Re: Andrew Bicknell
ORB File No: 6890
Hearing held on: Monday, August 11, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. C. Finley Members: Dr. P.E. Cook Dr. A. Park Ms. J. Ferguson Ms. B. Little
Parties Appearing:
Accused: Andrew Bicknell Counsel: Mr. A. Rai
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated September 18, 2025)
Introduction
On January 13, 2016, Andrew Bicknell was found not criminally responsible on account of mental disorder 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/the Board), dated September 12, 2024, discharging him with conditions.
On August 11, 2025, the Board convened to conduct the annual review of Mr. Bicknell’s disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Bicknell was present and represented by Mr. Rai.
At the outset of the proceedings, all parties were canvassed as to their positions on the issues to be determined by the Board: whether Mr. Bicknell continues to represent a significant threat to the safety of the public; and if so, the necessary and appropriated disposition having regard to the criteria set out in s.672.54 of the Criminal Code.
Ms. Warner, on behalf of the hospital, submitted that Mr. Bicknell remains a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current discharge with a change in reporting from not less than once every two weeks to not less than once every month. Ms. Culp, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions. Mr. Rai submitted that Mr. Bicknell no longer represented a significant threat and therefore was entitled to an absolute discharge.
Findings
- For the reasons that follow, the Board finds that the threshold for significant threat has not been met. Therefore, Mr. Bicknell is entitled to an absolute discharge.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated August 7, 2025 (ex. 1), and the viva voce evidence of Dr. Choptiany, Mr. Bicknell’s treating psychiatrist.
The Index Offence
- On May 28, 2015, Mr. Bicknell appeared in 102 Court at Old City Hall. As he was being escorted back to the cells, he was handcuffed to the rear. The escort, Officer M.M., was directly behind Mr. Bicknell. As they went through a narrow doorway, Mr. Bicknell suddenly stopped walking causing the officer to bump into him. He grabbed Officer M.M.’s crotch. She pushed him away, and he responded: “What, are you trying to get me hard?”
Background Information
The Hospital Report was made an exhibit, so it need not be reviewed here beyond the following material facts. Mr. Bicknell is a 34-year-old man who was born in Jamaica and immigrated to Canada with his family in 1990. He stopped attending school partway through grade ten.
After leaving school, Mr. Bicknell briefly worked at a variety of jobs, including landscaping and working in a warehouse. He is currently supported by the Ontario Disability Support Program (ODSP).
Mr. Bicknell reported that he first started using cannabis at the age of 14 in response to stress. At the time of the index offence, he was using cannabis daily. He also has a history of problematic cocaine and alcohol use.
Mr. Bicknell has a lengthy criminal history, with most convictions relating to crimes of dishonesty and failing to comply with court orders.
Mr. Bicknell’s first psychiatric admission was to North York General Hospital when he was 33 years old. He was admitted as an involuntary patient for a few months. Subsequent to his initial hospitalization, there have been many attendances and admissions to hospital in respect of his mental health, all of which are detailed in the Hospital Report. His current diagnoses are Schizophrenia, Alcohol, Cannabis, and Cocaine Use Disorders, Rule Out Antisocial Personality Disorder, and Rule Out Other Specified Paraphilic Disorder (coercive preference).
Mr. Bicknell was admitted to CAMH following his NCR verdict. He was discharged to reside in the community in October 2020. Over the course of the following two years, Mr. Bicknell was subject to two brief readmissions to hospital after experiencing a deterioration in his mental state in the context of substance use. Following his first readmission in October 2020, Mr. Bicknell agreed to engage in substance use relapse prevention with a psychologist, Dr. Pauls, and to participate in more support programs in the community, for example the Partial Hospitalization Program (PHP).
Following his discharge, Mr. Bicknell returned to his residence which is within walking distance of CAMH. It is operated by EcuHomes. Mr. Bicknell has his own bedroom but shares common areas with 6 other tenants. There are no regular staff on site during the day, and residents are responsible for preparing their own meals and sharing in cleaning responsibilities.
In February 2021, Mr. Bicknell relapsed by consuming alcohol. However, he continued to report to the clinical team and his mental status remained stable. He was not readmitted to hospital. Over the course of the year, he demonstrated a gradual improvement in his engagement with the clinical team and was more willing to approach the team for support in problem-solving.
Mr. Bicknell’s second and most recent readmission to hospital was from June to September 2022. He abruptly quit his job which impacted on his daily structured activities. As with the previous admission, although there was no critical incident, his mental status deteriorated. He attended his appointments with the clinical team and exhibited paranoia and increasing agitation. Initially, the team intervened and requested daily reporting and more frequent urine drug screens. However, these steps did not result in an improvement in Mr. Bicknell’s mental state and he was readmitted to hospital.
Following his discharge into the community on September 15, 2022, Mr. Bicknell agreed to the arrangement of texting his Case Manager on a nightly basis after he had taken the his oral medication, olanzapine. Since then, Mr. Bicknell has been very diligent in doing so and takes the initiative of asking for his olanzapine refills. He has never missed a dose of his oral medication.
