Re: R.M.
ORB File No: 7274
Hearing held on: Wednesday, June 18, 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: R.M. Counsel: Mr. T. McIver
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated August 1, 2025)
Introduction
On November 27, 2017, R.M., then 21 years old, was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault, uttering threats, sexual assault (x2), assault (x2), attempting to choke or strangle, and failing to comply with an undertaking, all contrary to the Criminal Code of Canada (the “Criminal Code”).
Mr. R.M. was most recently subject to a Disposition of the Ontario Review Board (“the Board” or “ORB”) dated June 28, 2024, discharging him on certain conditions, including a residence requirement, and a condition requiring him to report to the person in charge of the Southwest Centre for Forensic Mental Health Care (“Southwest Centre”, “SCFMHC”, or the “Hospital”) not less than four times per month.
On June 17, 2024, a panel of the Board convened to hold a hearing to review Mr. R.M.’s disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. R.M. was present for his hearing and was represented by counsel, Mr. McIver, throughout the proceeding.
The issues to be determined were whether Mr. R.M. 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.
At the commencement of the hearing, counsel for the Hospital submitted that Mr. R.M. remains a significant threat to the safety of the public and that the necessary and appropriate Disposition is continuation of the current Conditional Discharge, with a reduction of reporting requirements to not less than once per month. Counsel for the Attorney General and for Mr. R.M. agreed with the Hospital’s submission. At the conclusion of the hearing, all parties maintained their respective positions. The panel was thus presented with a joint position.
The Board received documentary evidence in the form of a Hospital Report dated June 2, 2025, marked as Exhibit 1. The Board also heard oral testimony from Dr. Ajay Prakash, Mr. R.M.’s treating psychiatrist.
For the reasons set out below, the Board accepted the parties’ joint position and found that Mr. R.M. continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Conditional Discharge in accordance with the proposed terms.
Index Offences
- The following description of the index offences is summarized from last year’s Reasons for Disposition. There are two groups of index offences. The first group occurred in Toronto. The second group of offences took place in May of 2017, in the Town of Exeter, Ontario, while Mr. R.M. was released on an Undertaking for the first group. In all cases, the victim was Mr. R.M.’s mother.
The Toronto Offences
On Tuesday March 15, 2016, the accused and the victim were at home alone. The victim noticed a change in the accused’s behaviour as he became very fidgety. The victim tried to calm the accused down and was in the kitchen when the accused approached her from behind and grabbed her buttocks from below, with one hand. The accused then reached around the victim with his other hand and proceeded to reach behind beneath her pants and grab her vagina.
The victim was able to push the accused away from her at which time he pushed her up against the cupboards and punched her in the face.
The accused then put his hands around her neck and began to squeeze. The accused picked the victim up off the floor and the victim found it difficult to breathe. The victim eventually managed to escape the accused’s grasp and yell for help.
The victim could be heard by another tenant in the building screaming for help and so police were contacted. As a result, the accused was apprehended by police and Formed at St. Joseph's Hospital.
On March 18, 2016, the victim came to police to advise of further incidents of sexual assault and assault as perpetrated by the accused. The victim revealed that the sexual assaults began in September 2015. The accused began grabbing at her breasts, tried to aggressively kiss her, and grab at her buttocks and vagina. The accused also at one point jumped on top of the victim and tried to pull his pants down in order to have intercourse with her as she lay on the couch in the living room. The accused has been becoming more aggressive and attempts to corner her in places in the home where he can assault her.
On another occasion, the accused cornered the victim and tried to pull her face toward his exposed penis in attempts to force her to perform fellatio. The accused grabbed the victim by the head and pulled her toward his groin. The victim was able to escape his grasp and lock herself in the washroom.
The accused was released from the crisis unit at St. Joseph's Health Care Centre and transported to Ontario Shores Centre for Mental Health Services
On Tuesday, August 30, 2016, the accused was granted a day pass from Ontario shores and surrendered himself to police at 22 division. The accused was then released back into the care of Ontario Shores via a promise to appear and undertaking.
The 2017 Offences
Count 1: CC 145(5.1) Fail to Comply with Conditions of Undertaking Given by Officer in Charge.
R.M. was charged with sexually assaulting his mother and choking her to overcome resistance. As a result, Toronto Police released R.M. 30th August 2016 on an OIC Undertaking with conditions not to be around his mother. R.M. lived with his father at a separate address. His mother moved to Exeter. His father decided that for financial reasons, that he would move back in with his wife, and since R.M. was living with him, that R.M. would move with him.
