Ontario Review Board
Re: Chad Fraser
ORB File No: 8624
Hearing held on: January 29, 2026
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas ON
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. R. Bigelow
Members: Dr. J.M. Bradford Dr. L.O. Lightfoot Ms. K. Tomaszewski Ms. B. Little
Parties Appearing:
Accused: Chad Fraser Counsel: Mr. P. de Jong
The Person in charge of Hospital: Counsel Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DISPOSITION
(Dated February 27, 2026)
Introduction:
The accused, Chad Fraser, was found not criminally responsible (“NCR”) on August 9, 2024, on a charge of break and enter a dwelling house, contrary to the Criminal Code of Canada (the “Code”). He is subject to a detention order under a Disposition dated June 3, 2025, with privileges that extend to living in the community of Southwestern Ontario in accommodation approved by the person in charge.
The index offence occurred on August 12, 2022. Mr. Fraser was the subject of an appearance notice for the index offence and was not bound by any conditions of release. He resided in the community following the NCR finding. He remained living in the community until February 26, 2025, when he was admitted to the Southwest Centre for Forensic Mental Health Care (the “hospital”). He has remained in the hospital since that time.
On January 29, 2026, a panel of the Board convened a hearing to review Mr. Fraser’s disposition pursuant to section 672.81 of the Code. The issues to be determined by the Board were whether Mr. Fraser constituted a significant threat to the safety of the public as defined in section 672.5401 of the Code and, if so, what was the necessary and appropriate disposition which was also the least onerous and least restrictive taking into account the factors set out in section 672.54 of the Code.
Mr. Fraser attended the hearing and was represented by his counsel, Mr. P. de Jong.
The Board had before it the Record; a Hospital Report dated November 21, 2025, marked as Exhibit 1; and the oral testimony of Dr. A. Malka, Mr. Fraser’s attending psychiatrist, who adopted the contents of the Hospital Report.
Position of the Parties:
At the outset of the hearing the parties were asked for their initial recommendations. Counsel for the hospital submitted that Mr. Fraser poses a significant threat to the safety of the public, and that the necessary and appropriate disposition is a continuation of the current detention disposition with no changes.
Counsel for Mr. Fraser submitted that Mr. Fraser did not pose a significant threat to the safety of the public, but that if the Board so found, the necessary and appropriate disposition is a continuation of the current detention disposition.
Counsel for the Attorney General adopted the hospital’s position.
All parties maintained their original positions at the conclusion of the hearing.
Findings:
- For the Reasons that follow, the panel found that the threshold for significant threat is met, and that the necessary and appropriate disposition is a continuation of the current detention disposition with no changes.
Index Offence:
- The allegations giving rise to the index offence are excerpted from last year’s Reasons for Disposition as follows:
On the 12th of August 2022, police were dispatched to a mischief call at T[…] St. E in the town of Blenheim. The complainant advised that someone had thrown a rock into an apartment T[...] and was climbing through the window. Police arrived on scene and located broken upper and lower pane of the exterior window to unit […], the residence of the victim. Police spoke to the witnesses of the event and three of the witnesses were able to positively identify the accused as the person they had seen breaking the window, enter, in or exit the apartment. Police looked at the balcony of the accused who was standing on his balcony at the time. They asked him if he had a minute to speak and he said he would come right down.
Police met the accused in the front of the building and arrested him. Police read the accused his constitutional rights and upon stating he understood he then began to tell police that he needed police to contact Arnold Schwarzenegger, he was his lawyer of choice. He continued to advise that he was innocent as he was acting on behalf of the United States Marshalls and they were the ones to tell him to get into the apartment as he had a .357 Magnum hidden in a safe under his coffee table.
Police contacted dispatch and informed them that the incident would now be a mental health call and brought Mr. Fraser to the hospital. Dr. Paizza issued a Form 1 for a psychologist assessment to be completed. Mr. Fraser was discharged from the hospital on August 21, 2024. He was later arrested and released on an appearance notice.
