Re: Timothy J. Iwamoto
ORB File No: 4640
Hearing held on: March 30, 2026
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. S. Clapp Members: Dr. P. Darby Dr. A. Gibas Ms. C. Murray Ms. B. Little
Parties Appearing: Accused: Timothy J. Iwamoto Counsel: Mr. D. Northcott Person in charge of hospital: Counsel: Ms. T. Newman Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DISPOSITION
(Dated April 14, 2026)
Introduction
[1]. On December 21, 2006, Mr. Timothy J. Iwamoto was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault with a weapon, possession of a weapon for dangerous purpose, and forcible confinement, all contrary to the Criminal Code of Canada (the “Criminal Code”).
[2]. On March 30, 2026, a panel of the Ontario Review Board (“Board” or “panel”) convened to review Mr. Iwamoto’s current Disposition pursuant to s. 672.81(1) of the Criminal Code. At the time of the hearing, Mr. Iwamoto was ordered detained at the Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs (“Waypoint” or “the hospital”), with privileges up to and including hospital grounds privileges, beyond the secure perimeter, escorted by staff.
[3]. Mr. Iwamoto was present at the hearing. He was represented by counsel, Mr. David Northcott, throughout the proceedings.
[4]. A Hospital Report dated March 6, 2026, was entered as Exhibit 1. A Rule 13 Request dated February 24, 2026, from Terri Newman of Waypoint to St. Joseph’s Healthcare Hamilton, West 5^th^ Campus (“SJHCH”) was entered as Exhibit 2. A Rule 13 Response dated March 27, 2026, from SJHCH to Waypoint was entered as Exhibit 3.
[5]. The issues to be determined are whether Mr. Iwamoto continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate Disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code.
[6]. For the reasons set out below and based on the evidence and opinions before us, the Board finds that Mr. Iwamoto continues to represent a significant threat to the safety of the public. The Board finds that a Detention Disposition, as set out in our formal Disposition, is the necessary and appropriate Order having regard to the safety of the public, which is the paramount concern, and also having regard to Mr. Iwamoto’s mental health, reintegration into society, and his other needs. The panel found that a transfer to SJHCH was not appropriate at the current time.
Current Psychiatric Diagnosis
[7]. Paranoid Schizophrenia
Position of the Parties
[8]. At the commencement of the hearing the parties were canvassed for their without prejudice positions. The Alternate Chair noted inconsistencies in prior Dispositions regarding the ‘no contact’ and the ‘weapons prohibition’ terms, and requested positions in that regard.
[9]. Ms. T. Newman, on behalf of the hospital, took the position that Mr. Iwamoto continues to represent a significant threat to the public. She submitted that the necessary and appropriate Disposition is a Detention Order with a transfer to SJHCH on the terms set out at page 111 of the Hospital Report with residual authority to Waypoint until such transfer takes place. In her initial position, Ms. Newman stated that the hospital does not request a weapons prohibition term. She also submitted that a provision prohibiting contact with Dr. Carly Thompson, her parents, Sarah Gignac, and her parents, need not be included in the Disposition Order.
[10]. Ms. S. Curry, counsel for the Attorney General, submitted that Mr. Iwamoto remains a significant threat to public safety and that the necessary and appropriate Disposition is a Detention Order. She deferred her position on the issue of a transfer, and terms for a no contact order and weapons prohibition until hearing the evidence on these issues.
[11]. Counsel for Mr. Iwamoto, David Northcott, conceded significant threat. He supported the position of the hospital including the request for a transfer to SJHCH.
Index Offences
[12]. The circumstances giving rise to the Index Offences are extracted from last year’s Board Reasons as follows:
“On July 29, 2006, shortly after being discharged from a psychiatric admission, Mr. Iwamoto was at home with his parents when the alleged offence occurred. Earlier that day, he had reported receiving disturbing messages from the television and experiencing 'negative thoughts'. During dinner, he asked to be taken to the hospital but was told to finish his meal. Shortly after, while his parents were in the living room, Mr. Iwamoto emerged from the kitchen holding a steak knife and made threatening motions toward his mother without speaking. His father later recalled Mr. Iwamoto stating that voices were telling him to kill someone. His mother fled the house and called police. Mr. Iwamoto's behaviour and statements suggested that he was experiencing significant psychological distress.”
