Re: Joshua Theobald
ORB File No: 7704
Hearing held on: Wednesday, June 11, 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. L. Maunder
Members: Dr. P. Prendergast Dr. G. Stones Mr. R. Bigelow Mr. A. Mete
Parties Appearing:
Accused: Joshua Theobald Counsel: Mr. A. Rai
The Person in Charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. J. McKenzie
REASONS FOR DISPOSITION
(Dated: July 25, 2025)
Introduction
On March 19, 2020, Joshua Theobald was found not criminally responsible on Criminal Code charges of utter threat and assault peace officer. At the time of the hearing, Mr. Theobald was subject to an order detaining him at St. Joseph’s Healthcare Hamilton, with privileges up to and including living in the community in approved housing. On June 11, 2025, the Board convened to conduct an annual review of Mr. Theobald’s disposition.
The parties all agreed that the necessary and appropriate disposition was a continuation of the detention order under the same terms. For the purposes of this hearing, significant threat was not contested. Thus, we had a joint submission. For the reasons set out below, the panel found that the evidence established that Mr. Theobald remained a significant threat and we agreed that a detention order remained necessary and appropriate under the same terms.
The Index Offences
The Hospital Report does not include any description of the index offences. We have had to rely on last year’s Reasons for Disposition which included a summary.
On March 23, 2019, a couple was walking down Yonge Street with their two-year-old daughter, when Mr. Theobald ran towards them swearing and threatening to punch the man and his daughter. The family stepped into a coffee shop and Mr. Theobald followed them, still yelling. He tried to pick up a table but was not successful. Employees intervened and insisted he leave. When the police approached Mr. Theobald to arrest him, he was screaming and yelling and swung at an officer. He was “very paranoid” and non-responsive to questions.
Background / Context
Mr. Theobald is 36 years old. His mother was a drug user, including during her pregnancy. He was taken from her when he was two and put into foster care and later lived in a group home. He showed some intellectual delay, evidence of fetal alcohol syndrome, and attachment issues.
When Mr. Theobald was approximately ten years old, he was described as “aggressive and uncontrollable” and had some involvement with psychiatric services. He may have been treated with antipsychotic medication.
Mr. Theobald has a grade five education. By the time he was 14 years old, he was homeless, using drugs and engaging in prostitution.
Mr. Theobald has an extensive history of using a wide range of substances. At one juncture he was diagnosed with a severe stimulant disorder.
Mr. Theobald’s criminal record runs to six pages, beginning when he was 14 years old and ending with him coming under the jurisdiction of the Board at the age of 31. In addition to mischief, theft, many instances of uttering threats and two dozen convictions for failing to comply with probation or bail terms, Mr. Theobald was convicted of more than a dozen assaults (one with a weapon, one causing bodily harm), one count of robbery, one count of trafficking and one count of possession of child pornography for the purposes of distribution.
Mr. Theobald had frequent contact with psychiatric services, in the community and while incarcerated. Personality traits and substance use often featured prominently in his presentation, complicating diagnosis. His presentation was also atypical – his behaviour often seemed regressive or childlike. On occasion, he was thought to be medication seeking or malingering. Eventually, after a three-month psychiatric admission in 2017, Mr. Theobald was diagnosed with schizophrenia.
Mr. Theobald was admitted to CAMH after the index offences, initially for a fitness assessment and then after he was found NCR. He remained at CAMH until November 2023. Initially, Mr. Theobald was very agitated, experiencing command hallucinations, and frequently required seclusion to manage his physically aggressive behaviour. He was treated with antipsychotic medication and a mood stabilizer but even after his medications had been optimized, his symptoms improved but did not dissipate. His mental state was fragile, and he decompensated quickly.
The implementation of a behavioural plan helped reduce the frequency of incidents that resulted in seclusion. Over time, Mr. Theobald began to ask for seclusion when he felt he might lash out.
It took a couple of years for Mr. Theobald to progress to using escorted passes onto the grounds of the hospital. In February 2023, he was moved from a secure unit to a general unit and began to use unescorted passes onto the grounds and escorted passes into the community.
