Re Patrick Michael Burke, 2026 CanLII 18291

Re: Patrick Michael Burke

ORB File No: 8381

Hearing held on: Wednesday, December 17, 2025

Place of hearing: Centre for Addiction and Mental Health

Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Ms. S. Kert

Members: Dr. T. Verny

Dr. G. Nexhipi

Hon. C. Nelson

Mr. W. Apted

Parties Appearing:

Accused: Patrick Michael Burke

Counsel: Mr. A. Rai

The person in charge of hospital: Counsel: Mr. D. Blumenkrans

Attorney General of Ontario: Counsel: Mr. M. Yousuf

REASONS FOR DISPOSITION

(Dated February 4, 2026)

Introduction

1. On August 22, 2023, Mr. Patrick Burke was found unfit to stand trial on account of mental disorder (“unfit to stand trial”), on Criminal Code of Canada (“Criminal Code”) charges of robbery (x2).

2. Mr. Burke is currently subject to a Disposition of the Ontario Review Board (the “Board”), dated December 30, 2024, finding him unfit to stand trial and detaining him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH”) with various conditions and privileges extending to his entering the community, indirectly supervised.

3. On December 17, 2025, the Board convened a hearing at CAMH to conduct the annual review of the current Disposition.

4. Mr. Burke was not present at the hearing. A reason was not given but Mr. Rai, his counsel, advised that he had met with him earlier in the day and had instructions. As there were no objections, Mr. Burke was excused from the hearing pursuant to s. 672.5(10)(a) of the Criminal Code. The hospital was represented by Mr. Blumenkrans; the Crown by Mr. M. Yousuf.

5. A Hospital Report, dated November 25, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. In accordance with s. 672.48(1) of the Criminal Code, the Board must decide whether Mr. Burke is still unfit to stand trial on the day of the hearing, within the meaning of s. 2 of the Criminal Code. Specifically, is Mr. Burke unable, on account of mental disorder, to understand the nature of a trial and the possible consequences of the proceedings or to communicate with counsel? The other issues before the Board are whether Mr. Burke is permanently unfit, and if so, whether he remains a significant threat to the safety of the public.

7. If Mr. Burke is found fit, he must be sent back to court. If he is found unfit, but not permanently so, the Board must make a Disposition that is necessary and appropriate, considering the criteria set forth in s. 672.54 of the Criminal Code. Similarly, if he is found to be both permanently unfit and a significant threat, the Board must determine the appropriate Disposition. If he is not found to pose a significant threat to public safety, he must be returned to the court.

8. For the reasons set out below, and based on the evidence before us, this Board has concluded that Mr. Burke is unfit to stand trial. The Board further concluded that at present it is premature to find that Mr. Burke is permanently unfit. The Board also found that the necessary and appropriate Disposition required to manage Mr. Burke's threat to public safety is a continuation of the existing Detention Order with an expansion of his community privileges to allow him to enter the Greater Toronto Area escorted or accompanied by staff, accompanied by an approved person, or indirectly supervised.

Outstanding Charges

9. The circumstances of the allegations against Mr. Burke are excerpted from last year's Board Reasons, as follows:

“According to the hospital report (page 16) Mr. Burke approached a woman and shoved her while attempting to take her cellular phone from her hand. She was able to fend off the attack and he fled the area. A short time later that same day, Mr. Burke approached another woman and asked if she had any money. She stated that she did not. He allegedly shoved the victim and grabbed her cellular phone from her hand and attempted to flee. Two passers-by grabbed him and police were called. He was charged with Robbery x2. Mr. Burke was released on bail.”

10. Mr. Burke’s history and background are outlined in the Hospital Report, and are accurately summarized in last year's Reasons:

“Mr. Burke was a good student and intended to go to university. However, he was unable to do so as his academic performance was negatively affected by the onset of illness. He entered a community college, but did not graduate. He was an avid sportsman. He had limited employment and has not worked since 2017, being supported by disability payments. He is not involved in any relationship and has no children.

