Re: Elvis Paul Elmer Mielke
ORB File No: 1605
Hearing held on: Thursday, December 4, 2025
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley
Members: Dr. P.L. Darby
Dr. G. Kerry
Ms. A. La Viola
Ms. D. Smith
Parties Appearing:
Accused: Elvis Paul Elmer Mielke
Counsel: Mr. D. Northcott
The Person in charge of Hospital: Representative: Mr. J. Thomson
Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DECISION AND DISPOSITION
(Dated January 13, 2026)
Introduction:
On April 20, 1993, Elvis Mielke, was found not criminally responsible on account of a mental disorder (“NCR”) on a charge second degree murder, contrary to the Criminal Code of Canada. He is currently subject to a disposition of the Ontario Review Board (“ORB”/“the Board”) dated December 3, 2024, whereby he is detained at the Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs, Penetanguishene (“Waypoint”/“the hospital”).
By letter dated October 3, 2025, the hospital advised the Board that on September 25, 2025, Mr. Mielke was placed in seclusion which lasted for a period greater than seven days. This resulted in an increase in the restriction of Mr. Mielke’s liberty, thereby triggering the notice provisions under s. 672.56(2) of the Criminal Code. The Board was later advised that Mr. Mielke was out of seclusion for approximately an hour on October 10, 2025, and then required a further period of seclusion where he continues to be held. All parties agreed that, given the circumstances, the period of restriction of Mr. Mielke’s liberty would be considered one continuous restriction from September 25 to the hearing date.
On December 4, 2025, 2025, the Board convened a hearing at the hospital to review the restriction of Mr. Mielke’s liberty and to conduct the annual review of his disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Mielke was present and represented by Mr. Northcott.
At the outset of the proceedings all parties were canvassed as to their position on the issues to be determined by the panel. Ms. Kraftschik, on behalf of the hospital, submitted that Mr. Mielke remains a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current disposition. With respect to the restriction of liberty, she submitted that Mr. Mielke’s seclusion was necessary and appropriate in the circumstances and represented the least onerous and least restrictive alternative to manage Mr. Mielke’s risk. Ms. Curry, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions.
Mr. Northcott agreed that Mr. Mielke remains a significant threat to the safety of the public. At the conclusion of the evidence, Mr. Northcott indicated that it was a joint submission on both the appropriateness of the restriction of liberty and the necessary and appropriate disposition.
Findings
- For the reasons that follow, the panel found that Mr. Mielke remains a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current detention order. Further, the panel found that the initial decision to seclude Mr. Mielke on September 25, 2025, and the ensuing restriction to the date of the hearing is necessary and appropriate and represented the least restrictive and least onerous measures available to the hospital to manage Mr. Mielke’s risk to the safety of the pubic.
The Evidence
- The evidence at the hearing consisted of the Hospital and Restriction of Liberty Report, (Hospital Report) dated October 31, 2025 (ex. 1), and the viva voce evidence of Dr. Hudson, Mr. Mielke’s treating psychiatrist.
The Index Offence
- The circumstances of the index offence are taken from last year’s Reasons for Disposition as follows:
“On May 14, 1992, Mr. Mielke walked into the municipal police station in Pembroke and told the police that he wanted to turn himself in because he had done something terrible. He handed over a large plastic Coca Cola bottle with a couple of ounces of the contents missing and told the police that they might want to have this because it contained poison.
Subsequently, after speaking on the telephone with his mother, he told police that he had killed Brian Harwood. Brian Harwood was described by the mother of the accused as a chum of the accused and indeed that they had been chums since the days of grade one in school.
Later that morning police found Brian Harwood’s body lying face down in the kitchen floor in his apartment. The body was covered with what appeared to be some sort of bedspread. A blood-soaked towel covered the neck of the body. The body was bare from the waist up, cold, and blood-soaked.
The evidence of the pathologist was that it would have taken perhaps some seven to eight hours for the body to become cold and that death would have occurred from any one of a number of lethal wounds. First, there was a ligature mark around the neck which together with a broken hyoid bone signaled possible strangulation. Other possible causes of death included several of the 24 or more stab wounds to and around the neck which were capable of being fatal. The carotid artery had been severed, as was the spinal cord. The neck wounds were consistent with having been made by a large kitchen knife of the type found on the floor near the body. The pathologist went so far as to suggest that, in his view, there had been an attempt made to actually sever the head from the body with a knife.”
