Re: T. (L.)
ORB File No: 5402
Hearing held on: Thursday, September 4, 2025
Place of hearing: North Bay Regional Health Centre – North Bay Site
Pursuant to: Section 672.81(2) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Fromstein
Members: Dr. S. Lessard
Dr. M. Kalia
Mr. E. Siebenmorgen
Mr. A. Mete
Parties Appearing:
Accused: T. (L.)
Counsel for Accused: Mr. C. Bracken
The person in charge of hospital: Counsel: Mr. P. Trenker
Attorney General of Ontario: Counsel: Ms. D. McCaig
REASONS FOR DISPOSITION
(Dated September 15, 2025)
Introduction
On June 23, 2009, Mr. T. (L.) was found not criminally responsible on account of mental disorder (“NCR”) on charges of utter threat to cause death or bodily harm (x2), assault with a weapon, possession of a weapon for dangerous purpose, breach of probation and mischief - not exceeding $5,000, all contrary to the Criminal Code of Canada (“Criminal Code”). T. (L.) was most recently subject to the terms and conditions of a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated January 24, 2025, pursuant to which he is ordered detained at the Forensic Programs, North Bay Regional Health Centre–North Bay Site (“NBRHC” or the “Hospital”), subject to several terms and conditions, including the privilege to enter the community of North Bay, indirectly supervised.
By way of a letter dated July 31, 2025, the Hospital requested an early review of T. (L.)’s Disposition. As the Hospital was seeking a transfer of T. (L.) to the High Secure Provincial Forensic Programs at Waypoint Centre for Mental Health Care (“Waypoint”), the Hospital also provided a Rule 13 Notice dated July 31, 2025.
On September 4, 2025, a panel of the Board convened in person at the Hospital to conduct an early review of T. (L.)’s Disposition, pursuant to s. 672.81(2) of the Criminal Code. T. (L.), who was in custody at the North Bay Jail, appeared via videoconference link from that institution. He was represented throughout the hearing by his counsel, Mr. Bracken.
The issues at the hearing were: (a) whether T. (L.) represented a significant threat to the safety of the public within the meaning of s. 672.5401 of the Criminal Code, and (b) if so, a determination of the necessary and appropriate Disposition, having regard to the factors in s. 672.54 of the Code. In particular, the panel was required to determine whether the Disposition should include a Detention Order directing T. (L.)’s detention at Waypoint.
The documentary evidence for the hearing consisted of the Hospital’s July 13, 2025, letter to the Board, correspondence from the Board dated August 5, 2025, the Rule 13 Notice dated July 31, 2025, and a Hospital Report, dated August 12, 2025. In addition, Dr. S. Le, T. (L.)’s attending psychiatrist, gave oral testimony.
The parties were canvassed, at the outset of the hearing, for their tentative positions in relation to the issues. Counsel for the Hospital, supported by counsel for the Attorney General, recommended no changes to the Disposition, other than an order directing T. (L.)’s transfer to Waypoint. Counsel for T. (L.) was opposed to the transfer. All counsel maintained their positions at the conclusion of the evidence.
For the following Reasons, the panel found that T. (L.) represents a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Detention Order directing T. (L.)’s detention at the High Secure Provincial Forensic Programs at Waypoint. The panel found that T. (L.)’s risk to the safety of the public cannot currently be safely managed at NBRHC.
Index Offences
- The incidents giving rise to the index offences are fully set out in the Hospital Report and have been reviewed by the panel. They are briefly summarized here, as follows:
The charges relate to an attack by the accused on his brother and mother on January 3 and 4, 2009, at their home in Wikwemikong on Manitoulin Island and his encounter with police who responded to the situation. While the events unfolded, T. (L.) was in possession of a knife, although injuries to the brother arose as a result of kicking and punching and not from the use of the weapon. He did however hold a knife to his brother’s throat.
The police, who had been alerted by the mother as to what had transpired, attended at the residence. At that time, T. (L.) exited the residence with an ice pick shovel and went towards the officers. He then caused damage to a police car. T. (L.) had consumed alcohol despite being bound by a Probation Order prohibiting same. At the time of the index offences, T. (L.) was suffering from persecutory delusions.
Of note, in May 2024, T. (L.)’s brother, Lawrence, who was a victim of the index offences, passed away due to an overdose.
Background Information
T. (L.) was 34 years of age at the time of the hearing and was 17 at the time of the offences. The details of his early life, substance use history, criminal record, psychiatric history, and his lengthy time under the ORB’s authority are fully set out in the Hospital Report. As that Report is in evidence, it is unnecessary to review this information for the purpose of these Reasons. Those matters that provide context for the issues are highlighted below.
