Re: Anthony Allison
ORB File No: 8258
Hearing held on: Tuesday, July 15, 2025
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley
Members: Dr. J.C. Ferencz
Dr. B. Bordoff
Ms. A. La Viola
Mr. A. Bouvier
Parties Appearing:
Accused: Anthony Allison
Counsel: Mr. P. De Jong
The person in charge of hospital: Representative: Ms. M. Kraftscik
Attorney General of Ontario: Counsel: Ms. J. Armenise
REASONS FOR DISPOSITION
(Dated August 21, 2025)
Introduction
On March 14, 2023, Anthony Allison was found unfit to stand trial on a charge of sexual assault, contrary to the Criminal Code of Canada. He is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”), dated July 29, 2024, detaining him at the High Secure Provincial Forensic Programs of the Waypoint Centre for Mental Health Care (“Waypoint”/the “hospital”) with hospital and grounds privileges, beyond the secure perimeter, escorted by staff.
On July 15, 2025, the Board convened a hearing at Waypoint pursuant to s. 672.48(1) and s. 672.81(1) of the Criminal Code to determine whether Mr. Allison continues to be unfit to stand trial and, if so, whether he represents a significant threat to the safety of the public, and if so, the necessary and appropriate disposition having regard to the criteria set out in s. 672.54 of the Criminal Code. Mr. Allison was present and represented by Mr. De Jong.
At the outset of the proceedings, all parties were canvassed as to their respective positions. Ms. Kraftscik, on behalf of the hospital, submitted that Mr. Allison remains unfit to stand trial. He also continues to represent a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order. Ms. Armenise, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions. Mr. De Jong initially deferred taking a position until after hearing the evidence. However, he ultimately agreed that Mr. Allison remains unfit to stand trial. In his submission, Mr. Allison no longer remained a significant threat to the safety of the public.
Findings
- For the reasons that follow, the panel finds that Mr. Allison remains unfit to stand trial and is likely permanently unfit. Further, he continues to represent a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated June 11, 2025 (ex. 1), an Update to that Report, dated July 11/25 (ex. 2), and the viva voce evidence of Dr. Mishra, Mr. Allison’s treating psychiatrist and Mr. Allison.
The Alleged Index Offence
- At the time of the alleged offence Mr. Allison was a patient in Kitchener hospital pursuant to a Form 4 under the Mental Health Act. It is alleged that on July 16, 2022, Mr. Allison approached the victim while her back was turned. She was a nurse in the Specialized Mental Health Unit. Mr. Allison hit her buttocks with his right hand. The incident was captured on CCTV.When questioned later, he stated, “I just grabbed your butt, not your pussy, or poom poom.” The victim reported that she was afraid for her safety, and medical staff noted an increase in Mr. Allison’s sexualized behaviour.
Background Information
The Hospital Report contains details about Mr. Allison’s background and psychiatric history and need not be reviewed here beyond the following material facts. Mr. Allison is a 37-year-old man who born in Jamaica. At age 12, Mr. Allison and two of his siblings were sponsored to immigrate to Canada by their father. Mr. Allison attended school in Cambridge, Ontario. He dropped out in Grade 10 due to experiencing difficulties with his mental health.
Mr. Allison resided with his father until his father felt that he could no longer manage his son’s behaviour. He frequently fought with his brother. After an incident when police were called, Mr. Allison was prohibited from returning to the family home. Mr. Allison’s father took him to a hospital in Cambridge and, according to his father, he was diagnosed with “a little touch of schizophrenia.”
As an adolescent, Mr. Allison drank excessively, used cannabis on a daily basis for several years, and also used cocaine and crystal methamphetamines. His substance use often contributed to behaviour that resulted in criminal convictions. Between 2001 and 2019 he had convictions that included possession of child pornography, ten convictions for sexual assault, three for possessing illegal substances and nineteen convictions for failing to comply with court orders. Of note, Mr. Allison has been identified as a High Risk Violent Sexual Offender.
