Re David John-George, 2025 CanLII 81149

Re: David John-George

ORB File No: 6953

Hearing held on: Thursday, June 19, 2025

Place of hearing: North Bay Regional Health Centre – North Bay Site

Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code

Before:

Alternate Chairperson: Mr. C. Fraser

Members: Dr. R. Kunjukrishnan

Dr. G. Stones

Ms. C. Murray

Mr. A. Bouvier

Parties Appearing:

Accused: David John-George

Counsel for Accused: Mr. C. Bracken

The person in charge of hospital: Counsel: Mr. P. Trenker

The person on behalf of hospital: Ms. J. Doyon

Attorney General of Ontario: Counsel: Mr. M. Wlodarczyk

REASONS FOR DECISION AND DISPOSITION

(Dated August 15, 2025)

Introduction

1. On May 6, 2016, David John-George was found not criminally responsible on account of mental disorder (“NCR”) on a charge of assault, contrary to the Criminal Code of Canada (the “Criminal Code”).

2. By letter dated March 26, 2025, North Bay Regional Health Centre (the “hospital” or “NBRHC”) notified the Board pursuant to section 672.56(2)(b) of the Criminal Code that Mr. John-George’s liberty had been significantly restricted for a period exceeding seven days. Mr. John-George was readmitted to the Forensic Programs at NBRHC from his community placement on March 13, 2025.

3. On June 19, 2025, a panel of the Ontario Review Board (“Board” or “panel”) convened for two reasons:

a. to review Mr. John-George’s current disposition pursuant to s. 672.81(1) of the Criminal Code. At the time of the hearing, Mr. John-George was ordered detained at the Forensic Programs of NBRHC with privileges up to and including living in the community in accommodation approved by the person in charge; and

b. to conduct a restriction of liberty (“ROL”) hearing.

4. The issues to be determined are whether Mr. John-George continues to represent 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. A further issue to be determined is whether the hospital’s decision to increase the restrictions of Mr. John-George’s liberty was warranted, necessary and appropriate for the period from March 13, 2025, to April 7, 2025 (when he was discharged and returned to his community residence).

5. Mr. Chad Bracken requested an order appointing him counsel for Mr. John-George. The order was granted by the Board pursuant to s.650.01(1) of the Criminal Code. Mr. John-George was present for his hearing and was represented by Mr. Bracken throughout the proceedings.

6. A Hospital Report dated May 21, 2025, was entered as Exhibit 1.

7. For the reasons set out below and based on the evidence and opinions before us, the Board found that Mr. John-George continues to represent a significant threat to the safety of the public. The Board finds that a Detention Disposition, with detention on Forensic Programs at NBRHC on the same terms as last year, is the necessary and appropriate Order having regard to the safety of the public, which is the paramount concern, and having regard to Mr. John-George’s mental health, reintegration into society, and other needs.

8. Additionally, the panel found that the restriction of Mr. John-George’s liberty from March 13, 2025, to April 7, 2025, was significant. However, it represented the least onerous, and least restrictive measure at the time it was imposed and for its duration.

Current Psychiatric Diagnoses

9. Schizophrenia

Substance Use Disorder (alcohol, cannabis), in sustained remission

Unspecified Intellectual Disability

Obsessive Compulsive Disorder

Position of the Parties

10. At the commencement of the hearing, the parties were canvassed for their without prejudice positions. Mr. Trenker for the hospital, supported by counsel for the Attorney General, Mr. Wlodarczyk took the position that the necessary and appropriate disposition is a Detention Order on the same terms as last year. They further submitted that the restriction of liberty of March 13, 2025, to April 7, 2025, was necessary and appropriate.

11. Mr. Bracken, counsel for Mr. John-George, conceded the issue of significant threat to the safety of the public and submitted that a Detention Order on the same terms remains necessary and appropriate. He also submitted that the restriction of liberty of March 13, 2025, to April 7, 2025, was necessary and appropriate.

12. Therefore, there was a joint submission on all issues.

Index Offence

13. The circumstances giving rise to the index offences are excerpted from the Hospital Report:

“…on the 5th of July 2013, at approximately 12:52 p.m., the victim was waiting for a City bus at the Bus Terminal located at 190 Wyld Street in the City of North Bay. The accused was also waiting for a City Bus at the same location. The victim was walking in the waiting area outside the terminal when he walked by the accused. Without warning, the accused placed both hands on the victim’s chest and pushed him to the ground in a violent manner. The victim fell backwards, landing on his back and head. Ambulance attended and transported the victim to the North Bay Regional Health Centre for treatment.”

