Re Mikhail Pismerov, 2026 CanLII 32125

Re: Mikhail Pismerov

ORB File No: 5917

Hearing held on: Tuesday, February 24, 2026

Place of hearing: Waypoint Centre for Mental Health Care

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

Before: Alternate Chairperson: Ms. L. Maunder Members: Dr. P. Darby Dr. L. Lightfoot Ms. M. Chamberlain Mr. J. Cyr

Parties Appearing: Accused: Mikhail Pismerov (did not attend) Counsel: Mr. A. Rai (by videoconference) Person in charge of Hospital: Counsel: Ms. J. Thomson Attorney General of Ontario: Counsel: Ms. S. Curry

REASONS FOR DISPOSITION

(Dated March 31, 2026)

1. On June 23, 2011, Mikhail Pismerov was found not criminally responsible by reason of mental disorder of a Criminal Code of Canada (“the Code”) charge of aggravated assault. Mr. Pismerov has been detained in the high-secure forensic program at Waypoint Centre for Mental Health Care (“Waypoint”) since then.

2. Mr. Pismerov did not attend the hearing. We excused him pursuant to s.672.5(10)(a) of the Code.

3. At this annual review of his disposition, it was not disputed that Mr. Pismerov remained a significant threat to the safety of the public and that until appropriate housing became available his continued detention at Waypoint was the necessary and appropriate disposition. The only real issue was regarding housing and what could or should be done to ensure progress in securing housing for Mr. Pismerov.

Significant Threat

4. Even with the issue effectively conceded, the panel was first obligated to consider whether Mr. Pismerov remained a significant threat to the safety of the public. A significant threat to the safety of the public means a “risk of serious physical or psychological harm…from conduct that is criminal in nature but not necessarily violent” – see s.672.54 and 672.5401 of the Code. This standard is an onerous one – the risk must be foreseeable, substantial, and likely – not speculative. The harm must be serious, not trivial. Applying this standard, the panel concluded that Mr. Pismerov does represent a significant threat to the safety of the public.

5. Mr. Pismerov’s risk derives from his combined diagnoses and how these manifest in his behaviour. Mr. Pismerov is diagnosed with intellectual disability, mild to moderate, autism spectrum disorder, obsessive compulsive disorder and generalized anxiety disorder. Although he is frequently described as cheerful, bright, polite, cooperative, and communicative, his mood is labile. Regularly, and often with little warning, he becomes anxious and irritable. Although he can sometimes be “supported, redirected and calmed” when this happens, often he cannot be and, in that state, he shows poor judgment and impulse control. These were the circumstances of his index offence when he bit off the top portion of a neighbour’s finger.

6. Since the index offence, Mr. Pismerov has engaged in episodic environmental, verbal, and physical aggression, including self-harm. He has broken a staff person’s finger. He has threatened and thrown things at people. He has punched holes in drywall.

7. As set out in the Hospital Report, even at Waypoint, with the use of PRN medication daily to try to avoid his more extreme behaviours, a finely tuned Crisis Prevention Plan, and the use of seclusion or restraints or both when he escalates, there have been occasions this year when Mr. Pismerov has threatened to kill staff, engaged in significant room destruction, lunged at staff in an effort to grab and scratch them, punched a staff member in the face through a gap in a door, and broken his own nose as well as caused his head to bleed.

8. Given this behaviour with significant safeguards in place, we had no difficulty concluding that Mr. Pismerov continues to pose a real threat of causing others serious physical harm such that he must remain under the jurisdiction of the Board.

The Necessary and Appropriate Disposition

9. The panel was thus obliged to render the “necessary and appropriate” disposition 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.

10. Mr. Pismerov has been subject to a detention order at Waypoint (initially the Bayview Dual Diagnosis Program within the Regional Division at Waypoint and more recently the High Secure Forensic Program at Waypoint, albeit on a dual diagnosis unit) with community living, since he came under the jurisdiction of the Board. For the first ten years, Mr. Pismerov continued to live at Kerry’s Place Autism Services, a group home where he had been living for several years at the time of the index offence. Although his behaviours were sometimes challenging, for the most part, Kerry’s Place was able to manage them. Mr. Pismerov was more likely to engage in dysregulated behaviours when there were staff changes or during season changes. Periodically, Kerry’s Place would call the police, and Mr. Pismerov would be admitted to Waypoint as a “reset.” Many of these admissions were quite short.

11. This pattern was interrupted in 2020. Mr. Pismerov was taking clozapine, and it was effective at reducing some of his more challenging behaviours. Unfortunately, Mr. Pismerov was diagnosed with immune thrombocytopenic purpura (“IPT”) and as a result all antipsychotic medication was discontinued (at least for a time). Mr. Pismerov’s behaviours became more challenging for Kerry’s Place to manage. His hospital stays were longer. His last discharge to Kerry’s Place, in September 2021, lasted about two-and-a-half weeks before he was readmitted to hospital. Part of the difficulty was (and remains) Mr. Pismerov’s self-harm behaviours – he is at risk of hemorrhaging given the low platelets associated with IPT.

