Re: Nancy Brubacher
ORB File No: 8699
Hearing held on: Friday, January 16, 2026
Place of hearing: North Bay Regional Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. P. Hageraats
Members: Dr. J. Watts
Dr. G. Stones
Ms. M. Chamberlain
Ms. C. Plyley via video conference
Parties Appearing:
Accused: Nancy Brubacher
Counsel: Ms. T. Raftery (for Mr. C. Bracken)
Person in charge of Hospital: Representative: Ms. C. Condie Counsel Mr. P. Trenker
Attorney General of Ontario: Counsel: Ms. D. McCaig
AMENDED REASONS FOR DISPOSITION
(Dated February 23, 2026)
Please see underlined change to original reasons made March 10, 2026.
Introduction:
On December 6, 2024, Mrs. Nancy Brubacher was found not criminally responsible (“NCR”) having committed the offence of first-degree murder, contrary to the Criminal Code of Canada.
Mrs. Brubacher is currently subject to an initial disposition of the Ontario Review Board (“ORB” or “the Board”), dated February 19, 2025. She was ordered to be detained at the North Bay Regional Health Centre Forensic Programs (“NBRHC”) while awaiting her transfer to a different forensic hospital, the Southwest Centre for Forensic Mental Health Care (“Southwest Centre”) in St. Thomas, Ontario.
Following the Board’s disposition of February 19, 2025, Mrs. Brubacher has remained an inpatient at the NBRHC. She benefits from privileges, up to and including to enter the community within the NBRHC catchment area, indirectly supervised.
Further privileges were made available by the disposition, including travel passes within the Province of Ontario, accompanied by staff or a person approved by the person in charge. Up to now, the hospital has yet to grant any travel passes.
On January 16, 2026, the Board convened at the NBRHC to conduct a first annual review. Mrs. Brubacher attended in person. She was represented by counsel, Ms. Tara Raftery, who appeared as agent for Mr. Chad Bracken.
Mrs. Brubacher’s husband, Mr. Cleason Brubacher, was present.
Materials were filed in evidence, including a cumulative Hospital Report, dated November 28, 2025.
The issues to be determined at the hearing are whether Mrs. Brubacher continues to present a significant threat to the safety of the public, and, if so, to determine the necessary and appropriate disposition.
Positions of the Parties:
- At the outset, the parties advised the panel that they were agreed on all issues. Significant threat was not contested. The parties jointly advised that the transfer order to Southwest Centre in St. Thomas is no longer necessary nor appropriate. Instead, they asked the Board to rescind the transfer order. Lastly, they recommended that all remaining terms of the current detention order remain in place, without change. For the reasons set out below, the Board adopted the parties’ joint submission. The transfer order to Southwest Centre was rescinded.
The Index Offence:
As described by the Honourable R. Bigelow in last year’s Reasons for Disposition, dated February 26, 2025, the circumstances are tragic and heart wrenching in the extreme. The victim was Mrs. Brubacher’s ten-month-old daughter, Selema.
At the initial ORB hearing, Counsel for the Attorney General had advised the panel that the facts agreed upon at Mrs. Brubacher’s trial reflected the information contained in the synopsis found in the Hospital Report. This is reproduced below. Last year’s panel was provided with the Crown’s undertaking to obtain the court transcript of agreed facts which was read into evidence at the trial.
The Board has yet to receive the court transcript. To complete the documentary record, we request this be investigated by counsel and that the missing transcript be provided to the Board on or before June 1, 2026.
Based on what has been provided, the circumstances may be summarized as follows:
On December 07, 2023, Nancy BRUBACHER (then age 30) was in her home in the Municipality of Grey Highlands, with her daughter Selema BRUBACHER (ten months). Nancy BRUBACHER’s three other children had taken the bus to school. Her husband Cleason BRUBACHER was outside in his nearby workshop, located on the same property.
Nancy BRUBACHER filled the bathtub three quarters full. She threw Selema into the tub and ran to another room. Nancy could hear Selema splashing around for several minutes. Nancy returned to the bathroom. With two hands, she held Selema face down in the water until Selema stopped struggling and no longer had a heartbeat. When interviewed by the police, Nancy told them she thought Selema had died in the tub and confirmed that was her intention.
Once Nancy BRUBACHER believed Selema was deceased, she phoned her husband Cleason and asked him to come into the house. When Cleason came inside, he phoned 911 and began CPR on Selema until emergency services arrived.
At the scene, Nancy BRUBACHER told police she had tried to drown her baby. She was arrested for attempt murder and advised of her right to speak to counsel. Nancy BRUBACHER was transported to the Chatsworth OPP detachment.
EMS transported Selema BRUBACHER from the scene to Markdale hospital. From Markdale hospital, Selema was transported to London Victoria Hospital.
Nancy BRUBACHER was charged with attempted murder contrary to section 239 of the Criminal Code, and Aggravated Assault contrary to section 268 of the Criminal Code.
