Re Eddie Munoz, 2026 CanLII 34223

Re: Eddie Munoz

ORB File No: 7298 Hearing held on: Wednesday, March 4, 2026 Place of Hearing: Southwest Centre for Forensic Mental Health Care, 401 Sunset Drive, St. Thomas Pursuant to: Section 672.81 (1) of the Criminal Code

Before: Alternate Chairperson: Ms. T. Mann Members: Dr. R. Chandrasena Dr. A. Kerry Mr. E. Siebenmorgen Ms. K. Brisson

Parties Appearing: Accused: Eddie Munoz Counsel: Ms. N. Circelli The person in charge of hospital: Counsel: Ms. J. Zamprogna Attorney General of Ontario: Counsel: Mr. J. Huber

REASONS FOR DISPOSITION

(Dated April 15, 2026)

Introduction

1On January 31, 2018, Mr. Eddie Munoz was found not criminally responsible on account of mental disorder (“NCR”), on charges of assault with a weapon, assault causing bodily harm, forcible confinement, and forcible entry, all contrary to the Criminal Code. Mr. Munoz was most recently subject to a Disposition of the Ontario Review Board (“ORB” or “the Board”) dated March 21, 2025 pursuant to which he is ordered detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London (“Southwest Centre” or “the Hospital”) subject to terms and conditions that include privileges up to community living in Elgin or Middlesex Counties in approved accommodation. Notably, Mr. Munoz has in fact been living in various supervised community residences since 2022. Since May of 2025, he has been living at the C.K. Clarke Centre Transitional Rehabilitation Housing Program in London.

2On Wednesday, March 4, 2026, a panel of the Board convened in person at the Hospital to conduct the annual review of Mr. Munoz’ Disposition. The issues for determination were whether Mr. Munoz represented a significant threat to the safety of the public within the meaning of s. 672.5401 of the Criminal Code and, if so, ascertaining the necessary and appropriate Disposition having regard to the criteria in s. 672.54 of the Code. Mr. Munoz was present and represented throughout the hearing by his counsel, Ms. Circelli. Several hospital staff and Mr. Munoz’ mother (the victim of the index offences) were also in attendance.

3The evidence for the hearing included the Hospital Report dated January 8, 2026 and an Update to that Report dated February 13, 2026. In addition, the Hospital led the evidence of two witnesses: Dr. J. Bajwa and Dr. Ajay Prakash, the latter being Mr. Munoz’ attending psychiatrist.

4At the outset of the hearing when counsel were asked for their initial, without-prejudice positions, counsel for the Hospital confirmed the position in the Hospital Report: that Mr. Munoz represented a significant threat to public safety, that the necessary and appropriate Disposition was a Detention Order, and that minor, mainly grammatical, changes should be made to the Disposition, as specified in the Hospital Report. Counsel for the Attorney General adopted the Hospital’s position.

5On behalf of Mr. Munoz, Ms. Circelli conceded that Mr. Munoz represented a significant threat to the safety of the public. She stated that Mr. Munoz was seeking a Conditional Discharge. Ms. Circelli recommended that the applicable terms from the current Disposition be incorporated into the proposed Conditional Discharge. In addition, she proposed that the following terms be included:

• a residence clause, specifying an independent apartment in which Mr. Munoz proposed to reside;
• a reporting clause consistent with that in the existing Disposition;
• a “consent to treatment” clause pursuant to s. 672.55 of the Criminal Code;
• two complementary Young¹ clauses (one for attendance at the Hospital for assessment, the other for attendance for admission to the Hospital).

6Having thus heard from counsel for Mr. Munoz, counsel for the Hospital stated that if the Board imposed a Conditional Discharge, the Hospital would also be seeking similar clauses.

7The parties maintained their respective positions at the conclusion of the evidence.

Findings

8For the following Reasons, the panel concluded that Mr. Munoz continues to present a significant threat to the safety of the public and that the necessary and appropriate Disposition in the circumstances is a Conditional Discharge. The terms of the Disposition are largely consistent with those proposed by counsel for Mr. Munoz and in the alternative submission of counsel for the Hospital. The one major change made by the panel to the original proposal is that, instead of naming Mr. Munoz’ desired independent apartment in the Disposition, the panel determined that Mr. Munoz is required to reside at his current location at the time of the hearing, namely the C.K. Clarke Centre Transitional Rehabilitation Housing Program in London, Ontario. The specific conditions are attached as an Appendix to these Reasons.

The Index Offences

9The index offences are interwoven with Mr. Munoz’ prior psychiatric history and his conflictual relationship with his mother who had been his substitute decision maker (SDM) for psychiatric treatment for some eight years. The following summary is taken from various portions of the Hospital Report.

10Mr. Munoz was first diagnosed with schizophrenia in May of 2009 after being brought to hospital while employed in the Canadian Armed Forces. He was found incapable of consenting to his treatment and was treated with the substituted consent of his mother. He was placed on a Community Treatment Order (CTO) in 2012 and his mother again became his SDM. He became involved with the Prevention and Early Intervention Program for Psychosis (PEPP) in the London community.

11Mr. Munoz, who originates from Columbia, travelled there in August of 2014. He self-reported having discarded his supply of antipsychotic medication at the beginning of the trip. He reportedly stayed with his maternal grandmother and her husband. In November of 2014, he set fire at a travel agency, reportedly because he was angry that he was not permitted to book a tour. He was reportedly not charged due to his mental illness. Shortly thereafter, his mother and maternal grandmother arranged to have him admitted to a private mental health clinic. Mr. Munoz was resentful toward both his mother and grandmother over this. He returned to Canada in January of 2015. He was followed by Dr. A. Haque of Parkwood Mental Health in London, with his mother continuing in her SDM role.

12Mr. Munoz was receiving injections of antipsychotic medications with his mother’s substituted consent but stopped his medication in November of 2016 and no longer attended his clinic. During his criminal responsibility assessment, he reported that he purchased a crossbow and arrows in October of 2016, intending to use them to kill his mother. He wanted her to stop being his SDM.