When residing in the community, Mr. Allison was supported by an Assertive Community Treatment (ACT) Team in Cambridge. However, he has been evicted from various residences due to not following rules. At times, he has been homeless and living on the streets of Cambridge. Non-compliance with medication and follow-up treatment have been a significant issue for Mr. Allison.
In 2016, Mr. Allison had a 3-month admission to hospital for psychiatric care. His symptoms of psychosis included grandiose and paranoid delusions, auditory hallucinations, and disorganized thought. These would be exacerbated with polysubstance use. Other symptoms included what were then described as antisocial personality and hypersexuality. His behaviours included poor impulse control, agitation, inappropriate and intrusive sexual conduct towards women, bizarre and disorganized thought, threats, harassing people on the street, and physical and sexual aggression. It also was believed that he was cognitively delayed. When he refused oral antipsychotic medication, he became increasingly agitated, hostile, and threatening and required chemical restraints. He was diagnosed with Schizoaffective Disorder and Polysubstance Abuse/Dependency (Cannabis and Alcohol).
Over the following years, Mr. Allison was in and out of Maplehurst Correctional Institute. He exhibited symptoms of his psychosis in the context of substance use and medication noncompliance. In the fall of 2018, he was admitted to Waypoint pursuant to a Treatment Order in relation to charges of sexual assault and failing to comply with probation. He spent the entire time in seclusion due to continued inappropriate sexual comments towards female staff and masturbating in front of female staff. He was treated with antipsychotic medication and ultimately found fit to stand trial.
Mr. Allison was admitted to Waypoint for a second time in the spring of 2019, pursuant to a Treatment Order on charges of Sexual Assault (two counts), Forcible Confinement, Utter Threats, Breach Probation (two counts), and Theft Under. He was found unfit to stand trial by the court on February 27, 2019, and returned to Waypoint on a Treatment Order. Once again, he spent the entire time in seclusion and, after receiving antipsychotic medication, was ultimately found fit to stand trial.
Shortly before the alleged index offence Mr. Alison had been residing in Kitchener and was being followed by an Assertive Community Treatment (ACT) team. On April 21, 2022, he was admitted to Grand River Hospital in Kitchener for “medication optimization”. At the time of his admission, he was experiencing auditory hallucinations and grandiose beliefs. It was during the course of this admission that the alleged index offence occurred.
Mr. Allison was initially admitted to Waypoint for an assessment as to his fitness to stand trial. He was found unfit and, at the conclusion of a Treatment Order, remained unfit to stand trial. Upon that finding, on March 14, 2023, Mr. Allison was returned to Waypoint and referred to the ORB for his initial hearing.
Course Since the Last Disposition
Mr. Allison continues to reside at the Beckwith Program within the High Secure Provincial Forensic Program at Waypoint under the care of Dr. Mishra.
Mr. Allison’s current diagnoses are:
Schizoaffective Disorder, Bipolar Type
Unspecified Paraphilic Disorder
Amphetamine Use Disorder, severe
Notwithstanding compliance with treatment, Mr. Allison continues to experience both auditory and visual hallucinations, grandiose delusions, and paranoia. He appears to be constantly responding to internal stimuli and remains sexually preoccupied. In addition, Mr. Allison exhibits a lack of motivation, a negative symptom of his mental illness.
The Hospital Report includes a number of examples of Mr. Allison’s behaviour over the course of the last year. He often told staff that he was in charge of Waypoint and staff were obliged to follow his directives. Conflicts arose when staff did not comply with his delusions. He could become irritable, argumentative, and challenging with staff, in particular female staff.
