Ontario Review Board
Re: Grace Phillips
ORB File No: 8859
Hearing held on: Tuesday, January 20, 2026
Place of Hearing: Providence Care Hospital
Pursuant to: Sections 672.48(1) and 672.47(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Hanbidge
Members: Dr. R. Kunjukrishnan
Dr. W. Loza
Ms. K. Weisbaum
Mr. A. Bouvier
Parties Appearing:
Accused: Grace Phillips
Counsel: Mr. C. Carter
Person in charge of hospital: Counsel: Ms. T. Tom
Representative: Dr. S. Hasan
Attorney-General of Ontario: Counsel: Mr. G. Skerkowski
REASONS FOR DISPOSITION
(Dated February 5, 2026)
Introduction
On August 27, 2025, the accused, Grace Phillips, was found unfit to stand trial on two charges of assault causing bodily harm contrary to the Criminal Code of Canada (“Criminal Code”). The Honourable Court referred the matter to the Ontario Review Board.
On January 20, 2026, the Ontario Review Board convened at the Providence Care Hospital, hereinafter referred to as the hospital, to conduct Ms. Phillip’s initial hearing pursuant to s. 672.47(1) and 672.48(1) of the Criminal Code. Ms. Phillips was not in attendance at her initial hearing but was represented by her counsel, Mr. Chad Carter, who had instructions to attend on her behalf. All parties and the members of the panel agreed to proceed, following the Alternate Chair’s order, pursuant to s. 672.5(10(a) of the Criminal Code, permitting Ms. Phillips to be absent during the whole of the hearing.
Preliminary Matters
- The following documents were entered as Exhibits at the hearing:
Criminal Code Information
Undertaking Release Order – September 8, 2025
Fitness to stand trial assessment order dated December 3, 2024
Disposition hearing outcome dated August 27, 2025
Fitness to stand trial forensic assessment dated February 3, 2025
Springview Residential Services Letter - undated
Ms. Phillips’ parents letter dated March 11, 2024
Email by Jessica Warren dated February 25, 2025
Crown Brief Synopsis
Prior Criminal Record
Transcript of court proceedings dated August 27, 2025
Hospital Report dated January 13, 2026
- Ms. Phillips’ pronouns are they/them.
Initial Positions of the Parties
On behalf of the Hospital, Ms. Tom submitted that Ms. Phillips continues to be unfit to stand trial. The appropriate Disposition is a Detention Order as set out at page 17 of the Hospital Report. This includes continued residence at Springview Residential Services (“Springview”). Ms. Tom confirmed that the Hospital is not seeking to send Ms. Phillips’ case back to court at this time.
On behalf of the Attorney General, Mr. Skerkowski submitted that the Crown agreed with the Hospital.
On behalf of Ms. Phillips, Mr. Carter confirmed that it is a joint submission, subject to the evidence.
Index Offences
- The circumstances giving rise to the charges of “2x assault causing bodily harm” on the index offences are set out in the Hospital Report and summarized as follows:
“On 23 August 2023 at approximately 10:54 pm Victim #1 Kiera GRIEG was working as a group home worker at Springview Residential Group Home at 3020 Forest Road, South Frontenac Twp, Ontario.
Victim #1 Kiera Grieg advised police that Grace Phillips had asked her to accompany her to her room in the basement. Once inside the room the Accused stated: "I'm going to do something" and then came towards the victim and grabbed her by her hair, bent her over and struck her in the back of the head with a closed fist several time. (Count#1)
Victim #1 yelled for help and 2 other staff members came into the room.
Victim #1 had a sore neck and no signs of injury visible to the Officers.
Victim #1 attended Kingston General Hospital on the 24th of August 2023 for treatment.
Victim #1 provided and Audio Video Statement to Police on the 24th of August 2023.
Victim #1 advised Police that she sustained a concussion from the assault.
On 23 August 2023 at approximately 10:54 pm Victim #2 Macayla Perrin-Landon was working as a group home worker at Springview Residential Group Home at 3020 Forest Road, South Frontenac Twp, Ontario.