- Mr. Fraser’s self-report of these events is described by Dr. W.J. Komer in the January 5, 2024, NCR Assessment Report as follows:
Regarding the August 12, 2022, incident, Mr. Fraser said that he had not consumed any alcohol or drugs and had probably taken his medications that day. He referenced there being a “main frame” and satellites from space being linked to computers and tablets. Mr. Fraser stated, “It’s in the electrical control room. I wanted it turned off completely” so it couldn’t harness connections into it. He said that there was a “sound frequency thing” which was “making me deaf.” Mr. Fraser told me that there was a “sound tower aimed at my apartment” which was “violating my safety and privacy rights.” He stated, “I broke them out because I had to,” “They can kill people with these things. You got to look into it,” “Seemed like they were trying to kill me with pressure,” “I went in there to save my life,” “I couldn’t find anything, so I left,” “I found nothing, so I left,” “I didn’t care. Saving my life” and “My only intent to go in there was to turn off a switch to shut this down.” Mr. Fraser said that he wanted to stop being suffocated. He referenced pressure being around his head and nothing being done about it. When I asked him if other people would have done what he did if they had known what he knew, he replied, “I sure hope so.” Mr. Fraser explained that he tried to locate the device, shut it off, dismantle it, give it to the FBI as evidence and for them to be arrested. He referenced wanting to get access to the internal memory of the main frame to get the evidence and to do something before the system killed people. Mr. Fraser stated, “They still haven’t done it yet. It’s still running.” He said that he does not know where it is now, and it is no longer impacting him. Mr. Fraser told me that they had to remove him from the building so they could do repairs to his apartment. He said that he “definitely” tried to save other people’s lives and not just his own. Mr. Fraser told me that he wanted Arnold Schwarzenegger called because he is “an authority figure.” He said that he does not recall saying anything about the US Marshalls or a gun being in a safe. Mr. Fraser stated, “I’m on the side of good.” He reported that he was not too sure if he felt he would have been charged. Mr. Fraser said that all I have to do is get information from the internal memory. He referenced Bill and Melinda Gates being involved. Mr. Fraser expressed a belief that the judge will throw it out or pardon him “because I’m pretty not guilty with anything I did.” He reported that he did something good. Mr. Fraser said that he told the man why he went through his window and apologized to him.
Background Information Regarding the Accused:
Mr. Fraser was born in Chatham and had a normal birth and development. He has a younger full brother, three older stepbrothers and an older stepsister. His father died in 2019. His mother is still alive and is a personal support for Mr. Fraser.
Mr. Fraser has a grade 9 education. He “probably” had an Individualized Education Plan (IEP). He self reports that he was suspended for fighting and expelled for truancy. Mr. Fraser participated in sports and volunteered.
Mr. Fraser reported that he displayed “a little bit” of behaviour problems as a youth including stealing, fighting, lying, truancy, running away from home, fire setting, vandalism, and defiance.
Mr. Fraser has a previous criminal record. He has convictions in February, April and July 2003 for offenses which include forcible confinement, attempting to obstruct justice and failing to comply with a recognizance.
Mr. Fraser has worked as a general labourer and in farming. He volunteered for the government years ago when he was on Ontario Works. He last worked “a long time ago.” He has been on ODSP for fifteen to twenty years.
Mr. Fraser has never been married or been involved in any common-law relationships. He has no children. Mr. Fraser does not currently have a partner. He identifies his mother; a brother and a few friends as supports.
Mr. Fraser’s mother was interviewed on December 10, 2024. She reported that she lives 15 minutes away from Mr. Fraser by car and only sees him for his injections. He was banned from her apartment building because he verbally threatened one of the tenants, which is why she only had contact with him when he gets his injections.
After the index offence, Mr. Fraser lived in Blenheim. From October 2023 to May 2024, he was homeless, stating, "I slept in banks, and crashed on couches.” From May 2024 to October 2024, Mr. Fraser reported that he was living at a friend’s place; however, he had a conflict with him which required him to move. After October 2024, Mr. Fraser lived in another friend’s house. When asked whether he was comfortable living in his current situation, he replied stating, "I don’t know if there are devices in my house; but I won’t’ tear apart the walls because I don’t want to jeopardize my living situation."