Mr. Allison has continued to display inappropriate sexual behaviour. The medications appear to have addressed his aggression and irritability however, there has been no change to his delusional beliefs or the paraphilic behaviour. The following observation was made by the Behavioural Support Specialist as found in the Hospital Report, at p. 45:
“Mr. Allison is frequently sexually inappropriate. His historic risk factor for sexual aggression is high and he shows little insight when health teaching is provided, feeling he is justified in sexually commenting or touching people due to the fact that, “he makes the rules”, or “pays them for sex”. His sexual inappropriateness shows no bias and is directed at any sex or age. This adds to his risk factor.”
Mr. Allison is currently subject to a Crisis Prevention Plan (CPP), which identifies triggers and particular behaviours. He continues to act in keeping with his delusional beliefs and his poor behaviour can escalate in the face of limits being set or his needs not being met. Staff are also encouraged to maintain an appropriate distance from him when he is out of his room, and to closely monitor his whereabouts on the unit.
The Hospital Report includes a description of three occasions over the clinical year when Mr. Allison required seclusion. When his demands were not met, he became increasingly irritable and threatening towards staff, causing an increased risk for violence. As Mr. Allison remains incapable to consent to treatment, the Public Guardian and Trustee is his Substitute Decision Maker. Mr. Allison’s medications were adjusted, with an increase in his dosage of clozapine, zuclopenthixol, and divalproex. He continues to receive Lupron.
Mr. Allison also experiences a number of physical health issues, including obesity and diabetes. Efforts to assist him in making appropriate nutritional decisions and exercise remain ongoing. Mr. Allison's negative symptoms and his delusional beliefs significantly hinder his ability to engage meaningfully in structured activities.
Mr. Allison’s fitness to stand trial has been assessed a number of times over the course of the year. Throughout he has consistently maintained that had not done anything illegal as the law at the time allowed him to act accordingly. Even though he could answer some of the fitness questions correctly, given the ongoing extent of thought disorder experienced by Mr. Allison and his persistent psychotic symptoms, in the doctor’s opinion, Mr. Allison will struggle to participate meaningfully in court proceedings.
According to the Hospital Report, Mr. Allison shows extremely limited, if any, insight into his mental illness, his risk of violence, and his need for treatment. He fails to appreciate the impact of his sexually inappropriate behaviour on others and minimizes or dismisses the adverse impact of his past sexual assaults. Under Clinical Assessment of Risk, Dr. Mishra makes the following observations as found in the Hospital Report, at pp. 58-60:
“To summarize briefly, Mr. Allison has had at least 25 distinct sentencing dates and no less than 40 offences. He has multiple convictions for sexual assault including a sexual assault involving a vulnerable, intellectually impaired individual.
During the last review period, Mr. Allison has had 3 relatively brief periods of time in seclusion. The need for seclusion arose because of his agitated behavior and threats towards staff of physical harm. These also included sexually inappropriate comments and were accompanied by risk of violence towards staff.
Mr. Allison continues to have episodes where he can become quite agitated and frightening for our staff. He has delusions of significant wealth and any discussions about his personal finances must be handled delicately as they can be a cause of significant anger for Mr. Allison..._ Staff are very skilled at recognizing his potential triggers and adept at managing potential issues before they escalate and require seclusion …
Despite some improvements over the course of the last review period, Mr. Allison remains highly symptomatic with positive symptoms of his psychotic disorder and ongoing inappropriate sexual behavior driven by a combination of paraphilia and grandiose delusions. In a less secure setting, he would be at high risk for sexual and physical aggression as well as a return to substance use. He cannot be safely managed in a mixed gender setting or in the company of vulnerable individuals.”
Dr. Mishra testified before the Board. He indicated that he last assessed Mr. Allison’s fitness to stand trial the day before the hearing and there was no change. Mr. Allison continues to experience significant psychotic thought disorder and grandiose delusions. He continues to maintain that the law changed in order to allow him to touch others. At times he has confused the roles of the various players in a criminal trial.
In Dr. Mishra’s opinion, Mr. Allison is unable to meaningfully participate in a court process. He fails to appreciate how any proceedings may relate to him.