Background and History
[13]. The Hospital Report contains extensive information regarding Mr. Iwamoto’s background and history, the entirety of which need not be repeated here in detail. However, the following particulars are noteworthy.
[14]. Mr. Iwamoto is a single 45 year old man from Barrie, Ontario. He completed his high school education. He went on to pursue post-secondary studies but his mental illness interfered with his ability to complete his education. His sister was diagnosed with schizophrenia in her teens and lives in a group home. Mr. Iwamoto has two brothers; one of the brothers maintains contact with Mr. Iwamoto.
[15]. Mr. Iwamoto has limited work experience and is supported by the Ontario Disability Support Program.
[16]. Mr. Iwamoto has no history of illicit substance use.
[17]. Mr. Iwamoto experienced his first psychiatric admission to hospital in 1999 at the age of 18, when he was admitted to Oakville Trafalgar Memorial Hospital. He received a diagnosis of paranoid schizophrenia. He was admitted to Royal Victoria Hospital Barrie (“RVH”) in December 2002 and June 2003. Prior to his June 2003 admission, Mr. Iwamoto committed offences including uttering forged documents (x5) and utter death threat. As a result, in July 2003, he was admitted to Waypoint for an assessment of criminal responsibility. It was determined that he was not eligible for a NCR defence. He was registered as an outpatient at Waypoint from July 25, 2004, to September 12, 2005. Mr. Iwamoto was admitted to RVH in October 2005 and subsequently transferred to Waypoint’s Psychosocial Rehabilitation Program. He was discharged from the Psychosocial Rehabilitation Program on March 23, 2006, to a Home for Special Care in Barrie. He was admitted to RVH two further times in 2006 prior to the index offences.
[18]. Mr. Iwamoto was detained at Waypoint on a Detention Order from 2006 until 2018 when he was transferred to Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) under the authority of an ORB Disposition. On July 7, 2021, Mr. Iwamoto was discharged to live in the community at a Home for Special Care in Scarborough that provided 24 hour supervision and medication monitoring. In August 2021, a medication error at the group home resulted in Mr. Iwamoto missing five doses of clozapine. He experienced a decompensation in his mental state requiring readmission to hospital. In January 2022, he refused several doses of clozapine. His mental state again decompensated and he exhibited bizarre, highly unpredictable behaviours and engaged in unprovoked incidents of violence. On February 24, 2022, Mr. Iwamoto was ordered to be detained at Waypoint after Ontario Shores brought an early hearing before the ORB seeking a change to the Detention Order. As of the date of this hearing, Mr. Iwamoto continues to reside at Waypoint on the Awenda Program.
[19]. Mr. Iwamoto is incapable of consenting to his psychiatric treatment. His brother, Travis, is his substitute decision-maker.
[20]. This reporting period, Mr. Iwamoto required seclusion on one occasion, from April 26, 2025, to May 7, 2025, when he suddenly struck a nurse several times. A restriction of liberty hearing was held on May 29, 2025, to review the restriction of liberty. The Board concluded that the hospital’s decision to seclude Mr. Iwamoto was warranted and represented the least onerous and least restrictive decision that could be taken. It is also noteworthy that in January 2025, Mr. Iwamoto was secluded for a few days due to violent behaviour.
[21]. Mr. Iwamoto began refusing his clozapine in mid-July 2025. Attempts to encourage him to accept clozapine were unsuccessful. By August 1, 2025, staff noted his presentation had changed and attributed his behaviours to the discontinuation of clozapine. Throughout August 2025, Mr. Iwamoto was seen waving his arms, mumbling to himself, staring, and he became uninterested in activities he previously enjoyed. Bizarre behaviours continued to be noted in October 2025 but were not threatening.