Mr. Fraser accessed the local food bank and soup kitchen.
Mr. Fraser was interviewed at the Southwest Centre on December 10, 2024. As noted in the Report at pages 12 – 13:
During the interview, Mr. Fraser was cooperative; however, he presented with pressured, rapid speech, and delusional thought content, which was persecutory in nature, generally involving electronics, devices and lasers recording or interfering with him. Thought form was tangential, with client in most cases able to initially answer the questions partially, before adding statements that often were delusional in nature. When asked, he denied any delusions, paranoia, or visual hallucinations. When asked about voices he experiences, he replied, "they are stuff that's voiced out around my head, it has to do with psychological testing or accessibility or something like that." When asked if they were male or female, he replied "Whatever it wants, it does not have a name." Mr. Fraser reported that the last time he tried to talk to his voice was yesterday, stating "I asked the question, what are you a part of, and it wouldn’t say anything." He initially denied that the voices tell him to do things but then stated that, ‘they sometimes tell me to kill myself in irritating sounds". He said that he has never followed through on any of their instructions and never will. During the interview, he intermittently added tangential statements such as "It’s a government house; I’m pretty sure there's a speaker behind the wall that someone could wirelessly tap into; I think the hydro company has something to do with it, when they get fed into those lines; its Hydro impulse to reflex."
When asked, Mr. Fraser described his mood as "Good, a 10/10, " with a mildly blunted affect. He denied any thoughts of self-harm, suicidal ideation, violent ideation or any accompanying intent or plan, and he denied any suicidal attempts. In terms of self-harm, Mr. Fraser ported that he engaged in superficial cutting at age 12 or 3, "lots of self-withdrawal, the only time I would resort to cutting was so I could vent my aggression and so I wouldn’t cause anyone else harm." When Mr. Fraser was asked about any historical legal issues, he denied any issues with violent interactions with the law since December 2023. Upon further questioning; however, he stated, "In October, the police met with me and gave me a trespassing document for housing buildings and the post-office.” When asked whether he identified as someone that breaks the law, he replied, "No. i would rather help enforce it."
Psychiatric History:
Mr. Fraser was diagnosed with schizophrenia. Dr. Malka, Mr. Fraser’s attending psychiatrist told the panel that she has revised the diagnosis to schizoaffective disorder. Mr. Fraser has also been diagnosed with substance use disorder (in remission in controlled environment), with a history of using crystal methamphetamine, cannabis, and alcohol.
Mr. Fraser was in his early 30’s when he had his first contact with psychiatry, and was under the care of a psychiatrist as early as 2010. After the index offence, Mr. Fraser had approximately four psychiatric admissions from 2022 to 2023.
During an admission in October 2022, Mr. Fraser left the hospital on a day pass and did not return. Following a discharge on January 26, 2023, Mr. Fraser failed to attend CMHA for his long-acting injection.
During an assessment in February 2023 by Dr. Oyebode, Mr. Fraser reported that wires in his home were affecting him. He wanted to return home to ensure that the superintendent switched off the machine which was causing his symptoms. Mr. Fraser said that this had nothing to do with his continued use of crystal methamphetamine, which he denied using, but was detected in his urine. He insinuated that a spirit was involved in salt being on his food without his knowledge.
During that same admission, after Mr. Fraser went on a fresh air pass, his urine tested positive for amphetamines, he remained unpredictable and chronically delusional, he did not want to stay in hospital, and he wanted to be discharged. His prognosis was noted to remain poor because he would continue using crystal methamphetamine.
Dr. Awoniyi assessed Mr. Fraser on July 11, 2023. He was stable but still had delusions about electromagnetic fields. He was diagnosed with schizophrenia, a substance related psychotic disorder, and a substance use disorder-methamphetamines and amphetamines.