Dr. Mishra testified that the main focus over the past year has been on Mr. Allison’s physical health. The treatment team has encouraged Mr. Allison to become involved in some physical activity. Staff continue to encourage Mr. Allison to exercise and make appropriate dietary choices. The focus has been on getting Mr. Allison to get up and off the unit to go for a walk as many times as possible.
In terms of treatment for Mr. Allison’s mental health, Dr. Mishra testified that the dosages of his medication recently have been increased and the team is waiting to see if there is any impact with that increase. Dr. Mishra indicated that any decision to increase medication must be balanced with the burden of side effects.
Notwithstanding compliance with medication, Mr. Allison’s problematic behaviours continue unabated. In Dr. Mishra’s opinion, the level and intensity of Mr. Allison’s ongoing symptoms would be difficult to manage in a less contained setting. In addition, in a less secure unit, access to substances would be of concern. Any substance consumed would result in a significant decline in Mr. Allison’s mental status.
Before recommending a move to a less secure facility, Dr. Mishra would want to see a decline in Mr. Allison’s threatening, challenging and sexually inappropriate behaviour. The doctor characterized his current level as “relentless”. Unfortunately, Mr. Allison currently is too disorganized to participate in any formal therapy.
In response to questions by Mr. De Jong, Dr. Mishra agreed that there has been a general improvement in Mr. Allison’s conduct. His threatening behaviour has been primarily verbal though it could escalate to property damage. This has been a significant development over the course of the year. Some of that improvement is due to the highly trained staff currently working with Mr. Allison who are able to immediately respond and set boundaries.
In response to a question from a panel member, Dr. Mishra reiterated his view that a diagnosis of antisocial personality disorder was not present because Mr. Allison's "psychosis is so pervasive and impactful," thereby making it difficult to tease out behaviour driven by psychosis from that which could be attributed to personality
Mr. Allison currently resides on the Beckwith unit, the most structured program in the hospital. If Mr. Allison continues to improve, the next step would be a move to the Beausoleil program. Before that were to be recommended, there would need to be a significant period of stability and no sexually inappropriate behaviour.
When asked by a panel member whether Mr. Allison had a reality-based understanding of the court’s process and whether he could be meaningfully present in a trial, Dr. Mishra answered no to both.
Dr. Mishra testified that as a result of being on Lupron, Mr. Allison’s testosterone levels are very low and it has effectively eliminated any physical desire behind his sexually inappropriate behaviour. Lupron does not appear to have any impact on Mr. Allison’s psychotic symptoms. In addition, the various antipsychotic medications that Mr. Allison is currently prescribed do not appear to have lessened that behaviour. Again, none of the medications appear to have addressed Mr. Allison’s paraphilic behaviour. Dr. Mishra testified that Mr. Allison’s paraphilia is a separate entity in its own right and not necessarily connected to his psychosis. While the impulsive side of his behaviour may have been addressed, the verbal aggression would be best addressed through psychological therapy. Dr. Mishra testified that he hopes that the recent adjustments in Mr. Allison’s medications will result in an improvement such that he will gain some awareness of the impact of his behaviour.
Dr. Mishra testified that currently Mr. Allison is on a unit that does not have female co-patients. It would be problematic were Mr. Allison to be detained on a less secure co-ed unit.
Mr. Allison chose to testify. His evidence was difficult to follow and demonstrated his inability to participate meaningfully in the hearing.
Ms. Kraftscik maintained the hospital’s position that Mr. Allison remains unfit to stand trial. He remains a significant threat to the safety of the public and he is currently appropriately placed in the High Secure Program at Waypoint. Ms. Armenise concurred and submitted that the mitigation in Mr. Allison’s behaviour was in part due to the trained staff’s ability to intervene and deescalate any problematic conduct.
Mr. De Jong agreed that Mr. Allison remains unfit to stand trial. In his submission the behavioural changes have been significant and highlighted that Mr. Allison has had no physical aggression over the course of the year in review. In his submission, there is some question as to whether Mr. Allison currently represents a significant risk. Should the Board find otherwise, the current disposition should continue with the additional privilege of being able to access the community should his behaviour continue to improve.
