Re: Mr. P. (A.)
ORB File No: 8916
Hearing held on: Monday, February 23, 2026
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Sections 672.47(1) and 672.48(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Maunder
Members Dr. R. Sheppard (by video)
Dr. L. Lightfoot
Ms. M. Chamberlain
Mr. J. Cyr
Parties Appearing:
Accused: Mr. P. (A.)
Counsel: Ms. M. Perez
Person in charge of Hospital: Counsel: Ms. J. L. Lefebvre
Attorney General of Ontario: Counsel: Ms. S. Curry
*Pursuant to s. 672.501(1) of the Criminal Code, the Ontario Review Board prohibits the publication, broadcasting, or other transmission of any information that could identify a victim in this matter or a witness who is under 18 years of age.
REASONS FOR DISPOSITION
(Dated March 19, 2026)
In December 2025, Mr. P. (A.) was found unfit to stand trial on Criminal Code of Canada (“the Code”) charges of sexual assault and fail to comply with probation. The trial court did not make a disposition but ordered Mr. P. (A.) to be held at Waypoint Centre for Mental Health Care (“Waypoint”) pending an initial disposition hearing.
The panel found that Mr. P. (A.) remained unfit to stand trial and agreed with the position jointly taken by the parties that Mr. P. (A.) be subject to a detention order and ordered transferred to an all-male unit at the Centre for Addiction and Mental Health (“CAMH”). The specific privileges were not all agreed upon and are discussed below.
Mr. P. (A.) Remains Unfit
In considering whether Mr. P. (A.) remained unfit to stand trial, the panel had regard to the definition of fitness as set out in s.2 of the Code and elaborated upon, by the Supreme Court of Canada, in R v Bharwani (2025 SCC 26).
Mr. P. (A.) is diagnosed with major neurocognitive disorder due to medical condition, moderate with agitation, and alcohol-induced major neurocognitive disorder, amnestic-confabulatory type, with moderate or severe use disorder.
Mr. P. (A.) is 75 years old. He has a history of alcohol and narcotic use, possible brain injury, and suspected bipolar disorder (with recorded symptoms of mania, including psychosis, grandiosity and paranoia in 2009 and 2022). Until his fitness was assessed in 2025, he had not been diagnosed with dementia or any other neurocognitive condition, but his clinical history suggested he developed confusion in 2021 or 2022. During an admission to hospital in 2022, Mr. P. (A.) was transitioned from living in a shelter to long-term care due to his level of confusion and inability to manage in a shelter.
Based on the Hospital Report and the unchallenged testimony of Dr. Mishra (who had assessed Mr. P. (A.)’s fitness most recently three days before the hearing), the panel was convinced that Mr. P. (A.)’s neurocognitive disorder rendered him unfit to stand trial.
At Waypoint, Mr. P. (A.) did not present with any mood or psychotic symptoms. He had adjusted well to the environment. He was, however, disoriented to time, place, and date. He had impaired short-term memory and significantly impaired delayed recall. His condition has resulted in functional impairment that was described as “severe”.
Although Mr. P. (A.) was familiar with court processes and potential outcomes, he did not remember being arrested, did not remember the events that led to his arrest, suggested the charges might be related to him owing money to the government, and was unable to say why he had been in jail (and then did not recall that he had been in jail two months earlier). His memory was such that his ability to retain relevant information so that he could then consider his options was compromised. Combined with his suggestibility and confabulation, it was clear that Mr. P. (A.) would not be able to understand the reality of his situation or meaningfully participate in court proceedings. Mr. P. (A.) is unfit to stand trial.
The Necessary and Appropriate Disposition
Having found that Mr. P. (A.) remained unfit to stand trial, the panel was obliged to render the “necessary and appropriate” disposition – a conditional discharge or detention order – keeping in mind the safety of the public as the paramount consideration, as well as the mental condition of the accused, the reintegration of the accused into society, and the accused’s other needs. See s.672.54 of the Code.
The parties jointly submitted that Mr. P. (A.) should be detained at Waypoint until he could be transferred to an all-male unit at CAMH. They also jointly submitted that once at CAMH, Mr. P. (A.) should be granted privileges that would allow him (at the discretion of CAMH) to exercise passes into the community accompanied by staff or approved persons. The only dispute turned on whether, once Mr. P. (A.) has moved to CAMH – a less secure hospital – it was necessary and appropriate for him to be subject to a substance prohibition and terms allowing the hospital to demand and screen urine samples for drugs.