On September 11, 2023, Mr. Fraser saw Dr. Awoniyi again. He reported that he continued doing well but had chronic delusions about electromagnetic fields and continued talking about conspiracy theories. Mr. Fraser talked about notifications through the speaker system in his apartment and viruses in the computer system. He said that his apartment was due to be renovated the following week, during which time, he would be staying with his mother or cousin. Mr. Fraser reported that he had not used any crystal methamphetamine in a long time and was aware that it affects his mental health and would never use it again. He was diagnosed with schizophrenia, a substance related psychotic disorder, and a substance use disorder-methamphetamines and amphetamines. Mr. Fraser was prescribed Invega Sustenna 100 mg by injection every four weeks, Zyprexa 10 mg at bedtime and Clonazepam 1 mg at bedtime.
During the team’s interview with Mr. Fraser’s mother on December 10, 2024, she reported that Mr. Fraser’s delusions and his anger had "gotten increasingly worse" over the past year or so. In terms of anger, she mentioned that Mr. Fraser had broken a chair in her house; and punched her windshield out because he thought there were spirits in her car.
At page 14 of the Report,
Mr. Fraser’s mother reports that he had vaguely stated he wanted to kill some family members when he gets annoyed with them in the moment. She also reported that he will make comments that he wanted to kill himself when he gets dysregulated, but never mentioned any method or rationale for doing either. She denied that Mr. Fraser ever committed violence towards another person or to her. Finally, she also reported that she does not feel like Mr. Fraser is a threat currently, but added "If things don’t go his away, he will get aggressive, but he has never laid hands on me yet."
Regarding other psychotic symptoms, Mr. Fraser’s mother mentioned that she sees him talk to himself a lot but that he never tells her what the voices were telling him to do. Instead, she reported that Mr. Fraser believes these voices are giving him information on things. Regarding substance use, she reported that "he says no, but at times I think he’s been using". When asked why she thinks so, she replied "I don't know, you just sense it, he goes through money like crazy."
Finally, regarding support systems, Mr. Fraser’s mother reported that she was his main support along with a friend Harold, and another person named Bev that he goes to church with. She denied having any knowledge of Mr. Fraser presenting to the emergency room or being hospitalized for his mental health in the past year. When asked whether he has had any issues with the law in the past year, she replied that she did not know, as Mr. Fraser does not tell her everything.
- Dr. Malka confirmed that Mr. Fraser has poor insight across all spheres. When asked about the index offence, he continued to state that he had no intention of hurting anyone and that his actions were justified. He believes that he does not have a mental illness, and does not need a psychiatrist. He has poor insight into his need for medications. When asked if he would reoffend in the future, he stated, “I don’t know.”
Evidence at the Hearing:
Dr. Malka told the Board that when Mr. Fraser was admitted to the hospital, he was exhibiting symptoms of mania and delusional thoughts.
The mania is currently controlled, but the delusional thoughts remain.
Mr. Fraser is incapable of consenting to treatment of his mental disorder and his mother is his substitute decision maker.
Since the Hospital Report was prepared, changes have been made to Mr. Fraser’s medication to address mania. Clozapine was added in October 2025, but it is not yet at a therapeutic level, and the dose continues to be increased.
While Mr. Fraser has been adherent to his medications in the hospital, he requires supervision. He says he will stop the medication if given a choice. He does not believe he has a mental illness.
In Dr. Malka’s opinion, Mr. Fraser’s adherence to medication is externally motivated by the goal of being discharged from the hospital.
Mr. Fraser has not used substances since his admission to the hospital, but as Dr. Malka pointed out, he has not had any privileges to leave the unit so his access to substances has been severely curtailed.
He has remained at a privilege level of 0 for most of the reporting period, although he briefly held level 1 privileges. While holding level 1 privileges he immediately acted against the hospital guidelines, so his privileges were revoked. Level 4 privileges are required before the hospital will investigate putting an approved person in place.