13After not seeing his mother since 2012 (confirmed by his mother), Mr. Munoz attended at her home on January 31, 2017 (the day before the index offences). He declined her invitation to come in and remained at the door, telling her that he and his doctor, Dr. Haque, would be visiting her the next evening at 8:00 p.m. Mr. Munoz’ mother subsequently spoke with Dr. Haque, who told her that he had not spoken with Mr. Munoz and had no plans to attend at her home. He warned her not to be alone with Mr. Munoz, as he had been off his medication since November and may be suffering from paranoia.

14Mr. Munoz went to his mother’s home early in the afternoon of February 1, 2017. He rang the doorbell but had run off by the time she answered the door. She later saw him walking along her street and stopped her car to invite him to her home so that she could cook dinner for him. He refused at that time and his mother went home.

15Mr. Munoz came to his mother’s door again shortly after 6:00 p.m. on February 1. When she answered the door, he stood there with an arrow loaded into his crossbow and fired it at her abdomen. As she was wearing think clothing, the arrow did not penetrate her skin and fell to the floor. His mother tried to close the door, but Mr. Munoz forced his way into the residence. He tried to fire another arrow into his mother but was too close to her. She grabbed the metal-tipped arrow and struggled to take it away from him. He grabbed it and repeatedly tried to stab her in the abdomen before returning outside to get more arrows. Once again, his mother tried unsuccessfully to close the door. Mr. Munoz grabbed her head with one hand and with the other, attempted to drive an arrow into her eye. His mother was able to redirect the arrow and he drove it into her orbital bone, causing her face to bleed.

16Mr. Munoz’ mother was eventually able to open the door again and screamed for help. Neighbours heard her and called the police. Mr. Munoz tried again to pull her back inside, but she was able to break free and run toward a neighbour’s home. Mr. Munoz pursued her, trying to stab her in the abdomen and chest with an arrow. Neighbours began coming out of their homes. Mr. Munoz fled the scene but was later arrested nearby. His mother was taken to the hospital and treated for a gash under her right eye and other injuries.

Personal History and Background

17Mr. Munoz was 36 years of age at the time of the hearing and 27 at the time of the index offences. He is single and has no dependents. His family and personal background prior to the commission of the index offences are set out in detail in the Hospital Report. As this Report is in evidence, this information need not be extensively summarized Certain matters are highlighted below to help explain the panel’s “significant threat” determination and its approach to the management of Mr. Munoz’ risk.

18Prior to his arrest, Mr. Munoz had been living in student housing in the Masonville area of London, Ontario with two roommates He was financially supported by a “medical pension” from the military for approximately the previous five years.

19As previously noted, Mr. Munoz was born in Columbia. His parents never married but Mr. Munoz described a generally positive relationship between them. He stated that his mother moved to Canada on her own and left Mr. Munoz in the care of his maternal grandmother and her husband. She maintained contact with him by telephone. Mr. Munoz joined his mother in Canada in 1998, when he was eight years old. He described being physically punished by his mother, using various objects around the house. He denied having been injured by this form of punishment. He also stated that when she was angry, she would threaten to kill him. Around the age of 12, Mr. Munoz began to display aggressive behaviour when his mother became upset. He described striking her in the right eye on one occasion in 2001.

20Mr. Munoz described leaving high school before completing grade 12. After a presentation by a military representative at his school, he went to a recruiting office and joined. He started working at Wolseley Barracks in London. He left home and moved in with two roommates.

21Mr. Munoz was hospitalized twice in 2009 while working in the military, briefly while stationed at a base in Petawawa, and then a lengthier admission in London from May 12 to July 6, after he had returned to Wolseley Barracks. Following treatment with his mother’s substituted consent, he was discharged to the care of his supervising officer who had brought him to the hospital. The plan was for him to live with the military in London and take some full-time high school classes. Reportedly, he then completed his grade 12 in an Adult Learning Centre.

22Mr. Munoz does not have a prior record of criminal convictions. However, he was charged with criminal harassment in June of 2010 as a result of ongoing behaviour involving a female with whom he had been in a brief relationship that ended in May of that year. After being charged, he was found unfit to stand trial and was made the subject of a treatment order. The charge was eventually diverted from the court system.

Mr. Munoz’ Course Following the Index Offences

23Mr. Munoz was admitted to the Southwest Centre on February 28, 2017, for an assessment of his criminal responsibility. However, on March 29, 2017, he was found unfit to stand trial, a treatment order was made, and he was returned to the Southwest Centre. He was returned to court on May 17, 2017, and was found fit to stand trial. He remained at the Hospital thereafter, including for his criminal responsibility assessment. He returned to the Hospital following the NCR finding and continued as an inpatient, pursuant to a series of Board dispositions, until he transitioned to living in the community on June 30, 2022. On May 26, 2025, he moved to the C.K. Clarke Centre Transitional Rehabilitation Housing Program (TRHP) in London so that the treatment team could support his long-term goal of living in London independently.

24Mr. Munoz has consistently been found incapable of consenting to his psychiatric treatment. Of note, his mother remained his SDM until April of 2018, when she relinquished that role and the Public Guardian and Trustee (PGT) took on this responsibility.

25Mr. Munoz’ course since the index offences and under the Board’s jurisdiction is chronicled in detail in the Hospital Report. Certain features of that history are highlighted below.

26During his criminal responsibility assessment, Mr. Munoz denied having symptoms of a mental illness but consistently expressed a belief that his life was in danger because of his mother’s desire to kill him. For several years after the verdict, he continued expressing that the index offences were justified as an act of self-defence. In 2018, during his first year under the Board’s authority, he voiced that his mother destroyed his life and deserves to be killed. He stated that that he had a plan to kill her once he was discharged from hospital.

