Re Scotty Isabel, 2025 CanLII 72928

Ontario Review Board

Re: Scotty Isabel

ORB File No: 8265

Hearing held on: Tuesday, June 17, 2025

Place of hearing: Southwest Centre for Forensic Mental Health 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: Scotty Isabel Counsel: Ms. N.C. Circelli

The person in charge of hospital: Counsel: Ms. J. Zamprogna

Attorney General of Ontario: Counsel: Mr. D. Rows

REASONS FOR DISPOSITION

(Dated July 22, 2025)

Introduction

1Scotty Isabel was found not criminally responsible on account of mental disorder on March 23, 2023, on charges of assault with a weapon, aggravated assault, and possession of a prohibited weapon, contrary to the Criminal Code.

2Mr. Isabel is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated July 3, 2024, which detains him at the Southwest Centre for Forensic Mental Health Care (“SCFMHC” or the “hospital”) with a variety of privileges up to living in the community of Elgin and Middlesex Counties in accommodation approved by the person in charge of the hospital.

3On June 17, 2025, a panel of the Board convened to review Mr. Isabel’s Disposition pursuant to s. 672.81(1) of the Criminal Code. He was present for his hearing and represented by his counsel, Ms. N. C. Circelli, throughout. Mr. Isabel’s parents also attended the hearing to support their son.

4The issues to be determined at the hearing were whether Mr. Isabel represents a significant threat to the safety of the public, and if so, the necessary and appropriate Disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code.

5When parties were canvassed for their initial, tentative positions at the commencement of the hearing, counsel for the hospital submitted that Mr. Isabel remains a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Detention Order containing the same terms as found in the previous Disposition, with the expansion of accompanied passes. The purpose of the expansion of these passes is to facilitate more trips with his mother, who is an approved person. Counsel for the Attorney General and counsel for Mr. Isabel both supported the hospital’s position.

6All parties maintained their respective positions at the conclusion of the evidence, and the Board was thus presented with a joint submission on all issues.

7Following deliberations, the panel unanimously agreed with the joint submission and concluded that Mr. Isabel is a significant threat to the safety of the public as that term is defined in s. 672.5401 of the Criminal Code and explained in the governing authorities. The panel further found that the necessary and appropriate Disposition for the management of Mr. Isabel’s risk is a Detention Order on the terms jointly recommended by the parties.

Index Offence and History

8The following information is summarized from the Board’s Reasons for Disposition dated July 22, 2024:

“The accused in this case is Scotty Isabel and the victim is his mother. The victim resides with her sister. The accused resides elsewhere.

On January 1, 2022, the victim was at her residence with her sister. At approximately 11:40 a.m. the victim heard a knock on the door and the accused entered the residence. The two exchanged pleasantries and then the victim asked the accused to go into the garage attached to the residence.

The accused and victim were then speaking in the garage about the accused’s children which he does not have custody of. The accused was upset and was blaming his mother, the victim, for withholding his children from him.

The accused then removed a can of bear spray from his coat pocket and sprayed his mother in the face causing immediate pain, and temporary vision loss. The victim then turned around and attempted to enter into the residence for assistance. While trying to get into the house the accused removed a small knife which was in his possession and stabbed the victim once in the left side of her body.

The victim’s sister was inside the residence and observed the victim coming into the house with a bright red face and appeared to be injured. When the garage door was opened by the victim, The sister was able to see that the accused was standing alone holding a knife in his hand. Emergency services were contacted and found the victim to be covered in bear spray and suffering from a stab wound to the left torso.”

9At the time of the index offences, Mr. Isabel was subject to hallucinations. He believed implanted technology had caused him to act out. Mr. Isabel suffered from serious mental health issues dating back to 2018. Mr. Isabel had a motor vehicle accident in 2013 that caused him to have suicidal thoughts.

10Mr. Isabel has a criminal record which includes assaults and resisting arrests.

11Mr. Isabel has a history of alcohol and substance abuse. He, and the mother of their two children, separated in 2013. Mr. Isabel went to live with his father. His children are in their teen years. His ex-wife and his daughter have visited him at the hospital, though only once last year. He has not seen his son for many years.

