Ontario Review Board
Re: Doris Caribou
ORB File No: 8707
Hearing held on: Tuesday, January 27, 2026
Place of Hearing: Southwest Centre for Forensic Mental Health Care
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. R. Bigelow
Members: Dr. J. Bradford Dr. L. Lightfoot Ms. K. Tomaszewski Ms. B. Little
Parties Appearing:
Accused: Doris Caribou Counsel: Mr. R. Cunningham
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DISPOSITION
(Dated February 26, 2026)
Introduction
On January 15, 2025, Ms. Doris Caribou was found unfit to stand trial with respect to a charge of aggravated assault contrary to the Criminal Code. She is currently subject to a disposition of the Ontario Review Board (the Board) dated April 11th 2025 finding that she continued to be unfit to stand trial and ordering that she be discharged subject to conditions including residence, reporting, abstention from substance use, a requirement to provide samples of blood and/or breath, a weapons prohibition and a prohibition from contact with a specific individual.
On Tuesday, January 27, 2026, the Board convened a hearing at the Southwest Centre for Forensic Mental Health Care (the Hospital or Southwest) to review Ms. Caribou’s disposition pursuant to sections 672.48(1) & 672.81(1) of the Criminal Code. The issues to be determined at the hearing were whether Ms. Caribou continued to be unfit to stand trial and, if so, to determine what was the necessary and appropriate disposition that was also the least onerous and least restrictive taking into account the factors set out in 672.54 of the Criminal Code.
Initial Positions of the Parties
At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. Counsel for the Hospital indicated that it was the Hospital position that Ms. Caribou continued to be unfit to stand trial, was likely permanently unfit to stand trial, that the current conditional discharge was no longer adequate to manage risk and meet Ms. Caribou’s needs and that the necessary and appropriate disposition was a detention order with privileges and conditions as set out at pages 32 – 33 Hospital Report.
Counsel for the Attorney General supported the Hospital position
Counsel for Ms. Caribou conceded that his client was unfit to stand trial and likely permanently unfit to stand trial but took no position with respect to the change from a conditional discharge to a detention order.
Evidence at the Hearing
- The evidence at the hearing consisted of the Hospital Report dated December 1, 2025, and the oral evidence of Dr. Ajay Prakash standing in for Dr. Mokhber, Ms. Caribou’s most responsible physician.
Findings:
- For the Reasons that follow, the Board finds that Ms. Caribou continues to be unfit to stand trial, is likely permanently unfit and that the necessary and appropriate disposition is an order detaining her at the Hospital with privileges as set out at pages 32 – 33 of the Hospital Report.
Index Offences:
- The circumstances surrounding the alleged index offence as summarized in last year’s reasons for disposition are as follows:
The victim and the accused are both known to each other as they are friends. I On Thursday March 9, 2023 BOS and the accused were within the accused's apartment located at 323-202 McNay Street in the City of London. The two were socializing, and consuming alcoholic beverages.
At approximately 10:00 p.m. while BOS was seated in a recliner chair within the living room, the accused asked BOS if there was any more beer to which BOS replied "no". The accused proceeded to check the refrigerator and confirmed that BOS was correct and there was no longer any beer. This enraged the accused who obtained a paring knife, and approached BOS from behind, as he was seated, and swung the knife toward him in a stabbing motion. The accused attempted to stab BOS four times. BOS deflected two of the four attempts but suffered a stab wound to the chest, as well as a stab wound in the left elbow which he sustained trying to block her attack.
BOS began bleeding from the chest, and at approximately 10:54 p.m. contacted the London Police Service, and Emergency Medical Services for assistance. At 10:57 p.m. several Police Officers responded in priority fashion (lights and sirens). Upon arrival Police made entry to check the welfare of the occupants. BOS and the accused were located within the unit. BOS was escorted out of the unit and into the hallway where Police observed a puncture wound to the center of his chest. He advised Constable HEWITT that the accused had stabbed him.
BOS's injuries were considered serious, but not life threatening. From the CT scan it was discovered that the knife punctured BOS's chest cavity and hit his right lung.
Background Information Regarding the Accused:
Ms. Caribou is currently 68 years of age and was born in Manitoba where she grew up with nine siblings. She attended a residential school until grade 8 but did not continue her education past that level. Although she is unable to provide specifics, it appears that she was the victim of physical and sexual abuse.
She has a history of working in part-time jobs over the years but has not worked since 1993. She is supported by disability benefits managed by the office of the Public Guardian and Trustee but is unable to provide details as to what led to this. Prior to the alleged index offence, she was living in a rental apartment in London and received help with her daily activities including grocery shopping from community services staff.