27During his early years in the Hospital, Mr. Munoz displayed active symptoms of his schizophrenia, which was characterized as treatment-refractory. He refused to engage in the blood monitoring required so that clozapine could be administered. He was frequently heard and seen responding to internal stimuli, characterized by yelling and screaming and hitting the walls of his room. He also exhibited prominent negative symptoms and had very limited engagement in any off-unit programming. His delusions continued to be fixated upon his mother, including that she was a witch and could place a curse upon him through objects that she sent to him at the Hospital. In his risk assessment in October of 2019, it was noted that he expressed a fixed belief that violence is justified in the name of revenge, so that if a female wronged him he could kill her and it would be deemed legal.

28In 2020, it was reported that while he gave varied explanations for the index offences, they involved the common premise that his mother, in her role as his SDM, was the main perpetrator in a conspiracy to ruin his life by forcing him to take medications that would harm him. He viewed his plan to remove her as his SDM as having succeeded as now that role was that of the PGT, a situation that he regarded as more bearable. As he had obtained the desired result, he stated that he no longer intended to contact or harm his mother as she now meant nothing to him. He declined to receive a birthday card that she had sent to him in June of that year.

29Medication changes in 2020 began to yield results. First, lithium was added to his antipsychotic medication in August (titrated to a therapeutic dose by mid-September) to augment its effects and promote stabilization of his mood. Then, beginning on November 10, Mr. Munoz agreed to a trial of clozapine. The dosage of clozapine was very gradually titrated up through the 2021 reporting period and has continued unchanged through the reporting period immediately preceding the current hearing. Modest improvement was observed through 2021, with Mr. Munoz’ responses to internal stimuli reducing in both frequency and intensity, with further improvement in this regard observed in 2022. He continued to experience negative symptoms, including impaired motivation, drive, and follow-through, unless his tasks were aligned with his delusions and fixed ideations. He did participate in occupational therapy assessments designed to determine his preparedness for community living, along with limited therapeutic recreational programming. One of his fixed ideations was that he would only consider living in the north London Masonville area, where he would rent or own a house and purchase a specific model of car to reflect his special social status.

30During 2021 and 2022, Mr. Munoz reportedly generally avoided conversations about his mother but continued to experience entrenched residual persecutory delusions involving her (most prominently) and also members of the military and past healthcare providers. Despite his mother having provided a letter of consent (in April of 2021) for him to contact her as well as expressing a desire to have a relationship with him, Mr. Munoz continued to be adamant that he wanted no contact with her. In 2022, he expressed that she was a witch, that she was the reason for his forensic admission and the cause of all his legal problems. He believed that she would again try to have him hospitalized once he was out of the forensic system. He stated that if he ever met his mother in the community, he would turn and walk the other way and not engage with her at all. He would not attack his mother again because he had achieved what he had set out to do.

31As previously noted, Mr. Munoz transitioned to community living in 2022, initially on a leave of absence on June 30 and then to a formal discharge on September 22. He had previously struggled with socialization but since moving to his group home was working hard to engage with staff and other residents. His participation in activities improved and he appeared to enjoy having a structured day, attending all programs offered through the Canadian Mental health Association (CMHA). In addition, he completed a classroom program at the YWCA to improve his literacy. However, it was noted that he experienced anxiety and became flustered when faced with new situations. He experienced rigidity in his thinking, poverty of thought and perseverative responses. He also had difficulty concentrating for any length of time. He continually required guidance and reminders from staff to stay on task and focus on one thing at a time.

32On July 31, 2023, Mr. Munoz moved to “The Station”, a program managed by Indwell offering independent apartments but with 24-hour staffing to provide onsite support, security, and a daily meal program. Mr. Munoz maintained his stability but required a great deal of support from his treatment team concerning: problem-solving, redirection, and education regarding his treatment. His compliance with his oral medication was monitored through the supervision and support of Indwell staff.

33Mr. Munoz experienced social withdrawal and ongoing symptoms of anxiety. He sometimes became preoccupied. For example, he ruminated so much about not missing an upcoming dental appointment that he forgot to take his medication for one day.

34Mr. Munoz began to experience a degree of insight around his index offences, recognizing their severity and acknowledging that failing to take his medication may have contributed to his behaviour, but continued to lack remorse. However, among his stated goals (which included obtaining a conditional discharge, returning to his former apartment in north London, and attending school), he expressed a desire to discontinue his medication.

35Mr. Munoz was readmitted to the Hospital on only one occasion since being discharged to the community in 2022. That readmission occurred on August 27, 2024 and continued until September 3, 2024. The reported circumstances are described herein in some detail. Prior to his admission, concerns were reported regarding changes to his presentation. At times, he was heard by Indwell staff and by other residents of the building, yelling quite loudly while alone in his bedroom or in the elevator. Historically such behaviour had been an early sign of relapse of his illness. He was also noted to be pacing more around the Indwell building and stopping to look into open doors without engaging with those in the room. Mr. Munoz did not acknowledge or recognize these behaviours and continued to deny any stress, anxiety or symptoms of psychosis.

36On July 24, 2024, the treatment team received an update from the Indwell staff that the concerning behaviours were increasing in severity. On one occasion, he was heard yelling, "It's your fault, it doesn't matter what you say, it's your fault, not mine!" On July 18 and again on July 28, his interactions with staff, when they inquired whether he was experiencing delusions or hallucinations, were characterized by increased irritability and frustration. On the latter occasion, a change was observed as to the manner in which he spoke about his mother. He had normally spoken of her as merely “the parent”. However, he shifted to calling her “the angry parent” and the reason for this change was unknown.

37The Hospital Report states that on August 27, 2024, Mr. Munoz agreed with a brief readmission to be further assessed for a relapse of psychosis. While on the rehabilitation unit, he followed the rules, took his medications, and there was no observed psychosis or behavioural issues. On September 3, 2024, he returned to his apartment on a 30-day Leave of Absence (LOA) and was subsequently discharged after the LOA lapsed.