In November 2023, Mr. Theobald was moved to St. Joseph’s. He continued to experience symptoms of psychosis, and he engaged in “intrusive and sexualized behaviours”, but these were managed with only brief seclusions (often at his request).
In March 2024, Mr. Theobald’s cognitive functioning was assessed, and he was diagnosed with intellectual disability – severe (discussed further below).
The Current Year
Dr. Jonathan Duboff, Mr. Theobald’s psychiatrist from the time of his transfer to St. Joseph’s in November 2023 until April 2025 (when he was transferred to a different unit), testified at the hearing. He had read and adopted the Hospital Report.
Mr. Theobald’s current diagnoses are schizophrenia, intellectual disability, historical diagnosis of fetal alcohol syndrome disorder, borderline and antisocial personality traits, stimulant use disorder, severe, in sustained remission in a controlled environment, and polysubstance abuse. Although last year’s psychological assessment diagnosed Mr. Theobald with intellectual disability – severe, Dr. Duboff testified that Mr. Theobald’s functioning was above what you would expect from someone who had a severe intellectual disability.
The combination of his chronic experience of symptoms of psychosis (including distressing paranoid delusions), intellectual disability and “personality disturbance” manifests in episodes of immature, “child-like and attention-seeking behaviour” and impulsivity. During the year, Mr. Theobald kicked a shoe hitting a staff person in the face, threw a water bottle at staff, touched people, engaged in environmental aggression, and threatened to kill people.
Over the course of the year, Mr. Theobald showed some improvement in his behaviour. He engaged in some therapeutic recreation programming and used passes successfully (indirectly supervised on the grounds and escorted in the community).
As a result of his diagnosis of intellectual disability, Mr. Theobald has additional funding through Disabilities Services Ontario (DSO) that pays for a behavioural support worker to work with him regularly.
Mr. Theobald’s mother (who is also his SDM) lives in Alberta and is in poor health. She does not have a cell phone, and he has minimal contact with her, causing him some distress. Fortunately, with some facilitation by the unit social worker, Mr. Theobald’s uncle has assumed a more active role in offering emotional support to Mr. Theobald. They talk on the phone regularly and he visits occasionally.
Mr. Theobald has been assessed as needing “medically monitored”, 24-hour supported housing with behavioural support. He is on the DSO waitlist. Unfortunately, it may be many years before he is offered a placement. The team does not believe any other referrals are appropriate at this time.
Significant Threat
- The panel was satisfied that Mr. Theobald remained a significant threat to the safety of the public. Despite a combination of medications (including clozapine), Mr. Theobald continues to experience symptoms of schizophrenia including paranoid delusions. His mental state is fragile, and he decompensates quickly triggered by psychosocial stress. In combination with his personality features and his intellectual functioning, this results in Mr. Theobald engaging in conduct that is often merely intrusive but is sometimes threatening and aggressive, such that someone could be hurt. If Mr. Theobald did not have the support, structure, and rapid interventions offered by the treatment team in hospital, he would without a doubt worsen in response to stress and his conduct would escalate quickly. We were satisfied that without the oversight of the Board, Mr. Theobald would immediately pose a real risk of causing serious physical or psychological harm to those around him.
Necessary and Appropriate Disposition
The panel concluded that the necessary and appropriate disposition was a continuation of the detention order on the same terms as last year, as jointly recommended by the parties. Mr. Theobald is still in hospital and any chance he has of a successful transition to living in the community will require housing that meets his complex needs, and a slow and careful transition that allows for the hospital to bring him back in if he decompensates. A detention order remains necessary and appropriate for these reasons.
Prior to next year’s annual review, the Hospital Report should be amended to include a description of the facts of the index offences that formed the basis for the finding of NCR. If the Hospital Report does not include these facts, we ask that the representative for the Attorney General provide them to the Board in advance of that hearing.
DATED this 25th day of July 2025, at the City of Toronto, in the Toronto Region.
Leslie Maunder
Alternate Chairperson
Office of the Registrar
Ontario Review Board