Re Lawrence Caines, 2026 CanLII 32146

Re: Lawrence Caines

ORB File No: 8374

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.L. Darby

Dr. L.O. Lightfoot

Ms. M. Chamberlain

Mr. J. Cyr

Parties Appearing:

Accused: Lawrence Caines

Counsel: Mr. A. Rai

Person in charge of hospital: Representative: Ms. T. Murdock

Attorney-General of Ontario: Counsel: Ms. S. Curry

REASONS FOR DISPOSITION

(Dated April 7, 2026)

1. On August 17, 2023, Lawrence Caines was found not criminally responsible on account of mental disorder on charges of first-degree murder, contrary to the Criminal Code of Canada (the “Criminal Code”).

2. Mr. Caines is subject to a disposition of the Ontario Review Board (the “Board”) dated March 14, 2025, which orders that he be detained at the High Secure Provincial Forensic Programs, Waypoint Centre for Mental Health Care (“Waypoint”), with privileges up to hospital and grounds, beyond the secure perimeter, escorted by staff.

3. On Tuesday, February 24, 2026, the Ontario Review Board convened a hearing at Waypoint pursuant to s. 672.81(1) of the Criminal Code. Mr. Caines was in attendance and was represented by his counsel, Mr. A. Rai.

Position of the Parties

4. Ms. Murdock, on behalf of the Hospital, submitted that Mr. Caines remained a significant threat to the safety of the public and recommended that he be transferred to the forensic program at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) with privileges as set out at page 47 of the Hospital Report. This position was supported by Ms. Curry, on behalf of the Attorney General. Mr. Rai also joined with the Hospital and stated that his client wanted to be transferred to Ontario Shores.

Index Offences:

5. The circumstances of the index offences are taken from the most recent Reasons for Disposition, as follows:

“On January 14, 2022, numerous 911 calls were made for a mental health well-being check on Donald Caines, (known to have been diagnosed with mental disorders), about smashing items in his apartment. Police discovered an unconscious male inside the dwelling, and another male, Lawrence Caines, running on the roof. After a foot chase, Lawrence Caines was tasered and taken into custody. He admitted to inflicting physical abuse on his brother, (Donald), who was found dead in the bathroom. Mr. Caines confessed to various acts of violence, including attempting to drown his brother, using a belt around his neck, inserting a wooden pole down his throat, and removing his eyes with a plunger handle.”

Background:

6. Lawrence Caines is a 58-year-old man who was born in Collingwood, Ontario. He has two brothers and sister. He grew up in a home environment marked by domestic violence. At age nine, he was placed in foster care due to behavioral issues and later became a Crown Ward after his parents separated. His siblings were also placed in foster care.

7. Mr. Caines struggled with behavioral difficulties throughout adolescence, frequently running away from foster placements. This led to his transfer to Brookside Training School and later, his incarceration. Mr. Caines reported experiencing sexual abuse both while in foster care and by his brother Donald during childhood. Having left school in Grade 9, Mr. Caines later established a garage door repair business.

8. Mr. Caines was in a long-term relationship with his common-law wife from the age of 19, and despite periods of instability, they raised five children together. He has maintained ongoing contact and support from his wife and children.

9. Mr. Caines has a long history of alcohol abuse, which contributed to difficulties with work, relationships, and aggression, though he has been abstinent for many years. He also struggled with opioid addiction but has reported no opioid or alcohol use since 2015. He has used marijuana during periods of illness, including in 2018, raising uncertainty about whether it was a form of self-medication or a trigger for his underlying mood disorder and psychosis.

10. Mr. Caines’ record includes 25 criminal convictions between 1984 and 2019, ranging from break and enter, escape custody, and impaired driving, among others. It is noted that he was reportedly manic and psychotic during the 2009 and 2019 convictions.

