Re: Ronald Shepherd
ORB File No: 5368
Hearing held on: Tuesday, October 28, 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: Mr. B. Garrow
Members: Ms. J. Ferguson Dr. R. Sheppard Dr. L. O. Lightfoot Mr. S. Duffy
Parties Appearing:
Accused: Ronald Shepherd Counsel: Mr. D. R. North
The person in charge of hospital: Counsel: Mr. D. Blumenkrans
Attorney General of Ontario: Counsel: Mr. R. Mushlian
REASONS FOR DISPOSITION
(Dated March 10, 2026)
Introduction
On June 8, 2009, Ronald Shepherd was found unfit to stand trial on charges of assault, utter a threat to cause death or bodily harm, and weapons dangerous, all contrary to the Criminal Code of Canada. He is currently subject to a Disposition of the Ontario Review Board (“ORB/the Board”), dated October 22, 2024, discharging him with conditions, including that he reside at 80 Stanley Road in North York.
On October 28, 2025, the Board convened to determine whether Mr. Shepherd remains unfit to stand trial, and if so, review Mr. Shepherd’s disposition pursuant to s.672.48(1) and 672.81(1). Mr. Shepherd was present and represented by his counsel, Mr. North.
At the outset of the proceedings the parties were canvassed as to their positions on the issues to be examined by the panel: whether Mr. Shepherd continues to be unfit to stand trial and, if so, what is the necessary and appropriate disposition, taking into account the criteria set out in s. 672.54 of the Criminal Code.
Mr. Blumenkrans, counsel for the hospital, submitted that Mr. Shepherd continues to be unfit to stand trial and is likely permanently unfit. In his submission, the necessary and appropriate disposition is a continuation of the current disposition of a conditional discharge. Mr. Mushlian, on behalf of the Ministry of the Attorney General, agreed that Mr. Shepherd remains unfit and the necessary and appropriate disposition is a continuation of the current order.
Mr. North agreed that Mr. Shepherd remains unfit to stand trial and agreed with the position of the hospital that the necessary and appropriate disposition is the continuation of the current conditional discharge on the same terms. The Board considered the joint submissions of the parties in arriving at its disposition.
Findings
- For the reasons that follow, the panel found that Mr. Shepherd remains unfit to stand trial and, in all likelihood is permanently unfit and the necessary and appropriate disposition is a continuation of the current Conditional Discharge, including the requirement that he continue to reside at his current residence.
The Alleged Offences
- In May 2009, Mr. Shepherd was residing at the White Eagle Nursing Home. It is alleged that on May 23, 2009, Mr. Shepherd punched a co-resident in the back with a closed fist and threatened to kill him. The director of the nursing home separated the two men. Mr. Shepherd, who was still agitated, began stabbing the table with a knife while mumbling to himself. After this incident, the staff determined that it was no longer safe for him to remain at their facility as he was too violent.
Background Information
The Hospital Report provides limited information concerning Mr. Shepherd’s background due to Mr. Shepherd’s limited intelligence and communication skills. Mr. Shepherd has genetic syndrome 22q11DS which includes features such as mild mental retardation, psychosis with grossly disorganized behaviour, irritability, and impulsivity. His intellectual functioning was assessed in 2004 and the results reflected that he related at a functional level of just over 6 years.
Mr. Shepherd has lived in a number of supportive residences. There have been longstanding difficulties attending to his hygiene and medical needs due to inadequately controlled aggression and impulsivity characteristic of 22q11DS. Unfortunately, undertreated medical conditions in the long run have made his aggression worse as new or previous existing exacerbations of medical issues can cause or increase aggression, especially in someone with an intellectual disability. Readmission to hospital has been required on more than one occasion.
Mr. Shepherd is currently 70 years old and living in a reactivation care centre (RCC) at 2111 Finch Avenue West, North York, through Humber River Hospital (HRH).