38During his time at the Indwell apartment, Mr. Munoz continued to voice his desire to move to a three-bedroom townhome and share it with two roommates as he had done prior to the index offences. He expressed the need to live with roommates in the future as he said he would “go crazy” on his own. His hygiene practices were noted as variable and he was described as at risk of not attending follow-up visits if he were living without supervision. His main source of stress was an appeal to Veterans’ Affairs to increase his monthly pension so that he could afford the proposed move to his preferred type of housing in London. He appeared distracted and preoccupied by this. He was described as still being affected by prominent negative symptoms of his illness and it was very unlikely that he would be able to recognize signs of decompensation and know when to seek out supports. He continued to believe that he did not need his medications and his risk assessment indicated that he would likely not remain adherent if left to manage himself independently. His oral medication continued to be administered by Indwell staff.

39Mr. Munoz has continued to experience negative symptoms of his illness since his move to the Clarke Centre, specifically in relation to his variable hygiene. He has been noted to have difficulty remembering topics and continues to have limited problem-solving skills. He also has made limited use of adaptive coping strategies and has required staff support to manage both everyday and stress-invoking situations.

40Mr. Munoz’ insight continues to be described as poor across all spheres and has remained essentially unchanged throughout his time under the Hospital’s care. He has remained adherent to his medication administration, with some lapses when he has been distracted by other preoccupations. However, he voiced that he takes his medication only because it is ordered by his doctor and by the Board. He has said that he would not hurt anyone or reoffend if he stopped his medication.

41Mr. Munoz still says that he has no remorse over the index offences. He has stated that he did not think this would happen again because he no longer thinks that his mother is a witch. He still does not wish to reconnect with her, however.

Oral Evidence at the Hearing

Dr. Bajwa

42Dr. J. Bajwa, a second-year postgraduate student with Western University’s psychiatry program, first gave evidence on behalf of the Hospital. He has worked under the supervision of Dr. Ajay Prakash since December 15, 2025 and in that capacity became familiar with Mr. Munoz’ case. He had seen Mr. Munoz personally on approximately three occasions over the two months prior to the hearing.

43Asked to provide an update as to Mr. Munoz’ mental condition and how it compared to the previous year, Dr. Bajwa said that Mr. Munoz remains guarded. While he does not exhibit overt symptoms as he did at the time of the index offences, he does exhibit some thinking that may fall in line with that which was evident at the time. Dr. Bajwa also drew attention to the diagnostic development which removed obsessive-compulsive disorder and added autism spectrum disorder (ASD).

44Dr. Bajwa was referred to the staff observations of Mr. Munoz responding to unseen stimuli reported at p. 166 of the Hospital Report. He stated that whether these responses were related to cognitive or psychotic impacts, they nevertheless indicate that Mr. Munoz still requires a high degree of support. Without that, these responses constitute a significant risk factor.

45Asked for an update on Mr. Munoz’ Veterans’ Administration matter, Dr. Bajwa reported that Mr. Munoz is now awaiting a response, having completed the necessary paperwork.

46Dr. Bajwa discussed the interrelationship among Mr. Munoz’ medication adherence, degree of insight, and his housing situation. He observed, at the outset, that as of late May of 2026, Mr. Munoz would be one year into his maximum two years of permitted residence at the C.K. Clarke Centre. His next residential placement has not yet been identified. Staff at the Clarke Centre supervise the administration of Mr. Munoz’ oral medications, and his adherence, which is externally motivated, is currently dependent upon the fact of his residence there. Mr. Munoz lacks insight into both his illness (he disagrees with his diagnosis of schizophrenia) and his need for treatment (he believes there would be no impact if he were to discontinue his medication). Dr. Bajwa reminded the panel of Mr. Munoz’ history of non-compliance with his medication for some three months prior to the index offences.

47Asked whether Mr. Munoz’ medications are optimized, Dr. Bajwa stated that they constitute a complex regimen (including long-acting injectable medication received through the Hospital). No changes to his medications were made over the past reporting period and there is no currently perceived need to make changes.

48In Dr. Bajwa’s opinion, Mr. Munoz requires the level of supervision and support that he currently receives at his residence. He was referred to the result of the current reporting period’s HCR-20 v. 3 risk assessment which stated that the violence risk profile is low in the context of a detention disposition while living in the community. Dr. Bajwa said that this risk formulation depends upon Mr. Munoz’ residence in a place like C.K. Clarke. The three sets of protective factors listed in the Hospital Report (current living situation supervised by mental health professionals; professional care provided by the Forensic Outreach Team and Clarke Centre staff; and the external control provided by a detention disposition) are all external to Mr. Munoz.

49Dr. Bajwa adopted the re-offence scenario and the overall clinical assessment of risk set out at pp. 176-177 of the Hospital Report. He noted that Mr. Munoz has no social supports in the community. Although his mother has provided consent for him to contact her, he has no contact with her. He has referred to a suspicion that she may want revenge upon him but has refused to elaborate further as to why he wants no contact with his mother. When later asked about this by Ms. Circelli, Dr. Bajwa stated that this was a brief statement and did not perceive it as a threat. He was unable to say whether Mr. Munoz had been informed that his mother had provided her consent to be contacted by him.

50Dr. Bajwa described a proposed plan for Mr. Munoz’ next residential placement. This would likely be at a program operated by Indwell in London, consisting of independent apartments and a lesser level of supervision than is provided at the Clarke Centre. The Indwell facility is expected to open in April of 2026. Dr. Bajwa stated that Occupational Therapy would be beneficial for Mr. Munoz, to help him learn new skills for independent living. The doctor stated that Mr. Munoz would need to do more work in this area before being able to live independently. Dr. Bajwa reiterated that it would constitute a greater risk for Mr. Munoz to live independently at the Masonville residence that he proposed, as there would be no professional supports for him.

51Dr. Bajwa outlined the reasons for recommending a continued Detention Order in the new Disposition. He cited the need to approve Mr. Munoz’ accommodation and the “early warning capacity” of a Detention Order, noting that Mr. Munoz’ transition out of the Clarke Centre would increase his level of stress and thus his risk. The doctor stated that Mr. Munoz cannot recognize signs of his decompensation and thus would not return to the Hospital without prompting. Dr. Bajwa also opined that the Mental Health Act itself would be an insufficient tool, as it is more reactive than preventive and as its criteria require that Mr. Munoz have been seen by a doctor within seven days of a proposed admission. In his opinion, one would have to wait for Mr. Munoz to experience a decompensation before utilizing the Mental Health Act to admit him involuntarily.

