Ontario Review Board
Re: Jaiden Wilson
ORB File No: 8735
Hearing held on: Monday, August 25, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Section 672.47(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Weinstein
Members: Dr. A. Park Dr. M. Kalia Ms. C. Murray Mr. A. Mete
Parties Appearing:
Accused: Jaiden Wilson Counsel: Ms. G. Smith
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated September 23, 2025)
Introduction:
On February 25, 2025, Mr. Jaiden Wilson was found not criminally responsible on account of mental disorder, on a charge of aggravated assault, contrary to the Criminal Code of Canada. (“Criminal Code”). That finding was based on an assessment, and related report, of Dr. Roland Jones, dated October 23, 2024.
The court did not make a Disposition and, pursuant to a Release Order, dated February 25, 2025, allowed Mr. Wilson to live with his mother, subject to certain conditions. The court also ordered, pursuant to s. 672.471 of the Criminal Code, that he be bound by the Release Order pending a Disposition of the Ontario Review Board (the “Board”).
On August 25, 2025, the Board convened a hearing at the Southwest Centre for Forensic Mental Health Care, St. Thomas (“Southwest”), to make an initial Disposition.
Mr. Wilson was present at the hearing, as was his mother, and was represented by his counsel, Ms. Gail Smith.
By letters dated June 5 and June 9, 2025, Ms. Smith issued a Rule 14 Notice, requesting that Mr. Wilson’s care be transferred to the Centre for Addiction and Mental Health, Toronto (“CAMH”). There has been no response from CAMH.
An initial Risk Assessment, dated June 3, 2025 (the "Risk Assessment"), was entered as Exhibit 1.
The first issue at this hearing is whether Mr. Wilson is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate Disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code. The next issue before the Board is whether Mr. Wilson’s care should be transferred to CAMH.
For the reasons set out below and based on the expert evidence and opinions before us, the Board concluded that Mr. Wilson represents a significant threat to the safety of the public. The Board ordered that his risk can be properly managed with a Detention Order at CAMH, with residual authority resting with Southwest, on the terms and conditions set out in our formal Disposition. The Board concluded that the above is the necessary and appropriate Disposition in the circumstances.
Current Psychiatric Diagnoses:
- Schizoaffective Disorder – Bipolar Type
Substance Use Disorder (in remission)
Index Offence:
- The circumstances giving rise to the Index Offence are extracted from the Risk Assessment, as follows:
“Narrative:
The accused, Jaiden WILSON (2003/06/01) does not have a criminal record or a history with the Waterloo Regional Police Service. The accused is currently a student at the University of Waterloo. The accused and the victim have been living in the same dorm room for approximately two months. There had been no prior confrontation. There are no barriers separating either bedroom.
Charges Before the Courts:
On July 6, 2022, at approximately 20:47 hours, the accused and the victim were in their dorm room located at 8119-165 University Avenue West in the City of Waterloo. There had been no previous interaction prior to the incident. Both parties were separated and spending time at their own leisure. The accused stabbed the victim from the back into the right side of his neck with a pair of green and white scissors. The unprovoked assault resulted in a puncture wound that lead to excess bleeding in the dorm room.
The witnesses helped aid the victim and control his bleeding. Police arrived on scene and observed the victim to have a puncture wound on the right side of his neck and blood on himself.
The victim received stitches to his wound."
Course Prior to the Index Offence:
- Mr. Wilson’s course prior to the Index Offence is extracted from the Risk Assessment, and the following paragraphs are relevant to this hearing:
“Self-Report
In the months prior to the index offence, Mr. Wilson reported that he had been feeling dysphoric and poorly motivated. He had a co-op placement during early 2022.
He returned to Waterloo in May 2022 and was excited to do better. He said he was not able to sleep and he thought cannabis would help. He started smoking cannabis again on his birthday, 1 June 2022. Mr. Wilson said he “liked cannabis too much” and started smoking it during the day as well.