11. Following the finding of ‘not criminally responsible,’ Mr. Caines was admitted to the Forensic Assessment Unit at Waypoint on December 13, 2023, under the care of Dr. Van Impe until his transfer to the Beausoleil Program in 2024.

12. Mr. Caines’ current psychiatric diagnoses are listed in the Hospital report as:

• Bipolar Disorder I (most recent episode severe mania)

• Opioid Use Disorder, moderate, in early remission

• Post-Traumatic Stress Disorder

• Tobacco Use Disorder

• Mild Cognitive Impairment

Evidence at Hearing:

13. The evidence at the hearing consisted of the Hospital Report dated January 23, 2026, the Rule 13 response from Ontario Shores, as well as the testimony of Dr. Mishra.

14. Mr. Caines’ progress since his last annual review is summarized in the Hospital Report as follows:

“During this review period and in the context of a high-secure forensic facility, Mr. Caines has adhered to his psychotropic medications and has abided by the institution’s rules, regulations, and behavioural expectations. He has also participated in various structured therapeutic programs including Anger Management, CBT Skills Group, CBT Advanced Skills Group, CBT Seminars, Dollars and Sense (money management), Life Skills Group, and Learning Leisure. Notably, he engaged in a series of weekly individual addiction counselling sessions, participated in the SMART Recovery Group, attended weekly Alcohol Anonymous meetings, and was compliant with random toxicology tests. He was involved in the employment skills training program and is the Beausoleil B unit worker. He participated in recreational activities and maintained positive relationships with hospital staff and co-patients. Overall, Mr. Caines has responded well to both therapeutic interventions and psychopharmacological treatment. After the interview for this assessment, a referral was made for individual psychotherapy to specifically address grief and trauma; he was agreeable to meeting with the psychotherapist for weekly sessions “

15. Ms. Murdock called Dr. Mishra to give evidence on behalf of the hospital. The doctor agreed with the contents, including the recommendations of the Hospital Report.

16. Dr. Mishra informed the Board that Mr. Caines had continued to do very well in the last reporting year. His mental status had remained stable, and he was complying with medication. Mr. Caines had remained at a C5 level of security which was the highest level available to him. He attended recreational and vocational programs with no issue and had not had any problems interacting with other patients.

17. Mr. Caines was attending individual counselling for addictions and CBT. Mr. Caines was trying to understand why the index offence happened which was very hard for him.

18. Mr. Caines had a recent neurocognitive assessment that showed some deficits in delayed recall, and he had been referred for both a geriatric and neuropsychological assessment.

19. Dr. Mishra testified that Mr. Caines had developed good insight into his mental illness as well as the role that substance use had in aggravating it.

20. Dr. Mishra stated that Mr. Caines’ family has been supportive to him and very involved in his care. The family reside in the Ontario Shores geographic area and if Mr. Caines were to be transferred to that hospital, they would be more able to interact with him. Dr. Mishra also noted that Mr. Caines had not displayed any maladaptive behavior in the past year and, therefore, felt that he could go into the community indirectly supervised once he was transferred to Ontario Shores.

21. In response to questions from the Board, Dr. Mishra agreed that Mr. Caines would have more access to substances at Ontario Shores. He noted that Mr. Caines had been stable for some time and opined that he would be able to resist the temptation to engage in substance use. He also pointed out that the Hospital was requesting the disposition include the requirement for urine testing and that this would catch any use of nonprescribed medication. Further, the doctor informed the Board that Mr. Caines was currently engaged in substance use counselling and that his insight was quite good. Counselling would also be available to Mr. Caines at Ontario Shores and Dr. Mishra would recommend that he continue with it once he was transferred.

22. Dr. Mishra was asked if he had any concerns with Mr. Caines’ decision to discontinue Suboxone which was used to treat his opioid addiction. The doctor stated that there have been no reported issues since Mr. Caines stopped taking this medication. As part of his preparation for transfer to Ontario Shores, the Hospital would address with Mr. Caines that if he were to begin having symptoms again, this medication should be restarted.