T. (L.) began using alcohol and other intoxicating substances at a young age and has an extensive history of substance use that has persisted during his time under the Board’s authority. While subject to Detention Order Dispositions at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”), he was engaged in drug trafficking to support his own substance use habit. His main drugs of choice are cannabis and “Spice” (a synthetic form of cannabis that is not considered detectable on conventional drug screens) and he acknowledged consuming these substances for four years at Ontario Shores and in the community without getting caught.
The Hospital Report refers to records documenting that T. (L.) had a turbulent history with members of his family that involved abuse and incest, of which he was both the victim and a perpetrator.
Following the NCR verdict, T. (L.) was initially detained at Waypoint. He was transferred to Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) on February 9, 2011. He was discharged to transitional housing in June of 2015, readmitted to the hospital in January of 2016, and discharged to a different supervised residence in November of that year. He had several readmissions due to mental health deterioration and relapses into substance use. He lost his community accommodation in June of 2018: after making death threats to staff at the home, he left the residence and police were called. He reportedly assaulted two officers while being taken into custody.
T. (L.) stopped taking his prescribed antipsychotic medication after being readmitted to Ontario Shores and his mental health deteriorated. Notably, in March of 2019, he suddenly and repeatedly punched his roommate in the head, along with another patient who tried to intervene. He threatened and challenged staff to fight him, and eventually, with the assistance of numerous staff members, he was transferred to the PICA (Psychiatric Intensive Care Area) at Ontario Shores. He subsequently removed his shirt, paced in his room, and threatened to kill staff if they entered his room to give him an injection. He engaged in property destruction and started to sharpen a piece of metal. Police were called and he was secluded with their assistance. He became violent later, after waking up from sedation, and police were again required (10 people) to hold him down and place him in restraints. He reportedly fought “vigorously” against the officers. He was deemed too unsafe to be managed in the PICA and was transferred, utilizing a Form 3 under the Mental Health Act, to Waypoint. The details of these incidents are provided at pp. 47-48 of the Hospital Report.
The Board held an early hearing in 2019 to review T. (L.)’s Disposition and to inquire into the significantly increased liberty restrictions prompted by his behaviour. A portion of the Board’s reasons appears in the Hospital Report and is excerpted as follows:
“As noted by Dr. Harrigan, Waypoint is able to provide a more graduated and secure way to allow patients off the unit and there is more staffing to enable more attention to each patient. Programming is available that is similar to that offered at Ontario Shores with respect to insight, anger and substance use, all of which Dr. Harrigan hoped T. (L.) would engage in. In addition, there are numerous cultural supports should T. (L.) wish to participate.”
T. (L.) remained at Waypoint from April of 2019 to December of 2022. The Hospital Report chronicles many incidents of challenging, threatening and assaultive behaviour engaged in by T. (L.) during these years, triggering “code white” alarms requesting additional assistance, restrictions of T. (L.)’s privileges, periods of seclusion (sometimes extending into weeks and months), and incidents requiring multiple staff wearing personal protective gear and carrying shields as they intervened to restrain him and/or administer medication.
Following a period of relative stability, it was determined that T. (L.) no longer required the high level of security provided at Waypoint and he was transferred to NBRHC. He arrived on December 6, 2022.
T. (L.) exhibited incidents of agitated and threatening behaviour in September and October of 2023, was sexually inappropriate with female staff, and expressed hostility, including a desire to fight people. There was one specific incident where he engaged in combative behaviour with nursing and security staff who had entered his seclusion room. Although he was eventually subdued and both physical and chemical restraints were applied, T. (L.) identified several staff members whom he wanted to kill at the first opportunity. He had placed one security staff member in a partial headlock. This individual attended the emergency department following the incident.
Following a code white incident on December 8, 2023, T. (L.) reportedly stated that nursing staff antagonized patients and therefore deserved any harm that came to them.
T. (L.) experienced a more stable reporting period in 2024 and the first part of 2025, with no significant management concerns and no incidents of seclusion or the application of restraints. All random urine samples tested negative for prohibited substances. In July 2025, he completed Cognitive Behavioural Therapy (CBT) for substance use and developed a relapse prevention plan. He identified wanting to become a Mixed Martial Arts (MMA) fighter as a motivator to maintain sobriety, and described deep breathing, exercise, and movies as ways to cope with cravings. He identified high-risk situations as returning to jail or being around users, fearing he would relapse in such circumstances. He was highly engaged in one-on-one meetings with his psychotherapist. He acknowledged ongoing cravings for various substances, as well as demeaning and persecutory auditory hallucinations.