Two days before the incident, Mr. Wilson reported that everything changed. Mr. Wilson stated "I felt like I uncovered the key to the universe. Everything made sense. I felt like I was Jesus Christ.” He reported that he looked at his reflection in the bathroom mirror and saw the words "I am" carved into his forehead.
Mr. Wilson said that he remembered thinking that being high on cannabis was getting him closer to God.
Mr. Wilson elaborated that he thought the world would end on 31 July and that there was a prophecy he had to fulfil. He believed Ryan was the antichrist and was stopping him from saving the world, and he had to do something to stop the antichrist from preventing him saving the world.”
Criminal History:
- Mr. Wilson has no criminal history.
Psychiatric History:
- Mr. Wilson has no prior psychiatric history.
Education History:
Mr. Wilson attended Frances Lieberman high school in Scarborough from grade 9 to grade 12. He excelled academically, achieving an average of 94% in his final year. His strongest subject was physics, in which he scored 97%. He was also active in track and field, representing his school in 800-meter events at Ontario Federation of Schools Athletics Association (OFSAA) competitions. In addition, he represented his school in W5H (general knowledge) competitions.
Mr. Wilson was never suspended or expelled from school. He was not bullied, nor did he bully others. He graduated high school with honours and received the following awards: Physics, English, French, and Honours Society.
After graduating from high school, Mr. Wilson enrolled at the University of Waterloo to study chemical engineering. He reported that he enjoyed being at university but found that he was not focusing on academic work. He reported that during the first term he obtained an average score of 73%. He decided to try to do better in his second term. However, the Index Offence occurred during that second term, following which he was expelled from the University.
Cannabis Use History:
- Mr. Wilson’s substance abuse history is set out in the Risk Assessment. The following extracted paragraphs are relevant to this hearing:
“Mr. Wilson said that he first consumed cannabis when he was in high school at the age of 15.
Mr. Wilson was using cannabis daily prior to the time of the index offence. He noted insomnia to be present days leading to the index offence and thought that smoking cannabis would help him sleep.
Mr. Wilson reported (during his hospital admission on 27 July 2022) that with daily cannabis use he began having hallucinations, seeing numbers on his skin and feeling crawling on his legs, initially only when using cannabis, but it extended more than 24 hours after use.”
Course Subsequent to the Index Offence:
- Mr. Wilson’s course subsequent to the Index Offence are set out in detail in the Risk Assessment. The following extracted paragraphs are relevant to this hearing:
“Mr. Wilson attended London Health Sciences Hospital on 27 July 2022. He reported that he had started smoking cannabis in early July 2022. With daily use he began having hallucinations.
Also in July 2022, Mr. Wilson experienced a sudden onset of symptoms of psychosis [delusional perception, ideas of reference, grandiose and religious delusions, and visual hallucinations described under Index Offence].
Hospital Admission, 8 August to 29 September 2022
Mr. Wilson was admitted to hospital initially under Form 1 of the Mental Health Act. The day prior to the hospital admission, the police visited their home to undertake a wellness check because they had seen screenshots of content, he had posted on Instagram stating "goodbye cruel world, this will be my final post." He had been also noted to be laughing quite hysterically at times when sitting alone.
Mr. Wilson reported a number of delusions stating that he is a direct descendent of Jesus Christ and that he is immoral, and has a special role to rid the world of slavery.
Mr. Wilson was discharged on a Community Treatment Order (CTO) on September 27, 2022. His medication at discharge was lithium 1050 milligrams daily and Invega Sustenna 150 mg every four weeks. At the time of discharge, Mr. Wilson continued to experience psychotic symptoms,
Mr. Wilson was followed regularly as an outpatient by Dr. Subramanian. His psychotic symptoms were documented as being in remission. He had a reduction in dose of Invega to 100mg every four weeks.
On 23 February 2023, he reported that he had obtained cannabis.
