed placement, the treatment team continues to require the ability to approve his housing and to maintain a high level of supervision and monitoring once he is living in the community. They also need the ability to return him quickly to hospital, particularly if his placement is unsuccessful. All of this can occur under the current detention disposition.
Accordingly, taking into consideration public safety (which is paramount), as well as Mr. John’s mental condition, his reintegration into the community and his other needs, we agree with the joint position of the parties that the current disposition (with the removal of the redundant clause) should continue for the coming year.
DATED this 18^th^ day of July, 2025, at the City of Toronto, in the Region of Toronto.
Ms. S. Kert Alternate Chairperson
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Office of the Registrar Ontario Review Board