Mr. Burke has an extensive psychiatric history and involvement in the criminal justice system. He also had many family issues. a history of verbal and physical aggression and threats towards his family. Since 2012, Mr. Burke’s family had become increasingly frightened of him. At the outset of his mental illness, Mr. Burke frequently threatened his brother’s life. His brother took the threats seriously. Mr. Burke’s brother moved out of the family home in 2015 and his sister also moved out by 2016, in part due to Mr. Burke’s erratic behaviour.

In 2016, Mr. Burke threatened to assault his father with a golf club. In 2019, Mr. Burke’s parents changed the locks of their family home as they feared serious physical harm from him. His parents were unwilling to live with him in their family home as of 2019. In 2022, Mr. Burke explicitly threatened to kill his brother. Mr. Burke’s family relationships eroded as a result of his behaviour and his father remained Mr. Burke’s only family support.

Mr. Burke had an extensive history of polysubstance use including cannabis, cocaine, crack cocaine, crystal methamphetamine, alcohol, cigarettes, and caffeine and energy drinks. In his lifetime, he used an opioid, and ecstasy. Most recently, Mr. Burke’s presentations to hospital were associated with methamphetamine, cocaine, and cannabis use (hospital report, pages 5 - 7).

Mr. Burke’s involvement with the criminal justice system is not entirely clear. In 2019, Mr. Burke was charged with Indecent Exposure and in a separate incident, Sexual Assault after he propositioned a woman to have sex in a public bathroom and tried to restrain her as she fled. In 2021, Mr. Burke was reportedly charged with Robbery, and Possession of Stolen Property (distinct from the index offences) arising from an incident at a convenience store.

In early 2022, he apparently was charged with Attempted Robbery and Assault. The circumstances are not clear. On September 15, 2022, he apparently stole a car. In 2021, he was found guilty of assault, as a lesser included offence of sexual assault and conditionally discharged with twelve months’ probation. In 2022, he was found guilty of assault (x2) and theft under $5000 (x4) and given a suspended sentence and probation.

Mr. Burke’s extensive psychiatric history is set out in the hospital report. It may be summarized thus: At the time the report was prepared, Mr. Burke’s diagnoses were schizoaffective disorder (bipolar type) and substance use disorder (amphetamines, cannabis – severe, in early remission within a controlled environment).

In 2012, Mr. Burke’s parents first observed prodromal symptoms of a primary psychotic disorder such as inconsistent sleep, social withdrawal, a decline in academic performance, and bizarre behaviour which included pacing around the house and practicing golf very late at night. There were also frequent episodes of “rage” over golfing and minor conflicts at home, with threats set out above.

Mr. Burke’s first inpatient psychiatric admission occurred in 2014. Since 2014, Mr. Burke was admitted for inpatient psychiatric treatment every year to CAMH. Mr. Burke was first on a CTO between May and September 2015 after which the CTO was discontinued as his presentation improved. However, Mr. Burke stopped engaging with outpatient psychiatric follow-up and was non-adherent with his medications. Mr. Burke was maintained on a CTO since August 2016. Psychiatrists at the CAMH Slaight Centre Early Intervention Service (SCEIS) were his community treatment providers (CTP) until May 2020. Since May 2020, Mr. Burke’s CTPs were psychiatrists at the CAMH Downtown East Assertive Community Treatment Team (DeACTT). Mr. Burke’s parents both served as substitute decision makers (SDM) for psychiatric treatment decisions until 2018. As of 2018, Mr. Burke’s father was his sole SDM.

When unwell, Mr. Burke was described as disorganized, exhibited paranoid delusions of sexual impropriety involving non-existent female partners, exhibited grandiose delusions of being a military official, and endorsed a variety of connections to celebrities including Elon Musk and Drake. Mr. Burke’s symptoms were exacerbated by substance use and complicated by severe substance dependence. His illness was characterized “by erratic and aggressive behaviour, paranoid delusions, and compromised insight and judgment… and auditory hallucinations.”