[Mr. Wilson] elected to stop taking antipsychotic medication in August 2023, and stopped taking lithium in April 2024. [He was no longer on a CTO at this time, confirmed by Dr. Subramanian].
On 25 September 2023, Mr. Wilson entered into a voluntary CTO as he was found capable of consenting to his own treatment. He had discontinued Invega Sustenna at his request, the last dose he received was in August 2023. On 24 November 2023 the dose of lithium was reduced to 900mg. His mood and psychotic symptoms were stable. He had requested to stop it altogether. In January 2024 his dose of lithium was tapered down at his request (and faster than recommended) to 300mg daily.
When seen on 21 March 2024 [Mr. Wilson] had discontinued all his medication. His mental state was stable. He did not wish for the CTO to be renewed and it was discontinued.
A month after he discontinued all of his medication] Mr. Wilson was admitted to hospital under the Metal Health Act due to a relapse of psychosis on 22 April 2024. During the admission he displayed symptoms of psychosis including the preoccupation with the belief that he could send and receive energy to and from others, and that he could control others. He was religiously preoccupied, and at times he was agitated and combative. During the admission, he was found incapable to consent to treatment, and medication was restarted. He was initially treated with lithium, but it was stopped due to side effects (acne and increased urinary frequency). Prior to discharge he was restarted on an involuntary CTO.
Mr. Wilson was seen in outpatients by Dr. Subramanian the day after discharge and was readmitted to hospital. Mr. Wilson had ongoing psychosis and concerns about side effects of medication. During the admission he had to be sent to the Psychiatric Intensive Care Unit (PICU) after he had an altercation with another patient.
After stopping lithium in April 2024, Mr. Wilson said that he experienced severe mood swings and he thought he was going to do something violent. He said that he was experiencing hallucinations and seeing things disappear in front of him.
On April 9, 2025, he stated that he continued to have feelings of experiencing energy and, in fact, in the last week he had believed that an individual on the bus had gestured to him a sign that he took to mean that his energy was robbed from him. He stated that he could indeed feel this energy drop and so was convinced that indeed the gesture was meant to take his energy away. May 6, 2025, it was reported that there was some apparent worsening over the last couple of weeks with Mr. Wilson’s psychotic symptoms (of note, his mother was in Jamaica during this time).”
Position of the Parties:
At the commencement of the hearing, counsel for the hospital recommended a Detention Order Disposition, with the highest privilege being to reside in the community, in accommodation approved by the person in charge.
Counsel for the hospital was not opposed to a transfer to CAMH.
Counsel for the Attorney General joined the hospital in its recommendations.
Counsel for Mr. Wilson advised that she was requesting a Conditional Discharge, with the terms to be determined by this Board, as well as a transfer to CAMH.
Counsel for Mr. Wilson did advise that for the purposes of this hearing, significant threat would not be in dispute.
Evidence at the Hearing:
Evidence of Dr. Mokhber
- The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Mokhber. Dr. Mokhber conducted the Risk Assessment. She testified as follows:
a) She is Mr. Wilson’s assessing psychiatrist.
b) She first met Mr. Wilson on March 25, 2025. She had a follow-up call with Mr. Wilson and his mother on May 13, 2025.
c) Since that last conversation, she has been in communication with his community psychiatrist, Dr. Subramanian, who is responsible for Mr. Wilson’s treatment. She has reviewed all Dr. Subramanian’s progress notes and has had multiple conversations with him to keep herself updated.
d) The Index Offence happened almost three years ago, and Mr. Wilson has been living in the community since then, without exhibiting any violent behaviour.
e) Dr. Mokhber highlighted several hospital admissions following relapses, often prompted by non-adherence to medication or increased stress, and sometimes compounded by substance use. She noted that, although Mr. Wilson has not displayed violent behavior since the Index Offence, his stability has required close supervision, structured treatment, and consistent medication, none of which could be guaranteed outside of a detention setting.
