Re Pemba Tsering, 2026 CanLII 21120

Re: Pemba Tsering

ORB File No: 6271

Hearing held on: Thursday, November 27, 2025

Place of hearing: Centre for Addiction and Mental Health

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Ms. C. Finley

Members: Dr. Y. Alatishe

Dr. L.O. Lightfoot

Hon. B. Allen

Mr. J. Cyr

Parties Appearing:

Accused: Pemba Tsering

Counsel: Ms. M. Addie

The person in charge of hospital: Counsel: Ms. M. Warner

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

REASONS FOR DISPOSITION

(Dated January 22, 2026)

Introduction

1. On January 16, 2013, Pemba Tsering was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault, forcible entry, and assault with a weapon, all contrary to the Criminal Code of Canada. He is currently subject to a disposition of the Ontario Review Board (“ORB” or “the Board”), dated November 21, 2024, detaining him at the all-male forensic service at the Centre for Addiction and Mental Health, Toronto (“CAMH” or “the hospital”), with discretionary privileges up to and including the ability to reside in all-male supervised accommodation in the Greater Toronto Area (“GTA”) approved by the person in charge.

2. On November 27, 2025, the Board convened a hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Tsering was present and represented by Ms. Addie. A Tibetan interpreter attended virtually and was available to Mr. Tsering.

3. The issues to be determined were whether Mr. Tsering continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition to manage that threat having regard to the criteria set out in s. 672.54 of the Criminal Code.

4. Ms. Warner, on behalf of the hospital, submitted that Mr. Tsering remains a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order. Mr. Feindel, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions. Ms. Addie agreed that Mr. Tsering continues to represent a significant threat. However, she submitted that the necessary and appropriate disposition is a discharge with conditions. Mr. Tsering wished to reside in his own apartment.

Findings

5. For the reasons that follow, the panel finds that Mr. Tsering remains a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current detention order.

The Evidence

6. The evidence at the hearing consisted of the Hospital Report, dated October 15, 2025 (ex. 1), and the viva voce evidence of Dr. Jaiswal, Mr. Tsering’s treating psychiatrist, and Mr. Tsering.

Index Offences

7. A summary of the index offences is included in the Hospital Report:

“On July 26, 2012, Mr. Tsering and the victims, his parents, were at their City of Toronto residence. He wanted his mother to take him to get a loan for money, but she refused. He became with angry her and grabbed her in an attempt to get her out of the house to go with him. His brother (Victim #1) got in between Mr. Tsering and his mother to try and stop him, and Mr. Tsering grabbed him and choked him. He got away and managed to get Mr. Tsering outside the home. Mr. Tsering was locked outside the home, which angered him further. He began banging on the front door, trying to get back inside. He eventually forced his way into the house by breaking down the front door and then breaking down the interior door. His father (Victim #2) was standing behind the interior door with his daughter, trying to stop Mr. Tsering from entering the home by pushing up against the door. Mr. Tsering took the door, lifted it up, and slammed it down onto his father’s left foot. He grabbed his mother, hit her in the face, and then dragged her out of the home. He dragged his mother down the street for approximately one block by the time police arrived on scene. No charge was laid as she did not want to proceed with the charges.”

Background Information

8. The Hospital Report provides an extensive and detailed account of Mr. Tsering’s history and background. It need not be reviewed here but for the following material highlights. Mr. Tsering is a 41-year-old man who was born in Kathmandu, Nepal and immigrated to Canada in 2007 at the age of 23 years. He has been supported by ODSP since 2009 but was able to maintain part-time employment for a brief period.

9. Mr. Tsering began smoking cannabis at age 17 and drinking alcohol at age 19. His parents reported that he became increasingly angry, demanding and threatening at home.

10. In 2008 and 2009, Mr. Tsering received a suspended sentence on three separate occasions for charges of criminal harassment. At least two convictions arose in the context of Mr. Tsering repeatedly approaching a young girl. In January 2012, he was convicted of sexual assault arising out of repeatedly requesting a teenage girl to go to McDonald’s with him and rubbing her upper thigh. His sister reported that he was displaying sexually impulsive behaviours including grabbing a woman and asking for sexual favours.

11. Mr. Tsering was admitted to CAMH in February 2009 for an assessment of criminal responsibility related to the charge of criminal harassment. He was described as having “unmet sexual urges leading to inappropriate sexual behaviours” and an IQ in the borderline range. He also was noted to be suffering from alcohol dependence and a psychotic illness, likely schizophrenia.