Background and History

14. The Hospital Report contains extensive information regarding Mr. John-George’s background and history the entirety of which need not be repeated here in detail. The following particulars are noteworthy.

15. Mr. John-George is a 36-year-old Indigenous man. He did not complete high school, does not have a history of gainful employment and is supported financially by Ontario Disability Support Program benefits. He is the father of one child with whom he does not maintain a relationship.

16. Mr. John-George reportedly started using illicit drugs, including crack cocaine, and alcohol around the age of 14 or 15. His drug use was sporadic, sometimes heavy, and at that time influenced by his peer group.

17. As a youth, Mr. John-George was convicted of trespass/prowl near dwelling house, utter threat to cause death or bodily harm (two counts) and fail to comply with undertaking or recognizance (2 counts). As an adult he was convicted of assault for which he received a suspended sentence and six months’ probation.

18. Mr. John-George has an extensive psychiatric history prior to the index offence. He had at least eight psychiatric hospitalizations since turning 16 and consistently received a diagnosis of schizophrenia. When unwell, he presented as verbally threatening and physically aggressive and experienced psychotic symptoms including auditory, visual, and tactile hallucinations as well as persecutory, suicidal, and homicidal ideation. He has a history of non-compliance with psychiatric treatment and a lack of insight into his illness or need for treatment.

19. In November 2017, Mr. John-George was discharged from hospital to Morin’s Home for Special Care in North Bay, which is a 24-hour supervised home that provided a high level of support. Unfortunately, this placement ended in September 2020 due to his repeated positive urine drug screens, nonadherence to medication, and having a switchblade and cap gun in his room. He was readmitted to hospital and stabilized. Mr. John-George was discharged from hospital to Percy Place on December 21, 2020, where he still resides.

Course Since Last Disposition

20. Mr. John-George remains incapable of providing consent for his treatment. His mother is his substitute decision maker (“SDM”).

21. Mr. John-George underwent a gradual tapering off of disulfiram and a discontinuation of that treatment for his alcohol use disorder in the fall of 2024. Unfortunately, there was a drop in his serum clozapine levels with the tapering and discontinuation of the disulfiram. He began to experience a resurgence of some psychotic symptoms. Clozapine was increased and by February 4, 2025, his serum clozapine levels were in the therapeutic range. Following a visit to his mother’s home from March 10 to 12, 2025, Mr. John-George’s serum levels were very low leading the treatment team to suspect non-adherence while he was away at his mother’s home for three days. This resulted in a need to re-titrate his dose of clozapine.

22. On March 13, 2025, due to the serious complications that can arise with the initiation of clozapine, Dr. Le felt it safest to monitor Mr. John-George in hospital while his medication was re-titrated. Dr. Le also further noted that since Mr. John-George receives clozapine in liquid form, it would have made titrating the dosage difficult in the community as this medication is compounded in the hospital pharmacy and takes days to be delivered to Mr. John-George’s group home. Mr. John-George was admitted voluntarily on March 13, 2025. He was discharged back to his group home on April 7, 2025, once he reached the optimal clozapine dosage and returned to his baseline mental status. Since his return to community the treatment team has reported some unusual behaviours, such as dressing in multiple layers and wearing a life jacket.

23. Dr. Le’s discharge summary dated April 7, 2025, noted that during his admission, Mr. John-George became overtly psychotic and at one point raised his fist as if he were going to hit a staff member. He was demanding, intrusive, hostile, and his thoughts were disorganized. Over the next several days as the clozapine was titrated up to therapeutic levels, he rapidly showed improvement.

24. The Hospital Report notes that the assistance and external controls provided by the group home staff and the Forensic Outreach Team have enabled Mr. John-George to manage his daily activities, follow his medication regimen, and abstain from substances, which has allowed him to remain living in the community.

25. Mr. John-George struggles to remember and understand discussions with Dr. Le. He lacks insight into the risk he poses to the public when he is untreated.

26. On occasion, the staff at the group home noted unusual behaviours and discovered items during room searches that raised concerns about possible substance use. However, all urine drug screens have returned negative for substances.

27. Mr. John-George participates in recreational activities through Percy Place Home, PEP Place, cultural and spiritual events, and meets with a Community Living North Bay worker for Developmental Services Ontario (“DSO”) passport funding.

28. During the reporting period, Mr. John-George exhibited hoarding behaviours, accumulating numerous items, believing that he needed to spend available funds quickly. The Public Guardian and Trustee manages his finances.

29. Mr. John-George has had regular contact with his family, including prearranged visits with his mother and occasional visits with his siblings.