f) A detention order is considered necessary because:
i) Mr. Wilson’s mental illness is still active and not optimally managed.
ii) He lacks sufficient insight into his condition and the importance of ongoing treatment.
iii) His ability to remain well and non-violent is contingent on close external supervision, particularly from his mother and psychiatric care teams.
iv) There is uncertainty regarding future housing and support, especially if he were to move to Toronto, where no guaranteed psychiatric support or supervision currently exists.
v) Without a detention disposition, the hospital could not proactively intervene before he became a risk to the safety of the public
vi) If he were to decompensate, and there was a lapse in supervision, he would pose a moderate-to-high risk to public safety.
vii) In the past, Mr. Wilson has demonstrated non-adherence to medication and clinical follow-up, when not under a Community Treatment Order (“CTO”).
g) Mr. Wilson’s mother is a tremendous support for him. She ensures his adherence to his medication regimen.
h) Mr. Wilson plans to go to university in Toronto, in September 2026.
i) Mr. Wilson’s potential housing options continue to be in flux. He has expressed an interest in living with his father. However, the treatment team would need to discuss the matter with the father to determine whether such a living situation would be appropriate.
j) Mr. Wilson has also indicated that he is also considering the options of living independently, with a roommate, or returning to a dorm.
k) Mr. Wilson had to be readmitted to hospital multiple times since the Index Offence, including on: July 6, 2022, July 27, 2022, and from August 8 to September 29, 2022. It was during this latest admission that he was finally diagnosed with a schizoaffective disorder, as he was still experiencing psychotic symptoms despite having remained abstinent from substances since his previous admission.
l) He was again readmitted to hospital from August 23, 2023, to April 24, 2024. On April 22, 2024, he was deemed incapable to consent to treatment and was put on an involuntary CTO, as set out in paragraph 18 of these Reasons, under Course Subsequent to the Index Offence.
m) Mr. Wilson was subsequently admitted again on June 11, 2024, as well as in October 2024.
n) In August 2023, Mr. Wilson stopped taking his antipsychotic medication and his lithium. He was no longer on a CTO at that time. In September 2023, while he was on a voluntary CTO, he discontinued his Invega Sustenna.
o) In March 2024, Mr. Wilson discontinued all of his medication. He did not wish for the CTO to be renewed, and it was discontinued.
p) Her review of Dr. Subramanian’s notes, and her conversations with him, indicated that Mr. Wilson is always questioning his need for medication, asking for them to be decreased or discontinued. As recently as June 20, 2025, Mr. Wilson was “negotiating” his medication regimen with Dr. Subramanian. It is for this reason that she believes that Mr. Wilson’s insight into his need for medication is partial and that he requires more psychoeducation.
q) Mr. Wilson is a very smart man, with lots of potential; however, he suffers from a treatment refractory form of schizoaffective disorder, and his symptoms are currently active.
r) The hospital does not believe that a Conditional Discharge is appropriate, as the treatment team needs to approve his accommodation. Mr. Wilson’s delusions and his risks are unchanged from the time of the Index Offence.
s) Dr. Subramanian’s team is only permitted to treat Mr. Wilson for a term of three years, which ended last week. At Dr. Mokhber’s request, Dr. Subramanian agreed to keep treating him until the Board issues their Disposition. Accordingly, Mr. Wilson will not have any further psychiatric support in the community, absent an order of the Board.
t) The team is requesting a transfer to CAMH to get Mr. Wilson onto their waiting list, which is very long.
u) When Mr. Wilson was not adherent to his medication regimen, his mental state decompensated. Although he did engage in violent ideation at the time, he did not engage in any physical acts of violence.
v) While Mr. Wilson’s mother was away recently, he did not adhere to the regular schedule of medication administration, and Dr. Subramanian did notice a decompensation in Mr. Wilson’s mental state.