R.M. came to Exeter with his father and has been living in the same apartment as his mother, which was clearly in contradiction of his release conditions.
Count 2: CC 266 Assault
On Wednesday the l0th of May 2017, R.M. choked his mother with such force that she felt that she could not breathe. He also twisted her arms outwards in a display of strength; eventually she was able to release herself from his grip.
Count 3: CC 266 Assault
On Friday the 12th of May 2017, R.M. walked behind his mother while she was on the porch, grabbed her by the shoulders with both hands from behind, shook her violently and pushed her through the open door back into the house.
Count 4: CC 266 Assault
On 13th May 2017, R.M. choked his mother with such force that she felt that she could not breathe. He also twisted her arms outwards in a display of strength, eventually she was able to release herself from his grip.
Count 5: CC 264.l(l)(a) Uttering Threats - Cause death or Bodily Harm
On 13th May 2017, R.M. choked his mother with such force that she felt that she could not breathe. He also twisted her arms outwards in a display of strength, eventually she was able to release herself from his grip. While R.M. was choking her, he said "I want to kill you".
The Hospital Report outlines Mr. R.M.’s history and background and need not be repeated here in detail. The key features of his personal background are well summarized in last year’s Reasons and are essentially reproduced, with minor modifications, in the following paragraphs.
Mr. R.M. was born in Toronto and has one brother as well as one half-brother. His childhood was marked by instability and hostility in the family home. His parents separated when he was young and his mother married his stepfather in 2001 but then divorced him around 2009. Mr. R.M.’s father was abusive to his mother, and Mr. R.M. himself was physically and emotionally abused by his stepfather. Mr. R.M.’s parents reconciled about 13 years after first separating. The Children’s Aid Society was involved with the family on one occasion after his mother took Mr. R.M. out of the province without his father’s permission.
Mr. R.M. completed Grade 9 but did not go further. He has a history of part-time employment at Booth Industries at age 17 and worked at the Salvation Army in 2012-2013. Since then, he has been financially supported by Ontario Disability Support Program.
Mr. R.M. reported that he used marijuana daily since age 14 and had used cocaine once or twice. He said that he started drinking alcohol as a teenager, typically one beer a week at weekend parties. He admitted to selling drugs to friends but stated he had not incurred any drug-related charges. He had not been involved in therapeutic addiction programs.
Mr. R.M.’s criminal history primarily consists of the index offences. Other reported criminal behaviour includes assaulting his father (May 2, 2016), assaulting a cab driver (April 15, 2016), and sexually assaulting many others (up to 20, including a vulnerable elderly male patient at Ontario Shores), as well as molesting children between the ages of five and 10 (i.e. when he was six to nine years old).
Mr. R.M.’s psychiatric history is detailed in the Hospital Report which is in evidence and need not be repeated in detail here.
Mr. R.M. was admitted to the Southwest Centre following his NCR verdict. He was administered clozapine shortly after his admission. His dose was gradually increased as he continued to experience active symptoms of psychosis, including responding to unseen stimuli. Nevertheless, since his admission to the Hospital in 2017, there have been no reported incidents of sexually assaultive behaviour, preoccupations, violence, aggressive or impulsive behaviours.
Evidence at the Hearing
Mr. R.M. is currently diagnosed with Schizophrenia, Intellectual Disability (mild), Social Anxiety Disorder, and Cannabis Use Disorder, in sustained remission.
Dr. Prakash emphasized that Mr. R.M. does not carry the diagnoses of sexual sadism or antisocial personality disorder, on the basis of longitudinal observations of Mr. R.M.. Dr. Prakash adopted the following opinion, taken from pages 143-144 of the Hospital Report:
On November 26, 2019, Mr. R.M. attended the Sexual Behaviours Clinic at the Centre for Addiction and Mental Health (CAMH) in Toronto. Despite the lack of phallometric testing completed, Drs. Wang and Wilkie at CAMH did offer their diagnostic impression and treatment recommendations. Regarding the underlying etiology of his previous sexually violent behaviours:
Mr. R.M.’s sexual behaviours and offences are likely linked to his underlying psychotic disorder, coupled with poor intellectual functioning and early exposure to sexual material and behaviours. Given his limited cognitive capacity, it is likely that Mr. R.M. had difficulty understanding the nature of sex and sexual relationships with others, furthered by the fact that this began at a young age. His recollection of his sexual offences and behaviours as an adult were all linked to psychotic symptoms and accordingly, he was deemed Not Criminally Responsible for multiple sexual assault charges. Absent significant psychosis for the last two years, there have not been any problematic sexual behaviours, which suggests that his inappropriate sexual behaviours were closely linked to psychosis.