The treatment team has attempted to engage Mr. Fraser in one-on-one therapy and in groups. He declines because of the delusional belief that he will be discharged from the hospital at his ORB hearing. He has believed this would happen at each ORB hearing, and continues to believe this despite continued education by the treatment team, and continued disappointments that he has not been discharged at an ORB hearing. In Dr. Malka’s opinion this is not a hope, but rises to the level of a delusion.
Mr. Fraser remains vulnerable to substance use. He has experienced significant methamphetamine use since age 17 or 18; has no insight into the impact of substance use on his mental status; and refuses treatment for substance use.
Mr. de Jong asked Dr. Malka several questions about Mr. Fraser’s compliance with medications in the community. Dr. Malka indicated that although it is not clear what Mr. Fraser’s adherence was at any given time, he has a history of several involuntary admissions under the Mental Health Act.
When he was admitted to Southwest, he had been difficult to locate for the assessment; did not want to go to the hospital, and maintained his stance that he had no mental illness and did not want to take medications. This stance has not changed.
He has also expressed delusions that medications have been affected by satellites. This also makes it less likely Mr. Fraser will take medications willingly.
When asked to describe Mr. Fraser’s risky behaviour, Dr. Malka responded that Mr. Faser’s response to delusions is unpredictable. He has no insight into the delusions.
He has told his mother that he sometimes does not listen to the command auditory hallucinations, but he believes the delusions. He still speaks about government conspiracies, machines and satellites used to effect internal states or surveil him. Delusions continue to develop.
For example, the week prior to the hearing Mr. Fraser developed diabetes. This is directly related to the Clozapine. He has refused treatment because of the delusional belief that the tools used to diagnose diabetes were designed by the treatment team to harm him, and he does not really have diabetes. He is making treatment decisions based on delusions. The metformin he has been taking is for preventative purposes, and it is no longer adequate. He is not receptive to dietary teaching for diabetes management.
With respect to his ability to live independently, Dr. Malka told the Board that he needs prompting for showers and laundry. He is isolative to his room and does not care for his hygiene. For a period of time, he left fecal smears on chairs. He refused to wear underwear for a few months. This continues to be a concern.
Dr. Malka stated that Mr. Fraser’s mother said that he did this when he was younger when he was upset. According to his mother, this is oppositional behaviour.
Dr. Malka noted that after the index offence, in 2024 Mr. Fraser’s mother was concerned about being hit. The treatment team staff who assessed Mr. Fraser on February 26, 2026, were afraid for their safety.
Significant threat to the public encompasses more than criminal charges for violent behaviour. Mr. Fraser’s risk factors have not been addressed. His medications have not been optimized. He remains vulnerable to substance use and does not wish to engage in rehabilitation treatment programming. He is externally motivated to take medications, does not believe he needs them, would not continue to take them if given the choice. He has historically demonstrated variable compliance with medications.
He has historically demonstrated emotional dysregulation, screaming, destroying property and making statements about killing family members. He recently ended interactions early and angrily with a general practitioner and a pharmacist. When he is emotionally dysregulated, his response to his delusions is less controlled.
Much work needs to be done before Mr. Fraser will be able to enter the community. His medications need optimization. He needs to engage in programming and assessment so that the treatment team can understand how to provide support for his progress. It is premature even to consider approved persons.
His risk to the public cannot be managed other than under a detention disposition.
No further evidence was provided.
Closing Submissions:
All parties maintained their original positions.
Ms. Zamprogna submitted for the hospital that Mr. Fraser poses a significant threat to the safety of the public. His delusions are ongoing and similar to his presentation at the time of the index offence. He has a history of treatment non-adherence. Treatment has been only partially effective, and has not been optimized. His substance use has not been addressed, and this has contributed to several admissions since the index offence. His insight across all spheres is underdeveloped. He has refused to participate in therapeutic programming and the privilege level system. The HCR-20 (V. 3) indicates a low to moderate risk of violence under a detention disposition while residing in the hospital with supports, with a higher risk under less restrictive conditions.