Diagnoses

[12] Schizophrenia Substance Disorder

Evidence at the Hearing

13The Board received documentary evidence in the form of a Hospital Report dated April 23, 2025. The Board also heard oral evidence from Dr. N. Mokhber, Mr. Isabel’s attending psychiatrist until March 2025, when Mr. Isabel was moved to the rehabilitation unit. Dr. J. Quinn is currently Mr. Isabel’s attending psychiatrist.

14Dr. Mokhber adopted the Hospital Report and confirmed the diagnoses.

15Mr. Isabel has had a very good year. Dr. Mokhber told the panel that Dr. Quinn cared for Mr. Isabel a year ago, but when Dr. Quinn was introduced to Mr. Isabel in preparation for the transfer to the rehabilitation unit, “Dr. Quinn said that he did not recognize Mr. Isabel as the same man – there has been that much improvement”.

16Last year Dr. Mokhber ordered an MRI to rule out neurocognitive disorder and Mr. Isabel was placed on the waitlist. At this point, the rehabilitation team does not see the need for an MRI, since they have not noticed any significant issues with respect to cognitive function. The Treatment Team is still waiting for the results of psychological testing, but because the Treatment Team knows Mr. Isabel well, the delayed receipt of those results will not be a barrier to Mr. Isabel’s progress.

17Mr. Isabel’s treatment regime is established, and he is doing well on the rehabilitation unit. He is attending programs and has started using his accompanied passes with his mother, who is an approved person. He has already exercised three day passes, and the decision was made recently to extend the day pass to eight hours, before granting Mr. Isabel an overnight pass. Mr. Isabel has also recently begun using indirectly supervised passes.

18The Treatment Team is moving cautiously to integrate Mr. Isabel into the community, especially considering that his mother was the victim of the Index Offence. His mother has taken steps to have the tenant remove the firearm(s) from her home, so that Mr. Isabel can attend her home without breaching his Disposition.

19On July 17, 2024, Mr. Isabel drank beer at his father’s apartment while on an accompanied pass. His father was an approved person at that time. His father had nothing else to offer Mr. Isabel to drink, so he offered him a beer. Mr. Isabel did not think he would be caught and accepted the beer. Mr. Isabel’s father was removed as an approved person, and Mr. Isabel’s privileges were put on hold until July 26, 2024.

20Dr. Mokhber testified that Mr. Isabel has great regret and remorse for this incident. The doctor also noted that it was a small amount of alcohol, and that it was offered to him. He did not seek it out. The positive outcome from this incident, is that Mr. Isabel knows he is at risk of relapse into alcohol use, and he is willing to work on his alcohol and substance use/relapse issues.

21Mr. Isabel has agreed to attend an addiction recovery program at Westover. This will begin in the very near future.

22Mr. Isabel is compliant with his medications and no longer questions their effectiveness. He is now capable of making treatment decisions. He has some potentially serious side effects. The Treatment Team will explore how to manage these, since there is a high chance that serious side effects could eventually lead Mr. Isabel to discontinue the medication.

23According to Dr. Mokhber, Mr. Isabel wants to find a job so he can send money to his children to show them that he cares for them. He says he is now ready to apologize to his ex-wife and to try to support them. He appreciates now that he has lost time with his children and family and wants to remedy this. He also says that he knows now that he needs to have skills to avoid drugs because if he goes to the community, he knows drugs will be available. Mr. Isabel told Dr. Mokhber that “If I use drugs I may be back here”.

24Dr. Mokhber told the panel that Mr. Isabel is starting to think deeply about his situation. This is the first movement towards internal motivation to resist substance use and maintain his mental stability. In Dr. Mokhber’s opinion, his willingness to be in touch with his family, even indirectly through sending money, “brings life to his motivation”. There is now evidence of external and some internal motivation, although there is still room for improved motivation.

25Mr. Isabel’s insight across all spheres is developing. External supervision is very important in managing Mr. Isabel’s risk to the safety of the public. The Treatment Team needs to provide adequate psychoeducation to improve and expand Mr. Isabel’s insight, especially with respect to substance use.

26No further evidence was led by the parties.