Mr. R.M. continued to reside at the same residence where he has lived since February 2022. This residence is a 24/7 supervised group home and provides support and supervision around medication administration, meals, appointments and scheduling, and general counselling. He has managed very well in this environment, which is quiet as the home has only a small number of residents (less than 10) and he has a private bedroom. It is part of the Community Homes for Opportunities (CHO) program where Mr. R.M. can receive additional support from a CHO worker if needed (i.e. activities or assistance with shopping). Mr. R.M. follows the rules at the home, and the group home staff feel he is a “good fit for the home”.
Mr. R.M. continues to do well in the community and had a very good year in the context of living in a highly supportive residence, with more frequent and longer passes. He has been exposed to cannabis and other substances without relapsing.
Mr. R.M. is capable to make treatment decisions. His clozapine levels are stable, and he has improved in his management of his smoking. He consistently denied the presence of any positive symptoms of his schizophrenia. He correlates his previous positive symptoms with the use of cannabis and demonstrates awareness of the negative impact substance use had on his mental illness. He has experienced various stressors and maintained mental stability; his feelings were congruent with the situation and understandable given the stressors. Mr. R.M. has not identified any anxiety throughout the review year and has not demonstrated any anger or self-destructive behaviours. There has also been no evidence of affective, behavioural, or cognitive instability.
Mr. R.M. socializes well, attending CHO outings and engaging appropriately with both the group home staff and other residents. Mr. R.M. enjoys spending time with his support worker (Dillon), made available to him through DSO Passport funding. Mr. R.M. is described as “cooperative, pleasant and friendly”.
Mr. R.M. demonstrates motivation and drive and continues to be goal oriented. However, he demonstrates some cognitive limitations including difficulty with his memory. He requires a great deal of support with new tasks and with organizing personal appointments and day-to-day tasks.
During the report period, Mr. R.M. expressed a desire to complete tasks independently. With mentoring and repetition, he was able to follow through with the task of booking his own taxi to a bus stop in London and taking the bus to Exeter to visit his parents. Also, in February 2025, Mr. R.M. needed to pay off his phone bill, and after some initial reminders, he was able to independently coordinate paying off his bills with both Community Living Elgin, and Telus mobility.
He has shown some improvement in his ability to organize, plan, and solve problems. For example, while on a pass in November 2024, Mr. R.M. missed the bus to Exeter and instead of phoning his Outreach team, he reached out for support from his mother and the group home manager. The Outreach team was only informed after the fact by the group home manager, which demonstrates his improved problem-solving and coping.
Mr. R.M. recognizes the importance of having structure and routine to his day. For much of the reporting period, he volunteered at Mission Thrift store Monday to Friday in the mornings. Outside of volunteering, he spent his time watching movies, listening to music, exploring “still action” videos, going for walks, and biweekly outings with his support worker. Mr. R.M. also enjoys speaking to his family daily on the telephone and has had numerous visits to see them at their home.
He has good insight across all domains, although he believes that the only time he could become violent again is if he smoked cannabis. Mr. R.M. has indicated his desire to remain substance free.
Mr. R.M. has also expressed a desire to live independently. According to the Hospital Report, the group home manager has expressed concerns about the high level of support he currently receives and whether it could be replicated if he were to live independently. The Hospital’s Occupational Therapist’s opined that:
[given that] Mr. R.M. has never lived alone, a slow and gradual transition (i.e. transitional housing) to independent living would ensure that he maintains stable mental health and is able to progress to the next step. He will require a high level of support both in preparation and learning independent living skills and during each transition. He would benefit from hand over hand learning, overlearning activities, written instructions, calendars, reminders, and frequent follow up. He requires a support team that will come to him for assessment, provide direct, in vivo teaching, and provide compensatory strategies to support success.”