On July 15, 2025, Dr. Le reported on an interaction with T. (L.) as follows:
“T. (L.) reported that he was ‘good,’ and this was the answer he gave when asked how things had been going for him. He asked if I had heard any negative comments about him or how he has treated staff/peers. I told him that I had not, only that he had been talking about UFC fighting and teaching fighting skills. He abruptly added that he thinks that all men are inherently violent which led to him asking my opinion on why men were ‘guarded,’ do not talk about their feelings with others, and act out violently. I discussed social standards and how they impact men and women. This culture expects people to hold in emotions and feelings to be viewed as strong. He stated that he disagreed with this and that men were ‘just violent’, and he had no qualms about hitting women even. I allowed him to feel heard but tried to impress upon him that, whether that was true or not, violent behaviours were not acceptable. I asked if he was thinking about harming anyone, and he stated that he had no desire to act out violently. He reported that no one has been bothering him and he would only respond with violence if someone ‘got up in [his] face.’
I tried to redirect him to future-oriented thinking and the possibility that he could be living in the community one day. He stated that he did not believe it would happen, and he would die at the age of 40. I told him that I had no concerns that he was dying anytime soon, but that I would like to draw labs if he would let me. He declined this offer. Unlike some of our previous meetings, he stated that he had no plans for his future. He said that he does not think about it much. Fortunately, he added that he still has ‘a little hope.”
Diagnoses
- The Hospital Report for the current reporting period lists T. (L.)’s diagnoses as:
schizophrenia;
post-traumatic stress disorder;
cannabis use disorder;
alcohol use disorder;
gambling disorder; and
antisocial personality disorder.
Dr. Le explained, in answer to a panel member’s question, that the diagnosis of post-traumatic stress disorder was recently included, due to T. (L.)’s history of family trauma. Thus far, it has been difficult to treat this condition as T. (L.) does not like to discuss this history.
Evidence at the Hearing
Dr. Le gave evidence. She has been T. (L.)’s attending psychiatrist since July of 2024. She reviewed the current year’s portion of the Hospital Report and confirmed that a large portion of the contents at pp. 130-136, setting out the events of July 29, 2025, is taken from her notes. She was present for the events reported and adopted that portion as reflecting her observations.
The incident that prompted the Hospital’s request for an early review of the Disposition began during the exercise of an off-unit privilege by T. (L.) and another patient. On his return at 2:00 p.m., unit (Owl Lodge) staff observed that T. (L.) exhibited an angry affect and poor eye contact. He began pacing by the nursing station, posturing, and “looking out of the corner of his eye and counting.” He held his belt in his hands and stated, “Wish me luck!” while pulling the belt tighter between his hands.
Just prior to T. (L.)’s return to the unit, Dr. Le was contacted. Her account, adopted in her evidence, is as follows:
“I received a page from the Owl [Unit Lead] at 1343 stating that T. (L.) had struck another patient on the arm while they were out on privilege. She reported that they were both still out and would not return until 1400. The patient who was struck called to report the incident and stated that it was unprovoked.
She [Unit Lead] paged again at 1355 that she got clarification and stated that T. (L.) hit the other patient in the face and not the arm. There was a witness to the assault, another patient. She reported that she told the patient who was assaulted to stay off of the unit so that we could talk to T. (L.) and get his side of the story without distractions. She stated that she would also alert security to be present when we confronted him. I told her that I would be up to assist and concluded my interview that was in progress with another patient.
I arrived on the unit at 1400, and T. (L.) was already there. On my way up, I saw his psychotherapist, [M. Marsden], and asked if she would assist. She has a fairly good rapport with him. The Unit Lead from Heron also came to assist since she was with me during the interview with the patient on Heron Lodge. When we entered, T. (L.) was dressed casually and had a cup of water in his hand. He was pacing back and forth on the unit. The situation escalated quickly over the next few minutes. As we were standing in the nursing station to await hospital security for safety, T. (L.) became increasingly agitated. He began to puff out his chest, glare into the nursing station, and grimace. After security staff and management arrived, he removed his shirt and belt and began holding it taut between his hands as if he were going to use it as a weapon. This was quite concerning, as he has removed his clothing in the past before engaging in a serious assault of several staff members. He began shouting out taunts and threats, asking staff to come fight him. He then proceeded to pick up chairs and throw them at the nursing station glass. After that, he started searching over the nursing station desks on the unit. He found a cell phone and removed it from the protective case and threw it multiple times, smashing the device. It seemed, in preparation for a fight, he poured water from a bottle onto the floor and then got dish soap from the kitchen and squirted all over the floor. He used a table and chairs to block the back entrances to the hallway where he was located so that security staff would have to walk through the hazard he had just created. By this time, I had assessed that we could not manage this situation with our nursing, allied, and security staff. Local police were called to assist and were on the way.
