Ontario Review Board
Re: Frederick O’Donnell
ORB File No: 4349
Hearing held on: Monday, January 19, 2026
Place of Hearing: Providence Care Hospital
Pursuant to: Sections 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Hanbidge
Members: Ms. K. Weisbaum, Dr. R. Kunjukrishnan, Dr. W. Loza, Mr. A. Bouvier
Parties Appearing:
Accused: Frederick O’Donnell Counsel: Mr. P. K. Casey
Person in Charge of Hospital: Counsel: Ms. T. Tom Representative: Dr. Z. Selhi
Attorney-General of Ontario: Counsel: Mr. A. R. Scott
REASONS FOR DISPOSITION
(Dated February 4, 2026)
Introduction
On November 28, 2005, Mr. O’Donnell was found not criminally responsible on account of mental disorder (‘NCR’) on charges of repeated communication causing fear for safety (x2), utter threats to cause death (x4), utter threat to cause damage to property (x1), and fail to comply with probation order (x1).
In addition, on December 22, 2005, he was found NCR on charges of utter death threats (x6), utter threat to cause damage to property (x1), criminal harassment (x1), and fail to comply with probation order (x1). Mr. O'Donnell has remained under the Board's jurisdiction since then.
Mr. O’Donnell is currently subject to an Ontario Review Board ('Board' or “ORB”) Disposition dated February 4, 2025, under which he is detained at the Secure Forensic Unit of the hospital, Providence Care Hospital ('PCH') in Kingston, with privileges extending to living in the community in a 24-hour supervised Developmental Sector Home co-supervised by the hospital and Developmental Services Ontario.
On January 19, 2026, this panel of the Board convened at the hospital to conduct the annual Disposition review for Mr. O’Donnell.
The Issues, Evidence Introduced, and Parties’ Positions at the Hearing
The issues to be decided were whether Mr. O’Donnell poses a significant threat to the safety of the public at this time, and, if so, what Disposition is necessary and appropriate for him for the coming year. In deciding the second issue, the Board is required by s. 672.54 of the Criminal Code to consider four factors, being the safety of the public, as the paramount consideration, and Mr. O’Donnell's mental condition, reintegration into society, and other needs.
The evidence included a Hospital Report dated January 8, 2026 (the 'Hospital Report') and the viva voce evidence of Dr. Zoe Selhi.
At the outset of the hearing, Ms. Tom advised that the hospital asserted that Mr. O’Donnell continued to represent a significant threat to the safety of the public, and that it was recommending that all the same terms of Mr. O'Donnell's current Disposition be continued in his new Disposition for the coming year, save and except for two changes as follows:
(1) amend Clause 1 to delete the words: “the Secure Forensic Unit of”, such that the condition should now read: “the accused be detained at the Providence Care Hospital, Kingston, Ontario”;
(2) amend Clause 2 (l) to delete the words: “a 24-hour supervised Developmental Sector Home co-supervised by the hospital and Developmental Services Ontario”; such that the condition should now read: “to live in the community in accommodation approved by the person in charge”.
- Both Mr. Andrew R. Scott for the Attorney General and Mr. Phillip K. Casey for Mr. O'Donnell supported the recommendations. In closing submissions, the parties maintained that joint position. For the reasons given below, the Board agreed and ordered Mr. O'Donnell's new Disposition accordingly.
Index Offences
- The two sets of index offences are described in the Hospital Report (pgs. 2-5), and have been fairly summarized as follows in a number of recent Board Reasons for Disposition:
"Between August 2001 and October 2005, Mr. O'Donell made eight communications mostly with a former probation officer of his, and one to a former uncle and one to his grandmother. These communications were by letter and among other things threatened death, hatred, and assaults. Additionally, his mother received a number of phone calls from him, threatening to kill her.
"Between February and October of 2005, Mr. O'Donell made nine communications also of a threatening nature, either by letter or by phone calls, to the same former probation officer and the same uncle.
"In each set of offences, a number of the offences took place while he was under a probation order to keep the peace, and he was also charged with failing to comply with these orders."
Relevant Prior Personal and Mental Health History
The Hospital Report should be referred to for an account of Mr. O'Donnell's relevant past history. As that Report is an exhibit, its detailed contents need not be reiterated here.