On Monday, December 11, 2023, at 10:52 a.m., DC Scott ORSAN of the Southern Georgian Bay Detachment Major Crime Unit arrested Nancy BRUBACHER for First Degree Murder contrary to Section 235(1) of the Criminal Code. BRUBACHER was by then in custody at Central North Correctional Centre. DC ORSAN asked if BRUBACHER understood the new charge and she responded, ‘Yes, they told me already.’
Prior to arrest, BRUBACHER told DC ORSAN that the courts had already notified her of Selema’s passing and that police were going to be arresting her on the new charge that day.”
When undergoing the psychiatric assessment into criminal responsibility, Mrs. Brubacher provided a more detailed account of the events. This was consistent with information gathered by the police and is reproduced at pp. 7-8 of the Hospital Report. No purpose would be served to reproduce those details in these Reasons.
During the assessment, Mrs. Brubacher also provided a detailed self-report concerning the days, weeks, and months preceding the index offence. This information is relevant to an appreciation of her ongoing risk to public safety and the Board’s responsibility to manage that risk by crafting the necessary and appropriate Disposition that will keep the public safe while balancing the other listed considerations found in s. 672.54 of the Criminal Code.
Mrs. Brubacher’s Background:
Nancy Brubacher is 32. She is married and has three surviving children, presently aged seven, nine and ten. At the time of the index offence, she was living with her husband and children. She has no prior criminal record nor any history of alcohol or other substance use.
Mrs. Brubacher was born in the Waterloo Region of Ontario. Her family was part of a local Mennonite community. Her mother was a homemaker while her father operated a welding business. Nancy Brubacher has described a supportive relationship with her mother but characterized her father as angry, stating that he physically disciplined the children and sometimes yelled and broke items in the house. She described experiencing verbal abuse from her father during her childhood. He also engaged in problematic behaviours such as drinking and infidelity, and acted in ways that upset her mother, including destroying her garden and watching pornography.
Mrs. Brubacher’s speech development was delayed, as she began speaking at the age of 18 months. The family’s language at home was Pennsylvania Dutch. Mrs. Brubacher faced challenges when she started school, where English was the language of instruction. She struggled with comprehension and timely completion of assignments. In Grade 5, she was placed in a special education class but was never formally diagnosed with a learning disability and never had an individualized education plan.
Mrs. Brubacher withdrew from school after completing Grade 8, as was customary in her community. Since then, she has had no formal education. Instead, she developed homemaking skills. She served as a “mother’s helper” in as many as 20 different households, often travelling as far as 100 kilometres from her home and spending extended time away. Although she enjoyed being away from family tensions at home, she was occasionally criticized for taking too long to complete her chores. Mrs. Brubacher described finding it challenging to stay up overnight to help with a baby and then to spend the day attending to chores with very little sleep. Her experiences as a mother’s helper left her fearful of childbirth because of the pain associated with labour and the expectation of having large families in her community. She continued to do this work until her own marriage.
Family History
Mrs. Brubacher started to date her husband at the age of 16. They married when she was 19. As noted in the criminal responsibility report, she became pregnant six weeks after the wedding. Following a miscarriage at approximately 16 weeks, she underwent a dilation and curettage procedure. Five months later, she again became pregnant but experienced another miscarriage at 13 weeks’ gestation. Not long after, she became pregnant for a third time. At age 20, she delivered her first child.
Mrs. Brubacher experienced symptoms of postpartum depression, saw a psychiatrist, and reluctantly started to take prescribed antidepressant medication. Her mood improved with the medication, and she began to enjoy her child more. When the child was six months old, she tapered down and then discontinued her medication.
This cycle was repeated with Mrs. Brubacher’s second child. However, after discontinuing her medication once her second child was six months old, she began to experience difficulties, including irritability and anger, and found herself no longer enjoying activities that had previously given her pleasure. Her next two pregnancies both resulted in miscarriages. These pregnancies and subsequent miscarriages were accompanied by symptoms of depression and some suicidal ideation, but the symptoms largely resolved with medication. She remained on antidepressant medication through another pregnancy which resulted in the birth of her third child, a son. She reportedly enjoyed parenting her son but was overwhelmed by having to care for a newborn in addition to her two older children. She remained on her medication until she stopped breastfeeding her son.
Mrs. Brubacher became pregnant a month later but again experienced a miscarriage. This time, antidepressant medication did not improve her symptoms. Her condition worsened to the point where her husband called emergency services, and she was brought to hospital by ambulance accompanied by police. Although her symptoms resolved with treatment, they returned six weeks later, and this time she also became impulsive and physically aggressive. She reportedly struck her husband in the head and fractured one of her fingers. Her husband contacted emergency services and Mrs. Brubacher was taken to hospital on August 2, 2020. This admission, which lasted until August 26, is discussed below under Psychiatric History.
Mrs. Brubacher reportedly experienced anxiety about her compatibility with her husband. She had difficulty trusting him due to fears stemming from her own mother’s past experiences. Despite exhibiting symptoms of depression and struggling with anger, she generally had a good relationship with her husband, attributing their harmony to his non-confrontational nature. However, she often felt inadequate and hard to love, especially after discovering that he occasionally watched pornography, despite their positive sexual relationship.