Over the course of the following year, Mr. Bicknell met with Dr. Pauls on a weekly basis, focussing on relapse prevention, impulse control and craving management strategies. The doctor noted that Mr. Bicknell was engaged and took feedback well.
Since his discharge from hospital in September 2022, Mr. Bicknell has continued to reside at his residence near the hospital. There have been no concerns raised by the housing provider. Mr. Bicknell recently confirmed that he was satisfied with his current housing and did not have any plans to move.
Mr. Bicknell’s mental state has remained stable and no changes in his medication have been required. His schizophrenia is well controlled with regular injections of anti-psychotic medication coupled with nightly doses of olanzapine, which he administers independently. Although at one point there was some discussion of decreasing his dosage of olanzapine, Mr. Bicknell decided against it when cautioned about the risk of decompensation. All urine drug screens have been negative.
Mr. Bicknell’s insight into the role of medication can best be described as limited. However, he has remained compliant with treatment with the support of the clinical treatment team. Mr. Bicknell acknowledges that discontinuing medication can have negative results.
Likewise, Mr. Bicknell’s insight into the impact of substance use on his mental state also has been described as limited. However, he is aware that his abstinence has helped him avoid engaging in problematic behaviour that could result in a readmission to hospital. Further, he is aware that any use would be a breach of his disposition and could have an impact on his progress under the ORB. According to the Hospital Report, Mr. Bicknell has stated that he plans to remain abstinent from substance use even if he was no longer under the ORB. He denied having specific cravings for substances, though he still avoided environmental exposures when possible as a precaution.
Dr. Choptiany testified before the Board. He took on Mr. Bicknell’s care in May 2025, when Mr. Bicknell’s previous psychiatrist went on a leave of absence. Dr. Choptiany indicated that Mr. Bicknell managed the transition to a new doctor well. Mr. Bicknell has had another year of stability in the community. He has abstained from substances, as confirmed by regular urine drug screens, adhered to his antipsychotic medication and has been polite and engaged during each of their appointments. Mr. Bicknell’s work with a landscaping company continues to go well.
Dr. Choptiany testified that Mr. Bicknell’s most salient risk factor is his history of substance use. He has told the doctor that he “won’t return to it”. However, in Dr. Choptiany’s opinion, given Mr. Bicknell’s long history of substance use and history of relapsing, Mr. Bicknell has yet to internalize an understanding of the impact of substance use on his mental status. Mr. Bicknell does not have a fulsome appreciation of the risk that substance use poses.
Dr. Choptiany testified that the treatment team has concerns that, should Mr. Bicknell receive an absolute discharge, he would relapse into substance use. In the short-term he would continue with follow-up care but in the long term there is a high risk that he would return to substance use. Should that occur, Mr. Bicknell would likely discontinue his oral medication and fall away from care. He would become irritable and act out in an aggressive or sexually inappropriate manner.
In the doctor’s opinion, even removing the condition in his current disposition prohibiting substance use would be problematic, as the team is concerned that he would see it as permissive and return to substance use. Dr. Choptiany pointed to Mr. Bicknell’s recent relapses in 2018, 2020 and 2021 when he became intoxicated and his mental status deteriorated. He became irritable and paranoid and there was potential for aggression.
Dr. Choptiany indicated that the team was recommending a reduction in Mr. Bicknell’s reporting requirement. That would allow the team to gather further evidence that Mr. Bicknell is able to manage his risk. The team also would reduce the number of urine drug screens and make them more random to see if Mr. Bicknell was able to maintain his abstinence. Further, over the course of the next year, the team would look to transition Mr. Bicknell to a non-forensic team in the community and overlap his care.
In response to questions from Ms. Culp, Dr. Choptiany identified unstable housing as a salient risk factor for Mr. Bicknell. His current housing through EcuHomes is permanent.
In Dr. Choptiany’s opinion, Mr. Bicknell is currently externally motivated to be successful in the community. When Dr. Pauls left CAMH, Mr. Bicknell was offered ongoing support which he declined. He also declined to participate in recommended further substance use programming. However, Dr. Choptiany did allow that Mr. Bicknell has done extensive programming and may well experience program fatigue.
Mr. Bicknell’s time currently is structured with work and time at a gym. His primary personal supports in the community are his family.
In response to questions from Mr. Rai, Dr. Choptiany agreed that Mr. Bicknell has recognized that ongoing abstinence has helped him, he has denied experiencing any cravings, and his mental status has remained stable. Mr. Bicknell can continue to reside at his current residence and he has not expressed any desire to move. Further, Mr. Bicknell has remained compliant with his medications, never asking for a reduction in his dosage, and has expressed remorse for the index offence. There has been no recent aggressive or threatening behaviour.