Victim #2 Macayla Perrin-Landon attempted to restrain the accused with the assistance of staff member (Witness) Edward Brown.
While staff members were attempting to restrain the accused, the accused kicked Victim #2 in face striking her nose with a deliberate kick. (Count #2)
Victim #2 had swelling and bruising to the nose visible to Officers upon arrival.
Victim #2 called police at approximately 10:50 pm and reported the assault.
Both Victims were treated by Ambulance at the scene. Neither were transported to hospital.
Victim #2 attended Kingston General Hospital on the 24th of August 2023 for treatment.
Victim #2 provided an Audio Video statement to Police on the 24th of August 2023.
Victim #2 advised Police that she sustained a fractured nose and concussion from the assault.
Grace Phillips was identified by staff members to police as the suspect in the assault at the scene.
Grace Phillips was arrested for Assault, Read her Rights to Counsel and Caution which she advised she understood. Grace Phillips spoke to Duty Counsel at Detachment.
The Accused was charged with 2 Counts of Assault and Released on a Form 10.
The Accused was given a 1st appearance date of 03 October 2023 at 9:00 am at 279 Wellington St Kingston-Ontario Court of Justice.
The Accused was re-arrested on the 8th of September 2023 for Assault Cause Bodily Harm x 2 based on the new Medical Information from the two Victims.
The Accused was Read her Rights to Counsel and Caution which she advised she understood. Grace Phillips was to contact her lawyer at a later date with assistance of group Home staff.
She was released on a Form 10. The Accused was given a 1st appearance date of 03 October 2023 at 9:00 am at 279 Wellington St Kingston-Ontario Court of Justice."
Criminal History
- A review of Ms. Phillips’ CPIC suggested that they have previously been charged with assault between September 2020 and October 2022.
Background History, including Psychiatric History
Ms. Phillips’ personal history is set out in detail in the Hospital Report. Briefly summarized, Ms. Phillips is the middle child in a sibling line of three. During an interview, Mrs. Phillips described a planned pregnancy and recalled trying to conceive for two years after her oldest son was born. She described her happiness when she learned of her pregnancy prenatal use of alcohol or substances was reported.
Ms. Phillips is now 21 years old with a longstanding and complex neurodevelopmental history. Her current diagnoses include Moderate to Severe Intellectual Disability, Autism Spectrum Disorder (“ASD”), Attention Deficit Hyperactivity Disorder (“ADHD”) and Oppositional Defiant Disorder (“ODD”). Ms. Phillips has experienced significant developmental, cognitive, and behavioral impairments since early childhood, following early medical concerns including epilepsy and seizures. From a young age, they demonstrated difficulties with motor coordination, written output, sensory integration, emotional regulation, and increasing aggression and self-injurious behavior.
Ms. Phillips has received extensive medical, psychiatric, and community-based interventions, including multiple psychiatric diagnoses. Ms. Phillips has a history of repeated hospitalizations for aggression, property destruction, threats of suicide, self-injury, and absconding. They have required intensive educational and rehabilitative supports, including modified curriculum, occupational therapy, speech-language therapy, assistive technology, and one-to-one assistance. Ms. Phillips has no established pattern of substance misuse, though collateral information notes marijuana use in 2019. There is no known family history of major psychiatric illness.
According to Dr. Hasan’s entries in the Hospital Report, who was first associated with Ms. Phillips’ case in August 2025 in her capacity as community psychiatrist, Ms. Phillips currently resides in the supervised residential care setting of Springview Residential Services and is under the clinical psychiatric management of Dr. N. Khan. Dr. Hasan reports that Ms. Phillips demonstrates concrete thinking, markedly limited abstract reasoning, poor generalization, and significantly impaired adaptive functioning. Apparent verbal compliance does not reliably indicate comprehension. Ms. Phillips’ capacity for independent decision-making and self-regulation is substantially compromised.
Dr. Hasan also documents that Ms. Phillips reports intermittent, vague auditory experiences without command or persecutory content and without associated distress. These experiences are considered more consistent with ASD- or trauma-related phenomena rather than with primary psychotic illness. There are ongoing episodes of severe behavioral dysregulation, including agitation and reactive aggression toward others and the environment.