Psychiatric History
Mrs. Brubacher is currently diagnosed with Bipolar I Disorder. She has a lengthy history of mental health challenges, including significant depressive symptoms. Mrs. Brubacher has struggled with being in post-partum or peri-partum periods for much of her adult life beginning with her first pregnancy following her marriage at the age of 19. According to the hospital report, she has experienced 11 pregnancies, including the birth of four children and seven miscarriages.
Mrs. Brubacher reported experiencing insomnia starting at about the age of 15. She said that a sedative prescribed by her doctor was effective in treating this. She also described an episode of depression from about the age of 18, experienced while she was staying with her sister after the birth of the sister’s first child. The sister was experiencing symptoms of post partum depression at the time. Mrs. Brubacher attributed her own feelings of depression to a lack of sleep and due to feeling shame that her sister did not trust her to watch the baby due to her insomnia. She reported feeling anxious and depressed, along with feelings of guilt and worthlessness. She was seen by her family physician shortly before her wedding and was prescribed both a sleep aid and an antidepressant. She did not take the latter medication due to worry about its potential impact on her fertility.
As noted above, Mrs. Brubacher experienced further major depressive episodes after the birth of each of her children, with the symptoms becoming increasingly severe. She also experienced symptoms of depression following several miscarriages. As detailed below, she was hospitalized for several weeks in 2020 due to symptoms of mania and psychosis.
Mrs. Brubacher’s first documented psychiatric admission was from August 2 to 26, 2020. She reportedly experienced a miscarriage in late June of that year and reportedly voiced fears of the future and a lack of desire to live. Her husband reported that she had been sleeping very little, talking more than normal for her, speaking quickly, and being physically aggressive toward him. Reportedly, these symptoms had begun on July 29, 2020, following the insertion of an intrauterine device (IUD) for contraception.
On August 3, 2020, soon after the police brought Mrs. Brubacher to hospital during this first major psychiatric crisis, a Code White was called. Mrs. Brubacher threw medication at staff, threatened to kill a nurse, and grabbed a psychiatrist. During her admission, she displayed further symptoms of mania, including disorganized behaviour, racing thoughts, physical aggression, elation, and sexually inappropriate behavior with co-patients. Her symptoms gradually resolved following treatment with antipsychotic and mood stabilizing medications. She was discharged home with a plan to follow up as an outpatient. She was counselled regarding the risk of recurrence in future pregnancies, including the risk of developing bipolar disorder.
Following her discharge from hospital, Mrs. Brubacher was seen by Dr. A. Anago, a community psychiatrist. With Dr. Anago, Mrs. Brubacher reported feelings of depression and concerns for her relationship with her husband. She consistently denied symptoms of psychosis or suicidal or homicidal ideation. On assessment, it was determined that she experienced significant symptoms of depression, anxiety, and difficulty managing her anger after most of her pregnancies, and that these symptoms had become more severe over time.
Mrs. Brubacher’s next psychiatric admission was in mid-February of 2023, days after the birth of her fourth child (the victim of the index offence). Initially, she attended at the emergency department, complaining of insomnia and depression. Medication changes were made. Her outpatient psychiatrist recommended hospital admission, but she declined. The next day, she came twice to the emergency department, the second time having been brought by ambulance after her husband had called the police, worried that she might hurt the newborn baby.
She was hospitalized until March 3. Throughout her admission, Mrs. Brubacher had significant insomnia. This only resolved just two days prior to her discharge. She endorsed feelings of anxiety and being overwhelmed with her new baby. She voiced concerns about her ability to care for the baby and her three other children, while also expressing passive suicidal ideation. Following the baby’s delivery, she had not re-started her usual medications. Medication dosages were adjusted and she was discharged to continue under outpatient care with Dr. Anago.
A month later, on April 9, 2023, the ambulance again brought Mrs. Brubacher to hospital. She had continued feeling “numb” and unattached to her new baby. She had gone to the pond on her property intending to drown herself and had to be physically removed from the water. On admission, Mrs. Brubacher had significant depressive symptoms. She was distressed by difficulty bonding with her child and by her belief that the child preferred the “mother’s helper” who was supporting the family at home. Reportedly, she had feelings of failure as a mother along with thoughts of drowning the infant in the bathtub.
On April 27, 2023, while still in hospital, Mrs. Brubacher attempted suicide by trying to drown herself in a bathtub on the psychiatric unit. She voiced a belief that her family “no longer wants her”. Having shown limited response to several medications, she underwent eleven of twelve scheduled sessions of electroconvulsive therapy (ECT) prior to her discharge on June 16, 2023. She had several successful passes to her home prior to her discharge before resuming outpatient care with Dr. Anago.
A Brief Summary of Mrs. Brubacher’s Self-Report
As provided during the NCR Assessment:
Following discharge from hospital in June 2023, Mrs. Brubacher did not return to feeling like her normal self. When the mother’s helper left in August 2023, leaving Mrs. Brubacher alone to care for the children, she recalled ongoing feelings of being stressed and unable to cope. She later reported that she was highly stressed, irritable and angry for some time, and no longer enjoyed visiting friends and family on Sundays, finding these excursions extremely stressful to manage. She reported extreme feelings of anger and being on the verge of not being in control and would occasionally lash out physically. On one occasion, she struck the young mother’s helper when the helper woke her up. She found she was slower to complete tasks, had decreased motivation and felt as if her “brain shut off” due to her stress. She struggled how to complete routine tasks that she knew well. For example, she had to re-learn how to sew a shirt, as she had forgotten how. Others would sometimes tell her, “The way I talked didn’t make any sense.”