However, this brief summary is given. Mr. O’Donnell is now 53 years old. He was born in Toronto, to parents who both drank heavily, reportedly including during his mother's pregnancy with him. His mother had been unable to care for him, and his maternal grandmother became his primary caregiver. When he was three years old, his parents separated. He resided in foster care.
At an early age, he experienced motor and speech delay and was provided with special education classes at school. He has an early history of aggression and oppositional behaviour with others and had tried to kill a pet kitten. By eighteen years old, Mr. O'Donnell had been able to attain a grade five or six education. He then worked for short periods in labouring type work but has been unemployed for most of his adult life and has been supported through ODSP. For years, he lived in hostels and on the streets.
Mr. O’Donnell had a past extensive history of alcohol-related substance use. He also reported using cannabis and magic mushrooms, has a history of experimenting with cocaine, and has used Listerine and rubbing alcohol. He has a long history of threatening to kill himself and threatening his grandmother and his mother. In his twenties, he reportedly broke his cat's back when he was intoxicated. He has often been incarcerated on criminal charges and convictions and has been the subject of restraining orders involving many of his family members. He has had many psychiatric hospital admissions as an adult, detailed in the Hospital Report.
A clinical psychology assessment in 2008, when Mr. O'Donnell was 36 years old, concluded that his intellectual functioning fell in the 'extremely low' range, below 99 percent of his peers (a decline from his previously reported 'borderline' range of functioning), and that his compromised intellectual functioning posed a significant barrier to learning verbally mediated abstract concepts, and would affect his ability to benefit from therapeutic programs.
Current Diagnoses
- Mr. O'Donnell's current psychiatric diagnoses, described in some detail in the Boards' Reasons for Disposition of December 3, 2023, and Reasons for Decision on ROL review of July 22, 2024, are set out in summary on the cover page of the Hospital Report as follows:
(1) Intellectual Development Disorder (Mild-Moderate),
(2) Paraphilia(s), by History,
(3) Personality Traits or Disorder, by History, and
(4) Substance Use Disorder(s), by History.
- Mr. O’Donnell has a lengthy criminal record beginning in 1992, outlined in the Hospital Report (pgs. 5 - 7). This record includes convictions for many property offences, and also for assault, uttering threats, sexual assaults, criminal harassment, indecent telephone calls and uttering threats to cause death. As noted above, his history includes incarcerations due to criminal charges and convictions, restraining orders, and diversions to mental health care.
Course under the Board’s Jurisdiction, from the Hospital Report
Reference should be made to the Hospital Report, for detailed annual accounts of Mr. O'Donnell's course under the Board's jurisdiction following the NCR findings in late 2005. Again, that Report's contents need not be reiterated here, but the following outline is noted.
Under his initial Disposition, Mr. O'Donnell was detained in January 2006 at the former Oak Ridge Division of the former Mental Health Centre, Penetanguishene – now the High Secure Forensic Programs Division of Waypoint Centre for Mental Health Care ('Provincial Division' of 'Waypoint'). He remained there for ten years.
In February 2016, he was transferred to the Secure Forensic Unit of PCH in Kingston. His September 2019 Disposition expanded his privileges to include the opportunity to live in the community in a 24-hour supervised Developmental Services Ontario ('DSO') sector home.
In the 2023-24 reporting year, Mr. O'Donnell was noted to have increased affective and behavioural lability since approximately December 2023 or January 2024, with generalized anxiety, some changes in cognitive functioning, multiple physical concerns including self-reports of frequent falls, and poor skills for coping with stress. These symptoms appeared to worsen as his discharge to community living approached, and they led to several medical investigations. Adjustments were made to his medications, and he was managed relatively well by a combination of medications and extensive psychotherapy. At the same time, his anxiety was seen to affect his therapeutic relationship with his team, and his stress and impulsivity were noted to lead to his sabotaging his care.
In March 2024, Mr. O'Donnell began his transition to live in a Dual Diagnosis Transitional Rehabilitation Housing Program (“DD-TRHP”) community home, under the joint care of the PCH Forensic Mental Health Outpatient Team ('Outpatient Team') and the Community Living association of Kingston and District (“CLKD”).