[22]. Mr. Iwamoto is fully compliant with his olanzapine and he no longer requires a medication watch. He is compliant with his long-acting injectable antipsychotic medication and oral olanzapine.
[23]. Dr. Mishra’s clinical assessment of risk of March 6, 2026, notes:
“Mr. Iwamoto has maintained the improvement in his mental state after discontinuation of clozapine, since around October 2025. There has been no noted risk behaviour.”
Oral Evidence at the Hearing
[24]. Dr. A. Mishra, Mr. Iwamoto’s psychiatrist and co-author of the Hospital Report, provided oral evidence at the hearing as set out below.
[25]. Since November 2025, Mr. Iwamoto’s mental state has been stable. There are no behavioural concerns.
[26]. On August 27, 2025, Mr. Iwamoto became eligible for the “Walk Program” which allows accompanied walks beyond the secure perimeter. He exercised this privilege on two occasions, most recently in March 2026. In March 2026, Mr. Iwamoto progressed to security level C5, which is the highest security level available at Waypoint. This permits four hours off unit unaccompanied; he exercises this privilege appropriately several times per day.
[27]. Mr. Iwamoto participates in groups on and off the unit. He has not shown interest in vocational programs or service work.
[28]. Mr. Iwamoto is treated optimally. Changes to his medications are not recommended at this time because he is responding well on the current medication regimen, behaviourally stable, and compliant with his medication regimen. Apart from the mental instability the team observed for three months following discontinuation of clozapine, Mr. Iwamoto has done “surprisingly well”. He is no longer on a medication watch.
[29]. Mr. Iwamoto displays response latency and some internal preoccupation. Mr. Iwamoto tends to deny symptoms. However, with sufficient probing by staff, he acknowledges some symptoms.
[30]. Mr. Iwamoto’s insight into his need for medication is “not absent, yet not ideal”. Mr. Iwamoto acknowledges that he suffers paranoia and auditory hallucinations and that medications may reduce these symptoms. He lacks insight into his risk behaviours and has no insight regarding inappropriate comments he makes to female staff.
[31]. Dr. Mishra testified that he believes Mr. Iwamoto can be managed in a less secure setting. Based on his knowledge of transfer wait times, Mr. Iwamoto is not likely to be transferred for three to four months. If Mr. Iwamoto did require an “odd day of seclusion”, SJHCH could manage him. Dr. Mishra acknowledged that it is possible that if Mr. Iwamoto was no longer in a high secure environment, he would not do as well and he could experience mental decompensation.
[32]. There are no concerns that Mr. Iwamoto would contact Dr. Carly Thompson, Sarah Gignac or their respective parents. However, Dr. Mishra had not reviewed the information regarding this issue during the time Mr. Iwamoto was not resident at Waypoint. He was unable to provide information regarding the connection of these individuals to the index offences.
[33]. In June 2025, prior to the discontinuation of clozapine, the dose of olanzapine was increased from 20mg daily to 30mg. The combination of zuclopenthixol and the higher dose of olanzapine seems to be more effective for Mr. Iwamoto than the combination of zuclopenthixol, clozapine, and the lower dose of olanzapine. He would not be prone to rapid decompensation because he is on the long-acting injectable, zuclopenthixol (which can be increased in dose, if needed). The treatment team is confident that Mr. Iwamoto is mentally stable enough to move to a less secure setting since the medication change has yielded positive behavioural changes. Dr. Mishra stated, “I am confident that by the time a transfer occurs, he will have been stable for over a year.”
[34]. Mr. Iwamoto remains a significant threat to the safety of the public for the reasons set out on page 111 of the hospital report. Mr. Iwamoto suffers from treatment refractory schizophrenia. When clozapine has been discontinued in the past, he has become very ill. The violence he displayed in the community when unwell was significant. Despite improvements in his mental state, it is suspected that Mr. Iwamoto continues to have symptoms of his illness including response latency and internal preoccupation.