Mrs. Brubacher had her last appointment with Dr. Anago in early September of 2023, three months before the index offence arose on December 7, 2023.
Mrs. Brubacher reported that in late November 2023, her insomnia was less intense although she continued to feel depressed, overwhelmed and had vague thoughts of ending her life. She recalled her actions were slower and that “things were sluggish at home”. She felt her low energy negatively impacted her children. She had recurrent thoughts of harming the youngest child at the time.
Although she was getting along better with the baby, her mood remained predominantly sad and afraid. She struggled to come to terms with what to do with her life. She did not think she should get pregnant again, despite her community’s cultural tradition of having large families. She reported believing that because she did not get along with the children as well as her husband, she should leave home, although she knew she had nowhere to go and worried about having to be homeless and “living on the streets” during winter.
She was not looking forward to her baby’s first birthday, as she knew that the child would soon start to walk and would then be “all over the place,” requiring greater supervision and would soon also develop into the “terrible twos”. Mrs. Brubacher continued to experience periodic thoughts of ending her own life while this was going on. Mrs. Brubacher became consumed by the thought that she would not be able to adequately care for her child. As divorce and adoption were frowned upon in their community, she felt she had “no options anywhere”.
She had significant feelings of guilt and came to believe that her difficulties were all her fault “because I was so mental … I felt it was my fault”. She reported that on some days, when her mood was particularly low, she would become preoccupied with thoughts of killing her child. On one occasion, she unbuttoned the child’s dress with the intention of drowning her in the bathtub. However, she changed her mind on that occasion as she felt that harming the child would “ruin the family”.
The criminal responsibility report provides further details of Mrs. Brubacher’s self-reported feelings in the days leading up to the index offence:
“Mrs. Brubacher further noted that there was a family gathering on December 3, 2023, however she was unable to enjoy the event as she was preoccupied with concerns that she was “ruining” the gathering as she believed her guests knew that she and her husband were not happy, and she believed that she was making the event ‘miserable for others.’ It was following this event that she made the decision to kill her infant daughter. She reported her mood was particularly low that day, as she was discouraged by some behavioural difficulties her older children were experiencing, and for which she felt responsible. She also saw no future for herself or for her infant daughter. She had little recollection of the days following this event, but felt that her mood was stable, but low. She was ambivalent about her decision to end her daughter’s life, as it was something she had previously considered and not acted on. She recalled ‘I was hoping they would go away. The thoughts were too overpowering,’ and noted that these thoughts continued, although with varying intensity.
There was a second family gathering on December 6, 2023, the day before the index offence. This seasonal gathering involved many community members attending the farm to butcher the family’s pigs. During the visit, Mrs. Brubacher again came to believe that her difficulties in forming an attachment to her youngest daughter and problems parenting were obvious to the guests. She noted she was experiencing profound feelings of inadequacy, guilt, and shame. During the course of this gathering, she again made the decision to end her daughter’s life and had intense thoughts of leaving the Mennonite community. Once she had made the decision to end her daughter’s life, her mood was brighter, and she was able to present in a fairly normal fashion. She does not believe that any of her extended family noted anything was abnormal.
Mrs. Brubacher reported that on December 7, 2023, she got up at her usual time, and had a number of chores to complete, in addition to getting the children ready for school. As the family had butchered a number of pigs the day before, she had to prepare the meat for freezing and had to do several loads of laundry. She sent her oldest three children off to school at around 8:00 a.m. She indicated that at that point she had decided to kill the victim and felt that this decision is what ‘my heart was telling me to do…it’s hard to explain…it was mostly so she didn’t have to grow up in this world.’ She had great difficultly articulating her emotions around this time, and was periodically inconsistent in her self report, for example also stating, ‘I never knew for sure it will happen – sometimes it surprises me that it did happen.’ She denied having any strong emotions that morning, although she continued to experience her usual symptoms of depression and low mood. She did not recall experiencing any symptoms of mania, hypomania, or any perceptual disturbances.”
Psychological Testing:
No actuarial risk assessment has been made available. Psychological testing was completed during the criminal responsibility assessment. The resulting opinion was that Mrs. Brubacher’s “… docility, dependency, and concerns around abandonment were likely reflective of the cultural expectations within the Mennonite community and did not meet diagnostic criteria for a personality disorder such as Dependent Personality Disorder”.
The criminal responsibility report includes an extensive extract from Dr. Lariviere’s psychological report. Certain observations are germane to identifying risk factors for Mrs. Brubacher and the management of her risk. These include the following:
(i) Mrs. Brubacher's profile indicates the presence of internal instability, including behaviours and interactions that are characterized by ambivalence, leading to emotional turmoil and a distorted perception of others and her environment. The core framework upon which she depends for understanding the world is likely impaired and her perception of psychological well-being is fragile. Although she is typically able to function appropriately, periods of emotional, cognitive, or behavioural dysfunction are likely.