There is a real risk of harm to the public. His mother expressed concern that he would hit her, although he had not hit her “yet”. In response to his delusions, he broke a vehicle windshield and broke a chair. He made threats about his family. When hospital staff assessed him in the community on February 26, 2025, they were fearful for their safety and requested police assistance to bring him to the hospital.
The Mental Health Act (“MHA”) was not entirely effective to manage Mr. Fraser’s risk to the public. The hospital needs the ability to return Mr. Fraser to the hospital quickly if he decompensates, under a Warrant of Committal. The hospital needs to be able to approve Mr. Fraser’s accommodation. The risk to the safety of the public can only be managed under a detention disposition.
Mr. de Jong, submitted on behalf of Mr. Fraser that Mr. Fraser did not pose a significant risk to the safety of the public. All the same risk factors in play at the time of the index offence have remained in place for a significant time without any other criminal charges or evidence of criminal behaviour in the community or in the hospital. Likelihood of risk is not sufficient. What might happen is not sufficient. What matters is what Mr. Fraser will do. There is no direct or reliable evidence of a threat of criminal behaviour.
In the alternative, if the Board finds that Mr. Fraser poses a significant threat to the safety of the public, a continuation of the current detention disposition is appropriate.
Ms. Dalrymple, counsel for the Attorney General, adopted the hospital’s submissions.
Analysis and Conclusion:
Significant Threat to the Safety the Pubic:
The Board must determine if Mr. Fraser is a significant threat to the safety of the public. For completeness, we set out the legal test which must be applied.
Parliament has defined that term in s. 672.5401 of the Code to mean “a risk of serious physical or psychological harm to members of the public...resulting from conduct that is criminal in nature but not necessarily violent”. Public safety has been determined by Parliament to be the paramount consideration. Thus, by the words chosen, the level of harm which could be created must be significant, not minimal or a mere annoyance.
The Supreme Court decision in Winko remains instructive as to how to interpret this section. A risk must be real and objectively supportable, not remote, theoretical or exist only due to one person’s fears. (See: Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] S.C.J. No. 31, at paras. 57, 62).
Further, the Board must determine if, at the time of the hearing, the evidence has established a risk of serious harm. It is not sufficient that, at some time in the future, the subject person could commit other, unspecified offences. Nor is it sufficient that at some time the subject will make a decision which is deleterious to his own mental health or stability. As stated by McLachlin, J. (as she then was) at para. 69:
“It is for the court or Review Board, acting in an inquisitorial capacity, to investigate the situation prevailing at the time of the hearing and determine whether the accused poses a significant threat to the safety of the public. If the record does not permit it to conclude that the person constitutes such a threat, the court or Review Board is obliged to make an order for unconditional discharge.”
The Court of Appeal has also emphasized that the test to be applied is stringent, and there must be both a likelihood of risk materializing and the likelihood of serious harm occurring. Speculation as to the level of risk is not sufficient, and the risk of a mental health relapse is not congruent with the standard to be applied and cannot justify detention. It is recognized that the absence of violent behaviour in itself does not eliminate the risk of significant harm to the public. Similarly, lack of insight into the index offences, the discontinuation of medication and substance abuse are all factors to consider (See: Re: Sheikh, 2019 ONCA 692; Re: Krist, 2019 ONCA 802; Re: Abdulle, 2019 ONCA 812).
That Court re-emphasized the onerous test in Re: Gibson 2022 ONCA 527, per Lauwers J.A. at para. 9:
Huscroft J.A. said in Carrick (Re), 2015 ONCA 866, 128 O.R. (3d) 209, at para. 17, that “the ‘significant threat’ standard is an onerous one”. He added that “[t]he board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the appellant in order to deny him an absolute discharge”. Mere speculation is insufficient. See also, Sim (Re), 2020 ONCA 563, at paras. 63-65, per Strathy C.J.O., Marmolejo (Re), 2021 ONCA 130, 155 O.R. (3d) 185, per Tulloch J.A., at paras. 33-37.”