Submissions:
[35]. Ms. Newman, Ms. Curry, and Mr. Northcott all submitted that Mr. Iwamoto remains a significant threat to the safety of the public.
[36]. Ms. Newman submitted that Mr. Iwamoto is compliant with his medication regimen. He prefers olanzapine over clozapine. He has not displayed violent behaviour in approximately a year. He is at the top level of privileges and using them appropriately. Mr. Iwamoto has had successful periods of time in less secure settings in the past and knows what is expected of him in those co-ed settings. The hospital believes that it is an appropriate time for Mr. Iwamoto’s transfer to a less secure setting. If concerning events were to arise between now and his transfer, the hospital would not proceed with the transfer. There is no evidence that Mr. Iwamoto would contact Dr. Thompson, Ms. Gignac or their respective parents. Therefore, a no contact clause is not necessary. If the Board orders Mr. Iwamoto transferred to a less secure setting, then the hospital would like a weapons prohibition in the Disposition.
[37]. Ms. Curry supported the submissions of the hospital, including the transfer to SJHCH. She noted that adding a no contact provision back into the Disposition (which appeared to be dropped as a term around 2019) would not be the least restrictive and least onerous measure. A weapons prohibition is requested by the Crown should the Board order Mr. Iwamoto’s transfer to a less secure hospital, given the nature of the index offences.
[38]. Mr. Northcott supported the submission of the hospital.
Analysis and Conclusions
[39]. Having heard and considered the entirety of the evidence as well as the joint submissions from the parties, the Board independently finds that Mr. Iwamoto remains a significant threat to the safety of the public.
[40]. Mr. Iwamoto has long-standing treatment-resistant schizophrenia. His illness is marked by unpredictable rapid decompensation with increased aggression and illness-driven acts of violence toward members of the public.
[41]. Mr. Iwamoto displayed assaultive behaviour toward staff in this reporting year. In April 2025, Mr. Iwamoto struck a nurse with a closed fist several times. On May 5, 2025, during the removal of restraints, Mr. Iwamoto struck out the opening of his door toward staff. In August 2025, Mr. Iwamoto stated, “Don’t be mad, but sometimes I think about hitting you in group.” Mr. Iwamoto elected to leave the group to prevent an assault. On February 23, 2026, Mr. Iwamoto raised his fists toward staff and stated “I’m just joking. I would never hit you.” Mr. Iwamoto was instructed to be mindful of actions like these but has failed to abide consistently.
[42]. In July 2025, Mr. Iwamoto discontinued his clozapine, though he continued to accept treatment with olanzapine. He experienced notable decline in his mental state including paranoid thoughts, violent thoughts, and sexually inappropriate comments toward female staff. Mr. Iwamoto’s mental state improved in approximately October 2025, but he remains internally preoccupied at times.
[43]. Mr. Iwamoto’s insight into his illness is lacking. He is unlikely to report any changes in his mental status or worsening of his symptoms.
[44]. In light of the Board’s finding of significant threat, it is charged with shaping a Disposition for the coming year.
[45]. Mr. Iwamoto has requested a transfer to SJHCH. SJHCH is not in support of the transfer request. SJHCH states in their Rule 13 response letter the following:
“Mr. Iwamoto has a long history of non-compliance with treatment including spitting out, and purging medication necessitating medication watches. Not only has Clozapine been discontinued but the medication watch was also discontinued. As noted in the Reasons form his last hearing in 2025, “[Mr. Iwamoto’s] currently stability is contingent on intensive monitoring, and structured supervision including in medication watch. The evidence demonstrates that when these supports are reduced, Mr. Iwamoto rapidly decompensates” (para. 25).
Acknowledging Waypoint’s expertise in the management of patients requiring maximum security and the assessment of determining those suitable for consideration of a less secure facility, most patients transferred to our facility have been stable, with few management issues.