(ii) Mrs. Brubacher's preoccupations with personal adequacy, chronic feelings of dejection and a consistently apathetic attitude suggest the presence of a persistent depressive disorder. Plagued with self-doubts, she is saddened by the view that she may be seen as both socially unattractive and physically inferior by others. In response to her profound dissatisfaction and sadness, she exhibits self-punitive behaviour, self-demeaning thoughts, and an over-sensitivity toward her own flaws. Despite her strong need for approval and love from others, her hopes seemed to be waning rapidly.
(iii) Mrs. Brubacher appears to experience the residual effects of a previously traumatic event during which she experienced intense fear and panic. The lingering effects of this experience seem to repeatedly resurface through upsetting memories, and she is prone to avoiding situations that mimic or signify elements of the traumatic incident in issue. Where these cannot be avoided, as in the case of recurring nightmares or flashbacks, she may become terrified once again and exhibit a number of symptoms of intense anxiety. Anticipating these recurrences may result in other signs of distress, including difficulty falling asleep, outbursts of anger, panic attacks, hypervigilance, and exaggerated startle response, or a numb and detached disposition.
(iv) Mrs. Brubacher was administered the State-Trait Anger Expression Inventory (STAXI-2). She showed a high propensity for expressing anger outwardly in a verbal fashion, but little or no inclination to hit someone or break things. She may experience significant difficulties in controlling her outward expressions of anger and could be prone to explosive behaviour at times, expressed through verbal or physical means. Overall, her Anger Expression Index (AX Index) scored as High, suggesting that she is inconsistently able to suppress her feelings of anger and directs these feelings outwardly when unable to do so.
Course in Treatment, Following the NCR Verdict, December 6, 2024, to January 30, 2025:
After completing the NCR assessment, Dr. Gillian Munro remained Mrs. Brubacher’s treating physician at the NBRHC. As the Board heard from Dr. Munro last year, Mrs. Brubacher did extremely well following her admission to the hospital on December 7, 2024. Mrs. Brubacher was described as a “model patient”. She was not irritable or impatient with staff or co-patients. Her mental status stayed relatively stable. During the first part of her hospital stay, Mrs. Brubacher was reported to be still experiencing mild features of depression.
At last year’s initial ORB hearing held on January 30, 2025, the hospital was hoping to place Mrs. Brubacher on their Hummingbird Lodge. This is an eight-bed, all-female unit. The clinical focus is to treat women who suffer from post traumatic stress syndrome and have a background of complex trauma. It was Dr. Munro’s opinion that Mrs. Brubacher would perhaps not need to complete the entire Hummingbird Lodge program, but perhaps only Phase I. Mrs. Brubacher was felt to be atypical for the patients who are treated at Hummingbird Lodge. That said, the program does house several other “atypical” patients.
The Hummingbird Lodge program comprises three phases. Phase I focuses on development of safety and stabilization skills. Phase II is an intensive recovery program addressing various forms of trauma, including post-traumatic stress disorder (PTSD). Phase III is a rehabilitation and reintegration program designed to prepare patients for community living.
A year ago, at the initial ORB hearing, the Board heard that Mrs. Brubacher’s primary risk factor to public safety would arise were she to become pregnant again. Dr. Munro noted that Mrs. Brubacher had been in a peri-partum or a post-partum period for most of her adult life. In the event of another pregnancy, Mrs. Brubacher would require very intensive support. In Dr. Munro’s opinion, an ‘‘exceptionally high risk’’ would be presented to any infant that may be born to Mrs. Brubacher.
Dr. Munro had extensive discussions about this with Mrs. Brubacher. Although the patient had been given an intrauterine device (IUD), this would not eliminate the risk of pregnancy. A tubal ligation was being contemplated to eliminate the risk of pregnancy.
At last year’s hearing it was thought that a transfer of care from North Bay to the Southwest Centre in St. Thomas was preferable. At the time, it was felt that she might benefit from an increased level of support by being closer to her home community. Having her remain in North Bay was seen as an impediment to future reintegration. Mrs. Brubacher’s husband does not drive. The long journey, from Owen Sound to North Bay, remains a challenge for Mr. Brubacher.
At last year’s hearing, the Board learned that Mrs. Brubacher was estranged from her Mennonite community. After the NCR court verdict, some repair to the relationship began. Up to then, the family would not welcome her. They would not take her calls nor want to communicate. Following the verdict, her parents and in-laws began to visit and phone. During the NCR assessment, Mrs. Brubacher was somewhat ambivalent about her community. Later, upon returning to the hospital, she expressed more interest in reconnecting with family.
In the Board’s Reasons for Disposition dated February 26, 2025, the Board acknowledged that Mrs. Brubacher has fewer risk factors than most people coming before the Board. The panel accepted Dr. Munro’s opinion that the risk of harm to any infant born to Mrs. Brubacher was “exceptionally high”.
