Re: Joseph A. Scott
ORB File No: 8661
Hearing held on: Wednesday, December 3, 2025
Place of Hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus
Pursuant to: Sections 672.48 (1) and 672.81 (1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks
Members: Dr. M. Attia Dr. P. N. Wright Mr. E. Siebenmorgen Mr. A. Mete
Parties Appearing:
Accused: Joseph A. Scott Counsel: Mr. A. Confente
The person in charge of hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Ms. C. Gzik
REASONS FOR DISPOSITION (Dated January 2, 2026)
Introduction
On October 18, 2024, Joseph Scott, who is now 27 years old, was found unfit to stand trial on charges of theft under (x2), failing to comply with a probation order (x5), fail to comply with a release order, and failing to comply with an undertaking. The offences covered the period from April 4, 2024 to July 27, 2024. Mr. Scott had previously been admitted to St. Joseph’s Healthcare Hamilton, West 5th Campus (“SJHH” or “the Hospital”) to the forensic Assessment Unit, pursuant to a treatment Order on August 28, 2024 as a result of an earlier finding that he was unfit to stand trial on August 22, 2024.
Mr. Scott was most recently subject to a Disposition of the Ontario Review Board (“ORB” or “the Board dated December 20, 2024 pursuant to which he was ordered detained at the Forensic Psychiatry Program of the Hospital, subject to various conditions and privileges, up to and including accompanied access to the community of Hamilton.
On Wednesday, December 3, 2025, a panel of the Board convened in person at the Hospital to inquire into Mr. Harding’s current condition and to determine: (a) whether Mr. Scott is fit to stand trial and must therefore be returned to court; and (b) if Mr. Scott is unfit, the necessary and appropriate Disposition that is also the least onerous and least restrictive, having regard to the factors in s. 672.54 of the Criminal Code. Mr. Scott was present and represented by counsel, Mr. Confente.
The evidence at the hearing consisted of the Hospital Report dated November 7, 2025 (the “Hospital Report”) and the oral evidence of Dr. A. Courtright, who has been Mr. Scott’s attending psychiatrist since the fall of 2024.
Positions of the Parties
- At the start of the hearing, counsel for the Hospital, supported by counsel for the Attorney General, took the position that Mr. Scott remained unfit to stand trial and that the necessary and appropriate Disposition was a continuation of the Detention Order on the existing terms and conditions, subject to the following amendments:
- to expand the geographical scope of Mr. Scott’s escorted and accompanied community privileges to include all of Southern Ontario;
- to add indirectly supervised community passes for up to seven (7) days within the catchment area of SJHH;
- to add community living in approved accommodation, within the catchment area of SJHH; and
- to add a reporting term of at least four times monthly while living in the community.
Mr. Confente advised that he was unable to obtain instructions from Mr. Scott.
All parties maintained their respective positions at the conclusion of the evidence. As a result of some questions at the hearing as to whether the community living privilege should specify “supervised” accommodation, Mr. Confente submitted that it was not necessary to limit the Hospital’s options in this regard.
Findings
- For the following Reasons, the panel concluded that Mr. Scott remained unfit to stand trial as of the hearing date. The panel found that the necessary and appropriate Disposition is a Detention Order on the terms and conditions specified in the initial Disposition, with the modifications identified as above.
The Index Charges
- The allegations surrounding the index offences are found in the synopses that form part of the Record for the hearing, which have been reproduced at pp. 2-7 of the Hospital Report. As the Hospital Report is in evidence, and since the allegations remain unproven, it is not necessary to reproduce them in these Reasons. By way of introduction, Mr. Scott was at the time of the allegations subject to a probation order dated January 24, 2024. In very general terms, the allegations include:
- On April 4, 2024, Mr. Scott was located inside the Shoppers Drug Mart located at 320 Colborne Street West, Brantford, in breach of his probation order;
- On April 18, 2024, Mr. Scott again attended inside the Shoppers Drug Mart located at 320 Colborne Street West, Brantford, in breach of his probation order;
- On April 21, 2024, Mr. Scott attended the Shoppers Drug Mart at 225 Fairview Drive, Brantford, where it was alleged that he was yelling and screaming at staff and customers. His January 24, 2024 probation order prohibited from attending at that location. By this time, he was also bound by an Undertaking with a condition that he not attend at any Shoppers Drug Mart stores in Brantford;
- On May 8, 2024, Mr. Scott stole a case of Coca Cola from a convenience store. His probation order directed him to keep the peace and be of good behaviour, and he was charged with both theft and breach of probation;
- On May 9, 2024, Mr. Scott entered the Shoppers Drug Mart at 320 Colborne St. in Brantford, in contravention of both his probation order and a judicial Release Order no to attend any Shoppers Drug Mart stores in Brantford. He stole deodorant and candy. He was therefore charged with theft, failing to comply with probation, and failing to comply with a Release Order;
- On July19, 2024, Mr. Scott entered the Shoppers Drug Mart at 269 Clarence Street in Brantford and stole several items that he concealed in his clothing. He was charged with theft and failing to comply with his probation order arising out of this event; and
- On July 27, 2024, Mr. Scott again entered the Shoppers Drug Mart at 269 Clarence Street in Brantford and on this occasion stole a hair straightener. He was again charged with theft and failing to comply with his probation order.