This DD-TRHP home is a newly established 24-7-staff supervised, highly structured and accessible house in the Kingston community, for providing daily living support for residents with dual diagnoses, i.e., with developmental disabilities and also other mental health concerns and under forensic system oversight. Mr. O’Donnell was supported in making this transition by his treatment team's Occupational Therapist, who had worked extensively with him since 2016; this support included helping to obtain physical supports he needed to live safely in the home and communing with the home staff about his level of independent functioning.
On April 15, 2024, Mr. O’Donnell was fully discharged to live as an outpatient in the DD-TRHP home. He was the home's first resident. Over the first two months there, his behaviour regressed, with increasing agitation, deteriorating functioning, and grandiose, bizarre, and some threatening behaviour. This apparently developed in the context of his psychosocial stress in the transition, the poor boundaries and inconsistent management of his behaviours by staff at the home, and a second resident beginning, in early/mid-May, the process of her transition to living in the home.
On June 10, 2024, he was readmitted to the Forensic Mental Health (“FMH”) inpatient unit of PCH, Pod A, following what is described in the Hospital Report as a decompensation in his mental state and bizarre behaviours over the weekend, placing both himself and the public at risk of harm. This significantly increased restriction on his liberty (“ROL”) was upheld as warranted on the Board's ROL review. The intention at the time of his readmission was for him to return to this community home when his mental state and behaviour had stabilized.
As noted in last Reasons for Disposition, dated March 21, 2025, Mr. O’Donnell remained in detention at the hospital's FMH unit. Initially, his behaviours worsened (including in verbal and physical aggression, sexually and other inappropriate acts, medication non-compliance, urinating on the floor, disrobing, and using the call bell inappropriately). In late July 2024, a behavioural plan was initiated to address his worsening maladaptive behaviours and poor coping skills. On August 9th, he was transferred to his previous housing unit on Pod C. He was placed in seclusions on six occasions between June 17th and August 30th, twice each month. He was described as coping better throughout September, until September 26th, when his highly agitated and aggressive state and his threats to kill staff led to his being placed in a seventh seclusion.
In addition, Mr. O’Donnell was formally diagnosed with Parkinson’s disease requiring medication.
As well, since his re-admission in June 2024, Mr. O’Donnell had had a variety of medication adjustments as it relates to benzodiazepine and antipsychotic medications which have improved his anxiety and mood stabilization. Equally important, as noted below in para. 31, has been the introduction of a behavioural plan to address his maladaptive behaviours and coping.
Mr. O’Donnell has had no seclusions following his last one in late September 2024 (for 3 days). Mr. O’Donnell had no AWOL attempts or positive urine drug screens throughout the reporting period. Mr. O’Donnell currently does not have any issues with illicit substance use; he abstains from all illicit and non-prescribed alcohol and substance use.
Mr. O’Donnell is capable of managing his own finances and does so with support from his inpatient and residential teams (depending on his living arrangements). He receives ODSP, and, when in living in the community, DSO Passport Program support funding.
Mr. O’Donnell’s mental health has presented with increased affective and behavioural lability since approximately December 2023/January 2024. There have been noted changes in his cognitive function (e.g. memory concerns, disorientation, confusion, etc.), as well as his expressed experience of anxiety leading up to his discharge and subsequent and community placement in the DD-TRHP home. While at hospital, Mr. O’Donnell continues to engage in attention seeking behaviours, most recently in unwitnessed falls.
The Hospital Report notes that Mr. O’Donnell’s decompensation, requiring his current re-admission, can be attributed to an overprovision of care and attention in combination with poor boundaries and Mr. O’Donnell’s impaired cognitive function.
As a result, the Hospital has supported the development and implementation of a highly structured Positive Behaviour Support Plan (with Mr. O’Donnell engaged in several individual psychotherapy sessions) to promote the stabilization of Mr. O’Donnell’s mental state and behaviour. While his progress has not been linear, he is making gains in a slow return to baseline. Unfortunately, this continues to be complicated by his ongoing physical health concerns.