To begin with, the panel agreed with the parties that a detention order was the least restrictive and least onerous disposition that would adequately protect the public.
At the time of the alleged index offence of sexual assault, Mr. P. (A.) was living in long-term care. He had been living there for about two years. The alleged victim was a woman who had recently moved into the long-term care home and had dementia. Prior to the event giving rise to the charge, Mr. P. (A.) was seen holding her hand and trying to move her hand to his genitalia. He was told not to do so and that she was not capable of consenting to sexual activity. Mr. P. (A.) was arrested when a nurse found him in the woman’s room with his pants at his ankles, on top of the victim (whose pants were down at her knees) and a full erection. The nurse recounted that upon interruption, the woman said, “It didn’t go in”.
Although Mr. P. (A.) has a very lengthy criminal record (including numerous assaults), there is no evidence he has been violent in some time. In hospital, he shows no aggression, anger or irritability.
On the other hand, Mr. P. (A.) has engaged in inappropriate sexual behaviour towards female staff. He has touched women while they were caring for him and shown himself masturbating in the shower. He is opportunistic. Dr. Mishra testified that there was a correlation between Mr. P. (A.)’s neurocognitive deficits and these behaviours – he has no history of sexual offending before his cognitive decline in 2021-2022.
The risk Mr. P. (A.) poses could, theoretically, be addressed in an all-male long-term care facility (although the female staff might not be as well equipped to protect themselves as the female staff in a forensic facility). Dr. Mishra testified that he did not know of any all-male long-term care facilities and noted his experience of difficulty finding placements for forensic geriatric patients with a history of sexual offending.
We were satisfied that the evidence established that Mr. P. (A.) posed a significant risk to women, particularly vulnerable women who he would have access to in any currently identified care facilities that would be able to meet Mr. P. (A.)’s other needs. For this reason, at least for now, a detention order was necessary.
We also agreed with all the parties that Mr. P. (A.) did not need to remain at a high-secure facility and should be transferred from Waypoint to an all-male forensic unit at CAMH as soon as a bed becomes available.
Ms. Perez, on Mr. P. (A.)’s behalf, was concerned that Mr. P. (A.) was going to be subject to more restrictions than necessary pending his transfer. While delays should be minimized, some time for transfers to be affected is necessary. Mr. P. (A.) has only just been moved from the assessment unit to Awenda A, a unit with a mostly older population with neurocognitive disorders and few behavioural challenges. He has been at Waypoint for only a few months. He is also scheduled for surgery (unrelated to his mental health) and will need to recover before transfer. The only less secure program at Waypoint includes women so is not suitable for Mr. P. (A.).
Regarding the substance prohibition and drug screening, the hospital originally proposed these terms at Waypoint and CAMH, based on Mr. P. (A.)’s significant substance use history including use of alcohol, cannabis and cocaine, and the likelihood that substance use would lead to sexual disinhibition and possible irritability and agitation. The hospital ultimately agreed with Ms. Perez that the terms were not necessary at Waypoint – given the high-secure setting Mr. P. (A.) was not going to have access to substances while at Waypoint.
The panel decided that the substance prohibition and drug screening were necessary and appropriate terms to include when Mr. P. (A.) is at CAMH. We were persuaded that given the significance of Mr. P. (A.)’s substance use history (including being on Methadone until about the time he moved into long-term care), it was important for the hospital to be able to screen Mr. P. (A.) in the event they observe a sudden change in his presentation. Abstinence is directly related to the safety of the public because Mr. P. (A.) continues to act out in sexually inappropriate ways and substance use would likely cause disinhibition. Although not necessary for our decision, we note also that abstinence will certainly promote Mr. P. (A.)’s other needs, given his mental and physical state.
Once moved to CAMH, Mr. P. (A.) will have privileges that allow him to access the hospital grounds and the community around the hospital accompanied by staff or an approved person. Mr. P. (A.) has recently reconnected with his son who may be interested in becoming an approved person.
Finally, the hospital should consider a geriatric consultation. In addition to any other benefit for Mr. P. (A.), they may know of all-male non-forensic geriatric settings that might be able to manage Mr. P. (A.)’s risk in the future.
DATED this 31st day of March 2026, at the City of Toronto, in the Region of Toronto.
Ms. L. Maunder
Alternate Chairperson
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Office of the Registrar
Ontario Review Board