Dr. Hasan’s brief written risk assessment indicates that Ms. Phillips’ difficulties are driven by impulsivity, low frustration tolerance, impaired executive functioning, and limited cognitive flexibility. She concludes that Ms. Phillips’ aggressive and oppositional behaviors are best conceptualized as reactive manifestations of her neurodevelopmental disorders rather than deliberate or goal-directed conduct.
Evidence at the Hearing
In response to questions from Ms. Tom, Dr. Hasan stated that she is the author of the Hospital Report and adopts its contents. Dr. Hasan is a consultant psychiatrist. Ms. Phillips is clinically managed in the community, with Dr. Hasan overseeing Ms. Phillips treatment and long-term management. Dr. N. Khan is a member of the Dual Diagnosis Community Outreach Team (“DDCOT”) and the clinical psychiatrist who oversees Ms. Phillips’ medication and other therapies. In her role, Dr. Hasan oversees issues with respect to the determinations of significant risk regarding Ms. Phillips.
As noted in the Hospital Report, Dr. Hasan met personally with Ms. Phillips in her home for 2.5 hours and then in her day program, which also takes place in her residential setting. Dr. Hasan also spoke with Ms. Phillips’ parents separately, and with the DDCOT.
Ms. Phillips continues to remain unfit to stand trial. Ms. Phillips was reassessed twice between 2007 to 2017. Their primary diagnosis is a moderate to severe intellectual disability, which means the equivalent of six to eight years old, with ASD and a primary neurological developmental disorder. This indicates that Ms. Phillips will remain unfit.
In terms of their interaction and regarding Springview Home. Dr. Hasan stated that Ms. Phillips has a history of long-standing disjointed care with respect to psychiatric hospital admissions, including multiple admissions, foster care, residential settings and part of multiple placements like Springview. Ms. Phillips’ history includes multiple medications and therapies, and multiple risks identified over that time. Behavioural therapies have resulted in an overall decrease in the frequency of incidents of behavioural difficulties; for example, when Ms. Phillips’ environment changes, they become upset. Behavioural support plans have been introduced: for example, daily schedules that are visual so as to reduce sensitization and anxiety, as well as a room that has been customized to individual needs so that Ms. Phillips can feel safe and contained. Such plans take time to implement.
Ms. Phillips’ index offence involves assault of Springview staff. Dr. Hasan’s investigation showed that the staff working at that time were not well trained to manage Ms. Phillips. New staff now receive consistent and proper training; they must be familiar with Ms. Phillips’ particular needs and related plans, which was lacking with respect to the staff involved with the incident.
Dr. Hasan stated that she would be concerned if Ms. Phillips was not able to reside at Springview, given her history. Springview staff have been able to manage Ms. Phillips in a “functional way” such that Ms. Phillips has shown positive functional changes, for example, Ms. Phillips is able to attend an in-house school.
Ms. Phillips’ current medication regimen includes Clonidine off label for ADHD and oppositional disorders, as well as behavioural interventions.
With respect to Ms. Phillips’ capacity related personal care/treatment and financial decisions, Dr. Hasan stated that the information (as found at page 1 of the Hospital Report) needs to be updated, given Ms. Phillips’ moderate to severe disability and corresponding abilities of age 6 to 8. While Ms. Phillips’ expressive communication conveys understanding, Ms. Phillips does not, in fact, understand and requires an enhanced capacity assessment with respect to finances, medications and day-to-day functioning. Dr. Hasan has also discussed this with Ms. Phillips’ parents. They agree that someone is needed to decide on Ms. Phillips’ behalf. The assessment has been discussed with the parents and is supported by Ms. Phillips’ team. A third party is needed for the property capacity assessment and the clinical team will assess capacity with respect to treatment. (In response to a request for clarification from the Alternate Chair, Ms. Tom confirmed that the anticipated “assessment” would be a capacity assessment, not a risk assessment.)
Dr. Hasan stated that Ms. Phillips has an ongoing relationship with their parents, including regular visits. The parents are not approved persons; however, the forensic treatment team will talk to the parents about this item.