12. As will be discussed further in the next section, Kerry’s Place has concluded they cannot manage Mr. Pismerov’s behaviours with their current facilities. This has led to Mr. Pismerov’s continued detention in hospital since 2021.

13. The Awenda program is a dual diagnosis unit with staff trained and experienced to meet Mr. Pismerov’s needs in hospital. He gets one-to-one support. Waypoint is also well suited to manage Mr. Pismerov’s aggressive behaviours (with others and himself) as the need arises with the use of seclusion and restraints only for as long as necessary.

14. The panel was convinced that, given Mr. Pismerov’s needs (driven by his diagnoses, psychiatric and medical) and volatility, the least restrictive and least onerous disposition remained a detention order at Waypoint where he can continue to be part of a dual diagnosis program within a high-secure environment to manage his risk, until appropriate housing is available. Anything else would be disruptive and destabilizing for Mr. Pismerov and dangerous for him and staff.

The Housing Issue

15. Mr. Pismerov is ready for community living but only someplace that is both willing and able to manage him when he becomes upset, agitated, and unpredictably dangerous to himself and others. As Dr. Ismail testified, Mr. Pismerov’s mental state is relatively stable – the situation would be much the same in the community as it is in hospital. Mr. Pismerov remains in hospital because there is no suitable housing for him in the community. Community housing would be less onerous and less restrictive than detention at Waypoint.

16. Since 2021, when Mr. Pismerov was readmitted to Waypoint and Kerry’s Place indicated they could no longer manage him with the facilities they had, Kerry’s Place has been willing and interested in creating an appropriate space for Mr. Pismerov and having him return to live with them. Staff from Kerry’s Place have kept in touch with Mr. Pismerov, arranged visits, and continue to advocate for him. Kerry’s Place is Mr. Pismerov’s preference for community living.

17. Appendix C to the Hospital Report is an “Update Letter from Kerry’s Place” dated January 23, 2025. In it, Melissa Gerbasi, the Director of Services and Supports, describes the efforts they have made to secure funding to create an appropriate housing situation for Mr. Pismerov. Those efforts include “extensive advocacy” with the Ministry of Children, Community and Social Services (“MCCSS”), including letters to the Assistant Deputy Minister, meetings with Ministry officials, providing detailed proposals and needs assessments specific to Mr. Pismerov. They have made efforts to identify an appropriate, currently existing, housing vacancy through Developmental Services Ontario (“DSO”) and other community partners. The letter also confirms Kerry’s Place’s commitment to finding a long-term solution for Mr. Pismerov:

…Kerry’s Place has committed to developing a specialized residential placement for [Mr. Pismerov] within our treatment centre facility. This innovative environment is being designed specifically to meet [Mr. Pismerov’s] unique needs. It will incorporate many of the safety features currently available at Waypoint and will include access to highly trained staff and robust mental and physical health supports. However, this process is extensive and involves significant renovations to the facility as well as the recruitment and training of staff. …

18. Ms. Gerbasi describes the plan as one they are collaborating on with MCCSS to secure approval and the resources to implement.

19. The Hospital Report describes quarterly meetings that take place between team members, Mr. Pismerov’s family, and Kerry’s Place to discuss updates and potential strategies. Kerry’s Place has not received responses to their recent funding applications.

20. The panel also heard that Mr. Pismerov is frustrated and finds it hard to see others discharged to housing. Mr. Pismerov’s father read a statement at the hearing in which he described his profound concerns for the lack of housing progress and its impact on his son.

21. As set out in the Hospital Report (page 101):

Waypoint is concerned that the delay is impacting the patient’s liberty and reintegration into society. The hospital is aware of the reasons of the Ontario Court of Appeal in Shortt (Re), 2020 ONCA 651, and the importance of addressing these concerns for Mr. Pismerov.

The other parties went further and explicitly advocated for the panel to take steps to secure a witness from MCCSS at the next annual review to answer the Board’s questions regarding implementation of a plan to appropriately house Mr. Pismerov, should the situation remain the same.

22. The panel agreed with the parties. Lack of housing and lack of funding to create appropriate housing is directly interfering with Mr. Pismerov having maximum liberty consistent with the needs of public safety, and his ability to reintegrate into the community. See Ramos (Re), 2025 ONCA 820 at para 59. Following Shortt (at para. 83), we ordered a prehearing conference to take place in three months, hopefully with the participation of counsel representing MCCSS, with a view to identifying an appropriate witness from MCCSS to testify at Mr. Pismerov’s next hearing and “identify precise implementation” plans to house Mr. Pismerov at Kerry’s Place Autism Services. Counsel for the Attorney General agreed to assist by communicating around the need to have counsel join the prehearing conference.

DATED this 31st day of March 2026, at the City of Toronto, in the Toronto Region.

Ms. L. Maunder Alternate Chairperson

Office of the Registrar Ontario Review Board