Relying on the Hospital Risk Summary, the Board accepted that future pregnancies would result in Mrs. Brubacher experiencing psychiatric symptoms similar to, or more severe than, those she had experienced before the index offence. The Board also accepted that it was imperative that her future and reintegration be highly supported, closely monitored and effected in a gradual, stepwise fashion. If left to her own devices, Mrs. Brubacher would return to her home and community where she likely would be faced with significant stressors. Absent oversight and support, it was highly likely that such stressors would result in a decompensation of her mental status. Mrs. Brubacher’s history of unreliable adherence to medication when living in the community also made it imperative that she have access to intensive support and monitoring to ensure her ongoing compliance outside the hospital setting.
In their reasons, the Board expressed added concern about demonstrated incidents of physical aggression in which Mrs. Brubacher had engaged during previous episodes of mania, prior to the index offence. Areas for further investigation were identified, including her ability to control her anger. The Board asked that a comprehensive risk assessment be conducted in advance of the next annual review.
Course in Treatment, January 30, 2025, to January 16, 2026
On March 13, 2025, Mrs. Brubacher was transferred from the Forensic Assessment Unit to the all-female Hummingbird Lodge. Still placed there, she is described as an active and highly involved participant.
Mrs. Brubacher’s clinical status has remained stable over the course of the reporting year. She is compliant with medication and is seen regularly by a general practitioner while enjoying stable physical health.
Most recently, on January 13, 2026, Mrs. Brubacher underwent the medical procedure which was earlier proposed in 2025. Dr. Munro has now confirmed that the tubal ligation was successful, and that Mrs. Brubacher has recovered well.
In February 2025, Mrs. Brubacher agreed to being started on Lithium medication. Olanzapine was slowly reduced and eventually discontinued on May 1, 2025. In June 2025 she experienced emerging symptoms of hypomania, correlated to a suboptimal Lithium serum level. Following adjustment in the Lithium dosage, the symptoms resolved and have not returned.
Mrs. Brubacher engages in weekly individual psychotherapy sessions to explore her deeper emotional experiences. She is dealing with internalized guilt, grief, shame and remorse over the index offence. In August 2025 she disclosed carrying an “unimaginable” burden. Although seeing her family brings her joy, it also serves as a constant reminder to her of “what I did to them”.
Mrs. Brubacher is typically described as settled, pleasant and cooperative. There has been no evidence of thought form disorder. She denies experiencing any anxiety or symptoms of psychosis and often describes her mood as good. More recently, she has felt a lower energy level. She is closely monitored for depressive symptoms due to having thoughts at times that “life is not worth living” which relates to uncertainty about her future.
Mrs. Brubacher has not posed a significant management concern to the hospital. In terms of exercising privileges, she handles these appropriately. She was recently granted indirectly supervised hospital and grounds privileges to travel to and from supervised groups on her own. Mrs. Brubacher gets to enjoy daily walks around the hospital perimeter on her own, indirectly supervised, for up to 30 minutes at a time.
Participation in hospital programs has been going well. Mrs. Brubacher enjoys cooking, colouring, gardening and arts and crafts. She will often seek out staff to facilitate an activity when finding the time long. Mrs. Brubacher actively participates in several therapeutic groups and programs which are listed in the Hospital Report. She is described as highly involved when attending recreation programs.
The occupational therapist and Mrs. Brubacher meet weekly to help her develop skills to manage stress tolerance. Individual psychotherapies continue to assist with identifying emotional triggers and to develop coping strategies. She is being introduced to Dialectical Behaviour Therapy (“DBT”) where she finds the concepts are new.
Mrs. Brubacher’s husband, Cleason Brubacher, remains supportive. Typically, he will travel to North Bay weekly, and sometimes, twice weekly. A driver from their community brings him to the hospital alone, or, at times, with others. These can include not just friends in the community, but also the Brubachers’ three children.
In July 2025, Mr. Brubacher was granted approved person status. He is now authorized to supervise his wife, both in the hospital and in the North Bay community.
The hospital and the Owen Sound Children’s Aid Society’s assigned worker are in communication. Terms of supervision for Mrs. Brubacher - whenever she is in the presence of children - have been established. At such times, her husband supervises her while another adult must also be always present with him to provide supervision of the children.
Current Psychiatric Diagnosis, Hospital Report, p. 19:
Bipolar I Disorder
- Mrs. Brubacher is treated on her own consent. She has been compliant with medication throughout her time in hospital. PRN (as needed) antipsychotic medication has not been required over the course of the current reporting period. The following medications are listed in the Hospital Report:
Escitalopram oxalate 20mg once daily
Lithium carbonate 1200mg daily
Quetiapine fumarate 50mg daily
Trazadone HCl 75mg daily at bedtime
Lorazepam 1-2mg po PRN (or IM ONCE)
Benztropine mesylate 1-2mg po (or IM ONCE)
Loxapine succinate 5-10mg PRN
Loxapine HCl 12.5 – 25mg IM ONCE PRN
Quetiapine fumarate 50mg PRN
Current Hospital Risk Assessment:
- Dr. Munro and the treatment team unanimously believe that Mrs. Brubacher poses a significant threat to the safety of the public. After listing several factors indicative of increased risk, and acknowledging factors contributing to lower risk, the following passage appears in the report by way of risk summary:
“It remains the opinion of the treatment team that in order to manage the risk to the safety of others, it will be imperative that Mrs. Brubacher’s future reintegration is highly supported, closely monitored and effected in a gradual, step wise fashion. Mrs. Brubacher has expressed feelings of inadequacy and an inability to manage expectations placed upon her. If left to her own devices, Mrs. Brubacher would return to her home and community where she will likely be faced with significant stressors. Absent oversight and support, it is highly likely that such stressors would result in a decompensation of her mental status. Although generally accepting of recommended treatment, Mrs. Brubacher does have a history of unreliable adherence to medication when living in the community. It will be imperative that she have access to intensive support and monitoring to ensure her ongoing compliance outside the hospital setting.”