w) The treatment team cannot find a trigger for Mr. Wilson’s cannabis use; however, they have noticed that stressors cause him anxiety, and one of his coping strategies in the past has been to use cannabis.
x) Her attention was drawn to the following paragraph on page 57 of the Hospital Report:
“Mr. Wilson's risk of violence in the short-term appears low to moderate but is contingent upon his continuity of care (CTO and case management), stable living situation, supervision and support from caregivers and structured treatment engagement. Dynamic risk factors (e.g., insight, symptoms, supervision reliance) remain prominent, and any disruption to his current supports (e.g., if the mother is unavailable) increases his risk.”
She agreed that without all those things in place, she would consider his risk to be higher than low-to-moderate. She confirmed that his CTO is no longer in place, and the treatment team cannot ask for a community treatment order.
- In response to questions from counsel for Mr. Wilson, Dr. Mokhber testified:
a) The last time she personally examined Mr. Wilson was March 31, 2025.
b) She is concerned with his non-adherence to medication, as well as his constant requests that Dr. Subramanian change, decrease, or completely stop, his medication .
c) She agreed that Mr. Wilson’s requests for medication changes are due to the side effects he is experiencing. However, there is always a trade off between a medication’s side effects and its benefits. In Mr. Wilson’s case, his medication is necessary to treat the active symptoms of his major mental illness, to manage the risk to the public and to himself.
d) The HCR-20 risk assessment states that Mr. Wilson has a history of problems with relationships, but no negative connotation should be inferred. It is only mentioned because being prosocial is more of a protective factor.
e) While Mr. Wilson is aware that he does suffer from a major mental illness, he is not fully aware of its symptoms, nor of the ways they impact him.
f) Mr. Wilson has refused to take clozapine, because of his concern about the damage to white blood cells. However, her assessment that he is not optimally treated is not limited to that refusal; there is still room to adjust his medication regimen. Mr. Wilson has not responded to at least two antipsychotic medications, and he is currently being trialled on a third.
- In response to questions from the panel, Dr. Mokhber testified:
a) The last time Mr. Wilson used cannabis was in March of 2024.
b) The hospital needs to approve Mr. Wilson’s housing to ensure that:
(i) he remains adherent to his medication regimen
(ii) there are appropriate persons to monitor his major mental health issue and any possible decompensation
(iii) he remains abstinent from substances.
c) Mr. Wilson’s mother is a wonderful support. If Mr. Wilson did not wish a transfer to live in Toronto, the treatment team would consider, at the appropriate time, including specifying her address as part of a Conditional Discharge, to protect public safety.
d) When asked about putting in a consent to treatment clause in a potential Conditional Discharge Disposition, Mr. Wilson is not capable to consent to treatment, and his major mental illness would interfere with his ability to appreciate the consequences of a breach. Should Mr. Wilson regain his capacity for treatment, the hospital would consider a Conditional Discharge, with a clause specifying his mother’s residence, as appropriate.
e) At this time, a Conditional Discharge would elevate Mr. Wilson’s risk to moderate-to-high. He would not likely return to the hospital voluntarily, nor stay there, under a Conditional Discharge.
f) Mr. Wilson’s mother plays a very important role in maintaining his wellbeing; she supervises his medication, and she is able to recognize when he is symptomatic and knows to call the treatment team.
g) If he were granted a Conditional Discharge it would increase the risk to the safety of the public; the hospital would have to wait until he was certifiable under the Mental Health Act, and Mr. Wilson’s mental state deteriorates very quickly. A Detention Order Disposition allows the treatment team to be proactive, preventing any serious event before it happens.
h) The hospital’s current plan is to allow Mr. Wilson to continue to reside with his mother; they have no plans to readmit him to hospital at this time, as he is doing very well under her supervision and care.