Background Information
The Hospital Report contains detailed information about Mr. Mielke’s personal background and psychiatric history and need not be reviewed in these Reasons beyond the following material points. Mr. Mielke is a 54-year-old man who has been under the jurisdiction of the Board for 32 years. He has held several full and part-time jobs. Immediately prior to the index offence he was employed as a janitor at a motel in Pembroke.
All family members indicate that they noticed deterioration in Mr. Meikle in 1992, when he was 18 years old. At one point he was charged with assaulting his father and received a period of probation which ordered that he not live with his family. As a result, his father helped him move into his own apartment.
Mr. Mielke began to believe people were conspiring against him and he barricaded himself in his apartment on several occasions. His family also noticed that he began to spend money recklessly, ignore his hygiene and not care about his job. At this time, he began to spend time with his friend Brian Harwood (the eventual victim of the Index Offence). Mr. Mielke also became infatuated with Mr. Harwood’s girlfriend.
Symptoms of Mr. Mielke’s mental illness became increasingly evident. He harboured paranoid beliefs. He talked about the mafia, and a prostitution ring that was operating out of his workplace. He believed that these people were conspiring against him. Mr. Mielke refused to answer his telephone and once confronted a neighbour about what he perceived to be her promiscuous lifestyle.
Mr. Mielke’s father was able to convince him to see their family physician, two days before the index offence. He was exhibiting difficulty with thought processes, paranoid beliefs, and auditory hallucinations. The doctor did not prescribe medication. A referral was made for a psychiatric evaluation.
Mr. Mielke’s first psychiatric assessment occurred at Oak Ridge (now Waypoint) following his arrest for the index offence. Mr. Mielke returned to Oak Ridge in April 1993 pursuant to a detention order. His mental status slowly improved. In 2011, the hospital recommended a transfer to the Brockville forensic hospital. Unfortunately, before his transfer was effected, Mr. Mielke experienced a significant deterioration in his mental status, exhibiting increased anxiety, auditory hallucinations, and catatonic and disturbing behaviours. As a result, the Board ordered that he remain at Oak Ridge.
Course Since the Last Disposition
Mr. Mielke’s current diagnoses are Treatment-Resistant Schizophrenia (vs Schizoaffective Disorder, Bipolar Type), and Major Neurocognitive Disorder due to Multiple Etiologies, With Behavioural Disturbance. He also has a medical diagnosis of Treatment-Resistant Epilepsy. He remains incapable of making treatment decisions. His sister is his Substitute Decision Maker. Mr. Mielke resides on the Beckwith program, the most structured of the units within Waypoint’s high secure perimeter.
Mr. Mielke continues to present as affectively and behaviourally labile. His mental status can change quickly without an apparent cause, from calm and cooperative to hostile and aggressive. He responds to unseen stimuli, and reports hearing God or voices. He often appears more stable in the morning and experiences behavioural dyscontrol during the evening hours. His mental status is monitored continuously.
Mr. Mielke’s behaviour fluctuates from calm and cheerful, to dark and angry. He presents with a bright and cheerful affect when he is more well. His speech is soft, or at times high-pitched. At these times, he makes and maintains eye contact and his body language is relaxed. However, his moods can change quickly. His voice becomes deep, angry and can be loud and pressured. His body language can become rigid. There are occasions when he becomes verbally aggressive, shouting and cursing at staff, making threats to harm or kill them; or he engages in environmental aggression, punching and kicking his door and walls; or he becomes physically aggressive, including striking out, without any seeming precursor.
Periodically, Mr. Mielke will drop to the floor and become non-responsive to staff’s attempts to engage him. Following one occasion, Mr. Mielke told staff, “I was hearing dark voices that became so strong I laid down” … “bad things about when I was abused, so I laid down so that I wouldn’t abuse anyone else in the same way” … “God has showed me wisdom to lay down and shut it off”. He reported that he “waits until it is safe to come back”.
Notably, staff know Mr. Mielke well, and an extra measure of patience is afforded him, given the depth of his illness and otherwise good nature.
Additionally, Mr. Mielke continues to be protective of certain female staff, for reasons unknown. He tends to follow them around, often shouting concerns for their safety. Staff offer reassurance that they are safe, however on occasion his concern for their welfare escalates into behavioural dyscontrol.
Over the past year, Mr. Mielke was secluded on seven occasions. Each are described in detail in the Hospital Report. They occurred in the context of Mr. Mielke become increasingly agitated and threatening toward staff. On occasion, his behaviour triggered a Code White.