Subsequent to the alleged index offence Ms. Caribou moved into Henley Place, a long-term care facility in London Ontario where she has now resided for over two years.
Substance Use History
- Ms. Caribou has a history of alcohol consumption which decreased from daily to every couple of weeks according to health records. She states that she “drank before” but could not provide specifics. She was under the influence of alcohol at the time of the alleged index offence.
Legal History:
- Ms. Caribou following criminal history:
1977-06-06 Winnipeg, Manitoba
Theft Under $200
Conditional Discharge for 6 months
1983-05-05 Winnipeg, Manitoba
Theft Under $200
Absolute Discharge
1987-09-18 Winnipeg, Manitoba
Fraud Sec 338 CC (1)
Fail to Comply with Recognizance Sec 133 (3) CC
Suspended sentence & probation 6 months
$100 I-D 10 days
1991-10-02 Winnipeg, Manitoba
Contempt of court
Time spent in custody (3 days)
2004-09-07 Stratford, Ontario
- Assault sec 266 CC
- Uttering Threats Sec 264.1 (1)(A)
1.-2. Suspended sentence & probation 2 years & Discretionary prohibition order for 10 years on each charge conc
2014-04-10 Stratford, Ontario
Assault with a Weapon Sec 267 (a) CC
1 day & probation 12 months (pre-sentence custody 15 days)
Current Diagnosis
- Ms. Caribou’s current diagnoses are:
Neurocognitive Disorder (Korsakoff's Dementia)
Query Post Traumatic Stress Disorder (PTSD)
- Korsakoff's Dementia is a neurocognitive type of dementia with the features of severe memory problems as well as difficulty registering and recalling information resulting from thiamine deficiency often observed in individuals who use alcohol.
Circumstances Surrounding Her Readmissions to Hospital Over the Reporting Year
On June 3, 2025, a co-resident advised staff at the LTC home that Ms. Caribou had consumed alcohol, was unwell and had told them that she had been beat up. Staff did a physical assessment and noted no active bleeding, but a pink substance was present on her arm and around her mouth. She was slurring her speech and demonstrated impaired cognition. A nearly empty 1 L bottle of Smirnov ice was found in her possession.
On June 11, 2025, outreach staff visiting the LTC home noted that Ms. Caribou appeared intoxicated with slurred speech and poor balance. Her room was searched and suspected alcohol and pop bottles were found. Although police were called to transport Ms. Caribou to hospital they failed to attend. The home enhanced their supervision by having someone sit outside of her room for the night but couldn’t maintain that level of supervision. On June 13, 2025, outreach staff attended the home and facilitated her return to hospital where she remained until June 15 and was then returned to the home.
On July 7, 2025, during a scheduled outreach visit Ms. Caribou became highly irritable, agitated and verbally abusive when asked about recent alcohol consumption. Staff noted that liquid containers in her room smelled of alcohol although she denied that the containers contained alcohol. Staff removed a bottle from her room, but Ms. Caribou demanded that it be returned to her as it was only cranberry juice. Staff offered to give her fresh cranberry juice, but she began swearing at them and returned to her room. She refused to provide a urine sample. Police were contacted and requested to bring Ms. Caribou to hospital for assessment due to behavioural changes and potential breach of disposition, but they failed to attend on that date and only attended on July 9 when she was brought back to hospital by police. She remained in hospital until July 14 when she returned to the residence.
On September 23, 2025, Ms. Caribou signed herself out of the residence at 1 PM and failed to return at the expected time. At 9 PM the LTC home staff contacted the police to assist in locating her. When she was found she was intoxicated and incontinent of urine and feces and stated that she fell and hit her head and right shoulder. She was taken to London Health Sciences Centre for medical clearance where blood tests revealed a level 35.6 mmol/L for ethanol, which exceeded the critical high threshold of 33 mmol/L potentially resulting in serious harm and she was placed on a Form 1. The following day outreach staff attended that hospital and transported her to Southwest. The Hospital Report does not clearly indicate when she was discharged from hospital and returned to her residence, but it is clear that she remained in hospital for at least a portion of October 2025.
Evidence of Dr. Prakash
- Dr. Prakash indicated that:
He had reviewed and adopted the contents of the Hospital Report. He had also met with Ms. Caribou virtually with the outreach team on January 21, 2026. He had assessed her fitness and came to the same opinion as that set out in the Hospital Report. He supported the recommendation for a detention order and noted that Ms. Caribou had three admissions to Hospital since her last Board hearing.