- In response to questions arising, Dr. Mokhber testified:
a) While Mr. Wilson usually listen to his mother, at one point while a CTO was in place, a Form 9 had to be used to bring him back to hospital. Without the provisions of a Warrant of Committal, as a CTO is no longer in place, it is not clear that Mr. Wilson would listen to his mother to go back to hospital, or to stay there voluntarily.
b) Mr. Wilson did terminate the CTO himself in the past, and he had to be restarted involuntarily on a CTO, to keep him in hospital against his will.
c) If Mr. Wilson were on a Conditional Discharge with his mother’s residence specified, the treatment team could not have him transferred to CAMH, without an early hearing.
d) Mr. Wilson has complained of numerous side effects of his medications.
Evidence of Ms. Marilyn Wilson
- Ms. Marilyn Wilson, Mr. Wilson’s mother, testified as follows:
a) She believes that the last time Mr. Wilson used cannabis was in 2022.
b) Mr. Wilson has complained to her of numerous side effects of his medication, such as the development of breasts, a lack of sleep or sleeping too much, amotivation and frequent urination.
c) She acknowledges that at one point Mr. Wilson did refuse to take his medications, and he was admitted to hospital. When Mr. Wilson is living with her, he is adherent to his medication regimen.
d) She believes Mr. Wilson went to hospital on his own volition and not because she asked him to.
e) She believes that if he stayed with his father, and said he needed to go to the hospital, his father would support him and take him there.
- In response to questions from counsel for the hospital, Ms. Wilson testified:
a) She disagreed with the following paragraph, on page 14 of the Hospital Report, because she believed the dates were incorrect:
“When seen on 21 March 2024 [Mr. Wilson] had discontinued all his medication. His mental state was stable. He did not wish for the CTO to be renewed and it was discontinued. He reported that he had used cannabis three weeks earlier. His mother found the cannabis and confiscated it. He reported that he had not used it since.
- No other evidence was called.
Analysis and Conclusions:
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: Mr. Wilson is a significant threat to the safety of the public.
In Winko, 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. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Mokhber, in addition to the documentary evidence before us.
Mr. Wilson presents with persistent psychotic symptoms, and his mental state remains fragile. He lacks insight into his mental illness, violence risk and need for treatment. Even under structured care (PEPP), he continued to mismanage his medications, occasionally becoming entirely nonadherent, which led him to be readmitted to hospital. Although his risk to self or others appears low-to-moderate at present, maintaining this level is contingent on his adherence to treatment, the presence of community supports, and the stability of his living situation. His risk elevates with changes in stress, housing, legal status, or support availability. Ongoing psychiatric, and legal, oversight, in conjunction with family support, remain crucial.
Mr. Wilson’s insight into his mental health is assessed as poor, and he has ongoing delusional symptoms. He has a history of non-adherence to his medication, and he acknowledged that he stopped taking his medication completely in 2023. Mr. Wilson is currently deemed incapable to consent to psychiatric treatment.
Mr. Wilson used cannabis as a way of coping with insomnia, which was caused by stress related to school. His increased use of cannabis was a contributing factor in the Index Offence and in his subsequent hospitalizations under the Mental Health Act.
In particular, the Board also relies on the following excerpts from the Hospital Report:
“Recent problem with major mental disorder (present and relevant): Mr. Wilson has active psychotic symptoms (ideas of reference); currently non-disruptive to behaviour. On April 9, 2025, he stated that he continued to have feelings of experiencing energy and, in fact, in the last week he had believed that an individual on the bus had gestured to him a sign that he took to mean that his energy was robbed from him. He stated that he could indeed feel this energy drop and so was convinced that indeed the gesture was meant to take his energy away. May 6, 2025, it was reported that there was some apparent worsening over the last couple of weeks with Mr. Wilson’s psychotic symptoms (of note, his mother was in Jamaica during this time).
Recent problems with insight (present and relevant): insight into mental illness, need for treatment and risk of violence remains partial and needs more development – despite support and structure. During times when he is off his baseline presentation his insight significantly worsens.