On March 17, 2025, a referral to the Elgin ACT team was submitted in preparation for a future transition out of the forensic system. However, as of the date of this report he has not been accepted into their services and is on the waitlist. Mr. R.M. is happy to have the continued support of forensics or an ACT team and stated he will maintain the same routine regardless. Mr. R.M. welcomes any support he can receive and his transition to the ACT team once accepted is expected to be smooth. He is also agreeable to a voluntary Community Treatment Order (CTO).
Dr. Prakash told the panel that the Treatment Team has not been updated about when the Elgin ACT Team will accept Mr. R.M. as a client. The doctor indicated that given Mr. R.M.’s need for continuing structure and support to manage his risk to the public, a CTO and support from the ACT Team will need to be in place prior to recommending an absolute discharge.
The purpose of the reduction in reporting requirements is to more closely replicate a post-forensic situation. The doctor noted that the reporting requirement can be increased as needed, given that the suggested report requirement is a minimum of once per month.
No additional evidence was led by the parties.
Analysis and Conclusions
The panel agrees with the parties’ joint recommendation and finds affirmatively that Mr. R.M. represents a significant threat to the safety of the public. The evidence is compelling in this regard. The panel finds that without substantial support and structured supervision, there is a foreseeable and substantial risk that Mr. R.M. would commit a serious criminal offence, if discharged absolutely. The result of such offending behaviour is likely to be serious physical or psychological harm.
Mr. R.M. suffers from a major mental illness, schizophrenia, as well as intellectual disability. When unwell, he has engaged in numerous significant incidents of physical and sexual violence in the community. These behaviours flow from his major mental illness. Due to his cognitive abilities, Mr. R.M. requires support and supervision to maintain his clozapine serum levels to treat this illness.
The panel agrees with the Overall Clinical Assessment of Risk set out on pages 150-151 of the Hospital Report:
Mr. R.M.’s symptoms have been well controlled with his current medication regimen, and he has not required any readmissions to hospital since residing at the group home. He demonstrates motivation for treatment and continued stability but due to his cognitive abilities, without significant support, he would not likely be able to organize his day-to-day life i.e. attending appointments, caring for himself, and managing his medications long term;
Mr. R.M. has a history of non-compliance with medications within a less supervised environment likely driven by his cognitive limitations rather than a desire to be off his medications;
Improvements continued to be noted in Mr. R.M.’s negative symptoms and intellectual impairment and his independence in certain areas has improved. However, he requires ongoing support to assist him with day-to-day tasks and manage any future stressors that may arise;
Mr. R.M. has a history of substance use, which has been linked to past criminal and violent behaviours, including sexual violence, as well as decompensation of his illness; and
Although Mr. R.M. is supported by CHO, group home staff, and his DSO support worker Dillan, he has not been accepted by the Elgin ACT team yet, which will be essential in preparation for his transition out of the forensic system.
The panel considered an absolute discharge but agrees with the Treatment Team that although “Mr. R.M. has maintained successful tenure in the community with no readmissions to hospital, he has not yet established adequate professional community-based mental health supports that could manage his risk absent the forensic system. Due to his cognitive abilities, without significant support, he would not likely be able to organize his day-to-day life and maintain his current routine and structure.” As such, the panel agrees with the parties’ joint recommendation that a conditional discharge is appropriate until adequate professional community-based mental health supports are established.
The panel agrees with the parties’ joint submission that the reporting frequency be reduced to not less than once per month, to assess how Mr. R.M. adjusts to less oversight, in preparation for transition to the care of an ACT Team.
The panel also agrees that no additional changes should be made to the Disposition. Mr. R.M. has expressed an interest in independent living. Mr. R.M. is not capable of managing his finances, and because of his cognitive abilities he would not likely be able to organize suitable accommodation without significant support. The panel agrees with the Re-Offence Scenario set out on page 149-150 of the Hospital Report. It is appropriate to continue to specify Mr. R.M.’s place of residence in the Disposition while the Team awaits his transfer to the care of the ACT Team and the issuance of a voluntary CTO.
The panel congratulates Mr. R.M. on the progress he has made this year.
In reaching its decision, the panel has considered the evidence through the lens of the criteria set out in s. 672.54 of the Criminal Code, which are the safety of the public (as the paramount consideration), Mr. R.M.’s mental condition, his reintegration into society and his other needs.
DATED this 1st day of August 2025, at the City of Toronto, in the Region of Toronto.
Ms. K. Tomaszewski Legal Member
Office of the Registrar Ontario Review Board