In response to questions from Mr. Skerkowski, Dr. Hasan stated that a fitness assessment was started before Dr. Hasan met with Ms. Phillips. The meetings to date with Ms. Phillips had not been under circumstances conducive to talking about the index offence. Staff had advised that Ms. Phillips would not understand and would become upset. This will be addressed going forward. Dr. Hasan stated that the goal of the first few meetings with individuals with developmental disabilities, including Ms. Phillips, are about slowly developing rapport and a relationship. Going forward, there will be further attempts to discuss items such as the nature and object of court proceedings.
In response to questions from Mr. Carter, Dr. Hasan stated that at Springview, Ms. Phillips has very good 24-hour support. Things to add will include recommended updated speech and sensory assessments. Ms. Phillips’ team is receptive to updating these assessments; for example, they have already made a referral for occupational therapy. There is ongoing training of new staff, and specific training of all staff involved in Ms. Phillips’ care if there is a new recommendation, for example, from a behavioural therapist.
Before the behavioural component of any plan for Ms. Phillips, management of her care was somewhat “hit and miss”; for example, their potential for sensory overload was not known, rather, it was ad hoc based on who knew Ms. Phillips best. The current structured program allows for consistent care and approach; for example, if Ms. Phillips has a designated “personal space” in both the communal area and in their own bedroom where they can go to self-regulate. Staff also assist with this diversion.
Restraints have been used with Ms. Phillips in the past, however, over the past three months, where there would have been six to seven incidents, there are now one to two incidents. Staff training has also helped reduce incidents.
Dr. Hasan stated that Ms. Phillips goes home to see their parents for the weekend every four to six weeks. Being in their home community can sometimes be a triggering factor related to Ms. Phillips’ childhood experiences, so the parents try to plan for her trips home. There have also been some violent behaviours at home historically, but these have been less recently.
In response to questions from the panel, Dr. Hasan stated that Springview offers a few day programs for residents such as Ms. Phillips who have dual diagnoses and developmental disorders. Program staff are qualified to work with individuals with disabilities.
Revisiting her account of having two initial meetings with Ms. Phillips, Dr. Hasan stated that for a person like Ms. Phillips with a severe intellectual disability with social and communication difficulties, it takes time to develop relationships. The first meeting with Dr. Hasan was about who Ms. Phillips is, how they live and what their environment looks like. The second meeting was about what Ms. Phillips is able to do, for example, in terms of being in a classroom setting. So far, Dr. Hasan stated she felt very positive about the growing relationship with Ms. Phillips. Nevertheless, because of their developmental disability, Ms. Phillips will most likely not be able to understand court processes and related issues tied to fitness, again, given their corresponding age range of six to eight years old and considering Ms. Phillips’ overall history.
Dr. Hasan stated that Dr. Khan prescribes for Ms. Phillips in the community. The DDCOT oversees Ms. Phillips’ care. Clonidine is very beneficial with respect to impulsivity, even as an off-label use. There has been a decline in Ms. Phillips’ incidents over the past six to eight weeks since that medication was introduced. Clinically, Ms. Phillips will remain under the management of the developmental disorder team. If needed, Ms. Phillips would come to Providence Care Hospital to be hospitalized.
With respect to the ODSP funding that Ms. Phillips receives, the parents were consulted, but they do not feel able to manage Ms. Phillips’ finances. Funds are directed to the residential manager by a local agency. Again, a capacity assessment will likely change how finances are managed.
As Dr. Hasan is the consulting psychiatrist overseeing the forensic aspects of Ms. Phillips’ case, and not the treating psychiatrist to Ms. Phillips, Dr. Hasan will not be doing the capacity assessment. The capacity assessment related to property will be done by the third party. The clinical psychiatrist who is part of Ms. Phillips’ team, Dr. Khan, will assess capacity for treatment. Going forward, the Office of the Public Guardian and Trustee will most likely become Ms. Phillips’ substitute decision maker.