Although, Mr. Iwamoto’s recent stability, and reduction in assaultive behaviours is encouraging, our position is that a longer period of stabilization is required. Considering the unpredictability of his condition, the change in medication over the reporting period (and lack of medication monitoring), and that Mr. Iwamoto “is not fully open about his symptoms and is unlikely to report any changes or worsening of his symptoms” (page 110, Hospital report), in our opinion, a transfer to a less secure facility is premature.”
[46]. After extensive consideration and deliberation regarding the transfer issue, the Board agrees with the reasoning of SJHCH and finds that a transfer to a less secure facility is premature. In particular, the panel noted that Mr. Iwamoto’s clinical stability has been described as “fragile” and heavily reliant on close supervision and structured clinical support. While he has experienced some stability in the latter part of this reporting year, this has not been a prolonged period of stability, especially when considering his history under the Board and Dr. Mishra’s “surprise” at how well Mr. Iwamoto has done off clozapine. The panel recognizes that Mr. Iwamoto has only had C5 privileges for a couple of weeks and has only gone on two escorted walks beyond the secure perimeter. Though this is the highest privilege level, the panel notes that this is a very brief period and there is room for him to utilize these privileges more extensively. The panel also considered that Mr. Iwamoto had not been violent for three years prior to the last transfer recommendation in January 2025; and then “completely out of the blue” he displayed rapid decompensation and, due to aggression and violent behaviour, the recommendation for a transfer was revoked. On the heels of the January 2025 episode of violent behaviour, Mr. Iwamoto displayed further episodes of aggression in this reporting year, as described in paragraph 41. Mr. Iwamoto has now maintained stable behaviour for approximately five months. Given his history and the severity of his aggression when he decompensates, a longer period of stability is necessary before transfer to a less secure facility.
[47]. The Board appreciates that the parties put forward a joint submission that Mr. Iwamoto be transferred to a less secure facility. The panel does not reject this joint submission lightly. As the Court of Appeal stated in Hassan (Re), 2011 ONCA 561, [2011] O.J. No. 3800 at para. 24, the Board “ought to tread cautiously” before making an order that restricts the accused’s liberty beyond that which the hospital and Crown believe is necessary. However, the court went on to say the following at para. 25:
“However, the Board does not necessarily err because it declines to follow a hospital’s or Crown’s recommendation. Automatically adhering to the position of a hospital or Crown would mean abdicating its own role. A review board is composed of medical and legal experts with specialized knowledge and experience in mental health and in risk assessment and management. Parliament has vested these boards with authority to make their own independent and often difficult determinations after weighing the package of factors in s. 672.54 of the Code.”
[48]. It is clear that Mr. Iwamoto requires the supervision and structure of Waypoint at this time. A Detention Disposition is appropriate and necessary to manage Mr. Iwamoto’s risk to the safety of the public given his challenges with treatment-resistant illness, history of medication non-compliance, lack of insight, and aggressive behaviours within this reporting year.
[49]. A “no contact” provision will not be included in the Disposition; there is no evidence regarding its necessity. Given the nature of the index offences, a weapons prohibition will be included in the Disposition. It would appear that the exclusion of a weapons prohibition was an oversight in previous years.
[50]. It is encouraging that Mr. Iwamoto experienced an improvement in behaviours in the latter half of the reporting year. We encourage him to continue his engagement in programs on and off the unit. We wish him the best in the coming year.
[51]. The Board considered and weighed the factors set out in section 672.54 with the safety of the public as the paramount consideration, and Mr. Iwamoto’s mental condition, reintegration into society and his other needs. The Board finds that the necessary and appropriate, least onerous and least restrictive Disposition is a continuation of the Detention Order at Waypoint with changes, as set out in our formal Disposition.
DATED this 14th day of April 2026, at the City of Toronto, in the Region of Toronto.
Ms. C. Murray Legal Member
__________________ Office of the Registrar Ontario Review Board