Re Judd Monk, 2025 CanLII 78498

Ontario Review Board

Re: Judd Monk

ORB File No: 7857

Hearing held on: Tuesday, May 6, 2025

Place of hearing: Waypoint Centre for Mental Health Care 500 Church Street, Penetanguishene

Pursuant to: Section 672.81(1) of the Criminal Code

Before: Alternate Chairperson: Mr. M. Segal Members: Dr. K. Hand Dr. L.O. Lightfoot Ms. M. Chamberlain Mr. J. Cyr

Parties Appearing: Accused: Judd Monk Counsel: Ms. C. Francis (via Zoom) The person in charge of hospital: Representative: Ms. M. Kraftscik Attorney General of Ontario: Counsel: Ms. S. Curry

REASONS FOR DISPOSITION

(Dated August 5, 2025)

Introduction:

1Judd Monk, age 36, was found on March 1, 2021, not criminally responsible on account of mental disorder on charges of possession of a weapon for a dangerous purpose and other threat to cause death or bodily harm, contrary to the Criminal Code.

2On May 6, 2025, Mr. Monk appeared before the Ontario Review Board (the “Board”) from the Waypoint Centre for Mental Health Care (the “hospital”) for his annual hearing. The main issue concerned whether Mr. Monk should be transferred to another institution under Rule 13.

3The Board had before it as Exhibit 1, a Hospital Report dated February 11, 2025, as updated April 3, 2025. As Exhibit 2, the Board had Rule 13 correspondence from Ontario Shores, the Centre for Addiction and Mental Health St. Joseph's Healthcare Hamilton.

4In preliminary positions no party suggested any change to the current Disposition. All parties were in favour of a Rule 13 transfer. At the outset of the hearing the accused favoured CAMH. By the end of the hearing all parties were in favour of St. Joseph's Healthcare Hamilton. After hearing the evidence, the Board concluded that a transfer to St. Joseph’s was the most appropriate course, while maintaining the current disposition as is.

Index Offence

5The details of the index offences are taken from last year’s Reasons for Disposition, as follows:

“On October 28, 2019, the accused entered into a recognizance of bail before the Honourable M. GREENE at the Ontario Court of Justice - Toronto Region, Old City Hall. The accused agreed to the conditions placed upon him, specifically, "not to be in the City of Toronto unless in the presence of a staff worker of Hats Off House".

On Monday, December 09, 2019, the accused was on the mezzanine level of the Sheppard West TTC Station in a wheelchair. The accused was observed by the victim to be yelling obscenities and threats of death at nearby passengers. The victim approached the accused in an effort to move the accused along. When the victim neared the accused, he said: "I'm going to kill you". The victim advised that she was quite shaken up after the interaction.

When officers arrived on scene and investigated the accused, he was found to be in possession of a folding box-cutter style knife. The officers further determined that the accused was not in the presence of a staff member of the Hats Off House.

During the course of his interaction with arresting officer PC Gee #10198, a uniformed Peace Officer with the Toronto Police Service, the accused repeatedly falsely identified himself as Robin Ford.”

6The Board adopts the overview set out at paragraphs 9 to 15 of last year’s Reasons:

“The Hospital Report outlines in detail Mr. Monk’s history and background, so these need not be repeated. In brief, Mr. Monk is presently 37 years of age. He became a Crown ward at age 5. He was in the care of Hatts Off Specialized Services program beginning at age 9 due to behavioral concerns, including self-harm. While in their care he stabbed a nine-year-old boy in the shoulder and was admitted to the George Hull Centre crisis home. Mr. Monk was placed into segregated education classes until the age of 27, when his schooling ended. Mr. Monk was transitioned at age 29 to the adult services at Hatts Off and resided in supportive housing group homes after September 2015. He is supported by Ontario Disability Support Program (ODSP).

Mr. Monk has a criminal record commencing in 2016. It includes 41 convictions. Many of these relate to failures to comply with Court orders. It also includes convictions for uttering threat, mischief and obstruct peace officer.

Mr. Monk’s first contact with psychiatric services took place when he was five years of age. His current diagnoses include schizophrenia, mild intellectual disorder and antisocial personality disorder.

The Hospital Report notes that Mr. Monk has continued to experience significant positive symptoms of his mental illness including both auditory and visual hallucinations as well as grandiose delusions. He is often heard and seen responding to unseen stimuli in his room. He, at times, engages in aggression and has made threats of suicide. He shows poor capabilities for his personal hygiene. He can be pleasant and cooperative, as well as friendly and helpful to co-patients whom he views as lower functioning than himself. However, he can escalate to irritability and agitation quickly at which time he can become boisterous, belligerent, rude and condescending. He is known to shout vulgar profanities at times with threats and to make racial, homophobic and otherwise derogatory comments to others. The Hospital Report notes that Mr. Monk has thrown items at staff and once attempted to kick staff. He is encouraged at these times to return to his room to cool down. Mr. Monk externalizes blame and rarely demonstrates regret or remorse.