Dr. Hasan stated that Ms. Phillips’ day program is five days a week from 9am to 4pm. The classrooms are at the day program at the residence. There are three to four students in the classroom with individual programs. Ms. Phillips’ sensory stimulation issues are managed through their individual program.
With respect to Ms. Phillips finances, Dr. Hasan believed that it is the administrator at Springview who currently manages Ms. Phillips’ financing. With respect to addressing this as soon as possible, Dr. Hasan has raised this issue, which is part of current efforts to assess Ms. Phillips’ capacity with respect to property. (It was noted that Ongwanada, being a local Kingston agency, might currently officially hold Ms. Phillips’ funds.)
There were no follow up questions from any party. No further evidence was called.
Submissions
Ms. Tom stated that there remains a joint submission that Ms. Phillips is unfit to stand trial, relying on the evidence of Dr. Hasan and in the Hospital Report. Dr. Hasan had reviewed the Hospital Report and met with Ms. Phillips on two occasions and found Ms. Phillips to be permanently unfit, a determination that layers with Ms. Phillips’ ASD diagnosis. Ms. Phillips is also a serious threat to the safety of the public and a Detention Order is the appropriate Disposition. It is also appropriate that the Detention Order permit Ms. Phillips to continue to reside in the community at Springview with 24-hour supervision, and with ongoing assessment of her needs and the ability to bring her into the Hospital, if needed. Dr. Hasan’s ongoing role will be to act as a consulting psychiatrist and to conduct the ongoing fitness assessment.
Mr. Skerkowski submitted that the Crown aligned with the submissions of the Hospital.
Mr. Carter confirmed it was a joint submission.
Analysis
i) Unfit to stand trial
- The definition of “unfit to stand trial” is found at s. 2 of the Criminal Code:
“’unfit to stand trial’ means unable on account of mental disorder to conduct a defence at any stage of the proceedings before a verdict is rendered or to instruct counsel to do so, and, in particular, unable on account of mental disorder to:
(a) understand the nature or object of the proceedings;
(b) understand the possible consequences of the proceedings; or
(c) communicate with counsel.”
- The Board carefully considered the documentary evidence and oral evidence of Dr. Hasan and found that Ms. Phillips is unfit to stand trial. In making its finding, the panel considered the recent Supreme Court of Canada decision in R v Bharwani, 2025, SCC 26, at paragraph 6:
“[A]n accused is fit to stand trial when they are able to make and communicate reality-based decisions in the conduct of their defence or instruct counsel to do so. Conducting a defence includes making decisions that an accused must always make personally and those which relate to the exercise of their right to full answer and defence, such as decisions about pleas, the mode of trial, selection of counsel, whether to testify, whether to call or cross-examine witnesses, and closing submissions, among others. The capacity required to make those decisions is a reality-based understanding of the nature or object of the proceedings and their possible consequences, an ability to understand the available options and their consequences, and an ability to select between those options when making decisions. Fitness to stand trial does not require an accused to make decisions in their best interests. Rather, it requires making decisions based on an understanding of reality that is not overwhelmed by delusions, hallucinations, or other symptoms of their mental disorder. Transient mental health symptoms do not necessarily compromise an accused’s ability to conduct a defence. The focus is always on assessing the extent to which an accused’s mental disorder impairs their understanding of reality when making and communicating decisions in their defence.”
The panel is cognizant of the serious consequences of a finding of unfitness to stand trial, including the loss of the accused’s liberty, and appreciates that such a finding must not be made lightly (Bharwani, 2025 SCC 26 at paragraph 73.)
In Clayton (Re), 2025, ONCA 308, the Court of Appeal for Ontario held that “the nature of the charges and allegations” facing an accused is important context when applying the fitness test. In particular, at paragraph 11, the Court states that “the simpler the case is, the easier it is to understand, appreciate and talk about.”
The panel accepted Dr. Hasan’s opinion that Ms. Phillips lacks the ability to meaningfully participate in a court process, due primarily to developmental disability with all of the concurrent features described in the evidence. These features are directly tied to preventing Ms. Phillips from achieving a reality-based understanding of the court process as it relates to them personally and based on their history and sensory sensitivity.