In addition to his genetic syndrome 22q11DS, Mr. Shepherd has a diagnosis of schizophrenia. He is currently incapable of consenting to treatment and is incapable with respect to making financial decisions and the Office of the Public Guardian and Trustee is his Substitute Decision Maker and manages his finances.
The Evidence
The evidence at the hearing consisted of the Notice of Hearing dated January 24, 2025, the most recent disposition dated October 22, 2024, Reasons for the most recent disposition dated November 2, 2024, the Hospital Report dated October 6, 2025, and the viva voce evidence of Dr. Eid, Mr. Sheperd’s treating psychiatrist.
Over the course of the last reporting year, Mr. Shepherd had a relatively uneventful few months from December 2024 until he suffered an acute medical illness resulting in his hospitalization in December of 2024. The Hospital Report provides the following information with respect to this reporting year:
“At the time of the hospital report, Mr. Shepherd remained residing in a reactivation care centre (RCC) at 2111 Finch Ave West in North York, through Humber River Hospital (HRH). The Hospital Report, prior to his medical admission, Mr. Shepherd was residing in the community in a high support home for individuals with dual diagnosis through VITA with 24-hour staff supervision. This reporting year, there were no episodes of self-harm, violence towards others, or absconding from care.
“Mr. Shepherd has a diagnosis of schizophrenia which is treated with fluphenazine 20 mg per day. There were no overt symptoms of psychosis and he typically denied hallucinations or delusions. His speech remained mostly mumbled and monosyllabic. There were no significant changes to his overall mental status this year. His insight continued to be poor, and when asked about his mental health diagnoses and treatment, he said “none.”
“From September to December 2024, Mr. Shepherd continued to reside at his community residence where he was escorted by staff out on outings and to his follow-up appointments once a month to CAMH. Staff took him to visit his brother on occasion. He enjoyed going to Tim Hortons with staff and going to thrift stores.
“On December 15, 2024, Mr. Shepherd was taken to the emergency department (ED) at HRH after a 24-hour history of feeling unwell, having chills and fever. It was also reported that he was having some cough and congestion, eating less, vomiting as well as had increased urinary frequency. In the ED, he was tachypneic, febrile, slightly hypotensive and tachycardic. His blood pressure remained low even after receiving IV fluids. He was started on Levophed (norepinephrine). X-ray revealed a right sided infiltrate (indicating pneumonia) and he was started on antibiotics. Mr. Shepherd was admitted to the ICU due to his low blood pressure and hypoxia and required intubation. He grew E. coli in his urine and E. coli and Morganella in his blood; hence, he was diagnosed with urosepsis and treated on meropenem (antibiotics).
Mr. Shepherd was transferred to Sunnybrook Health Sciences Centre (SHSC) on December 16 as he had an ECG consistent with a myocardial infarction (MI) and an echocardiogram showed left ventricular dysfunction. Cardiac catheterization at SHSC did not indicate any significant coronary artery disease; he was diagnosed with a Type II MI and repatriated back to HRH on December 17.
“On December 20, 2025, Mr. Shepherd was extubated but needed to be re-intubated again that day due to respiratory arrest. He was successfully extubated on December 27 and then transferred to a medical ward on January 5, 2025. He further stabilized and was discharged to a RCC on January 20, 2025; there he was made alternate level of care (ALC), as he was not deemed appropriate to return to his group home.
“On February 5, 2025, Mr. Shepherd had an unwitnessed fall and was transferred to HRH ED. He had no focal neurological findings and his CT scan was non-acute and so he returned back to the RCC.
“On April 1, 2025, Mr. Shepherd was taken to the HRH ED as he had a witnessed absence seizure. CT scan of his head was unremarkable and he was medically stable and so he returned to the RCC.
“On April 5, 2025, Mr. Shepherd was taken to the ED as he had a previous fall and subsequent X-rays showed that he had a fracture of his pelvis. There were no acute interventions required as his fracture was non-surgical. He was also seen and cleared by physiotherapy. He was subsequently discharged back to RCC.