For Mr. O’Donnell’s course in hospital from September 2024 to December 2025, he has shown relative psychiatric stability in that he had no further seclusions. However, he remained preoccupied with various beliefs related to his detainment, health, and other matters, with increasing difficulty on his ability to be redirected from various topics.
Mr. O’Donnell had several verbally aggressive outbursts early in the most recent reporting period (November 2024); however, these have largely resolved. He had no acts of physical aggression, including no sexually inappropriate behaviours.
In addition, Mr. O’Donnell’s worsening tremors (oro-facial, upper extremity), secondary to Parkinson/PD, led to increased monitoring of his prescribed dopaminergic medications, though his antipsychotic medications ultimately increased over the reporting period.
Mr. O’Donnell had several falls that led him to have hip surgery in May 2025. Thereafter, he became highly dependent on staff for his care.
Following his surgery, the Hospital Report notes that Mr. O’Donnell has demonstrated inconsistent engagement in rehabilitation sessions and has also repeatedly cancelled these sessions and fired the staff working with him. In addition, Mr. O’Donnell’s mental status is also of concern as he is frequently fixated on somatic concerns, delusional beliefs, and is generally mistrustful around medications and his health needs. This complex clinical intersection of Mr. O’Donnell’s developmental disability, behavioural concerns, mental status and cognitive functioning, physical health problems, and now mobility status (i.e. non-ambulatory state) have resulted in significant limitations in terms of his functional progress over the course of the past year.
Mr. O’Donnell’s bed at the DD-TRHP house has been maintained for the time being. Should he return to that program significant changes will need to be made to ensure clear boundaries, structure, consistency of care, and communication between various staff officials.
During Mr. O’Donnell’s Risk Assessment from 2021, he underwent two forms of testing. As Mr. O’Donnell has sexual offences in his criminal history, he was tested using the Static-99R instrument to assess his risk for sexual and violent recidivism as a sexual offender. Mr. O’Donnell scored 8 on the Static-99R. As noted in the hospital Report, this puts Mr. O’Donnell in a risk level well-above average risk, resulting in his sexual reoffending about three to four times the average rate of reoffending for the overall population of individuals convicted of sexually motivated offences.
With Mr. O’Donnell’s further testing using the HCR-20v3 instrument, a structured clinical risk assessment measure, Mr. O’Donnell presents as a high long-term risk for violent re-offending. In terms of clinical and risk management factors, he presents as a low risk. Thus, overall, he can be considered to present a moderate risk.
However, as noted in the Hospital Report, this rating is due in large part to Mr. O’Donnell’s hospitalization and the high degree of supervision and structure currently being provided. It is difficult to know to what extent Mr. O’Donnell will maintain this status should he be released at the present time. Any reduction in his current structured environment must be made cautiously and in a very incremental stepwise fashion in order to monitor Mr. O’Donnell for deterioration in functioning.
In conclusion, the Hospital Report notes that, for the upcoming reporting period, Mr. O’Donnell will require ongoing, inpatient level of care, which may necessitate placement within the wider hospital setting at PCH. According, the Hospital is only suggesting the following changes to Mr. O’Donnell’s current ORB Disposition:
-in paragraph 1 - delete the words “the Secure Forensic Unit”;
-delete paragraph 2(l) – and replace with the words “live in the community in accommodation approved by the person in charge” as Mr. O’Donnell will require a highly structured setting to address his complex medical and psychiatric needs going forward.
Viva Voce Evidence of Dr. Z. Selhi
Dr. Selhi testified that she has been Mr. O’Donnell’s treating psychiatrist at PCH since April 2024. Dr. Selhi was the co-author of the Hospital Report and adopts its contents, including the opinion that Mr. O’Donnell has been and continues to represent a significant threat to the safety of the public.
The factors Dr. Selhi referenced to support her opinion in that regard included noting that Mr. O’Donnell requires the inpatient hospital setting for much needed support for his current psychiatric and medical conditions. According to Dr. Selhi, Mr. O’Donnell has been in this setting since 2016. At one point, there was an attempt to place Mr. O’Donnell in the community, but it was without success. Mr. O’Donnell presents with a variety of medical changes and needs to improve his psychiatric stability. The treatment team needs to carefully monitor Mr. O’Donnell as he has difficulty maintaining stability.