Having heard all the evidence and considered the submissions of counsel, the Board makes a positive finding that Mr. Fraser poses a significant threat to the safety of the public, for the reasons outlined in Ms. Zamprogna’s submissions.
There is no doubt that Mr. Fraser has a serious mental illness. He has been diagnosed with schizoaffective disorder and substance use disorder. The Board does not suggest that these illnesses in and of themselves make him a serious threat to the safety of the public. It is not the presence of an illness which the Board must consider, but whether due to that illness a person will act in such a way as to create a reasonable likelihood of danger to the public. That danger must be real; it must be beyond annoyance, as set out by the Supreme Court.
The evidence indicates that since the index offence, Mr. Fraser has not engaged in physical violence directly against others. Based on this, if the Board was only considering the likelihood of whether he would commit an actual assault, the test for serious threat would likely not be made out.
However, while living in the community after the index offence Mr. Fraser exhibited environmental aggression, and had several psychiatric admissions to hospital. The use of substances was a factor in these admissions. During those admissions, Mr. Fraser expressed delusions similar to those which precipitated the index offence.
The index offence was serious. Mr. Fraser broke into an innocent neighbour’s apartment, and caused damage to the apartment and its contents in response to his delusions. Mr. Fraser continues to have little insight into the index offence. Mr. Fraser continues to be at risk for repeating this type of behaviour in response to his delusions.
Mr. Fraser currently experiences delusions, and has recently chosen to refuse medical treatment and nutritional counselling for a diagnosis of diabetes in response to delusions and paranoia about the actions of the treatment team.
Mr. Fraser has not participated in substance use programming. Although it appears that Mr. Fraser may have abstained from crystal meth while living in the community and while under close supervision in the hospital, the Board has little confidence that he can remain substance-free in the community without extensive support and oversight of mental health professionals.
Mr. Fraser does not believe he has a mental illness, and does not believe he needs medications. He is externally motivated to comply with medications for the purpose of being discharged from the hospital and he has a history of failure to comply with treatment and follow-up.
After the index offence, he went AWOL on a hospital day pass, and during a different admission, tested positive for crystal meth use after returning from a pass. The Board has little confidence that he will remain compliant with medications in the community without extensive support and oversight of mental health professionals.
The Board adopts the Re-Offence Scenario set out at page 29 of the Report, which is well-supported by the evidence:
Absent extensive psychiatric supervision and treatment, Mr. Fraser will continue to experience his intense psychotic symptoms, including auditory hallucinations, delusions, and disorganized behaviours, despite treatment. If he were to discontinue his treatment, or experience increased stress related to his paranoid delusions, he would likely have an exacerbation of his symptoms. As a result, he likely would be unable to cope with stressors related to the exacerbated symptoms of his mental illness, significantly increasing his risk of reoffence and future violence. Also, his judgment would become increasingly impaired in the context of psychosis, and he would perceive any innocent individual as a threat and would act out violently, as in the index offence. Any of these circumstances would also increase the likelihood of substance use, further exacerbating his illness and risk of violence.
The Board finds that the evidence supports the overall clinical assessment of risk set out on page 30 of the Report:
Mr. Fraser’s mental illness is chronic. He continues to experience symptoms of his mental illness, including delusions and paranoia. His psychotic symptoms contributed to his index offence and those have remained unchanged, despite medication changes;
Mr. Fraser does not have insight into his mental disorder, treatment, or violence risk;
Mr. Fraser breached his disposition by consuming alcohol while living in the community. He requires further assessment and substance use treatment to determine the extent of his substance use disorder;
Mr. Fraser has been adherent to his medication, however, this is externally motivated. He has refused most programming;
Mr. Fraser has limited personal support, and no community professional supports.
Disposition
Although the Board had before it a joint recommendation, the Board considered whether a conditional discharge disposition would be necessary and appropriate in the circumstances.