“On June 17, 2025, Mr. Shepherd was taken to the ED with query seizures. It was noted that he appeared to have episodes of seizures vs pseudo seizures. In the ED, he was awake, conversive and CT Head and blood work was unremarkable. He was thought to have pseudoseizures and discharged from the ED.
“On July 20, 2025, Mr. Shepherd was taken to the ED with a 30 second absence seizure. It was noted that he did not have tonic-clonic symptoms and no post-ictal period. His medical work up was unremarkable, his vitals are stable and there was no seizure activity during his time in the ED. The assessing physician did not believe that a neurology consultation was required. He was assessed as having “Pseudoseizure vs staring episode vs absence seizure” and as discharged back to the RCC. He returned back to the ED later that day as his oxygen saturation was found to be low on room air. In the ED, his investigations were normal, there was no evidence of shortness of breath and his oxygen saturation was normal. There were no acute findings for his previous low oxygen saturation and he was discharged back to RCC.
“On September 17, 2025, Mr. Shepherd was taken to the ED to rule out head injury after being found on the floor with a small abrasion on his right eyebrow. A CT scan of his head revealed no signs of traumatic brain injury and Mr. Shepherd was discharged back to RCC.
“From January to the present time, Mr. Shepherd was not deemed suitable to return to his housing at VITA at 80 Stanley Road due to his being unsafe to utilize stairs (his apartment unit is on the basement floor). However, the team at RCC did not believe that he needed physical rehabilitation or any acute medical interventions, hence his status as an ALC patient. Mr. Shepherd continued to be followed by the EFOPS team every four to eight weeks. During these assessments, he appeared to be at his baseline mental status however complained that he did not wish to stay in hospital and wanted to go home.
“On September 5, 2025, a clinical case conference was held with members of the EFOPS team, HRH team and VITA team. The team at HRH reported that Mr. Shepherd was generally social while in hospital and interacted with staff appropriately. They believed that he was ready for discharge and being at the RCC was not ideal for him. The team at VITA advised that there were no housing availabilities at the current time that could accommodate Mr. Shepherd and that he would be presented in October for a lateral move within their organization. The housing team’s main concern was about his ability to navigate stairs safely and his need for an accessible home with an awake overnight staff. Mr. Shepherd continues to pay his rent at VITA. The EFOPS team advocated to ensure that VITA staff visit him so that his quality of life could be improved. The VITA team has committed to sending staff to visit Mr. Shepherd twice a week. The teams will explore whether his passport funding could be re-evaluated given his increased care needs. He currently has access to $13,000 of funding per year.
“An assessment by a physiotherapist on September 16, 2025, indicated that Mr. Shepherd ambulated with a 2-wheeled-walker. It was noted that he could negotiate stairs on his own with rails, however as he had an occasionally impaired balance, in combination with his history of pseudo-seizures and falls, it was suggested that some form of supervision on stairs would be safest for him in the community. It was concluded that this was likely his baseline and additional physiotherapy services would not likely change the level of support needed.
“At the current time, Mr. Shepherd continues to wait for housing within the VITA organization at RCC. He has remained generally stable despite being in an environment that is not well suited to his needs, given the busy and often overstimulating setting of the centre. Such an environment could reasonably be expected to increase his irritability or behavioural dysregulation. To his credit, Mr. Shepherd has interacted appropriately with staff and peers, with no incidents of physical aggression or conflict reported. There were noted to be a few verbal arguments with co-patients however.
- Mr. Shepherd’s treating psychiatrist gave evidence at the hearing. With respect to the issue of fitness to stand trial, Dr. Eid gave evidence that it is difficult to assess how much Mr. Shepherd understands about the ORB proceedings because his speech is difficult and he gives one-word answers. Dr. Eid testified that Mr. Shepherd could not provide meaningful answers to Dr. Eid’s questions the day before the ORB hearing. For example, he couldn’t list his criminal charges and made nonsensical answers. This is consistent with the findings set out in the Hospital Report which reads in part as follows:
“Mr. Shepherd was assessed with regards to his fitness to stand trial periodically. His answers were similar to previous fitness assessments over a number of years. At times, he lacked the motivation to participate in fitness assessments.