Mr. O’Donnell has presented with physical health problems in the last year, including, within the last few months, having suffered several falls leading to the necessity of surgery. Mr. O’Donnell now must ambulate with the use of a wheelchair. As a result, the major change for Mr. O’Donnell is having become highly dependent on nursing staff supports in order for him to function on a daily basis. This might lead to the current psychiatric nursing staff not being able to provide Mr. O’Donnell with his needed level of supports on an ongoing basis.
Mr. O’Donnell also suffers from Parkinson’s disease. Attempts to treat this illness with medication resulted in a worsening of some of Mr. O’Donnell’s movements and his psychiatric condition. As a result, a number of medication adjustments were required. Mr. O’Donnell has been doing better for the past three months, but that could also change given his declining neurological status.
The recommended changes to Mr. O’Donnell’s Disposition Order are based on the observations that, with Mr. O’Donnell’s ongoing health care needs, he may need to reside elsewhere in the hospital in the future, including in the hospital’s general unit where he would obtain specialized health care.
Furthermore, the condition that would allow Mr. O’Donnell to live in the community in a 24-hour supervised Developmental Sector Home is no longer an approved setting for Mr. O’Donnell’s future accommodation given his current medical needs. Instead, discussions are being undertaken to consider Mr. O’Donnell’s future placement in a long-term care facility (which may also be a setting that would be challenged to accommodate Mr. O’Donnell’s needs), although no actual referrals have been undertaken at the present time.
According to Dr. Selhi, the focus this upcoming year is to encourage Mr. O’Donnell to become engaged behavioural therapy programs, including physical therapy initiatives., as well as Mr. O’Donnell maintaining his psychiatric stability. Efforts would also be made to engage Mr. O’Donnell to continue participating in activities outside the forensic unit and elsewhere in the hospital setting.
In response to questions posed by Mr. Scott, on behalf of the Attorney General, seeking an explanation for the previous worsening of Mr. O’Donnell’s psychiatric stability, Dr. Selhi testified that, following his surgery, Mr. O’Donnell was inclined to focus on delusional matters to such a degree that it was difficult to redirect him, leading to his mental health decline. Dr. Selhi also testified that there was also some evidence of Mr. O’Donnell experiencing abnormal perceptions, which added to his entrenched delusional thinking. As a result, Mr. O’Donnell’s medication had to be increased, with him started on Olanzapine, although the added medication worsened his movements.
According to Dr. Selhi, at present Mr. O’Donnell’s mental status has improved; however, Mr. O’Donnell has always had difficulty being redirected from his psychosomatic thinking. With different medications being introduced, hopefully his symptoms will be reduced.
In response to questions posed by Mr. Casey, on behalf of Mr. O’Donnell, Dr. Selhi suggested that there may need to be changes made to Mr. O’Donnell’s medication regimen to address his symptoms, such as involuntary facial movements, if affected by his prescribed antipsychotic medications. However, Dr. Selhi noted that, if related to Mr. O’Donnell’s Parkinson’s disease, no medication exists at present to cure Parkinson’s disease, only medication to delay this progressive illness. Dr. Selhi added that Mr. O’Donnell has several diagnoses which are contributing factors to cause the prognosis of his Parkinson’s disease to increase at a faster pace. Mr. O’Donnell already has other intellectual and cognitive problems. No other medication is currently being discussed to deal with his Parkinson’s condition.
Dr. Selhi acknowledged that Mr. O’Donnell’s age and current infirmed condition contribute to a lowering of Mr. O’Donnell’s likelihood of sexually reoffending. Dr. Selhi also confirmed that Mr. O’Donnell is no longer prescribed Lupron (i.e. medication used to lower Mr. O’Donnell’s sexual drive), given that presently Mr. O’Donnell finds himself being monitored in a structured setting.
Dr. Selhi testified that the evidence of Mr. O’Donnell’s psychosis (especially his delusional thinking) was seen to have arisen sometime after Mr. O’Donnell’s surgery and was not thought to be a symptom of or related to schizophrenia. Instead, it relates more so to other factors, including the surgery, as well as Mr. O’Donnell’s cognitive decline and his other ongoing neurological insults.