Testimony Provided to the Board on January 16, 2026:
The Board also received direct testimony from the attending forensic psychiatrist, Dr. Gillian Munro. Dr. Munro confirmed the contents of the report filed in evidence before providing further explanations and responding to questions.
Dr. Munro confirmed that Mrs. Brubacher continues to do very well where she is placed at Hummingbird Lodge. She is considered to still be at “Pre-Stage I”. The treatment team is trying to help Mrs. Brubacher develop psychological stability by having her attend programs designed to help her manage her emotions and to help her establish a basic understanding of psychology and psychiatry concepts.
Mrs. Brubacher’s condition has improved with treatment by Lithium medication. Asked about the June 2025 episode of hypomania, Dr. Munro explained, this arose from a suboptimal Lithium level.
Responding to questions from counsel for the Attorney General, Ms. McCaig, Dr. Munro explained that community living is a long-term goal. The Hospital wants to take a gradual step wise and very slow approach to supervising Mrs. Brubacher’s access to the community.
Currently, the Children’s Aid Society have closed their file. With Mrs. Brubacher still detained in hospital, the Children’s Aid do not consider the children to be at imminent risk. Should Mrs. Brubacher return to her home community, if only for a short visit, the Society will reopen the file. The Hospital continues to believe supervision is needed whenever Mrs. Brubacher is with children under age 18.
Responding to questions posed by Ms. Raftery, appearing for Mrs. Brubacher, Dr. Munro confirmed that locally exercised community passes are going extremely well. Most of the time, these are exercised at the hospital and on the grounds.
Mrs. Brubacher and her husband are at times accompanied by other visiting community members when she is granted passes to enter the North Bay community. They will attend at the mall or local parks, go shopping and get to enjoy meals together. From time to time, hospital staff make spot checks. Mrs. Brubacher’s children have visited. These visits have also gone well. There too, the hospital makes spot checks. To date, no concerns have arisen.
Asked what can be anticipated in the coming reporting period, Dr. Munro advised that periods of access to the community could increase. So far, the patient gets to go out for up to four hours. The next step would see the Hospital consider approving day trips to the home community. Hospital staff would accompany Mrs. Brubacher. Overnight trips are not being considered at present.
Asked about the primary risk nexus (future pregnancy), Dr. Munro repeated that the concern has always been one of mood decompensation from post-partum or peri-partum phases. Mrs. Brubacher had several periods of decompensation of her mental health, involving depression and mania following each pregnancy. On each occasion, the decompensations became more severe. Dr. Munro added, even without a future pregnancy, Mrs. Brubacher is still a risk, due to her general mental illness.
Dr. Munro mentioned that Mrs. Brubacher had eleven pregnancies. Upon hearing this, Mrs. Brubacher addressed the panel, politely intervening to correct this. According to Mrs. Brubacher, she had nine pregnancies in all.
A Board member inquired about ‘‘sub-Lithium levels’’. Dr. Munro explained this arose during the early stage of the patient’s stabilization on that medication. The hospital does not know why this happened. After the hospital increased the dosage, her levels have been fine, with no concerns about compliance.
Dr. Munro stated that Mrs. Brubacher has been extremely complaint and very reliable with her prescribed psychiatric medications. The Hospital will be providing her with education, in continuous fashion, along with counselling, about the psychological issues she faces.
There are times when Mrs. Brubacher has difficulty understanding some of these concepts. Her cognitive levels were assessed during the criminal responsibility assessment. There have been learning difficulties since childhood. Her education did not advance past Grade 8. She is at a lower IQ level, having scored between 80 to 85. Her difficulty in dealing with concepts presented also has to do with the fact that her first language is Pennsylvania Dutch - and not English, which is her second language. Moreover, Mrs. Brubacher comes from a community which has a lower level of literacy regarding psychology and psychiatry.
Asked how Mrs. Brubacher is regarded by her Mennonite community, Dr. Munro stated, she was shunned at first. Following the NCR court verdict, community members later came to a greater level of acceptance. Mr. Brubacher was instrumental in speaking with her parents and in-laws, and other community individuals, to help them view Mrs. Brubacher in higher regard.
