Re Adler, 2026 CanLII 23888

Re: Ronald Martin Adler

ORB File No: 4030

Hearing held on: Thursday, February 19, 2026

Place of hearing: Centre for Addiction and Mental Health

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

Before:

Alternate Chairperson: Mr. P. Capelle

Members: The Hon. B. Allen Dr. R. Sheppard Dr. M. Mamak Mr. A. Mete

Parties Appearing:

Accused: Ronald Martin Adler Counsel: Ms. L. McCullough

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

Attorney General of Ontario: Counsel: Mr. D. Brandes

REASONS FOR DISPOSITION

(Dated March 16, 2026)     

Introduction

1. On August 30, 2004 Mr. Ronald Martin Adler was found not criminally responsible by reason of mental disorder on charges of uttering threats to cause death, carrying a concealed weapon, and failing to comply with a probation order, all contrary to the Criminal Code.

2. Under s. 672.81(1) of the Criminal Code a panel of the Ontario Review Board (“the Board”) was convened on February 19, 2026, at the Centre for Addiction and Mental Health (“CAMH” or “the Hospital”) to review Mr. Adler's threat to public safety and the appropriate disposition under s. 672.54 of the Criminal Code.

3. Mr. Adler did not attend the hearing. Ms. McCullough indicated she had instructions to appear at the hearing on Mr. Adler’s behalf. Under s. 672.5(10) of the Criminal Code the Board allowed counsel to attend on Mr. Adler’s behalf.

4. Mr. Adler’s existing disposition dated February 25, 2025, provides that he be detained at the Forensic General Service at CAMH with privileges up to and including the privilege of residing in approved accommodation.

5. The parties advanced a joint position that Mr. Adler continues to pose a significant threat to public safety and a detention order should be maintained on the existing conditions.

Disposition

6. For the reasons set out in these Reasons the Board concludes under s. 672.54 of the Criminal Code that Mr. Adler continues to pose a significant threat to public safety, and that the necessary and appropriate disposition is detention in the General Forensic Service at CAMH on the existing conditions.

Current Diagnoses

7. Mr. Adler’s current diagnoses are schizophrenia, alcohol use disorder in sustained remission, opioid use disorder, mild-moderate severity, sedative-hypnotic use disorder, mild to moderate severity and borderline and antisocial personality traits.

The Evidence

8. The Board has before it the Hospital Report dated January 14, 2026, which contains an account of Mr. Adler’s personal and psychiatric background which need not be repeated in detail here. The Board also has the oral evidence of Dr. Padraig Darby, the author of the Hospital Report.

Index Offences

9. The circumstances of the index offences are described in the Hospital Report at pages 10 and 11 and are summarized as follows:

On Tuesday, December 30, 2003, the accused, Mr. Ronald Adler, was in a meeting with the victim at the Office of the Publicly Funded Disability Support Program where the accused was a client. Mr. Adler had been harassing the office staff, making general threats towards the staff for the previous 2 or 3 days. On that day, he made a direct threat to the victim, stating she was going to get a bullet right through the head. During the incident, he became very aggressive and threw a chair across the office, causing property damage. The victim feared for her safety and for the safety of her staff. The police were called. Attempts to locate Mr. Adler were unsuccessful and a warrant was obtained for his arrest.

On February 20, 2004, the police were called to the same address, where Mr. Adler was seated in the waiting room. He was arrested. In the process of taking him into physical custody, he made a move to reach inside his jacket. He was restrained and handcuffs were applied. He was searched subsequent to his arrest. The search revealed that he had a knife with a seven-inch serrated blade concealed in his jacket. He was advised that he would be charged with Carrying a Concealed Weapon.

Criminal History

10. Mr. Adler’s criminal history before the index offence is very lengthy spanning from 1995 to 2003. The charges involve such offences as numerous assaults, an assault with a weapon, uttering threats, assaulting a police officer and escaping lawful custody, a considerable number of those charges having been withdrawn.