In response to questions posed by some panel members of the Board, Dr. Selhi noted that, at present, Mr. O’Donnell does not appear to require placement on a geriatric ward given he appears more stable and has his health care adequately managed by the nursing staff. However, if his condition changes, an alternative placement will be considered.
Dr. Selhi also confirmed that Mr. O’Donnell continues to represent a significant threat to public safety, noting the factors in support of her opinion that, while Mr. O’Donnell has not committing any acts of physical violence in the past reporting period (although he was placed in seclusion in September 2025), and his risk has been lowered by being now being placed in a wheelchair, Mr. O’Donnell’s psychiatric stability remains in flux, with it being unclear whether that stability exists.
Dr. Selhi testified that she and the other members of the treatment team need a lot more information to ensure Mr. O’Donnell’s psychiatric stability is maintained, given the length and severity of his history, and his ability to still lash out despite the increased level of nursing care.
It was noted that while Mr. O’Donnell has been under the Board’s jurisdiction for approximately twenty years, he has never been diagnosed with a major psychotic illness, although Dr. Selhi testified that, at various points, he was diagnosed with schizophrenia, but it is not an active diagnosis at the present time. Instead, Dr. Selhi opined that the psychotic features more recently experienced by Mr. O’Donnell followed the stress of his surgery, Parkinson’s, and a variety of other causes. Dr. Selhi added that Mr. O’Donnell’s symptoms of psychosis, as well as his mood stabilization, were currently being controlled by his prescribed medication regimen. Dr. Selhi also reported that Mr. O’Donnell was not experiencing any paraphilias in the last year.
Dr. Selhi testified that there were no plans to make changes to Mr. O’Donnell’s antipsychotic medication regimen, although alternative psychiatric medications may be considered to help reduce the features of Mr. O’Donnell’s Parkinson’s diagnosis.
Following further questioning by Mr. Casey, Dr, Selhi noted that it was unlikely that Mr. O’Donnell’s Intellectual Developmental Disorder or his Personality Traits/Disorder diagnoses were the causes of his psychotic symptoms, but more like the stress of his surgery and other factors.
Closing Submissions
- Counsel for all parties maintained their joint position as outlined at the commencement of the hearing, as noted previously in paragraphs 7 and 8.
Analysis and Conclusion
On the first issue, this panel of the Board has no hesitation in finding that at this time, Mr. O'Donnell represents a significant threat to the safety of the public. This was uncontested at the hearing, and the finding is amply supported by the evidence.
The term “significant threat” is defined in s. 672.5401 of the Criminal Code as “a risk of serious physical or psychological harm to a member of the public … resulting from conduct that is criminal in nature but not necessarily violent.” A finding of significant threat must be guided by the principles of law established in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625, as applied and elaborated in numerous judicial decisions since then. To state this jurisprudence in only a nutshell: A finding of significant threat cannot be speculative; it must be based on evidence. It requires positive findings, supported by the evidence, that the threat that a person would engage in criminal conduct is a “real” threat, and that the harm this conduct would cause would be “serious.” Both findings are required: Neither a miniscule risk of grave harm, nor a high risk of trivial harm, is sufficient to find a real threat of serious harm.
The evidence at this hearing includes the results of two actuarial-type measurement tools used for structuring clinical risk assessment, scored for Mr. O'Donnell as summarized in a Psychological Risk Assessment Report of October 2021 (Hospital Report, pgs. 132-34), and remaining relevant today.
On the Static-99R, the results for him indicate that he is at "well-above average risk” for sexual and violent reoffending, described as "about three to four times the average rate" of such reoffending for those convicted of sexually motivated offences.
On the HCR-20-v.3 guide for violent reoffence risk assessment, the results for him indicate a "high level of long-term risk" (based on historical factors), a "low-moderate shorter-term risk" (based on current dynamic factors), and a "low anticipated risk management risk". These are summarized as a "moderate overall risk" of violent reoffence, which is noted to be "due in large part to his hospitalization and the high degree of supervision and structure [the hospital] has been able to provide", with the caveat that it was "difficult to know to what extent Mr. O'Donnell would be able to maintain this status should he be released" from hospital.