Analysis and Conclusions

27The panel agrees with the parties’ joint position and is also independently satisfied on the evidence that Mr. Isabel is a significant threat to the safety of the public. His schizophrenia significantly disrupts his mental stability, causing him to struggle with hallucinations, impulsivity, and violent behaviour. Mr. Isabel has a history of reverting to substance use to cope with stress.

28Although his behaviours have improved, Mr. Isabel continued to experience some affective instability this reporting period. Mr. Isabel historically coped with stress by using substances. He will need to be assessed in a less supervised environment, as currently, his ways of coping and adapting appear to be largely externally motivated.

29Although his insight is improving, Mr. Isabel has a history of medication nonadherence and currently takes his medication in the supervised hospital environment. He will need to be assessed in a less supervised environment.

30Although improved, Mr. Isabel’s insight into the index offence, his mental illness, his need for treatment, and his risk for violence remains underdeveloped. His insight into these domains will need further assessment in a less supervised environment. Mr. Isabel has a history of substance use in the previous period. He will need to be further assessed following his treatment programming at Westover and while increased privileges are granted. Mr. Isabel has no professional mental health community support or adequate living arrangement outside the external control of the Forensic system.

31The panel adopts the Re-Offence Scenario set out on page 42 of the Hospital Report:

Absent forensic supervision, Mr. Isabel would likely be without a place to live or mental health supports. By acknowledging these two central risks enhancing factors, he would likely stop taking his medications and manage his stress with substance use, as he has historically. His psychotic symptoms would exacerbate, and he would likely believe that others (including his mother) were at fault for what he was experiencing (e.g., using AI to control him, having AI in his brain, or blaming the police). He would become paranoid and distressed that others were not believing him or helping him alleviate what he was experiencing and would likely become aggressive. His psychosis would compromise his judgement, and he would react violently in response to psychotically perceived threats, as demonstrated in the index offence.

32The panel is further satisfied that the necessary and appropriate Disposition is a Detention Order with the expanded accompanied passes recommended by the parties. The panel adopts the reasons for a Detention Order, rather than a Conditional Discharge, as set out on page 44 of the Hospital Report:

Mr. Isabel has a longstanding history of antisocial behavior beginning in childhood, including animal cruelty and other conduct-related issues. He first engaged with mental health services in 2018 during a period of homelessness and suicidality. Since then, he has experienced multiple psychiatric admissions, during which he has presented with psychosis and, at times, catatonia. He has a history of precarious housing and was living with his father in a one-bedroom apartment at the time of the index offence, during which he was using crystal methamphetamine. Despite previous involvement under a community treatment order and engagement with psychiatric care, [at times] he has questioned the effectiveness of his medication and mental health supports. He was admitted to the Southwest Centre in April 2023 after being found NCR and relapsed in January 2024 (previous reporting period), testing positive for amphetamines, and July 2024 (current reporting period), testing positive for alcohol. Although he has made notable progress in the forensic system, participating in various psychoeducational programs and counselling as well as preparing to attend Westover, his insight into his mental illness, risk factors, and need for treatment remains underdeveloped. These concerns raise questions about whether his engagement has been externally rather than internally motivated. Therefore, further assessment is recommended to evaluate his community readiness, capacity for independent living, and overall insight, to ensure appropriate accommodation and support are in place. The Mental Health Act would not be sufficient in protecting the public’s safety in Mr. Isabel’s case until a serious act of violence was committed.

33The panel is satisfied that it is necessary and appropriate to expand the accompanied passes from 48 to 72 hours in Elgin and Middlesex Counties, and to permit Mr. Isabel to enter the communities of Southwestern and Southern Ontario on accompanied passes. This expansion in passes will facilitate increased integration into the community while accompanied with his approved person (his mother) and will give the Treatment Team opportunities to assess Mr. Isabel’s mental stability and his ability to avoid relapsing into substance use, before community living is considered.

34The panel expresses its sincere hope that the positive trajectory that was established during the reporting period will continue over the year ahead, and that Mr. Isabel will continue to develop internal motivation with respect to relapse prevention and adherence to medication.

35In coming to these conclusions, the panel has considered the paramount factor of public safety, along with the objectives of addressing Mr. Isabel’s mental condition, his other needs, and his reintegration into the community.