52Counsel for the Attorney General asked further questions about Mr. Munoz’ situation at the Clarke Centre. Dr. Bajwa stated in response that Mr. Munoz is doing well there and is maintaining stability on his medications. Noting the history of missing medications, the doctor pointed out that staff prompt Mr. Munoz if he forgets to take them. He clarified that Mr. Munoz has not refused to take medication while at the Clarke Centre. Dr. Bajwa confirmed that Mr. Munoz’ serum clozapine levels are regularly tested and have remained in the therapeutic range. No symptoms, other than as noted in the Hospital Report, have emerged.

53Counsel for the Attorney General asked about the nature of the staffing and supervision available at the proposed Indwell facility, by way of comparison. Dr. Bajwa stated that this is a newer building and he was not aware whether there would be 24-hour staffing available. He reiterated that there would not be the same level of direct supervision for Mr. Munoz and was unsure whether the staff would include social workers.

54During her questions on behalf of Mr. Munoz, Ms. Circelli sought further details about the mechanism by which his oral medications are dispensed. Dr. Bajwa stated that they are provided to him at the Clarke Centre (he does not pick them up from a pharmacy). Currently, a three-day supply is placed in a lockbox in Mr. Munoz’ room (the doctor could not say whether they are contained in blister packs). He is responsible for managing his medications by taking them to the staff office in the home. Staff maintain “eyes” on his taking of the medication in this way.

55Dr. Bajwa stated, in response to Ms. Circelli’s question, that a Conditional Discharge with a term naming the Clarke Centre as the place of residence, with the same level of staff support, would be available for Mr. Munoz for the next year. Dr. Bajwa was uncertain, however, whether Mr. Munoz would still receive his injectable medication at the Hospital under a Conditional Discharge. The doctor confirmed that if Mr. Munoz were to report to his treatment team four times per month, any symptoms of his illness would not go unnoticed. He is engaged with his outreach treatment team, and cooperated with them on the occasion of his voluntary readmission to the Hospital in August of 2024. Currently, Mr. Munoz is seen weekly by a member of his outreach team. Dr. Bajwa has not discussed whether, under a Conditional Discharge, there would be flexibility to increase the frequency of visits, although staff resources could be a barrier to this. Dr. Bajwa confirmed that if needed, staff at the Clarke Centre could facilitate videoconferencing to facilitate Mr. Munoz being seen by his psychiatrist. Dr. Bajwa saw no reason to suggest that Mr. Munoz would refuse to meet with his psychiatrist.

56Dr. Bajwa was referred to the result of the HCR-20 v. 3 risk assessment by Ms. Circelli and was asked his opinion as to Mr. Munoz’ level of risk if placed on a Conditional Discharge. The doctor replied that in his opinion, the risk would be rated as moderate. He agreed that it could be possible, under a Conditional Discharge, for the treatment team to begin connecting Mr. Munoz to a community psychiatrist and potentially place him on a Community Treatment Order (CTO).

57With respect to Mr. Munoz’ capacity to recognize his signs of decompensation, Ms. Circelli asked when his last decompensation had occurred. Dr. Bajwa stated that he was unaware of there having been an overt decompensation.

58Dr. Bajwa had not spoken with anyone about Mr. Munoz’ proposed independent residence in the Masonville area and said that he was unfamiliar with it. Asked whether he believed that Mr. Munoz’ living situation presented a risk to his mother’s safety, Dr. Bajwa stated that this would depend upon the structure and supervision that was provided.

59Ms. Circelli asked Dr. Bajwa about the process of seeking DSO supports for Mr. Munoz in view of the results of psychological testing as revealed in the Update to the Hospital Report. The doctor stated that this process is underway but is incomplete. He anticipated that the outcome would not be known for “many months” into the future. He agreed with a panel member that it was speculative to say whether DSO would accept Mr. Munoz for additional supports.

60Several panel members asked Dr. Bajwa about the implications of the new autism spectrum disorder (ASD) diagnosis described in the Update to the Hospital Report. Asked first whether Mr. Munoz’ symptoms are better understood in the context of this diagnosis, Dr. Bajwa stated that he had not yet seen the full psychological report. He was only familiar with the portion contained within the Update document. He had not yet had a full conversation with Mr. Munoz about what the diagnosis means for him but advised that he accepted it. As of the hearing date, the treatment team had not made any changes to the nature and level of supports for Mr. Munoz as a result of the new report and there has not been a specific meeting of the treatment team to discuss it, although various team members have had individual conversations. The plan for the next year continues to be to work with Mr. Munoz to develop his internal motivation for his ongoing treatment.

61Dr. Bajwa was asked by the panel whether it would be days or weeks before signs of decompensation would become apparent if Mr. Munoz were to become non-adherent with clozapine, his main antipsychotic medication. The doctor replied that it would be a matter of days, adding that Mr. Munoz would not become floridly psychotic in just a day or two.

62Panel members asked Dr. Bajwa about the amount of time that it would take to bring about Mr. Munoz’ involuntary return to the Hospital by resorting to the “breach of disposition” provisions of the Criminal Code, should that be necessary, as compared to the speed of return under a warrant of committal issued pursuant to a Detention Order. While he could not be specific about the amount of time required under the former mechanism, Dr. Bajwa stated that it would take longer than under a warrant of committal, and that this additional delay would correlate positively to increased risk. The use of a warrant of committal involves, according to Dr. Bajwa, “fewer moving parts”.

63Having been directed by a panel member to the list of protective factors in the Hospital Report, Dr. Bajwa confirmed that the removal of one or more of those factors would increase the risk of mental state deterioration and could potentially lead to re-offending.

64A panel member asked about the stress that Mr. Munoz experiences in relation to his outstanding appeal over his level of Veterans’ Affairs benefits. Dr. Bajwa confirmed that Mr. Munoz is open to discussing this, and does so with staff at the Clarke Centre. He was unaware whether Mr. Munoz had legal representation to assist with this process.