Staff have developed and use a Crisis Prevention Plan (CPP) to manage and respond to Mr. Mielke’s behaviours. They have identified certain triggers and are aware that he is sensitive to overstimulation which can lead to him decompensating quickly.
Genetics testing was completed this review period and Mr. Mielke’s medications were adjusted. To date, there has been no material change in his mental status. Mr. Mielke accepts his long-acting injections without issue. However, Mr. Mielke has repeatedly expressed a desire to decrease or discontinue his medication. He has cheeked his oral medications on multiple occasions. Staff have observed that his mental status decompensates quickly following those occasions.
Restriction of Liberty
On September 25, 2025, Mr. Mielke approached a co-patient and suddenly tried to punch him. Staff quickly intervened. Mr. Mielke was escorted back to his room and, given his repeated aggressive behaviour over the preceding weeks, a seclusion order was obtained. His zuclopenthixol injection was increased from every ten days to every seven days.
Staff suspected that Mr. Mielke was not complying with his oral medication. His mental status remained unstable. He was yelling incoherently in his room, and the next day described as staring and not responsive to multiple attempts by staff to engage him.
At Waypoint, seclusion orders are reviewed daily and, to ensure objectivity, secluded patients are seen by an independent psychiatrist (not the patient’s most responsible physician) for review and assessment at the 72-hour post-seclusion mark, seven days post-seclusion, and every 28 days thereafter. Of additional note, secluded patients who are presenting appropriately following assessment of their mental status are provided opportunities for seclusion relief, often for one hour daily; seclusion is generally discontinued when the patient successfully participates in several relief opportunities and when they have returned to their baseline. While secluded, staff check-in with the patient every 15 minutes, often engaging them in brief conversation on those occasions. To assist with passing the time, patients are generally offered independent activities to complete if/as desired in their rooms, including reading books or working on activity sheets.
There were nine occasions when Mr. Mielke was offered and accepted seclusion relief. He tended to shower, and/or attend the outdoor courtyard, participate in group activities or watch television on the unit. On one occasion he declined an offered relief. On two occasions seclusion relief was not available due to operational needs on the unit.
On October 10, 2025, Mr. Mielke was cooperative with staff and interacted appropriately. The determination was made that seclusion was no longer necessary. However, within an hour Mr. Mielke exhibited protective behaviour toward a female staff. When redirected, he stated, “I should stay in my room a few more days. I don’t think I should come out of seclusion.” He reported that he continued to experience harmful thoughts and was struggling to follow staff’s direction. As a result, he was placed back in seclusion.
Over the next couple of days, Mr. Mielke continued to experience an unstable mental status. His olanzapine dose was increased. However, on October 21, 2025, an olanzapine pill was found in his room and another found outside of his room door. Mr. Mielke stated that he did not want to be on medication. Mr. Mielke successfully exercised seclusion relief eleven times. On four occasions he declined offers for seclusion relief and on one occasion it could not be offered due to staffing issues.
Mr. Mielke’s insight into his mental illness vacillates. When well, he appears to have some insight into his risk for violence and will return to his room when he feels overstimulated. However, when he experiences a deterioration in his mental status, his insight into his illness and his risk for violence is poor.
Mr. Mielke continues to receive support from his sister. They periodically speak on the phone and have, on occasion, visited virtually.
Dr. Hudson testified that Mr. Mielke remains in seclusion which remains necessary due to Mr. Mielke’s risk for violence. On two occasions Mr. Mielke attempted to strike someone with a closed fist and, fortunately staff were able to intervene. Dr Hudson reported that Mr. Mielke’s behaviour in those instances is psychotically driven. He does not want to actually harm someone.
Dr. Hudson testified that Mr. Mielke continues to regularly exercise seclusion relief, going onto the unit to watch television and socialize with staff. He also spends a lot of time in his room drawing. He is a very talented artist.
Mr. Mielke continues to be noncompliant with his oral medication, regularly feigning taking medication. As a result, his oral medication recently has been switched to a liquid form. Dr. Hudson has advised Mr. Meilke that his period of seclusion is directly related to his compliance with medication.
When in seclusion, Mr. Mielke’s privileges are capped at C2, which allows for him to go off the ward in the company of staff. This limitation has been maintained due to Mr. Mielke occasionally pretending to fall down and “kind of like a playing possum”. When staff go to assist him, he assaults them. Staff are now cognizant of this possibility, whereas co-patients are not.