Asked whether the Hospital had any liaison with elders in Mrs. Brubacher’s Mennonite community, Dr. Munro stated, they can explore this. Dr. Munro noted that any liaison would have to significantly involve both Mrs. and Mr. Brubacher. Dr. Munro thought this could be beneficial.
When asked about a separate issue, namely counselling involving both Mrs. And Mr. Brubacher, Dr. Munro replied, the treatment team is open to this.
Questions were asked about supervision of Mrs. Brubacher’s access to children. Mr. Brubacher’s involvement as an approved person is limited. He supervises only one person, Mrs. Brubacher. He is not there to supervise the children at the same time. Instead, this is done only by another adult, who cannot be a “mother’s helper”.
A question was asked about Mr. Brubacher’s transportation to North Bay. This involves eight hours travel time. Mr. Brubacher relies on a driver. During the coming reporting period, Dr. Munro confirmed, if the hospital does approve a home visit, Mrs. Brubacher would be accompanied by hospital staff.
The parties presented no further evidence.
Submissions of the Parties:
All three counsel confirmed the joint submission.
On behalf of her client, Ms. Raftery advised they specifically declined the previously ordered transfer of patient care to the Southwest Centre in St. Thomas.
Conclusions and Disposition:
Based on the evidence and supported by the appropriate joint position of the parties, the Board had no difficulty concluding that Mrs. Nancy Brubacher continues to present a significant threat to the safety of the public. Mrs. Brubacher is diagnosed with a severe major mental disorder, Bipolar I Disorder. A longstanding condition from which she had suffered for many years, it led her to commit the most serious and tragic index offence.
Mrs. Brubacher’s mental state in early adult years has involved prolonged and repeated bouts of heightened anxiety and deep depression. Her ability to manage and cope with the stressors of daily life and work obligations saw her overwhelmed - to the point that she had difficulty functioning to her own and to others’ expectations. A pattern of internalized despair and externalized anger became established. It saw her act out with violent aggression to those in her immediate surroundings, including to her husband and to a young female who was there to help with childcare. There were repeated suicidal behaviours.
Before the index offence arose in December 2023, several intensive mental health interventions were made. Unfortunately, in the time leading up December 2023, Mrs. Brubacher’s condition went on to seriously deteriorate as she declined treatment recommendations and appeared to withdraw her involvement in ongoing psychiatric care.
Fortunately, in the most recent reporting year while she remains an inpatient, things have started to go well. With new and apparent faithful compliance to prescribed medications and while benefitting from intensive non-pharmacological supports - which she appears to welcome - Mrs. Brubacher’s condition has stabilized.
When first appearing before the Board in January 2025, her risk of future violence was exceptionally high, particularly in any context where she might again become pregnant. At that point, it was not yet known how Mrs. Brubacher was going to manage as a new patient. Since then, Mrs. Brubacher’s condition has improved notably. Based on such improvement, and following the recent successful tubal ligation, her present level of future risk is no longer at the same ‘‘exceptionally high’’ level.
The Board accepts the hospital evidence that the present risk of future violence is more than significant. Mrs. Brubacher’s condition and situation remain complex. She is not yet clinically ready for return to the community. In addition to treatment with prescribed psychiatric medication, she will require ongoing involvement with intensive education and psychological counselling about the factors that can lead her to future decompensations as was seen in previous years and leading to the index offence.
Mrs. Brubacher appears to now be ‘‘in a good place’’ within the hospital’s Hummingbird Lodge. However, as Dr. Munro has explained, she is still only at pre-Stage I in terms of being able to acquire and apply the concepts and skills she needs to safely function in the community. The Board accepts that, going forward, it remains imperative that the hospital maintain close monitoring with a high level of support to ensure Mrs. Brubacher’s continued stability.
Regarding Mrs. Brubacher’s reintegration, and as was expressed by the Board last year, the hospital needs to take a measured, gradual stepwise approach. This very much remains necessary and appropriate. Now that Mrs. Brubacher has started to enjoy limited access to the North Bay community in the company of her husband and others, the hospital will be carefully considering just when, and the extent to which, she may be ready to access travel passes to the Owen Sound area.
The Board encourages Mrs. Brubacher to keep doing what she has been doing. She is to be commended for having developed and maintained positive relations with both staff and patients at the hospital. It is to her credit that she has, in this current reporting year, been demonstrating consistent collaboration with her treatment team at the NBRHC.
The Board agrees that last year’s Order to transfer the patient’s care to the Southwest Centre in St. Thomas can be rescinded. To date, Mrs. Brubacher has not had any contact with Southwest. Given the patient’s progress here in North Bay, where a positive therapeutic alliance is clearly established, such a transfer would be counter productive. Moreover, as the parties have advised, Mrs. Brubacher’s spouse and community members are finding it just as easy to travel to the NBRHC as opposed to St. Thomas.
For these reasons, having regard to the primary protection of the public, and balancing Mrs. Brubacher’s mental condition, her reintegration and other needs, a renewed detention order is issued on the same terms and conditions.
We thank the parties and counsel for their assistance.
DATED this 23rd day of February 2026 at the City of Toronto, in the Toronto Region.
Mr. P. Hageraats
Alternate Chairperson
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Office of the Registrar
Ontario Review Board