Dr. Ajay Prakash

65Dr. Prakash stated that Mr. Munoz is doing well with the structure that supports him at the Clarke Centre. Previously, while he lived at the Indwell program in St. Thomas, issues were noted that led to an admission to the Hospital secondary to a relapse. Dr. Prakash stated that this was a relapse into psychosis. Dr. Prakash stated that at that time, Mr. Munoz would not have been certifiable under the Mental Health Act, pursuant to either “Box A” or “Box B” criteria. Dr. Prakash stated that the “Box B” Mental Health Act criteria are more proactive than “Box A”. In response to a panel member’s question about the need for a Detention Order, Dr. Prakash stated that the Hospital would need the authority of the warrant to committal to ensure that Mr. Munoz remained in the Hospital long enough to stabilize him.

66Dr. Prakash agreed that under a conditional discharge, the Hospital would need a mechanism that could ensure Mr. Munoz’ stay in hospital would be long enough to stabilize him.

67Commenting on whether Mr. Munoz’ readmission in August of 2024 was voluntary, Dr. Prakash said that “voluntary” is a “loaded” word and that the process was not truly voluntary. He said that it was “voluntary” in the sense that it did not require the attendance of police.

68Dr. Prakash addressed the question of the likely speed at which Mr. Munoz’ mental condition would likely decompensate if he stopped taking clozapine. He stated that because of Mr. Munoz’ treatment-resistant condition, decompensation would likely occur in a matter of days. Previously, in 2017 when he had been untreated, Mr. Munoz had threatened hospital staff and required seclusion. It took some time to regulate him with medication.

69Dr. Prakash said that the contemplated transition from the more supervised setting at the Clarke Centre to a less supervised home (Indwell in London) is a critical one for Mr. Munoz. He described the contemplated move as “a kind of test” for him. The difficulty with expecting Mr. Munoz to voluntarily return to the Hospital is that if he decompensates, his cooperation falls away. In Dr. Prakash’s opinion, a Detention Order would aid in maintaining him in the community and doing so safely.

70Dr. Prakash was asked to describe his experience with the utilization of warrants of committal (issued under Detention Orders) as distinct from his experiences in effecting apprehensions of patients subject to Conditional Discharge dispositions. He said that the warrant of committal carries a great deal more weight with police, who tend to view Conditional Discharges as having a lower level of priority.

71Dr. Prakash was asked to comment on Mr. Munoz’ stated desire to live in an independent residence in the Masonville area. He said that the treatment team was unaware of this idea prior to the hearing date. It would be necessary to “construct” a level of supervision that would enable Mr. Munoz to move to a completely independent setting. Later, in response to questioning by Ms. Circelli, Dr. Prakash acknowledged that he was aware that this is the area where Mr. Munoz had lived prior to the index offences.

72In response to questions from the panel, Dr. Prakash stated that in his opinion, a move by Mr. Munoz to a completely independent apartment would result in the creation of a real risk of violence. In his opinion, the Hospital requires the authority to approve his community accommodation. Asked whether the plan is to move Mr. Munoz to Indwell in April or have hm stay at the Clarke Centre for a longer period, Dr. Prakash stated that “ideally” he would prefer that Mr. Munoz would live at the Clarke Centre for a few more months. However, if a unit at Indwell became available in the interim, he would not want to turn it down. Responding to the suggestion that the Board could order that Mr. Munoz reside at the Clarke Centre and then hold a hearing to permit a change to the residence, Dr. Prakash said that the Hospital often has a very limited time to respond to a community opening, and accordingly a delay in holding the necessary hearing could cause a community placement to be lost.

73Dr. Prakash confirmed, in answer to questions from Ms. Circelli, that Mr. Munoz’ condition stabilized after he started receiving clozapine. In response to counsel’s suggestion that there was no evidence that Mr. Munoz had said that he does not wish to stay on clozapine, Dr. Prakash replied that he has not said “to me” that he wants to stop taking it.

74No further evidence was led following the questioning of Dr. Prakash. However, in view of expressed questions as to whether Mr. Munoz’ mother would be at risk because of the geographic location of his residence in relation to her own, counsel for the Attorney General provided information from the mother that she lived in the southwestern part of London, and Mr. Munoz would be in the northern portion of the city.

Analysis and Conclusions

Significant Threat to Public Safety

75Dealing first with the matter of “significant threat”, the panel has no difficulty accepting the parties’ joint position in this regard and finds independently that Mr. Munoz represents a significant threat to the safety of the public. He suffers from a serious mental disorder, schizophrenia, that is described as both chronic and refractory. While the positive symptoms of his illness are well controlled by his current antipsychotic medications, he continues to experience negative symptoms. His medication is critical to his mental stability and thus to public safety.

76Mr. Munoz’ illness is closely associated with his history of violence. After discontinuing his prescribed medications, he committed the index offences by engaging in a prolonged and persistent attack upon his mother, with a crossbow and arrows, that could easily have had lethal consequences. In addition, while Mr. Munoz has no record of criminal convictions, a charge of criminal harassment was diverted following a finding of unfitness to stand trial and a treatment order. He also has a history of starting a fire during his trip to Columbia while non-adherent to his medication, and threatening behaviour directed at hospital staff while detained following the index offences. There have been incidents of sexually aggressive and inappropriate behaviour in relation to female hospital staff, as well. Fortunately, no such behaviour has been demonstrated during the years since Mr. Munoz’ clozapine treatment was optimized.

77Mr. Munoz has poor insight into his mental illness. He denies that he has schizophrenia, and has been persistent in that denial since receiving the diagnosis in 2009. He would not be able to recognize signs of decompensation. He also has poor insight into his need for treatment. He has consistently, during his years under forensic oversight, voiced a goal of not wanting to remain on medication once he is absolutely discharged. Notably, his understanding of his risk to the public when non-adherent to antipsychotic medication remains almost completely absent, as he has voiced during the most recent reporting period that he would not hurt anyone if he stopped his medication.