Analysis and Conclusion
- The Board has carefully considered the Hospital Reports and the evidence of both Dr. Mishra and Mr. Allison and unanimously finds that Mr. Allison remains unfit to stand trial. The panel has the benefit of the recent Supreme Court of Canada decision, R v Bharwani, 2025 SCC 26, at para 6:
“[A]n accused is fit to stand trial when they are able to make and communicate reality-based decisions in the conduct of their defence or instruct counsel to do so. Conducting a defence includes making decisions that an accused must always make personally and those which relate to the exercise of their right to full answer and defence, such as decisions about pleas, the mode of trial, selection of counsel, whether to testify, whether to call or cross-examine witnesses, and closing submissions, among others. The capacity required to make those decisions is a reality-based understanding of the nature or object of the proceedings and their possible consequences, an ability to understand the available options and their consequences, and an ability to select between those options when making decisions. Fitness to stand trial does not require an accused to make decisions in their best interests. Rather, it requires making decisions based on an understanding of reality that is not overwhelmed by delusions, hallucinations, or other symptoms of their mental disorder. Transient mental health symptoms do not necessarily compromise an accused’s ability to conduct a defence. The focus is always on assessing the extent to which an accused’s mental disorder impairs their understanding of reality when making and communicating decisions in their defence.”
It is clear from the evidence that Mr. Allison is not able to meet that threshold. He continues to experience psychotic symptoms that include delusions. He believes that his behaviour described in the alleged index offence was legal. He has no reality-based understanding of his legal situation. Further, as his evidence during the hearing demonstrated, he has no ability to communicate rationally with counsel or the court.
Notwithstanding compliance with medication, Mr. Allison continues to experience significant psychotic symptoms and ongoing inappropriate sexual behaviour. The Board accepts Dr. Mishra’s evidence that this conduct is relentless. Fortunately, Mr. Allison is supported by highly trained staff who are able to identify triggers, intervene early and deescalate his conduct. Without that support, Mr. Allison would be at high risk for sexual and physical aggression similar to the conduct in his previous convictions and in the alleged index offence. Such behaviour would rise to the level of risk contemplated in s. 672.5401 of the Criminal Code in that Mr. Allison would pose a risk of serious physical or psychological harm to members of the public… resulting from conduct that is criminal in nature but not necessarily violent. Further the Board finds that the risk is real and objectively supportable: see Winko1.
Having found that Mr. Alllison continues to represent a significant threat to the safety of the public, the Board must consider the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code, which includes the need to protect the public from dangerous persons, the mental condition of the accused, the integration of the accused into society and the other needs of the accused.
The Board unanimously finds that the necessary and appropriate disposition is a continuation of the current detention order. Dr. Mishra’s evidence is that in a less secure setting Mr. Allison would be at a high risk for sexual and physical aggression. Further there would be greater potential for accessing substances. Dr. Mishra testified that any substance use would result in a significant deterioration in Mr. Allison’s mental status. Finally, a less secure setting could include vulnerable female co-patients. Although his sexual misbehaviour has been directed at both men and women, it is clear that Mr. Allison has a history of targeting women, in particular.
Accordingly, the Board finds that the necessary and appropriate disposition is a continuation of the current detention order with the same terms and conditions. The Board declines to include a condition allowing for access to the community. The evidence before the Board is that the treatment team is currently making their best efforts to encourage Mr. Allison to be more physically active and engaged with some of the available programs available on the unit. There is no evidence to suggest that he is in a position to exercise passes in the community at this time.
DATED this 21st day of August 2025, at the City of Toronto, in the Region of Toronto.
Ms. C. Finley
Alternate Chairperson
Office of the Registrar
Ontario Review Board
Footnotes
- Winko v British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] S.c.J. No. 31.