12. Upon being found NCR, Mr. Tsering was admitted to CAMH. On the day of his admission, he sexually assaulted a female co-patient by touching her breasts and lifting them up. He underwent an assessment at the Sexual Behaviour Clinic. The ensuing report indicated that he had tested positive for a coercive sexual preference. He was compliant with antipsychotic medication but refused sex-drive reducing medication.

13. In 2015, Mr. Tsering was transferred to the all-male general forensic unit. During his course at CAMH, he continued to demonstrate sexually inappropriate behaviour and was unable to appreciate the impact of his actions on others. In September 2018, he agreed to take the medication Lupron, a sex-drive reducing medication. In addition, Mr. Tsering was provided extensive psychoeducation in the areas of boundaries, social cues and personal space issues as they pertained to females, both known and strangers.

14. In November 2020, Mr. Tsering was approved for housing at VITA, a male only 24-hour supervised facility in King City. By the end of October 2021, Mr. Tsering was expressing frustration with the rural location and the lack of independence. He expressed a desire to return to CAMH.

15. On December 4, 2021, Mr. Tsering attempted to abscond from the residence by jumping out of a second-floor window in the middle of the night. He sustained a broken leg and underwent surgery on December 5, 2021. He was transferred back to CAMH. Mr. Tsering has remained an inpatient at CAMH since that time.

Course Since the Last Disposition

16. Mr. Tsering’s current diagnoses are Schizophrenia, in partial remission, Unspecified Paraphilia, Coercive Sexual Preference, Borderline Intellectual Functioning, and Alcohol and Cannabis Use Disorder, in remission in a controlled setting.

17. Over the course of the past year, Mr. Tsering has remained abstinent from substances, as confirmed by frequent urine drug screens. He also has been compliant with his injectable antipsychotic medication and no psychotic symptoms have been noted. Mr. Tsering has not participated in any psychosocial programming geared to his risk factors, save a nicotine dependence group. However, he has participated in various recreational activities.

18. Over the summer of 2025, Mr. Tsering did attend six sessions of individual therapy that focused on appropriate sexual and interpersonal boundaries. He decided not to continue with individual therapy.

19. The Hospital Report describes a number of episodes of maladaptive behaviours. These include interpersonal conflicts primarily with co-patients, boundary crossing, and sexually inappropriate behaviours. In addition, there was an episode of fire setting while Mr. Tsering was exercising an escorted pass in the community. Mr. Tsering had been escorted to a park adjacent to the hospital by his passport worker. During the pass, Mr. Tsering placed “some leaves, trash, and a lighter together” and used “his cigarette to burn” the pile of accrued material. Both Mr. Tsering and the Passport worker put out the fire immediately.

20. Another example of Mr. Tsering’s concerning behaviour occurred in August 2025. While on an escorted pass into the community, Mr. Tsering consistently approached about eight separate women and tried to engage them in conversation. When they disengaged, he followed them. Mr. Tsering later told staff that he had done nothing wrong and “They didn’t say no! I would have stopped if they said no!”

21. Mr. Tsering’s impairments and judgement do not appear to flow from symptoms of psychosis. Rather, it is more in keeping with impairments in his intellectual function.

22. Dr. Jaiswal testified before the panel that he became Mr. Tsering’s treating psychiatrist when he was transferred from another general forensic unit in March 2025. However, as a result of a recent Code White involving an assault on a co-patient, Mr. Tsering was moved back to his previous unit the day before the hearing. This co-patient was particularly vulnerable as he is currently suffering from dementia. Apparently, a week prior to the assault, the co-patient unintentionally entered Mr. Tsering’s room. This caused Mr. Tsering to become focused on him which ultimately led to the assault. Mr. Tsering was immediately placed in seclusion. He was successfully trialed out of seclusion the next day and his transfer to the other unit was made. Since then, there have not been any incidents of aggression, irritability, or agitation.

23. Dr. Jaiswal reported that, following the incident, Mr. Tsering’s off-unit passes were put on hold. His current team will apply for higher level passes and continue the search for appropriate accommodations in the community for Mr. Tsering. Unfortunately, his previous application to the Dual Diagnosis Transitional Housing Program was not accepted. As a result, the focus this next year will be to focus on housing options.

24. Dr. Jaiswal testified that he would be concerned if Mr. Tsering was residing in his own apartment with no support or supervision. Mr. Tsering likely would fall away from treatment and likely fall away from engagement with the clinical team. In the doctor’s opinion, Mr. Tsering would not willingly take his medications without supervision. Mr. Tsering would have difficulty controlling his impulsivity and controlling his concerning behaviour associated with his limited cognitive abilities. In the doctor’s opinion, Mr. Tsering is likely to engage in behaviours that would either result in psychological or physical harm towards a member of the public, women in particular. Even when on an escorted pass, Mr. Tsering has had difficulty.