In the past, he verbally threatened, physically postured, and physically assaulted individuals ranging from his family members to hospital staff. He reportedly demonstrated sexual aggression towards female members of the public. He reportedly also damaged physical property and punched holes in walls, and broke windows and burnt holes in mattresses. Several of Mr. Burke’s admissions occur in the context of psychosis, noncompliance with medication, and substance use.

On four occasions, Mr. Burke presented to the Emergency Department stating suicidal ideation but later stated he wanted help accessing housing and rehabilitation services. Mr. Burke was managed on several psychiatric medications and was involved in several substance use programs.”

Initial Position of the Parties

11. The hospital submitted that the current Disposition detaining Mr. Burke at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH”) be maintained. Mr. Burke still remains unfit to stand trial, but it is premature to find that he is permanently unfit. His passes should be extended to include the Greater Toronto Area (“GTA”). The Crown agreed with the hospital but wanted to hear the evidence about expansion of his passes. Mr. Rai supported the hospital. The matter basically proceeded as a joint submission.

Evidence at the Hearing

12. The evidence at the hearing was provided by Dr. R. Jones, Mr. Burke’s psychiatrist, and author of the Hospital Report.

13. Mr. Burke has resided on FSUA (Unit 3-2) for the past reporting year. He has made progress with respect to having increased off-unit passes (up to escorted community passes). There have been no incidents of violence or aggression, and no inappropriate sexual behaviour. There has been an improvement in his self-care and overall, he has been calmer during the reporting year with more engagement with staff. However, he has significant ongoing disorganization of thoughts and behaviour and no insight into his mental disorder or the need for medication.

14. The reason the hospital is seeking an extension of passes in paragraph 2(e), (f) and (g) of last year’s Disposition, is to eventually allow Mr. Burke opportunities for rehabilitation that fall outside of central Toronto. Specifically, the hospital would like the passes extended to enable Mr. Burke to attend a program at the horse stables.

15. As far as Mr. Burke’s fitness to stand trial is concerned, not much has changed over the year. The team has tried to engage him, but he still presents with disorganized thoughts. He continues to endorse delusional beliefs. He suffers from schizophrenia and believes that he owns CAMH and that its employees, including his doctors, are his staff. When engagement is attempted, he often walks away. When fitness questions are asked, his responses are limited.

16. Quite recently, Mr. Burke appears to have shown some understanding of what a judge does and the role of defence counsel. He also appears to understand the difference between a plea of guilty and not guilty. However, he continues to insist that he does not have any charges against him. His ability to provide instructions is impaired. He denies having a mental illness. He continues to harbour delusional beliefs that he is a Navy Seal and a professional boxer. He mostly refuses to engage in discussions about court. He remains unable to identify his counsel or whether he has been able to communicate with his counsel. According to Dr. Jones, Mr. Burke remains unfit to stand trial from a psychiatric perspective.

17. Dr. Jones cannot state that Mr. Burke is permanently unfit as his medication (clozapine) has not yet been optimized. This is at least partly due to his reluctance to take the medication (he has been observed spitting it out), so there is still some opportunity to optimize his treatment. Whether this will render him fit in the future has yet to be determined. The treatment team will continue to attempt to assess him for fitness as his medication is optimized or changed.

18. In answer to questions from the Crown, Dr. Jones stated that Mr. Burke suffers from ultra-treatment resistant schizoaffective disorder (bipolar type). Even after being treated with different medications and having ECT treatments, he does not respond fully. As Mr. Burke has repeated episodes of noncompliance with his medication, now given in a syrup form, there is consideration being given to switching to an injectable form of antipsychotic medication.

19. As Mr. Burke’s thought process is very disorganized, he engages in no formal programs except for leisure activities. He does use escorted community passes.