Evidence at the Hearing

30. The Board had available to it the evidence and documents forming the Record, the Hospital Report, and oral evidence of Dr. Stephanie Le, Mr. John-George’s psychiatrist, and author of the Hospital Report.

31. Dr. Le testified that she has been Mr. John-George’s treating psychiatrist since August 2024. He continues to reside at Percy Place which is operated by the Canadian Mental Health Association (CMHA).

32. Dr. Le testified that Mr. John-George was not trying to be deceptive when he did not take his medication while visiting his mother in March 2025. He thought he had taken it. When he returned to Percy Place his clozapine levels were taken and his levels had dropped significantly. For his safety, while titrating the clozapine back to therapeutic levels, Mr. John-George agreed to come to hospital. When he first arrived at hospital his behaviours seemed fine, but his behaviours quickly deteriorated within a day and a half. He became increasingly paranoid of staff and posturing as though he was going to strike someone. Once the clozapine was titrated up to a therapeutic level, his behaviour returned to baseline.

33. Dr. Le is confident that Mr. John-George has not consumed alcohol or taken substances in the reporting year. Any decompensation she observed in him this year was due to his mental illness not substance use.

34. Mr. John-George is starting to gain insight into his mental illness though it does take repeated teaching. His biggest challenge is to gain insight into the need for medication and the link between medication adherence and stable mental health.

35. It is Dr. Le’s opinion that Mr. John-George would not be able to live by himself within the next 12 months.

Analysis and Conclusions, Annual

Significant Threat

36. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board independently finds that Mr. John-George remains a significant threat to the safety of the public.

37. Counsel for Mr. John-George did not contest a finding of significant threat to the safety of the public. Despite this, the Board makes its own finding of significant threat based on the oral evidence, documentary evidence, Winko and its related authorities.

38. Mr. John-George has been diagnosed with schizophrenia, which is severe and persistent. When he is unwell, he exhibits bizarre behaviour, verbally threatens people, and may become physically aggressive without provocation. He experiences poverty of thought, disorganized thought processes, perceptual disturbances, ideas of persecution, and suicidal and homicidal ideation. The index offence involved violent and threatening behaviour. Mr. John-George has an Unspecified Intellectual Disability. His limited cognitive capacity makes it challenging for him to follow abstract rules or expectations. He has a limited understanding of his mental illness and the necessity for treatment. He has a long history of non-compliance with psychotropic treatment.

39. While hospitalized between March 13 and April 7, 2025, Mr. John-George displayed symptoms of his major mental disorder including violent ideation or intent, instability, disorganization, and hostility.

40. The Hospital Report notes, “In considering the PCL-R:2 and HCR-20V3, historical, and protective factors, it is our current opinion that his Risk for Future Violence is High (without all the supports in place), Risk for Serious Physical Harm (i.e., severity of the violence) is High, Risk for Imminent Violence is Low (given all the supports in place).”

41. The Board accepts the joint submission on significant threat.

Necessary and Appropriate Disposition

42. In light of the Board’s finding of significant risk, it is charged with shaping a Disposition for the coming year.

43. Mr. John-George has fared reasonably well at Percy Place group home, compared to his 2017 placement at Morin’s Home. This is attributed to the nature of the services provided at Percy Place and the significant supports of the Forensic Outreach Team. The placement at Percy Place has enabled Mr. John-George to manage his daily activities, follow his medication regimen, and abstain from substances, which has allowed him to remain living in the community. It is necessary for the hospital to be able to be in control of the living arrangements for Mr. John-George for him to be able to remain living in the community where he is able to best integrate into society.

44. The Board finds that that the necessary and appropriate, least onerous, and restrictive Disposition, is continuation of the Detention Order, with terms as set out in our formal Disposition.

Analysis and Conclusion, Restriction of Liberty

45. The evidence supports a finding that the initial restriction of Mr. John-George’s liberty was necessary and appropriate; this was not contested at the hearing.

46. Mr. John-George was agreeable to the admission. He had failed to take his clozapine for three days while visiting his mother’s home. The hospitalization was necessary for the titration of his clozapine to a therapeutic dose. He experienced a sharp decline in his mental status shortly after hospitalization, which was due to the failure to take the clozapine for three days. His mental state rapidly re-stabilized and he was discharged from hospital back to the group home once he was stable.

47. The Board accepts the evidence set out in the Hospital Report and oral evidence of Dr. Le and finds that Mr. John-George’s restriction of liberty from March 13 to April 7, 2025, was warranted, appropriate and necessary.

DATED this 15th day of August 2025, at the City of Toronto, in the Toronto Region.

Ms. Christine Murray

Legal Member

Office of the Registrar

Ontario Review Board