25. In order to manage that risk to the public, the hospital requires the ability to approve Mr. Tsering’s housing to ensure that he has the necessary support and supervision. It is likely that an all-male residence would be necessary at this time. Further, expertise in managing patients with dual diagnoses would be required. In order to be ready to be discharged, Mr. Tsering will have to successfully progress through the pass ladder.

26. Dr. Jaiswal agreed with the following observation made by Dr. Cohen who had conducted a sexual behaviours assessment of Mr. Tsering that Mr. Tsering “may never be suitable for indirectly supervised privileges into the community”¹

27. Mr. Tsering is currently working with a behavioural therapist and developing a behavioural therapy plan. The unit that Mr. Tsering is currently on has a higher ratio of staff to patients and expertise with dealing with patients with a dual diagnosis. There may be more of an opportunity to offer Mr. Tsering supervised passes off the unit.

28. Dr. Jaiswal testified that Mr. Tsering is continuing to accept Lupron, which may result in a reduction of the frequency of his sexually inappropriate behaviours. Mr. Tsering also has begun to join the social skills group.

29. Dr. Jaiswal testified that the Mental Health Act would not be adequate to manage Mr. Tsering’s behaviour in the community. His intellectual functioning limitations would not be considered when assessing Mr. Tsering’s risk. The team would have to wait until Mr. Tsering was actually engaging in the inappropriate sexual conduct before the provisions of the Mental Health Act could be used to bring Mr. Tsering to hospital. Further, Dr Jaiswal did not believe that Mr. Tsering would voluntarily return to hospital if so requested by the treatment team.

30. Mr. Tsering testified that he was last in the community in 2021. He would like to reside with his parents. He indicated that he would abide by their rules. He also has a relative who lives near his parents who has a free basement apartment. Mr. Tsering expressed frustration that other patients on his unit are being discharged and he must remain.

31. All parties maintained their initial positions.

Analysis and Conclusion

30. The panel carefully considered the Hospital Report and the evidence of Dr. Jaiswal and Mr. Tsering and unanimously concludes that Mr. Tsering remains a significant threat to the safety of the public. Mr. Tsering’s risk flows from his diagnoses of Schizophrenia, in partial remission, Unspecified Paraphilia, Coercive Sexual Preference, and Alcohol and Cannabis Use Disorder, in remission in a controlled setting. He also has a diagnosis of Borderline Intellectual Functioning. Absent the oversight of the Board, Mr. Tsering would seek accommodation that would not provide adequate support and supervision, would fall away from treatment, and return to substance use. He also would be exposed to significant stressors which would be destabilizing. Mr. Tsering would experience a deterioration in his mental status and likely engage in violent behaviour. Women, in particular, would be at risk. As such, he remains a significant threat to the safety of the public.

31. Having found that the threshold for significant threat has been met, the panel also had to determine the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code. It is clear from the evidence that Mr. Tsering requires a significant amount of support and supervision. In the management of that risk, it is critical that the hospital be in a position to approve Mr. Tsering’s accommodations when living in the community.

32. Even when exercising escorted passes in the community, Mr. Tsering’s behaviour towards women required staff to intervene and redirect Mr. Tsering. He fails to appreciate that his behaviour is concerning. The treatment team’s ability to assist Mr. Tsering to develop insight in this regard is limited. Mr. Tsering’s impairments and judgement do not appear to flow from symptoms of psychosis. Rather, it is more in keeping with impairments in his intellectual function. As a result, the provisions of the Mental Health Act would not be adequate to admit Mr. Tsering to hospital should he return to substance use, become non-compliant with medication, and/or experience a decompensation in his mental status.

33. Mr. Tsering’s frustration is understandable. He was discharged to a supportive residence in 2020 and resided there until his attempt to flee the residence. Over the course of the next year, the treatment team will focus on identifying appropriate accommodation for Mr. Tsering. Such a residence will require significant support and supervision of Mr. Tsering. In the interim, Mr. Tsering will have the opportunity to continue working with a Behavioural Therapist and develop a comprehensive behavioural plan.

34. Therefore, the panel finds that the necessary and appropriate disposition is a detention order with the same terms and conditions. In arriving at this conclusion, the panel considered the paramount factor of the safety of the public, Mr. Tsering’s community reintegration, his mental condition, and his other needs as required by s. 672.54 of the Criminal Code.

DATED this 22nd day of January, 2026, at the City of Toronto, in the Toronto Region.

Ms. C. Finley

Alternate Chairperson

___________________

Office of the Registrar

Ontario Review Board

Footnotes

1. 1Hospital Report, p. 21