Substance Use

11. There is a substantial history of use of street drugs such as cocaine, using prescription medications such as benzodiazepines and abusing alcohol.

Mr. Adler’s Personal and Psychiatric History

Before the Current Reporting Year

Personal History

12. Mr. Adler is a 59-year-old single male, born in Toronto, Ontario. He has a brother and sister who live in Kingston, Ontario. He does not appear to maintain any contact with his parents. Mr. Adler has had three long-term relationships with females in the past. He has not lived common-law or been married and has no dependants. Mr. Adler resides in high support housing in the community and is supported by ODSP (“Ontario Disability Support Program”) benefits.

13. Mr. Adler completed high school and attended the University of Toronto for two years studying political science. He dropped out of university due to the onset of the symptoms of his mental illness. Mr. Adler held one full-time job between 1984 and 1986 in shipping and receiving and several part-time jobs thereafter.

Psychiatric History

14. Mr. Adler began to experience symptoms of schizophrenia at age 17 at which time he expressed his belief that his phone was bugged. Before the index offence he was admitted and discharged from numerous hospitals from 1987 to 2001.

15. During his hospitalizations Mr. Adler was non-compliant with treatment. Some of his hospitalizations followed the commission of pre-index offences. He exhibited hostile, disruptive and aggressive behaviour while in hospital and in the community. He went AWOL from hospitals for days at a time. Mr. Adler became involved in altercations with his parents. He was also admitted to hospital on several occasions after overdosing on prescribed medications and abusing alcohol and street drugs. Mr. Adler reported a history of using alcohol in order to reduce symptoms of stress and anxiety. He endorsed that cocaine increased his auditory hallucinations and led to paranoia. He also often reported experiencing paranoid thoughts about his neighbours and the police.

16. Following the index offences in 2004 Mr. Adler was also repeatedly hospitalized for periods of time and discharged to the community for short periods and then re-admitted to hospital.

17. Mr. Adler was detained at the Mental Health Centre, Penetanguishene (currently, Waypoint Centre for Mental Health Care) from 2004 to 2007 following the index offence. He was then transferred in 2007 to CAMH until 2009 when he was discharged to the community to reside in an unregulated boarding home in downtown Toronto. In 2010, approved by the Hospital, Mr. Adler moved to a shared apartment located in a 24-hour supervised CMHA (“Canadian Mental Health Association”) building and was re-admitted to CAMH in 2011 until he was discharged in December 2014.

18. While under the care of CAMH Mr. Adler was followed by the TCM (“Transitional Case Management”) team through CAMH’s FOPS (“Forensic Outpatient Services”).

19. Mr. Adler has been re-admitted to CAMH on a yearly basis following his discharge from CAMH in 2014. While in the community his schizophrenia was treated with antipsychotic medication and he was, in 2017, found capable of consenting to treatment. Mr. Adler stopped his medication at this time and was then re-admitted to the Hospital in August 2018 after concerns were raised at his residence. He was thereafter discharged to community later that year in December 2018.

20. During the 2017/2018 hospitalization Mr. Adler’s indirectly supervised privileges on the Hospital grounds and in the community for community programs were increased. An application for Mr. Adler to reside at LOFT housing was explored and he was ultimately accepted and moved into a LOFT residence in December 2018. Mr. Adler actively participated in his treatment plan. His understanding of his mental illness was fair, and he remained medication compliant.

21. During the period from 2020 to 2025 Mr. Adler continued to reside at his LOFT residence. He was generally cooperative but guarded, being mostly isolative, rarely interacting with co-residents or staff at LOFT.

22. There were a few incidents of concern such as acting abusively at a dentist’s office in 2022 which he denied when questioned by LOFT staff. Also, troubling was that Mr. Adler was heard telling his physician that he heard voices and that the voices did not bother him under circumstances where he had not reported hearing voices to his clinical team. To his credit Mr. Adler began to become more open and admitted to hearing voices for some time but explained that the voices did not bother him and they were not command in nature.