78In the panel’s opinion, the evidence renders entirely plausible the following re-offence scenario (which has remained consistent over the past several years) as extracted from the Hospital Report:

“Absent forensic support, Mr. Munoz would not comply with his medication regime, forget to take his required medications or feel as though his medications are not needed due to his continued lack of insight. He would become anxious, stressed, paranoid, and be unable to effectively problem solve or use adaptive coping mechanisms. He would quickly decompensate, and his persecutory delusions would exacerbate. He would likely believe that others want to cause him harm, which could lead him to act out with serious violence (as demonstrated in the index offence) on staff, peers or other members of the public. He would likely feel justified in his violent behaviours.”

79Accordingly, the panel found, in accordance with the positions of all parties, that Mr. Munoz continues to represent a significant threat to the safety of the public.

Necessary and Appropriate Disposition

80The matter of the necessary and appropriate Disposition occupied significant deliberation time for the panel. In our view, the evidence supports good arguments for the proposition that the least onerous and least restrictive Disposition is a continuation of the Detention Order, with the minor changes proposed by the Hospital and the Attorney General. Likewise, there are good arguments, based on the evidence, in favour of a Conditional Discharge.

81At the outset, the panel would make the following factual findings:

i. The risk that Mr. Munoz represents cannot, at this time, be safely managed by permitting him to reside in a completely independent residence without staff support. He requires the consistent support of trained staff to assist and support him in several areas, including the critical matter of administering his antipsychotic medication; ii. Mr. Munoz’ risk has been well-managed by the staff at the C.K. Clarke Centre, in conjunction with the Hospital’s Forensic Outreach Team, and this housing is available to him for another year; iii. Mr. Munoz is well-engaged with both his Outreach Team and with the staff at the Clarke Centre, and seems to have a good therapeutic relationship with these professional supports; iv. While Mr. Munoz is considered incapable of consenting to his psychiatric treatment and lacks an internal understanding of his need for it, he is currently adherent to it, with the professional supports that are in place; v. Since being discharged to live in the community in 2022, Mr. Munoz has experienced only one readmission to the Hospital, and it was relatively brief (August 27 to September 3, 2024).

82The panel has considered the foregoing facts and indeed the balance of the evidence in light of the well-known (and recently restated) principle that the statutory framework in Part XX.1 of the Criminal Code presumes liberty in the absence of significant risk and seeks to maximize liberty even when risk exists².

83A logical first step for the panel was to consider Ms. Zamprogna’s submission on the Hospital’s behalf, based upon the opinion evidence of Drs. Bajwa and Prakash, that it is necessary for the Hospital to approve Mr. Munoz’ accommodation. If the panel were to make such a finding, a Conditional Discharge would simply be unavailable³.

84In this case, the Hospital has already approved Mr. Munoz’ current accommodation. His risk is well managed at this residence. As both doctors testified, the treatment team is considering another move to an independent, yet professionally supported, apartment for Mr. Munoz in the near future. The evidence left uncertainty as to the precise nature of the support that would be provided to Mr. Munoz in the new Indwell program that is under consideration. In addition, Dr. Prakash stated that ideally, he would like Mr. Munoz to continue to live at the C.K. Clarke Centre for several more months prior to moving to a different setting.

85The panel agrees that Mr. Munoz should continue to live at the C.K. Clarke Centre for the foreseeable future. He clearly needs, and has benefitted from, the professional support provided by the staff there, both from the standpoint of maintaining the stability of his mental condition, but also in relation to his other needs, as already reviewed in the evidence. In addition, the panel notes the recent removal of Ms. Munoz’ OCD diagnosis and the addition of the ASD diagnosis. While the change in diagnoses has not yet yielded modifications to Mr. Munoz’ treatment plan, a further change to his living arrangement should await a more fulsome understanding of his mental condition, symptoms, and behaviours in light of this development.

86The panel is cognizant of the limiting factor here: that Mr. Munoz may only be able to reside at the C.K. Clarke Centre until May of 2027, and that by specifying his residence location as a term of a Conditional Discharge, the resulting Disposition could have the unintended effect of being more, not less, restrictive of Mr. Munoz’ liberty if he is unable to secure suitable alternate accommodation before his tenancy at the Clarke Centre expires. The risk of such an eventuality is, however, mitigated if Mr. Munoz’ next annual review is scheduled, as it should be, well before May of 2027. In addition, should Mr. Munoz or the Hospital be able to propose a suitable alternate placement in the meantime, it is always open to the parties to seek an early hearing from the Board. Ms. Zamprogna cautioned the panel that scheduling early hearings can take some time. However, in necessitous circumstances, such as where there is a need to quickly change a residence address, the use of videoconferencing technology can minimize any delay where the parties agree.

87In the circumstances of this case, therefore, Mr. Munoz’ accommodation can be identified and specified as a term of a Conditional Discharge.

88The fundamental question that has concerned the panel is whether Mr. Munoz’ risk can be safely managed under the terms of a Conditional Discharge. We are satisfied that it can, based on the evidence at the hearing. On behalf of Mr. Munoz, Ms. Circelli invited the panel to consider imposing Young⁴ clauses and agreed to a “consent to treatment” clause pursuant to s. 672.55 of the Criminal Code.

89Dealing first with the s. 672.55 clause, the effectiveness of such a term of a Conditional Discharge would normally be highly problematic where an individual is almost completely bereft of insight into their illness, public safety risk, and the need for medication to maintain their stability. However, in this case, Mr. Munoz does not completely self-administer his medication. He is required to keep his medications in a lock box in his room and bring the appropriate medication pack to the staff office to take his medication and sign off that he has taken them on Medication Distribution Record forms. If he were to forget or refuse to take his necessary antipsychotic medication, this would be detected by staff at the Clarke Centre immediately and remedial steps could be taken before his mental condition decompensated. Indeed, this has happened on occasion during the review period and Clarke Centre Staff were quick to notice and Mr. Munoz was quick to cooperate with taking his medication. As such, the “failsafe” plan in place has operated to ensure Mr. Munoz’s adherence to clozapine. In addition, on the evidence, it is more likely that Mr. Munoz would forget to take his daily dose of medication rather than outright refuse to do so. Given his adherence while under the Board’s jurisdiction, the possibility of a refusal while subject to a Conditional Discharge is more speculative than real.