Recent problems with instability (partially present and relevant): stability remains fragile, dependent on supervision and caregiver (mother).
Recent problem with treatment and supervision (present and highly relevant): Compliant with treatment but demonstrated some reluctance with new medications and requires prompting for medications. Furthermore, on May 6, 2025, he reportedly took double the dose of benztropine at nighttime. He stated that if he missed his afternoon dose, he would take the missed dose at nighttime, demonstrating non- compliance with medication regime.
Recent problems with violent intent (partially present and relevant): The recent report (April 9, 2025) of believing others were gesturing at him and stealing his energy while riding on public transit may increase risk if signs of decompensation are present.
Mr. Wilson will most likely experience future problems with living situation (relevant). He is currently residing with his mother and may move in with his father in Toronto, or dorm in downtown Toronto. However, there are a lot of possibilities and no concrete plan. His father’s house has not been assessed and Mr. Wilson reported that a lot of people live with his father, and he may want to live in a dorm setting instead. The index offence occurred in a dorm room.
Mr. Wilson will likely experience future problems with professional services and plans (relevant): He is currently receiving community care but continues to be vulnerable to changes. Should he move to Toronto, his care is somewhat still unknown but has an upcoming meeting with a psychiatrist from Toronto. A walk-in clinic would not be sufficient to manage his level of care and supervision as it pertains to his overall risk of violence. Dr. Naghmeh Mokhber will continue to liaise and communicate with Dr. Subramanian and/or other psychiatrists as needed to support wrap-around care and services.
Mr. Wilson may experience future problems with personal support (relevant): For instance, should his mother move to Jamaica or he moves to Toronto, he may experience problems with adaption to new settings and supports. Furthermore, he relapsed on cannabis use while living with his mother and without telling her; this is a concern should he move to a new setting.
Mr. Wilson may experience future problems with treatment and supervision response (relevant). He relies heavily on his external structure (community supervision) and his insight remains underdeveloped and worsens when decompensating. He historically and recently demonstrated non-adherence to his medication routine.
Mr. Wilson will likely experience future problems with stress and coping (relevant): His current coping strategies include physical activity and using the gym. He also relapsed on cannabis use (March 2024). His mental stability remains vulnerable under stress or change.
Re-Offence Scenario
Should Mr. Wilson experience any of the following: poor sleep, change in medications, increased stress (e.g., schoolwork), and an unsupportive or significant change in environment, he may decompensate. When decompensating, his psychotic symptoms exacerbate, and he loses insight into his illness and treatment. Also, in any of these situations, he may resort to using cannabis to cope and become non-adherent to his medication. He would likely present with religious preoccupations, believe others are taking something from him (his energy) or feel the need to protect himself (paranoia), resulting in using severe violence, as demonstrated by the index offence, to protect himself.
Overall Clinical Assessment of Risk
It is the opinion of Dr. Mokhber that Mr. Wilson poses a risk of serious physical or psychological harm to members of the public. The following evidence supports this opinion:
Mr. Wilson has a major mental disorder (schizoaffective – bipolar type) and continues to experience psychotic symptoms (paranoia), similar to the index offence. His recent decompensation and need for several hospital admissions following the index offence remain a concern;
Mr. Wilson’s mental state remains fragile and is dependent on ongoing supervision and support (an ongoing psychiatrist, mental health supports, and a stable living environment) as well as his consistent adherence to his medication regime;
Mr. Wilson has shown vacillating signs of medication non-adherence since being diagnosed with a major mental illness following the index offence. At points he believed not being on medication gives him his energy back and other times has acknowledged the effectiveness of medication. In March 2024, he went off his medications entirely and started using cannabis again. His insight into his mental illness, need for medication and treatment and violence risk remains underdeveloped. He requires ongoing education around these domains;
Mr. Wilson has plans to attend university in a challenging program in another city in September 2025. At present, he has no living arrangements and no follow-up psychiatric care. He would be placing himself in the same situation he was in at the time of the index offence;
Mr. Wilson has no structured plan related to his living arrangements should he attend school. Any change to his environment will increase his violence risk. Accommodations would need to be approved as his mental illness symptoms are clinically susceptible to relapse;
Mr. Wilson’s index offence was severe (aggravated assault) and his residual paranoia remains. Although these symptoms have not led to any recent violence, following the index offence, there were reports post the index offence of Mr. Wilson being violent (being combative and agitated, and getting into a physical altercation with another patient) and having violent ideations; and
Mr. Wilson's insight into his substance use disorder remains underdeveloped. He is able to discuss the effects of using substances on his mental health; however, he relapsed with cannabis (March 2024) and was admitted to hospital with exacerbated symptoms during this time. Cannabis is a contributing factor to his violence risk and treatment counselling and support should be applied to his treatment plan.”