He remains housed on the Awenda Dual Diagnosis Unit for persons who have cognitive impairments as well as mental disorders. Mr. Monk has engaged in incidents which have resulted in two seclusions during the past year. The Hospital Report sets out the details of the two seclusions that Mr. Monk required: one in February 2023 when he threatened staff and the other from June 9 to 12, 2023, when he threatened to kill and stab staff and threw pop at them.

In November 2023, Mr. Monk allowed blood work necessary for clozapine medication and agreed to cooperate with same. He was started on clozapine in mid-December 2023, pursuant to the agreement of his substitute decision maker, as a result, there has been improvement in his mental health. Mr. Monk has achieved privileges up to a level of B2, which requires that he be accompanied by staff off the unit. This is in part due to his inability to navigate himself safely and in part due to his unstable mental status.

Mr. Monk does not believe that he has a mental illness or accepts that he requires medication.”

Psychiatric Diagnoses

[7] Schizophrenia Intellectual Developmental Disorder, Moderate Attention Deficit Hyperactivity Disorder

Current Medical Diagnoses

[8] Asthma Spina Bifida Chronic Patellar Dislocation

Evidence at Hearing

9Dr. P. Ismail, the patient’s psychiatrist, testified. There have been small, recent adjustments to Mr. Monk’s medications. Mr. Monk is not on any medication aimed at his behaviours. He is compliant with his medications. There has been no return to psychosis. Some improvement to insight has occurred although Mr. Monk is still not capable of consenting to treatment. There have been no violent or aggressive behaviours in the last reporting period.

10In past, Mr. Monk could not string two sentences together. His organizational abilities have improved. His mood is largely stable. There are marked cognitive defects.

11Mr. Monk has a history of not following direction and saying the wrong thing at the wrong time.

12Mr. Monk has the highest privileges available bearing in mind he is wheelchair bound. It takes two staff to navigate his wheelchair. Mr. Monk also suffers from chronic dislocation of the knees.

13There have been no seclusions since June of 2023. Mr. Monk is on a DSO housing waitlist, but no positive word has been received yet.

14Mr. Monk benefits from staff who understand him. If issues arise, he can be redirected. This is supplemented by chanelling him toward more enjoyable activities, and the use of PRNs. Resort to seclusion in his case would be doing him a disservice. Work continues coping skills.

15Mr. Monk requires more help than most patients.

16Mr. Monk is somewhat vulnerable to other patients in terms of money and in relation to possible physical activity.

17Mr. Monk views Toronto streets as his home but he has no family or supports there. Mr. Monk is ready to go to a less secure forensic hospital. If given the choice, he would choose a hospital with a shorter waitlist.

18Mr. Monk now lives on the Awenda wing of the hospital with other dual diagnosis patients. Mr. Monk has a crisis prevention plan which can be replicated in a less secure forensic hospital.

19Dr. Ismail was of the view that St. Joseph's would be a better fit than CAMH. Waypoint has a partnership and a good relationship with St. Joseph's. While CAMH and St. Joseph's have lengthy waitlists, in view of the hospitals’ partnership, Dr. Ismail favours St. Joseph’s.

20There have been no signs of personality disorder following the introduction of clozapine. Mr. Monk now shows empathy and remorse. Whatever antisocial traits were previously apparent appear to be a function of his psychosis.

21Mr. Monk benefits from a structured setting. DSO housing would be ideal.

22By the conclusion of the hearing, Ms. Francis, acting for Mr. Monk, agreed that St. Joseph’s was the better fit.

Analysis

23Mr. Monk presented as a pleasant individual. The impacts of clozapine have resulted in improvements. The evidence, including the Hospital Report, makes it clear that although significant risk remains, the risk can be managed in a less secure forensic hospital. Both CAMH and St. Joseph’s have lengthy waitlists, however in Dr. Ismail’s view, St. Joseph’s would be the better fit. This is so because of the excellent lines of communication between the two hospitals – St. Joseph's and Waypoint. There is no real connection to Toronto on the part of the patient. St. Joseph’s campus may be somewhat easier for Mr. Monk to navigate. In all the circumstances, the Board is satisfied that a transfer to St. Joseph’s is the most appropriate destination for Mr. Monk. We wish Mr. Monk well.