“The clinical team last attempted to engage Mr. Shepherd in a fitness assessment on September 12, 2025. When asked what his charges were, he said “I don’t know.” When asked about the pleas available to someone who was charged with a crime, he simply said “hmm.” When asked about the meaning of an oath, he said “I wanna go to 1-5" (N.B. 1-5 is a forensic unit at CAMH). When questioned on the role of the judge, he said “1-5.” When asked about the role of the crown attorney or defence lawyer, he said “I don’t know.” When asked about the outcome of a finding of Guilty, he said "I don't know." When asked about the outcome of a Not Guilty finding, he went on a tangent and said “I wanna go shopping.”
Given Mr. Shepherds diagnosis of intellectual disability, it is likely that he remained permanently unfit to stand trial.”
- With respect to the issue of whether or not Mr. Shepherd continues to pose a significant threat, Dr. Eid testified that prior to the most recent destabilizing events when Mr. Shepherd had stable housing and was being well managed, that, although there were threats made by Mr Shepherd, staff dealt with them appropriately and no one was in danger. However, in his current situation, minor changes can cause him difficulty, and the threat of violence becomes more real. The Hospital Report contains the following with respect to the issue of significant threat:
“The clinical team is of the view that Mr. Shepherd continues to represent a threat to the safety of the public. Mr. Shepherd has had a long history under the ORB, and has assaulted several persons in his immediate environment, both in hospital and in the community, many of whom are vulnerable disabled persons. He has assaulted co-tenants of past group homes and has made threatening remarks while holding a knife. The last incident of physical violence upon another person perpetrated by Mr. Shepherd occurred in 2022 and police were called. Mr. Shepherd’s medication and group home have provided stability to his psychotic disorder and environment, respectively. In addition to the stability of optimized medications and structured and supported environment, Mr. Shepherd’s physical capacity for violence has decreased in degree due to his physiological age. Mr. Shepherd is one of the oldest living people with 22q11.2 deletion syndrome. However, given recent events and his inability to independently navigate the use of stairs, Mr. Shepherd is not able to return to the group home that he had been residing in successfully. It remains to be seen whether his next residence will confer the same stability as years past and the search for a suitable, accessible placement is ongoing.
“If Mr. Shepherd is to re-offend, this will likely transpire in an insufficiently supervised environment in which the symptoms associated with his cognitive impairment are allowed to manifest behaviourally, including aggression/violence and sexual intrusion. A change in staff person or new co-tenant to whom Mr. Shepherd objects, may also be a trigger for an impulsive, reactive outburst.”
Dr. Eid testified that Mr. Shepherd is no longer residing at 80 Stanley Road North York but is now living at Humber River Hospital Reactivation Care Centre. This move was necessitated for a few reasons, namely that there were stairs which Mr. Shepherd was having increasing difficulty with, and his medical needs have increased, and he needs more care. Dr. Eid was of the opinion that it would be unsafe for Mr. Shepherd to return to his residence. In terms of finding long term housing, Dr. Eid testified that there was a meeting with VITA Community Living Services the day prior to the hearing and potential residences for Mr. Shepherd were discussed. It was agreed that Mr. Shepherd needs housing without stairs and with supervisory staff available 24 hours a day but that no such accommodation is currently available.
Dr. Eid testified that Mr. Shepherd requires 24 hour supervised housing with the other provisions remaining the same. Dr. Eid gave evidence that the main goal for the coming reporting year will be to find adequate housing for Mr. Shepherd. Dr. Eid noted that even new people around Mr. Shepherd can lead to a change in his mental state and that changes can be very destabilizing for Mr. Shepherd. Therefore, the hospital would want to oversee any change to his housing. Dr. Eid also testified that the treatment team had engaged in discussions with respect to finding a psychiatrist for Mr. Shepherd outside of CAMH and that this option could be explored once Mr. Shepherd is again stable.