While we were waiting for law enforcement to arrive, T. (L.) started entering other patients’ rooms. We were not sure if he was going to harm them, and he rapidly exited the rooms. When he entered the room of the patient he assaulted earlier, he was in there for quite some time. We assumed he was damaging property. During this time, he was carrying around various items to be used as weapons. If he was not holding his belt, he had pieces of metal that he had broken off of furniture/items. When officers began arriving, he sat down in a chair facing the nursing station. He was shouting out threats and asking for a fight. His muscles were straining, and he turned red from the exertion. Officers quickly set up a plan of action and entered the unit as a team. I saw one officer use their TASER on him on approach, but this did not affect the patient in the slightest. I was unable to visualize the take down of T. (L.) fully, because one of the fire doors closed as they had to manually subdue him.
When I entered the unit, there were multiple officers on top of T. (L.). After he was cuffed, nursing brought in a stretcher for him to be held and then transported to the ED for examination. There was blood from T. (L.) all over the floor. I saw that he had blood on his nose and the right side of his face. Security staff and officers were removing debris from him (parts of the TASER). I asked the patient what happened, and he stated that he struck the other patient when they were out on privilege because he was ‘talking shit’ to him. I tried to engage him further, but he refused to talk to me and stated that he was ‘a lifer.’
At this point, I went to examine another patient that he assaulted during this incident on the unit and followed up by giving a statement to officers. T. (L.) was transported to the ED in police custody.
Dr. Le supplemented this account in her oral evidence by stating that it took approximately 15 to 20 minutes for the police to arrive. One of her great concerns during this interval was the safety of other patients on the unit, which did not have locking doors. T. (L.) had access to all other patient rooms and assaulted a dual diagnosis patient in one of those rooms. Asked whether the Hospital had any units that could contain the risk posed by T. (L.), Dr. Le replied in the negative.
Dr. Le explained that she had attended the unit just to speak with T. (L.), to get his version of what happened in the encounter with the co-patient in the elevator. At that point, she only had the other patient’s report of being hit by T. (L.). Later, camera footage revealed that T. (L.) appeared to be trying to get the other patient to fight. He then struck the patient in the face. Dr. Le opined that T. (L.)’s conduct was not driven by psychosis. From his history, such behaviour is not uncommon for him as he likes to fight.
Dr. Le described some background for T. (L.)’s punching of the co-patient in the elevator. She stated that T. (L.) had issues with a female co-patient who eventually had to be moved off his unit. The patient struck on July 29th was a friend of that female patient.
Dr. Le stated that the incident was very difficult for other patients on the unit to witness, noting that there was blood on the floor and that the police who responded were equipped with Tasers, “bean bag” guns, and shields.
Dr. Le testified that security staff at the Hospital are not equipped to manage situations such as that with which they were confronted. She was concerned that T. (L.) would hurt or even kill those staff. Noting T. (L.)’s considerable physical strength and desire to engage in fighting, she stated that at the Hospital, there is nothing that can really stop his behaviour. She contrasted hospital security and nursing staff with the police, noting that the latter were all dressed in tactical gear.
Dr. Le stated that since T. (L.) has been in jail, the Hospital receives updates from the nursing staff there. She is aware of conflicting reports as to whether he is taking medication while in custody. She is aware that there have been altercations involving him, and that he has required seclusion at the jail.
Dr. Le discussed the relationship between T. (L.) and the treatment team. She noted that T. (L.) has a long-standing difficulty working with female physicians and other female staff. Prior to the incident on July 29, there was observed improvement in his therapeutic relationship with both the psychotherapist and with Dr. Le. She felt that he was making some progress, noting that he was opening up about his feelings that it was “okay” for him to hit women.
Dr. Le stated that it was difficult for her to comment on whether she could re-engage in a therapeutic relationship with T. (L.), noting that in her role, she must be concerned for all staff on the treatment team and on the unit. She acknowledged that it would be difficult for her, personally, to re-engage with him.
No further evidence was led following Dr. Le’s testimony.