90In view of the foregoing discussion, the panel reminds itself that lack of insight, which in Mr. Munoz’ case has been enduring for some time, is a well-known risk factor. At the same time, it is a risk factor to be considered alongside any protective factors that are particular to the individual.

91The panel considered whether Mr. Munoz would likely abide by Young clauses and return to the Hospital voluntarily for assessment or, if necessary, for readmission if directed by his treatment team to do so. The evidence does indicate that Mr. Munoz would not be able to identify and detect signs of his own decompensation and seek readmission to the Hospital. However, his reattendance for admission is not dependent on his own ability to take this initiative. His residence at the Clarke Centre ensures that he will be seen by professional staff who can detect changes in his presentation. That supervision is, of course, augmented by regular appointments with members of his treatment team.

92Would Mr. Munoz comply with a direction to return to the Hospital and, if required, remain for admission? There is no evidence that he would not do so, and some evidence, from the circumstances of his August 2024 readmission, that he would attend. Mr. Munoz has experienced various challenges, as described in the review of the evidence above, during his time under the Board’s authority. However, he has no record of breaching any terms of his previous Dispositions. Indeed, for several years while subject to a succession of abstinence clauses, he remained abstinent of substances and consistently tested negative on his drug screens. Similarly, there is no evidence of Mr. Munoz having demonstrated management challenges or rule-breaking behaviour while in the Hospital or in his community residential programs since the time that the active symptoms of his illness became controlled.

93There was evidence from both doctors that if Mr. Munoz were to decompensate and/or stop taking his medication, a Detention Order would effect his return to the Hospital more quickly than could be done by resorting to the enforcement provisions in the Criminal Code⁵. However, on this reasoning, a Conditional Discharge would almost never be available. The Board has a duty to consider the likelihood that the delay in securing Mr. Munoz’ return to the Hospital occasioned by the use of the Criminal Code’s enforcement mechanisms would negatively impact his mental health and, consequently, his public safety risk⁶.

94Dr. Bajwa’s evidence was that if Mr. Munoz were to stop taking his clozapine, mental state decompensation would likely occur quickly, in a matter of days as distinct from weeks. However, he would not become floridly psychotic in just a day or two. Again, in the present case, a failure by Mr. Munoz to take his medication would be detected by Clarke Centre staff immediately, allowing for expeditious intervention.

95The panel recognizes that it is not merely medication non-adherence that could trigger mental status decompensation in Mr. Munoz’ case. There was no indication, at the time of his 2024 readmission, of medication noncompliance. At the same time, however, he was observed over a period of some weeks before a decision was made to re-admit him. He did not descend rapidly into a psychosis.

96It was suggested by Dr. Prakash in his evidence that the Criminal Code mechanisms for returning an accused to the Hospital would not be effective because the police do not necessarily take Conditional Discharge enforcement seriously, as distinct from warrants of committal issued pursuant to Detention Orders. To the extent that this state of affairs is true, it becomes essentially an argument that Detention Orders will always be easier to enforce. As the Court of Appeal has recently reminded all parties engaged in the operation of Part XX.1, operational convenience may not be used to deprive individuals of the least onerous and least restrictive limits on their liberty⁷. The Hospital’s evidence and submissions concerning the priority given by the police to enforcing Conditional Discharges speaks, if anything, to the need for effective communication and education. In the context of the present case, should enforcement of Mr. Munoz’ Conditional Discharge become necessary, communication to police by the treatment team of the circumstances of the index offences and the nature of the ongoing threat to public safety should assist somewhat.

97Reference was made to the potential unavailability of the Mental Health Act (MHA) as an adequate tool for the protection of public safety in the event that the treatment team decided that Mr. Munoz needed to be readmitted to the Hospital. In this regard, Dr. Prakash was of the opinion that Mr. Munoz’ presentation in August of 2024 would not have met the MHA criteria for involuntary admission. It must be remembered, however, that resort to provincial legislation is merely one of several tools at the Hospital’s disposal. The Hospital may require an early review of the Disposition pursuant to s. 672.81(2) of the Criminal Code. In addition, if Mr. Munoz refuses admission to the Hospital, he may be arrested for breaching his Disposition and a justice may order, pursuant to s. 672. 93(2), that he be detained in the Hospital⁸ pending a review of the Disposition by the Board.

98For all of the foregoing reasons, the panel found that the necessary and appropriate Disposition is a Conditional Discharge containing the conditions referred to in the Appendix to these Reasons. In approaching this matter, the panel has considered the evidence through the lens of the factors in s. 672.54 of the Criminal Code.

99The panel would make one further observation prior to concluding these Reasons. In the event that another appropriate residential opportunity for Mr. Munoz were to arise prior to the next scheduled annual review of his Disposition, the treatment team may be in a position to communicate with the housing program provider so that the opportunity to move into new accommodation is not lost prior to the scheduling of an early hearing before the Board.

Footnotes

1. 1See Re Young, 2011 ONCA 432 at para. 8.
2. 2Re Ramos, 2025 ONCA 820, 179 O.R. (3d) 126, at para. 30.
3. 3Brockville Psychiatric Hospital v. McGillis (1996), 1996 CanLII 1828 (ON CA), 2 C.R. (5th) 242 (Ont. C.A.), at para. 4.
4. 4Re Young, 2011 ONCA 432.
5. 5Specifically, this engages ss. 672.91-672.93.
6. 6Re Valdez, 2018 ONCA 657 at paras. 22-23; Re Ramos, supra, note 2, at para. 31.
7. 7Re Ramos, supra, note 2, at para. 23.
8. 8Re Ramos, supra, at paras. 34-39, overruling Re Negash, 2018 ONCA 179 at para. 12.