Background Information
Mr. Scott’s personal and family background, his substance use and psychiatric histories, and his criminal record are detailed in the Hospital Report. As the Report is in evidence, the information contained therein need not be summarized for the purpose of these Reasons. For the purpose of providing helpful context, the overview from last year’s Reasons for Disposition, with minor variations, is reproduced below:
Mr. Scott was raised by his mother and grandmother. It is reported his father left the home when Mr. Scott was an infant and he has met him only once. His father and brother have substance abuse histories. His mother relocated to Nova Scotia approximately 6 months prior to the hearing date [of December 19, 2024].
Mr. Scott began using cannabis and crystal methamphetamine at the age of 14, which progressed to daily use of crystal methamphetamine. It is reported that he changed as a result of his substance use and moved out of the home at the age of 16.
Mr. Scott had achieved some grade 12 credits at school but then dropped out.
He has a criminal record, mostly for offences of failures to comply with court orders. There are convictions of note in 2023 for indecent act and robbery. Mr. Scott has been issued probation orders, one of which is reflected in the current multiple alleged index offences charges of Fail to Comply (FTC) probation and which probation order remains in effect until January 24, 2025.
Mr. Scott showed psychotic symptoms and was first admitted to hospital in 2020 at which time he was diagnosed with substance-induced psychosis. He has had several further admissions to hospital in Brantford, including one in 2020 after he was evicted from his supportive living residence after setting fire to the apartment.
He was given, in 2021, a provisional diagnosis of schizophrenia. He was referred to and followed by the Rapid Access Addiction Clinic in Brantford. He was found incapable with respect to treatment decisions and his mother acted as his substitute decision maker (SDM). Mr. Scott was treated with long-acting injectable antipsychotic medication as well as antidepressants. In September 2021, he refused to continue with his injectable medications, complaining that it made him angrier and more depressed and that he preferred the use of crystal methamphetamine.
Course During the Current Reporting Year
- Mr. Scott is incapable to make treatment decisions, and his mother is his substitute decision maker (SDM). He is financially capable. His current diagnoses are:
- schizophrenia;
- stimulant use disorder (in remission in a controlled environment); and
- opioid use disorder (in remission in a controlled environment).
Mr. Scott was behaviourally more regulated over the past reporting year than he was prior to his initial Board hearing in December of 2024. However, the Notable Incidents listed in the Hospital Report describe several occasions when he threatened to harm others and/or made sexually inappropriate comments directed to staff.
Mr. Scott is reported to have been consistently co-operative with medication administration and the required monitoring, including clozapine related bloodwork. His psychotic symptoms are, however, very treatment resistant. He frequently expresses bizarre thoughts and ideas, when by himself or around others, randomly saying words or thoughts that are not related to any conversation that is being discussed at the time. He continues to experience ongoing auditory hallucinations and can often be seen pacing the hall or his bedroom having a full conversation in response to internal stimuli. He frequently responds to internal stimuli out loud, making comments that are nonsensical or inappropriate. He endorses that auditory hallucinations are distressing at times, stating that the voices are "arguing", "being mean", or "making fun" of him, or that the voices tell him to "kill myself". There are times when the auditory hallucinations are commanding, but he denies the urge to follow through on these commands. He accepts redirection most of the time, although his insight regarding his inappropriateness is characterized as poor. He often seeks out staff support and as-needed medication when distressed.
In terms of therapeutic activities, Mr. Scott has reportedly been highly engaged in therapeutic recreation programming. During group recreational activities, he has been respectful and cooperative with both staff and co-patients, although at times his thought process has tended to be disorganized, he has made inappropriate comments and has often been observed responding to internal stimuli. Mr. Scott was unable to engage meaningfully in structured Occupational Therapy programs due to his ongoing disorganization and preoccupation with internal stimuli. However, in September of 2025, he participated in some rudimentary teaching about the forensic system. While he demonstrated a limited appreciation of the information, he attempted to listen and understand it and follows general unit rules.
The Hospital Report notes that although community living was not included in Mr. Scott’s Disposition, the process of applying for housing was initiated due to the lengthy waitlists. On September 18, 2025, Mr. Scott successfully submitted an intake procedure for SOAR Community Services for supportive housing. Mr. Scott expressed a wish to find housing in Brantford.