23. There were no incidents of concern during the 2023/2024 reporting period. Mr. Adler denied homicidal and suicidal ideation and auditory or visual hallucinations. There was little change in his mental status. He was supported by EFOPS (“Extended Forensic Outpatient Services”) and the LOFT housing team. He complied with his antipsychotic and other medication regimens and on a whole his urine screens were negative for prohibited substances except for codeine which Mr. Adler indicated he took for back pain.

24. Also, during the reporting 2024/2025 there were no incidents of concern.

The Current Reporting Period – January 2025 to February 2026

25. There were no greatly concerning behaviours during this reporting year. On the whole Mr. Adler’s mental health remained stable. However, there were some matters of concern from a therapeutic perspective.

26. As noted, Mr. Adler is very guarded and suspicious during interactions with the EFOPS team and LOFT staff. This has been an ongoing challenge for the EFOPS team in terms of building a therapeutic relationship with him. This is concerning particularly in view of the fact that Mr. Adler endorses experiencing ongoing auditory hallucinations which he has described as “alien voices” although he contends the voices are not distressing.

27. There were two stressful events that drew the clinical team’s attention. He developed a painful ulcer on his tongue which required attending hospital emergency. And he experienced a financial crisis from having to cover his responsibility for water damage to his residential unit. In both circumstances to his credit, he reacted with some verbal aggression, but his behaviour did not rise to a level requiring de-escalation as Mr. Adler eventually came to accept the outcome.

28. The Hospital Report at pages 53 and 54 speaks to Mr. Adler’s risk to re-offend:

When unwell and paranoid, he tends to resist arrest and become combative with security personnel. Early episodes of violence were directed at family members.

Mr. Adler does not become violent during the early stage of psychotic deterioration. However, he does deteriorate within several days of becoming non-adherent with oral medication, and when in this deteriorated state becomes more aloof and guarded and less likely to accept the supports, he otherwise tends to begrudgingly accept. Non-adherence to medication would then escalate further and lead to acute risk of violence.

Mr. Adler’s history of abuse of sedating agents, codeine, and benzodiazepines, are factors that can increase the likelihood of future partial non-adherence to oral antipsychotic medication, thus contributing to the risk of violent recidivism.

Mr. Adler should receive antipsychotic medication in perpetuity. His positive symptoms have been significantly attenuated with ongoing treatment, though his adherence must be regularly monitored, as he has a history of non-compliance.

Oral Evidence of Dr. Padraig Darby

29. Dr. Darby did not offer material updates to the Hospital Report prepared on January 14, 2026.

30. Dr. Darby spoke of the positive factor that Mr. Adler has remained in the community since 2018. He pointed however to two areas of concern during the current reporting year.

31. The doctor expanded on the developments that occurred with his mouth and dental issue. He explained that Mr. Adler went to various hospital emergency departments seeking more analgesics for the pain for a tongue ulcer. When he was refused the medication, he became verbally aggressive. Mr. Adler did not inform CAMH about those hospital attendances.

32. The other area of concern emerged from Mr. Adler’s practice on three occasions of blocking the kitchen sink and toilet in his housing and running the water causing flooding damage. This threatened his tenancy at his housing. To avoid eviction, he has recently been required to pay for the damage on a payment plan. Mr. Adler became very irritated and has denied this is a problem and insisting it is not his fault. Fortunately making the payments has prevented his eviction.

33. Dr. Darby described as very troubling Mr. Adler’s marked suspiciousness and secretiveness about his activities. The Hospital Report states that although he has been generally cooperative, he is guarded. He is slow and careful in his speech. He declines social engagement and has no friends in the housing. Mr. Adler rarely interacts with co-residents and housing staff. But he engages reasonably well with the forensic outpatient team.