Analysis and Conclusions
The panel found that T. (L.) represents a significant threat to the safety of the public. Although this issue was not the subject of dispute at the hearing, the panel made that determination independently based on all of the evidence. T. (L.) has multiple diagnoses that include a major mental illness and significant substance use disorders. Despite treatment with antipsychotic medication, he has continued to experience intermittent, residual symptoms of his illness throughout his lengthy course in various hospitals while under the Board’s authority. He has a significant history of violent behaviour against family members, co-patients, hospital staff and police. While the symptoms of his mental illness have driven his violent behaviours, so too has his antisocial personality structure. Particularly during times when he has been refusing to take his prescribed antipsychotic medication, he has demonstrated threatening and physically aggressive behaviour toward co-patients and staff at each hospital where he has been detained. The evidence is overwhelming that in the absence of the structure and supervision of forensic mental health services and the oversight provided by the Board, T. (L.) would rapidly cease taking antipsychotic medication, would disengage from mental health services, would return to regular substance use, and engage in serious criminal conduct that would likely result in serious physical and/or psychological harm.
The panel had no difficulty in finding that the necessary and appropriate Disposition is a Detention Order. The Disposition must, of course, be one that is the least onerous and least restrictive on the evidence examined through the factors in s. 672.54 of the Criminal Code, such that it should provide T. (L.) with maximum liberty while maintaining the safety of the public. On the evidence, there is simply no air of reality to a lesser Disposition. For good reason, no party suggested otherwise.
Turning to the issue of transfer, the panel accepts Dr. Le’s evidence that NBRHC lacks the ability to safely manage the risk that T. (L.) currently presents to staff and patients. During the July 29^th^ incident, T. (L.) had access to all the rooms on the unit. He went into one of those rooms and assaulted a dual diagnosis patient during the time that elapsed while hospital staff awaited the arrival of the police. As Dr. Le testified, security staff at this hospital are not equipped to contain the threat that he presents. In September of 2023, an incident occurred that involved multiple security staff entering T. (L.)’s seclusion room, during which he fought, stated his desire to kill hospital staff and placed one security staff member in a headlock, resulting in a visit to the emergency department. This supports Dr. Le’s concern, on July 29, 2025, that T. (L.) could harm or even kill one of the security staff members.
As is apparent from a close examination of T. (L.)’s years at Waypoint from April of 2019 to December of 2022, T. (L.) demonstrated an ongoing desire to initiate fights with co-patients and staff, but trained and equipped staff at that facility could contain him without significant injury. NBRHC is simply not similarly equipped. As a maximum-security forensic facility, Waypoint possesses the physical structure, trained staff, and safety equipment (all of which is described at various points in the Hospital Report covering T. (L.)’s previous stay) that is plainly necessary to manage T. (L.)’s current risk to both patients and staff. At the same time, the panel is satisfied that Waypoint would provide T. (L.) with greater freedom of movement than would be available to him if he were to remain at NBRHC. In this regard, it is a less restrictive environment, as T. (L.) is clearly not appropriate to have indirectly supervised community passes in any event.
The panel has considered Mr. Bracken’s submissions that the incident on July 29, 2025, does not rise to the level necessary to require T. (L.)’s transfer to Waypoint, and that T. (L.) has had a positive therapeutic relationship with his treatment team that need not be terminated by such a transfer.
The panel observes, first, that T. (L.)’s recent behaviour at NBRHC, particularly when set in the context of similar incidents at both Ontario Shores and Waypoint as well as the occurrences at NBRHC in 2023, compels the conclusion that he represents an extreme risk to both staff and patients. The Board’s paramount duty to provide for the public’s protection requires it to order T. (L.)’s detention at the facility that can best mitigate that risk.
Second, the panel fully appreciates the value of a positive therapeutic relationship in addressing all the factors in s. 672.54 of the Criminal Code. Particularly in the case of an individual like T. (L.), who has been subject to the Board’s jurisdiction for a very long time, the value of a strong therapeutic relationship with one’s care team should not be readily minimized in considering the twin goals of Part XX.1. However, having regard to Dr. Le’s evidence, together with the uncertainty surrounding the duration of T. (L.)’s incarceration pending the resolution of his charges, the re-establishment of a therapeutic alliance at NBRHC is at best speculative. The interruption of the therapeutic alliance was the inevitable consequence of T. (L.)’s own actions, which on the evidence were not the product of a psychotic process.
Accordingly, the necessary and appropriate Disposition is a Detention Order requiring that T. (L.) be detained at the High Secure Provincial Forensic Programs at Waypoint, forthwith upon his discharge from a detention/correctional facility. To that end, the panel anticipates that staff from NBRHC will be in regular communication with both Waypoint and the North Bay Jail so that appropriate arrangements can be made.
DATED this 15th day of September 2025, at the City of Toronto, in the Toronto Region.
Mr. Eric Siebenmorgen
Legal Member
___________________
Office of the Registrar
Ontario Review Board