Although Ms. Phillips’ index offence is not complex, or unusual, it must be assessed in the context of her diagnoses and related equivalent age. Dr. Hasan was clear that Ms. Phillips has the ability to understand equivalent to that of a six- to eight-year-old child. While Ms. Phillips is emotive and can appear to understand, Dr. Hasan was clear that this cannot be taken to mean that Ms. Phillips understands. This raises further concerns that Ms. Phillips may be highly suggestable and/or acquiescent.
While it cannot be the only consideration, Ms. Phillips’ current functioning abilities push functionality to below the fitness threshold. Ms. Phillips is highly sensitive to external stimulation, particularly anything outside the structures of day-to-day routines, including the types of activities and discussions that would be fundamental to conducting a defence. A comprehensive discussion between Dr. Hasan and Ms. Phillips has not been possible to date, due to the stress it would cause Ms. Phillips and absent the time required to establish meaningful rapport in the therapeutic relationship. At this time, it is not possible for Ms. Phillips to have a reality-based understanding of the nature and object of court proceedings. Overall, the evidence showed that Ms. Phillips is not able to be meaningfully present and meaningfully participate in a trial.
While there was some discussion at the hearing on the question of whether or not Ms. Phillips is permanently unfit, the panel decided that it would be premature to consider that issue at this time.
ii) Significant Threat to the Safety of the Public
Having considered all the evidence tendered at the hearing and the submissions of the parties, the Board finds that Ms. Phillips meets the threshold of significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and as further defined in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 (Winko). In coming to its decision, the panel considered the four factors set out in section 672.54 of the Criminal Code, namely, the protection of the public, which is the paramount consideration, the mental condition of the accused, their reintegration into society and their other needs.
It was clear to the panel that if not for the specialized residence of Springview, including 24-hour supportive care managed by trained staff following an individualized program, the care by their clinical team and their current medication regimen, Ms. Phillips would pose a significant risk, at least, to the other residents. And while the structured environment at Springview did not work to prevent the index offence, it was also clear that the adjustments to training and individualized programming that have been and will be made on an ongoing, as-needed basis will serve to mitigate future risks posed by Ms. Phillips. Springview is Ms. Phillips’ home and provides structured and highly focused support conducive to meeting Ms. Phillips’ complex needs.
The terms of the Detention Order are:
detained at the Secure Forensic Unit of the Providence Care Hospital;
attend within or outside of the hospital for necessary medical, dental, legal or compassionate purposes;
hospital and grounds privileges, accompanied by staff or Springview Home staff;
hospital and grounds privileges, escorted by a person approved by the person in charge;
to enter the Province of Ontario, accompanied by staff or Springview Home staff;
to enter the Province of Ontario, escorted by a person approved by the person in charge;
passes for up to 72 hours to enter the Province of Ontario, accompanied by a person approved by the person in charge;
to live in 24-hour supervised accommodation, approved by the person in charge;
abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant;
submit samples of their urine and/or breath to the person in charge of the Providence Care Hospital, or their designate for the purpose of analyzing whether the accused has ingested alcohol, drugs or any other intoxicant;
refrain from having in their possession any firearm, ammunition or other offensive weapon, or being in the company of any person possessing a firearm other than a peace officer; and
when living in the community, report to the person in charge of the Providence Care Hospital, or their designate, not less than once a month.
Conclusion
Taking into account the definition of “unfit to stand trial” in the Criminal Code, the test in Bharwani and all of the evidence, the Board found merit in the joint submission of the parties and found that Ms. Phillips is unfit to stand trial.
The threshold of significant threat to the safety of the public is met, as defined in section 672.5401 of the Criminal Code, and as further defined in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 (Winko).
The Board notes it anticipates that for Ms. Phillips’ next hearing, there will be a completed fitness assessment, which will be of great use to the next panel in determining fitness. A concurrent comprehensive risk assessment will be similarly instructive.
Dated this 5th day of February 2026, at the City of Toronto, in the Toronto Region.
Ms. K. Weisbaum
Legal Member
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Office of the Registrar Ontario Review Board