Dr. Choptiany agreed that Mr. Bicknell currently has a family doctor in the community. Should Mr. Bicknell receive an absolute discharge, the treatment team would continue to support him until a team in the community was in place. There would be no obligation on Mr. Bicknell’s part to follow up with the current treatment team.
In response to questions from the panel, Dr. Choptiany agreed that Mr. Bicknell has basically been abstinent for four years. Another year subject to a conditional discharge would allow for the opportunity to internalize risk management, another year of abstinence confirmed by more random urine drug screens, and another year of stability.
All parties maintained their initial positions.
Analysis and Conclusion
In Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. The threshold for finding significant threat is an onerous one (see Carrick (Re), 2015 ONCA 866.)
The Board carefully considered the Hospital Report and the evidence of Dr. Choptiany and unanimously finds that the threshold for significant threat to the safety of the public has not been met in this case. Over the past four years, Mr. Bicknell has resided in the community with no concerns raised by staff at his residence. He has been compliant with treatment, including administrating his own medication every evening. Mr. Bicknell has been receptive to the support and advice from the clinical treatment team. He has structured days working and going to the gym. Mr. Bicknell also continues to have the support of his family. Critically, he has remained abstinent and stated, on more than one occasion, that he intends to remain so.
Mr. Bicknell’s insight is not robust. He states that he is committed to continue taking his medication and recognizes that he would get sick were he to stop. The fact that he reconsidered reducing the dosage of olanzapine because of the potential impact on his mental status demonstrates some appreciation of the benefits of continuing with his current treatment.
Mr. Bicknell also has stated that he intends to remain abstinent, even if he is granted an absolute discharge. The Board appreciates Dr. Choptiany’s concern that this stated commitment is not well grounded. The doctor believes that Mr. Bicknell’s abstinence is due to his current disposition and the support of the clinical treatment team and is externally driven. However, the fact remains that Mr. Bicknell has remained abstinent for four years and appears to appreciate the negative impact substances have had on his mental status.
As the Curt of Appeal of Ontario has stated, “Lack of insight has its place in the overall clinical picture; however, it must not dominate the significant threat analysis”: Woods (Re), 2019 ONCA 87, at para. 17. And in Kalra (Re), 2018 ONCA 833, the Court of Appeal stated, at para 52:
It bears stating that lack of insight is not of itself a basis to deny an absolute discharge. As the Supreme Court instructs, the mentally ill accused has insight into his or her mental illness, and the extent of that insight, is only part of the analysis in determining if there is a significant threat to the safety of the pubic. While insight is a treatment goal, it is one some persons living with mental illness may be unable to fully achieve. In some instances, particularly where the contemplated harm falls at the lower end of the spectrum, it may be unreasonable to require, as the Board did here, that an NCR accused’s insight into his or her illness be “entrenched on his consciousness” in order to obtain an absolute discharge.
While expressing appropriate concern about Mr. Bicknell’s salient risk factors, Dr. Choptiany also testified as to Mr. Bicknell’s progression through the forensic system, his successful independent living arrangements, longstanding compliance with medication, and his limited use of cannabis over three years ago. Although Mr. Bicknell has demonstrated irritability and aggression in the context of substance use, since the index offence, it has not risen to the level that would attract criminal charges. There has been no observed sexually inappropriate or aggressive behaviour over the last three years. Significantly, all of Mr. Bicknell’s urine drug tests since March 2021 have come back negative for substances.
The Board is also mindful of Dr. Choptiany’s evidence that Mr. Bicknell can continue to avail himself of the support of the clinical team until such time as a non-forensic team in the community can be identified. Mr. Bicknell currently has the support of his family doctor. That would have to be augmented by a community psychiatrist and a case manager. Consideration could be given to having Mr. Bicknell enter into a Community Treatment Order, should that be appropriate. As with the forensic clinical team, the provisions of the Mental Health Act would be available to a community psychiatrist.
The Board appreciates Dr. Choptiany’s caution with respect to Mr. Bicknell’s long history of substance use. He is looking for another year from Mr. Bicknell to demonstrate stability and abstinence. Yet Mr. Bicknell need not prove a lack of dangerousness, and bears no burden of proof. Absent a finding of significant risk, he is entitled to an absolute discharge. “There must be a real, foreseeable risk that is more than speculative, and that the consequent physical or psychological harm must be serious and criminal in nature: Winko.
As indicated by Dr. Choptiany, Mr. Bicknell is to be congratulated for his progress to date, particularly over the last three years. He has been consistently rule-abiding, receptive to support and recommendations, and positive in attitude towards the team’s continued supervision and oversight. He is to be particularly commended for his dedicated vocational pursuits, responsible medication management, sustained substance abstinence, and effective use of available professional supports.1
In conclusion, the Board finds that the threshold for significant threat to the safety of the public has not been met in this case and Mr. Bicknell is therefore entitled to an absolute discharge.
DATED this 18th day of September, 2025, at the City of Toronto, in the Region of Toronto.
Ms. C. Finley Alternate Chairperson
Office of the Registrar Ontario Review Board