Given the Board’s finding of significant threat, it is charged with shaping a Disposition for the coming year. The Board agrees with the hospital recommendation, that the necessary and appropriate Disposition to manage Mr. Wilson’s risk in the following reporting year is a Detention Order, for the reasons set out in paragraph 24 (f). Specifically, a Detention Order is required, and a Conditional Discharge would not be appropriate, because:
a) The hospital requires the ability to approve Mr. Wilson’s accommodation.
b) The Mental Health Act would not be sufficient to protect the safety of the public. Because of the balance of significant static violence risk variables and ongoing dynamic risk variables, Mr. Wilson is best managed under a Detention Order.
c) The hospital requires the ability to rapidly bring Mr. Wilson to the hospital, to assess and manage his violence risk in situations where he would not meet the criteria under the Mental Health Act of Ontario. Mr. Wilson has a history of non-adherence to medication and treatment, as well as cannabis use.
d) The Mental Health Act, being a non-forensic system tool, would not, and cannot, guarantee that Mr. Wilson could be held in hospital long enough to receive adequate treatment to avoid risk to the safety of the public, should he decompensate.
e) As set out in the Hospital Report, Mr. Wilson has no concrete plans about his living arrangements: where he might live, with whom, and who would be able to monitor his adherence to medication and ensure that he remains abstinent from cannabis. We are also mindful that the Index Offence occurred in a dorm room setting, which is one of the possibilities that Mr. Wilson is considering.
f) A Conditional Discharge with the residence specified would not be appropriate in these circumstances, as Mr. Wilson is asking that he be transferred to CAMH, to allow him to reside in Toronto, should he return to university. Accordingly, should a residence be specified in his current Disposition, he would have to have an early hearing. A consent to treatment clause is also crucial to any proposed Conditional Discharge Disposition. In addition to be certifiable under the Mental Health Act he would need to be seen by a physician within the last 7days. The only appropriate Disposition is a Detention Order. The Board did not have a response from CAMH. Regardless, we have sufficient information as to why any Hospital needs to approve his accommodations; Mr. Wilson has no concrete plan; his father’s residence has not been assessed for suitability to protect public safety; and the treatment team has not determined whether the father can, or would, provide the same support that Mr. Wilson is currently receiving at his mother’s residence.
g) The Board recognizes that approving a transfer to CAMH merely allows Mr. Wilson to be placed on the long waitlist for a bed . Should a bed become available in the coming reporting year, it is our experience that CAMH would require a Detention Order, as Mr. Wilson has no accommodations in its catchment area that can be approved at this time.
- Upon consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Wilson and his other needs, we conclude that the necessary and appropriate Disposition is a transfer to CAMH, with residual authority at Southwest, subject to the terms and conditions set out in our formal Disposition.
DATED this 23rd day of September 2025, at the City of Toronto, in the Region of Toronto.
Mr. J. Weinstein Alternate Chairperson Office of the Registrar Ontario Review Board