23. While discussing the privileges that the Hospital was recommending in the Hospital Report, Dr. Mishra opined that it might be appropriate for the disposition to include indirectly supervised passes into the community. Dr. Mishra stated that, given Mr. Caines’ current trajectory, it was likely that he would be ready for this privilege within the coming reporting year. He noted that the passes would not be automatically granted and would be dependent on Mr. Caines’ progress. Dr. Mishra felt that including indirectly supervised passes into the community in his disposition would likely compromise his progress over the next reporting year.

Final Submissions:

24. At the conclusion of the hearing, Ms. Murdock commended Mr. Caines on his progress and the year that he had had. She agreed that the inclusion of indirectly supervised passes into the community would be appropriate given the testimony of Dr. Mishra. Ms. Curry also congratulated Mr. Caines on the hard work that he was doing to engage in programming and learn about his illness. Counsel for Mr. Caines stated that he was in agreement with the Hospital position. He stated that indirectly supervised passes into the community would assist Mr. Caines in moving forward.

Findings of the Board:

25. The Board unanimously finds that Mr. Caines continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Mishra. The Board also relies on the Hospital Report, which notes the following:

“Mr. Caines has a history of bipolar disorder which has been punctuated with severe relapses often due to medication noncompliance and substance use. The relapses involved him becoming floridly manic and profoundly psychotic. He demonstrated significant violence during these episodes including the index offense. In addition, he would display labile affect and bizarre behavior. His grandiose delusions involved believing that he was God. He had attempted to strangle his nephew in the days before the index offense and had an assault conviction many years ago when unwell. The rapidity of the decline in his mental state when unwell remains extremely concerning with a high potential for violence. Mr. Caines has displayed considerable stability in his mental state and participated in groups and programming to gain a better understanding of his condition. He has remained fully compliant with treatment and there has been no concerns regarding his mental state.”

26. While his stability this past year is commendable, Mr. Caines has been in a highly structured setting and has not been tested with more liberties. Given how quickly Mr. Caines can decompensate, it is clear that he remains a significant threat to the safety of the public.

27. The Board accepts Dr. Mishra’s evidence that, while Mr. Caines continues to require the oversight of the ORB, his risk of significant harm to the public can be safely managed in a less secure forensic facility. Mr. Caines has done well in the high secure forensic setting at Waypoint. The Board agrees that it is now appropriate for him to move to a medium secure setting. This will allow him to progress through the ORB system while ensuring the safety to the public.

28. Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Caines poses to the safety of the public while still meeting their needs, is a Detention Disposition at the Forensic Programs of Ontario Shores Centre for Mental Health Sciences, subject to the following privileges and conditions:

a. To attend within or outside of hospital for necessary medical, dental, legal, or compassionate purposes;

b. Hospital grounds privileges, escorted or accompanied by staff, and/or indirectly supervised;

c. To enter the catchment area of Ontario Shores Centre for Mental Health Sciences, accompanied by staff and/or an approved person and/or indirectly supervised;

d. Abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant;

e. Submit samples of his urine and/or breath to the person in charge of the Ontario Shores Centre for Mental Health Sciences or his or her designate for the purpose of analyzing whether the accused has ingested alcohol, drugs, or any other intoxicant; and

f. Refrain from having in his possession any firearm, ammunition, or other offensive weapon, or being in the company of any person possessing a firearm other than a peace officer.

29. The Board is aware that it is unusual for a disposition to include passes into the community indirectly supervised in the first year after a transfer to a new hospital. Mr. Caines will not necessarily use this privilege in the coming year, but it should be available to him and the treatment team in the event that his progress continues at the current pace.

30. In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Mishra and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Caines’ mental condition, his reintegration into society and his other needs.

DATED this 7th day of April, 2026, at the City of Toronto, in the Toronto Region.

Ms. M. Chamberlain

Legal Member

Office of the Registrar

Ontario Review Board