The following extract from Mr. Scott’s Clinical Risk Summary provides an overall assessment of his first reporting year under the Board’s jurisdiction:
Despite treatment, Mr. Scott has exhibited a limited response, and symptoms of mental illness remain prominent. His insight into his diagnosis, violence risk and need for treatment remains absent. Despite this, he complies with medication on substitute consent. Given his persistent and severe psychosis, he exhibits ongoing cognitive, affective, and behavioural instability, which although improved, is still characterized by responding to internal stimuli, disorientation and disorganization, and disinhibition. However, to his credit he has been largely compliant with rules and expectations, with no incidents of violence.
In terms of risk management items Mr. Scott is anticipated to remain in hospital on a detention order where he will continue to have access to the clinical team, which can provide support and supervision in a way that is responsive to his mental status and risk needs. His mental status precludes meaningful engagement in professional plans and programming to reduce risk at this time, and his capacity to identify and cope adaptively with stress independently is largely unknown.
Testimony of Dr. Courtright at the Hearing
Dr. Courtright began her evidence by addressing Mr. Scott’s fitness to stand trial. She testified that she most recently assessed his fitness on December 1, 2025, two days before the hearing. She described Mr. Scott as calm, cooperative, and polite. He appeared happy to engage in the assessment and put good effort into the process.
During the assessment, Mr. Scott presented with ongoing thought blocking, indicating that he was internally preoccupied. His thinking process was disorganized and he exhibited loose associations. He experienced hallucinations and struggled to provide answers to Dr. Courtright’s questions.
Dr. Courtright stated that Mr. Scott has been provided with significant psychoeducation about the court process. This included the provision of information sheets, which he has studied.
Dr. Courtright testified that her assessment left her with significant concerns about Mr. Scott’s abilities to attend to evidence, to instruct counsel, and to communicate meaningfully. She also did not think that he could understand the consequences of his plea options, though he could understand that there were plea options available to him.
Dr. Courtright advised that Mr. Scott was able to understand the meaning of an oath and that it is wrong to lie in court. He was also able to use the names of the key personnel in court, though he did not understand their respective roles.
Dr. Courtright’s overall opinion was that Mr. Scott remains unfit to stand trial. His cognitive disorganization prevents him from being able to meaningfully participate in the trial process. His significant cognitive impairment impacts his executive functioning, including his ability to hear, integrate, retain and act on information. In her opinion, this impairment is secondary to his major illness. In addition, when actively engaged, he will still blurt out comments in response to internal stimuli. He will engage in full-blown conversations with himself and experiences clearly distressing hallucinations. The doctor stated that when interviewed, Mr. Scott presented as cognitively overwhelmed and with impulsive interruptions. He required considerable redirection to provide relevant answers to the questions posed to him.
Dr. Courtright stated that in her opinion, there has been progress in relation to Mr. Scott’s fitness to stand trial over the past reporting period. However, his degree of symptomatology still interferes in a significant way. In response to questions from Mr. Confente, she stated that in her opinion, neither the recreational therapy team nor the use of technological aids could help bring about the bring about the changes necessary for Mr. Scott to become fit to stand trial. In consultation with his mother as SDM, however, Dr. Courtright is considering adding amisulpride to work in combination with Mr. Scott’s clozapine, the dosage of which she cannot increase further.
Turning to Mr. Scott’s general presentation and course during this reporting period, Dr. Courtright said that the treatment team has seen a marked improvement in Mr. Scott. He was extremely unwell while residing on the Assessment Unit and he had been quite symptomatic for some time. There has been what the doctor characterized as a striking improvement in Mr. Scott’s level of agitation and irritability, and he is now very directable. However, Mr. Scott is frequently internally distressed by his symptoms.
Overall, the doctor said, Mr. Scott has experienced a positive year: he is social, respectful, interacts well with staff, seeks out staff support, is adherent to his medications, and is able to seek out as-needed medications from staff. He has been able to meet with his mother and keeps in touch with her.
Mr. Scott had been exercising indirectly supervised hospital privileges, on the secure side of the building, for several months without incident. Those passes were cancelled for a time in October of 2025 following an incident on October 15 when he threw water, unprovoked, on a co-patient. He reported having done so in response to a command hallucination to harm that co-patient. For the next week or two, he reported hearing command hallucinations to harm others. In response to Mr. Scott’s reports of these command hallucinations, his indirectly supervised privileges were held, as the team wished to see a period of behavioural stability before he used such privileges. There were no further issues thereafter. To date, Mr. Scott has only used escorted and accompanied community passes for medical appointments.