In Dr. Hudson’s opinion, the high secure program at Waypoint is the appropriate place for Mr. Mielke at this time. He is comfortable with the staff and enjoys interacting with them. Staff similarly enjoy him, and they are acutely aware of his risk for violence and are able to manage that risk. When Mr. Mielke raises his fist or threatens staff, he can be persistent in that behaviour and be on a trajectory to act on those thoughts. As a result, it is critical that he be supported by staff that know him well and are able to manage his risk to others.
Were Mr. Mielke to be in a less secure facility, he would likely have fewer and more restricted privileges. He would not have the same staff ratio and therefore would not be able to avail himself of the same number of activities.
Dr. Hudson indicated that Mr. Meilke’s behaviour fluctuates dependent on his compliance with his medication. Mr. Meilke is very adept at pretending to take his oral medication. The treatment team only becomes aware of his noncompliance after Mr. Meilke informs them. When not optimally treated, Mr. Meilke experiences psychotic symptoms that cause him to be aggressive. Dr. Hudson is optimistic that, over the coming year, Mr. Meilke will receive his medication consistently which will in turn, result in the conclusion of his seclusion.
At the conclusion of the evidence all parties were in agreement on the issues of the restriction of liberty, that the threshold for significant threat had been met, and the necessary and appropriate disposition.
Analysis and Conclusion
Significant Threat
The panel carefully considered the Hospital Report and the evidence of Dr. Hudson and unanimously concluded that Mr. Meilke remains a significant threat to the safety of the public. Mr. Meilke’s risk flows from his diagnosis of Treatment-Resistant Schizophrenia. The underlying index offence is extremely serious and included significant violence with the use of a weapon.
Mr. Meilke continues to present as behaviourally labile. His mental status can change quickly without an apparent cause. This has occurred multiple times over the review period where, despite presenting as calm and co-operative, he quickly became angry, loud, and physically aggressive with little warning. His aggression has been directed at both staff and co-patients. Over the course of the last year, multiple periods of seclusion have been required to manage his risk. As such, he remains a significant threat to the safety of those on his unit, both staff and co-patients.
Necessary and Appropriate Disposition
The panel also has unanimously concluded that the necessary and appropriate disposition is a continuation of the current detention order. Mr. Meilke currently is in seclusion in one of the most structured units within the high secure program at Waypoint. Mr. Mielke continues to exhibit fluctuating moods and threats of violence towards staff. Notwithstanding that, he is able to enjoy regular seclusion relief and is able to go off the unit when in the company of staff. These privileges would not be available at a less secure facility with a lower staff to patient ratio.
The treatment team like working with Mr. Mielke. They know him well and exercise great skill, professionalism and patience when managing his mental deterioration. They are to be commended for their work.
The panel shares Dr. Hudson’s optimism that Mr. Mielke will become compliant with his medication and enjoy longer periods of mental stability, whether that compliance arises from a change to liquid form, the introduction of a new medication, improved insight, or a combination of the three.
Restriction of Liberty (September 25, 2025, to the hearing date)
With respect to the decision to seclude Mr. Meilke on September 25, 2025, the panel unanimously concluded that it was necessary and appropriate and represented the least restrictive and least intrusive measure available to manage his risk to others on the unit. Mr. Meilke had experienced significant fluctuations in his mental status and was repeatedly acting in an aggressive manner, requiring a number of periods of seclusion leading up to that day. On September 25, 2025, he attempted to punch a co-patient and fortunately the staff were able to intervene quickly. In the circumstances, it was necessary to place him in seclusion.
Mr. Meilke has remained in seclusion due to his continuing noncompliance with medication. He continues to experience psychotic symptoms and has continued to demonstrate aggressive and threatening behaviour. As such, seclusion remains necessary and appropriate and represents the least onerous and least restrictive measure available to the hospital to manage his risk.
Conclusion
- In conclusion, the panel accepts that Mr. Mielke remains a significant threat to the safety of the public. He continues to require the highest level of support and structure available within the high-risk program at Waypoint, which also is able to provide him with liberties commensurate with his risk. In arriving at this conclusion, the panel has considered the paramount factor of public safety, Mr. Mielke’s community reintegration, his mental condition and his other needs, all as required by s. 672.54 of the Criminal Code.
DATED this 13th day of January 2026, at the City of Toronto, in the Toronto Region.
Ms. C. Finley
Alternate Chairperson
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Office of the Registrar
Ontario Review Board