The current reoffence risk factors for Mr. O'Donnell include his multiple prior diagnoses, most notably Intellectual Developmental Disorder and Paraphilia(s), his mental and behavioural instability, his limited insight, his stress and difficulty coping with it, and his past and recent history of relapsing into serious aggressive conduct. The panel agrees with Mr. Scott’s final submission noting that Mr. O’Donnell’s index offences involved criminal harassment and threatening behaviour, criminal conduct which can still be committed by Mr. O’Donnell despite being confined to a wheelchair. Accordingly, his risk management needs include ongoing expert forensic mental health care treatment, oversight, and support, and a highly supervised, structured setting with appropriately skilled staff members.
The Summary of Risk provided by Dr. Selhi in the Hospital Report (pg. 138), for the time following Mr. O'Donnell's return to hospital in June 2024 from the DD-TRHP community home, states as follows:
“This is a 53-year-old accused with a primary diagnoses of Intellectual Developmental Disorder. He returned to an inpatient level of care in June 2024 after a brief discharge to the community. He has been on a detention order since November 2005 and admitted to the PCH inpatient forensic unit since 2016.
Over the reporting period, Mr. O’Donnell was more stable and/or less aggressive from a psychiatric point of view, however he showed increasing medical problems, which ultimately led to his current, non-ambulatory state. At this time, Mr. O’Donnell will require ongoing, inpatient, level of care, which may necessitate placement within the wider hospital setting at PCH.
No changes to Mr. O’Donnell’s disposition are recommended [except as noted earlier in these Reasons]. While Mr. O’Donnell’s risk level has clearly been affected by his worsening medical status, reducing his capacity to engage in various physically assaultive behaviours, he requires a highly structured setting to address his complex medical and psychiatric needs.”
On the second issue, of the new Disposition, the same evidence makes it clear that the continuation of Mr. O'Donnell's detention order remains the necessary and appropriate Disposition for him for the coming year. It will properly protect the safety of the public, which is the paramount factor for the Board to consider. It will also serve other important and related factors respecting Mr. O'Donnell's best interests, including for ongoing treatment and stabilization in the structured and well-supervised hospital setting with its well-trained mental health care experts and supportive staff members.
This panel of the Board also agrees with the hospital’s request for two adjustments to the Disposition are warranted given Mr. O’Donnell’s current medical condition. Accordingly, the new Disposition will delete the words: “the Secure Forensic Unit of”, such that the condition should now read: “the accused be detained at the Providence Care Hospital, Kingston, Ontario”, in order to recognize Mr. O’Donnell’s ongoing health care needs, as he may need to reside elsewhere in the hospital in the future, including in the hospital’s general unit where he would obtain specialized health care. As well, Clause 2 (l) will be amended to delete the words: “a 24-hour supervised Developmental Sector Home co-supervised by the hospital and Developmental Services Ontario”; such that the condition should now read: “to live in the community in accommodation approved by the person in charge”, in order to address Mr. O’Donnell’s future accommodation needs given his current medical issues.
Some important issues will be addressed in the year ahead. Mr. O'Donnell has a number of health concerns, which include his diagnosis of Parkinson's disease, and symptoms such as involuntary facial movements. He is being actively followed with respect to ongoing psychotherapy and counselling, and to planning for potential physiotherapy and medication or other treatments respecting these health concerns.
Mr. O'Donnell's future transition to community living is not foreclosed at this time. However, time and work will be required to ensure he can be accommodated in an appropriate highly structured and supported 24-hour-supervised residence, with staff who are skilled in caring for and effectively managing dual diagnosis residents such as Mr. O'Donnell.
In making this Disposition, the Board carefully considered the joint position of the parties, the evidence of Dr. Selhi, and the contents of the Hospital Report entered as an exhibit at the hearing and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of sections 672.54 and 672.5401 of the Criminal Code and carefully considered the need to protect the public from dangerous persons (with the public’s safety being the Board’s paramount consideration), Mr. O’Donnell’s mental condition, and his reintegration into society and his other needs.
We wish Mr. O'Donnell all the best in the year ahead.
DATED this 4th day of February 2026, at the City of Toronto, in the Toronto Region.
Mr. J. Hanbidge Alternate Chairperson
Office of the Registrar Ontario Review Board