Dr. Courtright addressed the Hospital’s proposed changes to Mr. Scott’s Disposition. She was in favour of extending his escorted and accompanied community privileges to Southern Ontario. In response to a panel member’s questions, she explained that the expansion of these privileges, and the provision of seven-day passes, were for the purpose of enabling Mr. Scott’s gradual transition to appropriate housing, including in the Brantford community.
Dr. Courtright also supported the addition of a community living privilege, since the waitlist for supportive housing is lengthy. She was clear, however, that she considered it unlikely that Mr. Scott would be able to move out of the Hospital in the coming year, given his clinical presentation. In this regard, she referred the panel to the risk factors in the Clinical Risk Summary (Hospital Report, p. 28). Dr. Courtright stated that she would want to be confident that Mr. Scott could manage indirectly supervised community privileges before considering his discharge. One significant concern is his substance use history. He reports ongoing cravings to use substances. The doctor stated that Mr. Scott will be encouraged to engage in substance use counselling once his active psychotic symptoms are more controlled.
Dr. Courtright offered the opinion, in response to a panel member’s question, that Mr. Scott would likely require some form of supervised housing. She did not think he would necessarily require 24-hour supervision, however, and stressed that the Hospital would only discharge Mr. Scott to a housing setting that it considered to be safe.
No further evidence was led following Dr. Courtright’s testimony.
Analysis and Conclusions
Fitness to Stand Trial
The panel was satisfied, on the evidence in the Hospital Report, supplemented by the expert opinion and observations of Dr. Courtright, that Mr. Scott remained unfit to stand trial as of the hearing date. Dr. Courtright had recently (two days before the hearing) assessed Mr. Scott’s mental condition in accordance with the statutory fitness test.
Mr. Scott suffers from a serious mental illness, schizophrenia. His symptoms are very resistant to treatment. With antipsychotic medication, there has been improvement in Mr. Scott’s symptoms, reflected in significantly improved behaviour. He is far less agitated and irritable than he was prior to the administration of clozapine. However, his thought process remains disorganized and tangential, with loose associations, and he continues to experience hallucinations that cause him to be internally preoccupied.
As Dr. Courtright testified, Mr. Scott’s illness has produced significant cognitive impairment and disorganization that prevents him from being able to meaningfully participate in the trial process. This has impacted, and continues to impact, his executive functioning: his ability to integrate, retain, and act on information that he receives. The panel accepts this evidence. In addition, Dr. Courtright voiced her opinion, based upon her recent assessment, that Mr. Scott could not understand the consequences of his plea options. A consideration of this evidence, taken as a whole, precludes the panel from forming the opinion that Mr. Scott is now fit to stand trial.
That said, we note, along with Dr. Courtright, that Mr. Scott has made some improvements over the past reporting period that bring him closer to being able to conduct a defence. Mr. Scott has demonstrated a cooperative attitude and meaningful engagement in the efforts of Dr. Courtright and her team to provide psychoeducation on the court process. There is also a potential for a change to the medication regimen, and if this is successful in reducing Mr. Scott’s most serious and active symptoms, he may be able to move toward a reality-based comprehension of the court process so that he can conduct a defence or instruct counsel to do so. The panel is hopeful in this regard.
The Necessary and Appropriate Disposition
The panel had no hesitation in finding that the necessary and appropriate Disposition is a Detention Order. There is simply no air of reality to a Conditional Discharge, the only available less restrictive Disposition permitted by s. 672.54 of the Code. Mr. Scott is simply not yet ready to be safely discharged into the community.
Although Mr. Scott’s current mental condition prevents him from being safely discharged to community living at the present time, if his condition continues to improve and stabilize with the passage of time and optimized treatment, there is no reason not to plan for his eventual reintegration. As noted in the evidence, Mr. Scott would like to eventually live in the Brantford community and waiting lists for supportive accommodation are lengthy. While Mr. Scott may well require some form of supervised accommodation, the panel finds it unnecessary to specify this in the Disposition. This is a matter more properly to be determined on evidence, following the completion of the requisite assessments of Mr. Scott’s needs.
The expansion of Mr. Scott’s existing privileges to the geographical area of Southern Ontario is for the purpose of allowing him to attend at potential housing facilities to assess their suitability. In this regard, the indirectly supervised privileges would be to accommodate a leave of absence to a community residence on a pre-discharge trial basis.
The panel therefore found that the necessary and appropriate Disposition, having regard to Mr. Scott’s mental condition, eventual reintegration into the community, and his other needs, is a Detention Order on the same terms and conditions as found in the previous Disposition, with the modifications noted, including community living in approved accommodation. This Disposition is necessary, in keeping with the panel’s paramount obligation to protect public safety.
DATED this 2nd day of January 2026, at the City of Toronto, in the Toronto Region.
Eric Siebenmorgen Legal Member
Office of the Registrar Ontario Review Board