34. In answer to questions from Mr. Adler’s counsel about his compliance with and insight into his medication, Dr. Darby testified that Mr. Adler is currently medication capable but lacks an appreciation of the connection between his medication and the amelioration of the symptoms of his mental illness. The doctor associates his guardedness and suspicion with paranoid personality features and suggests that a diagnosis of paranoid personality disorder might be added to Mr. Adler’s psychiatric picture.

35. Dr. Darby concluded that although Mr. Adler has been in the community almost eight years, for the reasons enunciated, he requires the level of supervision he is currently subject to. It is Dr. Darby’s view that the Mental Health Act would be inadequate to address Mr. Adler’s risk in a sufficiently expeditious manner. It is the doctor’s opinion that a detention order is required to bring him back to the Hospital in view of the recent incidents during this reporting year and his guardedness about his mental status and secretiveness about his activities.

The Parties’ Positions

36. As noted earlier the parties’ joint position is that Mr. Adler continues to pose a significant threat to the safety of the public and that the appropriate disposition in the circumstances is for him to be detained at the General Forensic Service at CAMH with privileges up to including residing in the community in approved housing on the existing conditions.

The Board’s Conclusion

37. While mindful of the parties’ joint position the Board is required to come to an independent determination.

38. Based on the evidence before us the Board unanimously accepts the opinion, as stated in the Hospital Report, that Mr. Adler remains a significant threat to public safety within the criteria outlined in Winko, 1999 CanLII 694 (SCC), [1999] 2 SCR 625 and as defined in s. 672.5401 of the Criminal Code. The Board considered the criteria, as set out in s. 672.54, namely, the paramount criterion of the safety of the public and Mr. Adler’s community re-integration, his mental condition and his other needs.

39. We accept, in accordance with s. 672.54 of the Criminal Code, that the least onerous and least restrictive disposition, that is necessary and appropriate in the circumstances, is a detention order with privileges up to including residing in approved accommodation on the same terms as the existing disposition.

40. The Board arrives at that decision for the following reasons.

41. The Board accepts the opinions stated in the Hospital Report and by Dr. Darby in his testimony. Mr. Adler has had a long history of violent and aggressive behaviour that has been assuaged by optimization of his medication over the years so much so that during the last few reporting years he has not presented with significantly concerning behaviour.

42. However, while Mr. Adler is currently medication compliant, he continues not to appreciate the connection between his medication and his mental status. The Board is also troubled by Mr. Adler’s verbally aggressive behaviour during his attendances at the emergency departments for pain killers for his dental issue and concerned about his poor attitude in relation to flooding his housing unit. Mr. Adler did not report the emergency visits to the clinical team which is an example of the problem with secretiveness about his activities. These concerns bode in support of requiring Mr. Adler to continue to reside in supportive accommodation where he is followed and monitored by the forensic outpatient service and housing staff.

43. To Mr. Adler’s credit he has not displayed any significantly problematic behaviours during the current reporting year for which the Board offers our praise. However there remains the challenge of him overcoming his guardedness and secretiveness to allow the clinical team to develop a therapeutic relationship with him. His advancement through the system requires this.

44. Mr. Adler has a significant history of decompensations in the community with readmissions to hospital. The team is not confident he would agree to return to hospital voluntarily. The Board agrees. And given that Mr. Adler is treatment capable, the Box B criteria under the Mental Health Act would not be available.

45. Based on the Hospital Report and the evidence added by Dr. Darby’s testimony the Board concludes, under s. 672.54 of the Criminal Code, that Mr. Adler remains a significant threat to public safety and that currently the necessary and appropriate disposition, that is the least onerous and the least restrictive to mitigate threat to public safety, is to maintain the existing disposition. The existing disposition satisfies the paramount criterion under s. 672.54 of protecting the safety of the public and further meets Mr. Adler’s interests in community re-integration and supporting his mental health and his other needs.

DATED this 16th day of March, 2026, at the City of Toronto, in the Toronto Region.

The Hon. B. Allen

Legal Member

Office of the Registrar

Ontario Review Board