In support of the recommendation for a detention order, he referred to the clinical risk assessment contained in the Hospital Report at pages 31 and 32 where it states:
Given Ms. Caribou’s ongoing cognitive impairments, limited insight, and repeated breaches of her conditional discharge, particularly through continued alcohol use despite an abstention clause, her current disposition is no longer sufficient to manage her risk in the community. She has demonstrated poor engagement with supervision and treatment, and her coping strategies remain inadequate. While the Mental Health Act has been used in the past to facilitate hospital admissions, Ms. Caribou does not consistently meet the criteria under Box A and does not meet the criteria under Box B of the Mental Health Act, making it an unreliable tool for ongoing risk management. The safeguards afforded by a detention disposition, including the warrant of committal and the ability to approve accommodations, are essential to ensure consistent supervision, access to appropriate care, and rapid intervention in the event of decompensation or non-compliance. Continued alcohol use may result in hospitalization and loss of her LTC placement. Should this occur, Mr. Caribou would be left without an appropriate alternative residence, and securing a subsequent placement would be markedly delayed due to the extensive provincial waitlists.
The treatment team had recommended to her long-term care facility that Ms. Caribou be placed in a locked unit in order to prevent her consumption of alcohol but that the residence was resistant to this restriction on her freedom. However, he agreed that further discussions with the facility may be productive and there may be a middle ground which would manage risk with a minimal restriction on her freedoms.
During her inpatient stay in October 2025 she was started on Acamprosate to help curb her alcohol cravings.
The consumption of excess amounts of alcohol significantly increased her risk both to herself and others and a detention order would allow the hospital to intervene more quickly and effectively to manage both the risk to herself and to others.
Final Positions of the Parties
Hospital Counsel maintained her initial positions that Ms. Caribou was unfit to stand trial, likely permanently unfit and a detention order was the necessary and appropriate disposition. She submitted that when consuming alcohol Ms. Caribou became agitated and dysregulated and that the re-offence scenario as set out in the Hospital Report was realistic. She also noted that risk assessment contained in the Hospital report showed a higher level of risk than the assessment of the preceding year.
Counsel for the Attorney General also maintained her initial position supporting the Hospital and noted the seriousness of the alleged index offence and Ms. Caribou’s prior history of violence.
Counsel for Ms. Caribou submitted that convenience for the Hospital was insufficient basis for varying the disposition to a detention order and that the evidence was insufficient to support the change.
Counsel for Ms. Caribou also submitted that given Ms. Caribou’s aboriginal heritage and particularly her placement in a residential school, it would be appropriate to order a Gladeau report to be prepared prior to her next annual review. Both counsel for the Hospital and counsel for the Attorney General supported this request.
Analysis and Conclusion, Fitness:
- Although the issue of fitness was not contested at the hearing, the Board nevertheless makes an independent finding that the evidence clearly establishes that Ms. Caribou continues to be unfit to stand trial and is likely permanently unfit. She presents with cognitive impairments consistent with Korsakoff’s dementia, including memory loss, disorientation and limited capacity for abstract reasoning. These deficits significantly impact on her ability to understand the nature or object of legal proceedings, communicate meaningfully with counsel and make informed decisions about her case.
Analysis and Conclusion Necessary and Appropriate Disposition
The Board also finds that the evidence clearly supports a finding that the current conditional discharge disposition is no longer sufficient to manage risk and the necessary and appropriate disposition is a detention order. Although the Mental Health Act has been used in the past to facilitate hospital admissions Ms. Caribou does not consistently meet the criteria under Box A and does not meet the criteria under Box B and accordingly it is not a sufficient mechanism to manage ongoing risk.
The Board accepts and relies upon the clinical risk assessment contained at pages 31 and 32 of the Hospital Report and we agree that:
The safeguards afforded by a detention disposition, including the warrant of committal and the ability to approve accommodations, are essential to ensure consistent supervision, access to appropriate care, and rapid intervention in the event of decompensation or noncompliance.
Accordingly, the Board directs that Ms. Caribou be detained at the Hospital with the terms and conditions as recommended in the Hospital Report.
The Board also directs that a Gladeau report be prepared for consideration at Ms. Caribou’s next annual review.
DATED this 26th day of February 2026, at the City of Toronto, in the Toronto Region.
Robert Bigelow
Alternate Chairperson
Office of the Registrar
Ontario Review Board