The Board notes that although Mr. Fraser’s goal is to be discharged from hospital, find employment, and live at his friend’s home, Mr. Fraser has been unable/unwilling to take the necessary steps to achieve these goals.
The evidence supports the conclusion that Mr. Fraser is not yet ready to return to living in the community under a conditional discharge.
Mr. Fraser remains symptomatic. The hospital plans to optimize Mr. Fraser’s medications, and hopefully engage him in programming. A behaviour plan may also be developed for Mr. Fraser. Mr. Fraser, in response to his delusions, has refused to participate in programing and the privilege system, claiming that any program on or off the unit was “too hard on his body.” He requires extensive support and supervision to maintain compliance with his medications, as he does not believe he needs them and would stop taking them if given the choice. He requires support to maintain hygiene. He has not engaged in any substance use programing. His ability to maintain sobriety in the community has not been established, as he admitted to using alcohol in breach of his disposition, prior to his admission to the hospital.
The risk to the public would increase beyond “moderate” with unsupervised housing; minimal professional and personal supports; lack of structure; medication not optimised; no addiction programming; underdeveloped insight etc. Without the ability to approve accommodations, or to bring Mr. Fraser to hospital expeditiously under a Warrant of Committal, that risk would be higher.
The Board adopts the reasoning of Dr. Malka set out at pages 30-31 of the Report:
…the Mental Health Act of Ontario will be insufficient to manage his risk. Mr. Fraser has a history of violence related to the presentation of his mental disorder. He continues to experience active psychotic symptoms and lacks insight into his mental disorder. He has difficulty in shifting his mental state and in regulating his mood, and potential violence may be provoked by internal stimuli and may take place in an impulsive manner. Historically, he was not forthcoming with mental health professionals when he was offered treatment and a follow-up plan. Therefore, the clinicians would unlikely be able to predict the risk of violence in his case which is a prerequisite for using the requirements of the Mental Health Act to manage the risk; therefore, a Warrant of Committal would be able to serve in a pro-active rather than a reactive manner ensuring public safety. As well, moving forward, the Hospital would be required to approve accommodation.
The Board finds that a Conditional Discharge is not sufficient to manage the risk to the safety of the public, which is the paramount consideration, and that the necessary and appropriate disposition is a Detention Disposition.
The hospital requires the ability to bring Mr. Fraser to the hospital if he decompensates. There are no supports in place which could detect early signs of decompensation.
Mr. Fraser has no insight into his mental illness and continues to hold the types of delusions which precipitated the index offence. He does not recognize these as symptoms of mental illness. Mr. Fraser responds with environmental violence to anger.
For the foregoing reasons, the Board is of the view that a Detention Disposition on the terms recommended by the hospital, is the least onerous and restrictive disposition that is necessary and appropriate in the circumstances.
The requirement to abstain from the non-medical use of alcohol or drugs and the testing requirement provide extrinsic support for abstinence from substances. Substance use has been closely associated with decompensation in the past, and was present at the time of the index offence.
Because Mr. Fraser and the victim of the index offence both lived in the same small community, the non-contact provision is appropriate.
The community living clause will be retained. If Mr. Fraser cooperates with assessment, medication optimization, participation in rehabilitative initiatives, and develops and maintains a positive trajectory, he will hopefully be appropriate for community living in approved accommodation.
Approving housing is an important risk-mitigation strategy particularly where, as here, an individual was experiencing residential instability which in turn contributed to stress/increasing the likelihood of mental decompensation.
In making this Disposition, the Board has considered the criteria set out in s. 672.54 of the Code, which are the safety of the public, being the paramount consideration, the mental condition of Mr. Fraser, the reintegration of Mr. Fraser into society and the other needs of Mr. Fraser.
The Board wishes Mr. Fraser every success in working with the hospital to optimize his mental stability in the upcoming year.
DATED this 27th day of February 2026, at the City of Toronto, in the Toronto Region.
Katherine Tomaszewski
Legal Member
Office of the Registrar Ontario Review Board