When asked what Mr. Shepherd’s long-term future might look like, Dr. Eid responded that Mr. Shepherd’s medical issues began at the end of 2024 at which time he lost his stable housing. If we can’t find stable housing for him or if he doesn’t settle into his housing, the level of risk he poses could increase.
Dr. Eid testified that typically Mr. Shepherd lives in housing with very disabled people and that even the ability to strike out is serious because cohabitants are very vulnerable and that as a result the risk remains real. Dr. Eid confirmed that, in addition to his more recent mobility issues, Mr. Shepherd has other medical issues and special needs making finding appropriate housing more difficult. Dr. Eid testified that Mr. Shepherd needs assistance with hygiene, he needs someone to prepare his meals, he requires special food as he has a choking risk, and he requires staff that is awake 24/7. Dr. Eid also stated that long term care might be an option but that the level of care Mr. Shepherd requires is generally beyond the level provided in long term care facilities and that as he remains a threat, he requires staff that can address that issue.
When asked about what might be the appropriate disposition regarding housing, Dr. Eid indicated that he would not object to a disposition allowing Mr. Shepherd to reside in a broader geographical area than the GTA and to live in housing provided by organizations other than VITA. However, Dr. Eid reiterated that any housing must have 24-hour staffing. Dr. Eid suggested that the current provision regarding housing should remain and that if appropriate housing should become available that would not comply with the disposition, an early hearing could be arranged.
Analysis and Conclusion
Mr. Shepherd has had a long history under the ORB, and has assaulted several persons in his immediate environment, both in hospital and in the community, many of whom are vulnerable disabled persons. He has assaulted co-tenants of past group homes, and has made threatening remarks. Mr. Shepherd requires a highly structured and monitored environment, so staff can intervene and manage his aggression.
Having found that Mr. Shepherd continues to represent a significant threat to the safety of the pubic, the panel must consider the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code.
At the conclusion of the evidence, all parties maintained the joint submission. The current disposition requires Mr. Shepherd to reside at his former residence where he is no longer residing. However, he continues to pay rent and in the event that new suitable housing is found, an administrative change of address can be made. Therefore, the parties jointly submitted that the disposition should be to leave the current disposition as is.
The panel carefully considered the Hospital Report and the evidence of Dr. Eid and unanimously concluded that Mr. Shepherd remains unfit to stand trial. He has a diagnosis of pervasive development disorder and intellectual disability. He consistently has been unable to answer questions that would demonstrate an appreciation of his outstanding charges, an ability to instruct counsel, or engage in the proceedings in a meaningful way. He is incapable of making decisions with respect to his care and his finances and the Office of the Public Guardian and Trustee is his substitute decision maker. He is likely permanently unfit.
The panel also finds that Mr. Shepherd continues to represent a significant threat to the safety of the public. Mr. Shepherd has a diagnosis of schizophrenia for which he takes medication under supervision. He is also significantly challenged by his genetic syndrome 22q11DS.
The panel unanimously finds that the necessary and appropriate disposition is a continuation of his conditional discharge with the same terms and conditions.
It is clear from the evidence that appropriate 24 hour supervised housing is essential to the management of Mr. Shepherd’s risk. It is necessary and appropriate that the hospital have the ability to approve his housing to minimize risk. It is clear that without appropriate supportive and supervised housing, Mr. Shepherd’s risk for violence cannot be safely managed in the community.
In conclusion, the panel finds that Mr. Shepherd remains unfit to stand trial and the necessary and appropriate disposition is a continuation of his current conditional discharge. In arriving at this conclusion, the panel has considered the paramount factor of the safety of the public, Mr. Shepherd’s community reintegration, his mental condition and his other needs, as required by s. 672.5 of the Criminal Code.
DATED this 10^th^ day of March, 2026, at the City of Toronto, in the Toronto Region.
Ms. J. Ferguson Legal Member
__________________
Office of the Registrar Ontario Review Board