20. It is the team’s hope that optimizing his medication will improve his insight and fitness.

21. In answer to questions from Mr. Rai, Dr. Jones stated that there have been no violent incidents this year, although Mr. Burke was assaulted on two occasions. His engagements with staff have improved albeit, he has a “long way to go” in that area.

22. It is the team’s view that expansion of the geographical area of Mr. Burke’s passes will be motivational and will be beneficial because of the absence of drugs in that environment.

23. Mr. Burke’s father is his Substitute Decision Maker (“SDM”), but they do not see much of one another.

24. Recently, on October 28, 2025, a case conference was held to discuss potential transfer to a general unit, but it was decided that the most appropriate placement still remains a secure unit. It remains possible, however, that a move to a general unit may happen during this coming year.

25. General Forensic Unit 1-5 has an increased staff-to-patient ratio that might be an appropriate placement. A move will not be made while the team is still optimizing his medication. As well, Mr. Burke, at present, seems resistant to any move to another unit. Although Mr. Burke is not using indirectly supervised passes into the community yet, Dr. Jones encouraged the Board to allow this privilege to stand in this current year’s Disposition as there remains the possibility that this could occur.

26. In answer to a Board member’s questions, Dr. Jones re-emphasized there is no reason to take away the privilege of indirectly supervised passes into the community as, if Mr. Burke improves, this privilege will be used.

27. In answer to a further question from a Board member, Dr. Jones testified that it will be difficult for Mr. Burke to transfer to a general unit if his indirectly supervised passes are not used.

28. No further evidence was called.

Submissions

29. The hospital submitted that Mr. Burke remains unfit to stand trial. He is not permanently unfit as the team is still in the process of optimizing his medication in order to determine if he can become fit and in order to improve his quality of life. A disposition increasing the geographical area to include the GTA will increase Mr. Burke’s liberty privileges so that the Disposition, going forward, will be the least onerous and least restrictive Disposition available while still managing Mr. Burke’s risks.

30. The Crown, after hearing the evidence, agreed with the hospital.

31. Mr. Rai submitted that Mr. Burke had a good year with no incidents of aggression and a little more engagement with his team. Mr. Rai submitted that the contemplation of a move to a general unit with high support, in the coming year, was possible. He agreed with the hospital on the expansion of Mr. Burke’s passes to include the GTA.

Conclusion

32. Having heard the evidence and submissions of the parties, the Board finds that Mr. Burke remains unfit to stand trial but not permanently unfit. The Board makes this finding on the basis of the test to be applied as set out in the recent case of Regina v Bharwani, 2025 SCC 26. Mr. Burke suffers from a treatment refractory form of schizophrenia. His thoughts are very disorganized, making it difficult for him to instruct counsel. He continues to have delusions. Dr. Jones stated that even though Mr. Burke can answer some of the Taylor questions, he insists he has not been charged and, therefore, he cannot apply the information relevant to fitness issues to his own situation. In addition, his thoughts are so disorganized that he cannot choose between pleas of guilty and not guilty. This impacts his fitness to stand trial.

33. Mr. Burke is not permanently unfit so the Board must make a disposition to manage his risk that is necessary and appropriate but the least onerous and least restrictive considering the factors set out in s. 672.54 of the Criminal Code.

34. In ordering a Detention Order with the same terms as last year, except for the expansion of Mr. Burke’s community privileges to include the GTA for therapeutic purposes, the Board has taken into account the re-offence scenario set out at page 24 of the Hospital Report. The expansion of Mr. Burke’s pass privileges to include the GTA will require changes to paragraphs 2(e), (f), and (g) of his Disposition.

35. In arriving at our conclusion for the appropriate disposition, the Board has considered the paramount factor of the safety of the public, Mr. Burke’s community reintegration, his mental condition, and his other needs, all as required by s. 672.54 of the Code.

DATED this 4^th^ day of February, 2026, at the City of Toronto, in the Toronto Region.

Hon. C. Nelson

Legal Member

__________________

Office of the Registrar

Ontario Review Board