Re: Richard P. Pillar
ORB File No: 7345
Hearing held on: Monday, March 2, 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. B. Little (via videoconference)
Parties Appearing:
Accused: Richard P. Pillar
Counsel: Ms. L. Carnelos
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
On April 24, 2018, Mr. Richard Pillar was found not criminally responsible on account of mental disorder (“NCR”), on charges of aggravated assault and failure to comply with a probation order, contrary to the Criminal Code of Canada (the “Criminal Code”). Mr. Pillar 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 discharged subject to several conditions, including that he report at least twice monthly to the person in charge or delegate of the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London (“Southwest” or “the Hospital”), abstain from intoxicants, submit samples for analysis, refrain from the possession of weapons, refrain from communication or contact with the victim of the index offence, and on his consent, receive recommended treatment. Mr. Pillar’s previous Disposition was a Detention Order. He has resided in the community since November 11, 2021, with no readmissions.
On Monday, March 2, 2026, a panel of the Board convened in person at the Hospital to conduct the annual review of Mr. Pillar’s Disposition. The issues for determination were whether Mr. Pillar 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. Pillar was present and represented throughout the hearing by his counsel, Ms. Carnelos. Mr. Pillar’s mother and the Occupational Therapist from his Forensic Outreach Team were also among those in attendance.
The hearing proceeded based on a mainly joint submission. At the outset, counsel for all parties agreed that Mr. Pillar represented a significant threat to public safety and that the Disposition should be amended to remove the term requiring that Mr. Pillar abstain from the non-medical use of alcohol or other intoxicating substances. The parties parted company over a request by Ms. Carnelos on Mr. Pillar’s behalf to relax, somewhat, Mr. Pillar’s obligation to notify the person in charge of the Hospital, or designate, in advance of any intended absence from his residence of 24 hours or more. Counsel proposed an extension to a 48-hour threshold, or greater. In final submissions, counsel for the Hospital and counsel for the Attorney General opposed this proposed change. They otherwise maintained the joint position expressed at the outset of the hearing.
The evidence at the hearing consisted of the Hospital Report dated January 6, 2026 and the oral evidence of Dr. Ajay Prakash, Mr. Pillar’s attending psychiatrist.
For the following Reasons, the panel concluded that Mr. Pillar continues to present a significant threat to the safety of the public. The necessary and appropriate Disposition in the circumstances is a continuation of the Conditional Discharge in accordance with most of its existing terms. The panel decided to remove the prohibition on the non-medical use of alcohol or drugs or any other intoxicant, but to retain his obligation to notify the person in charge of the Hospital, or designate, in advance of any intended absence from his residence of 24 hours or more.
The Index Offences
- The index offences occurred in Windsor, Ontario. The circumstances are taken from last year’s Reasons for Disposition and are reproduced as follows:
"On Wednesday, September 28, 2016, at approximately 11 a.m., 83-year-old Rina Campagna was walking alone to the bank. Suddenly and without warning, she was accosted from behind and taken to the ground by Mr. Pillar. Mr. Pillar grabbed Ms. Campagna's head and stabbed her in the eye with a knife. Ms. Campagna suffered severe injuries as a result of the attack, including the loss of one of her eyes.
Ms. Campagna and Mr. Pillar had never met before and there was no provocation. Further, Mr. Pillar made no attempt to rob Ms. Campagna. As Mr. Pillar fled the scene, witnesses observed him discarding his clothing. Mr. Pillar was arrested later the same day. He was identified by surveillance footage, and the knife and his clothing were recovered. At the time of the attack, Mr. Pillar was bound by two separate probation orders, both of which prohibited him from possessing any weapons."
In his self-report during his criminal responsibility assessment, Mr. Pillar stated that he was two weeks late for his Abilify injection on the day of the index offences. He wanted to see what it was like if he did not take his medication. He reported not having consumed alcohol beforehand but did use crystal methamphetamine, along with two or three joints of cannabis. He reported hearing voices both with and without the use of crystal methamphetamine, but they became worse when he used the substance.
He said that he last consumed alcohol two or three days before his alleged offenses when he had twenty-six ounces of white tequila.
It was noted that on the day before the index offences, he had swung at another pedestrian but missed He was also seen throwing things in public.
Background Information
Mr. Pillar was 37 years of age at the time of the hearing. He is single and has no dependents. His mother, who lives in Windsor, has been and continues to be a major social support for him and he has made several trips to Windsor in the past year to visit her. He continued support was evidenced by her attendance at the hearing.
Mr. Pillar’s background prior to the commission of the index offences and his course under the Board’s jurisdiction are detailed in the Hospital Report. As the Report is in evidence, the information need not be summarized in detail in these Reasons. Several details that the panel considers pertinent to the issues at the hearing are highlighted below.
Mr. Pillar is considered capable to make treatment decisions and is also financially capable. His psychiatric diagnoses are listed as follows in the Hospital Report:
schizophrenia;
social anxiety disorder;
substance use disorder, in remission;
antisocial personality disorder, by history; and
specific learning disability (borderline intellectual functioning).
Mr. Pillar’s life prior to the commission of the index offences was marked by heavy substance use, mental health issues, and criminal behaviour. He reportedly started using alcohol when he was nine years old, consuming seven beers and becoming drunk on the first occasion. He started using cannabis at age 11, cocaine at age 14, and crystal methamphetamine at age 25. He stated that he became intoxicated with alcohol approximately weekly between the ages of 12 and 17. He reportedly often attended classes in school while under the influence of alcohol and cannabis. He started smoking cigarettes at age 11. While he also used other drugs at different times, crystal methamphetamine was the drug that he used most from age 25 or 26 onward.
Mr. Pillar displayed problem behaviours during his youth in addition to his substance use, including stealing, fighting, breaking rules, and truancy. He has a criminal record, beginning in his youth that includes convictions for assault, assault causing bodily harm, theft, mischief and failing to comply with probation. He had been monitored in the Intensive Supervision stream at Windsor Probation Services and was assessed as being at very high risk of reoffending. It is noted that the Hospital Report contains, at pp. 27-29, a list of Mr. Pillar’s convictions that includes his explanations for some of the offences.
Mr. Pillar’s extensive psychiatric history, from 2003 to the time of the index offences in 2016, is chronicled at pp. 7-12 of the Hospital Report. The history includes multiple Community Treatment Orders (CTOs), during which Mr. Pillar continued to use drugs and alcohol and was non-compliant with his prescribed medication and appointments. The history also includes several attempts at mental health diversion for various criminal charges. His reported symptoms, when unwell, included command auditory hallucinations to kill both men and women, but chiefly women. Notably, while in pre-trial detention at the South-West Detention Centre in April of 2017, he struck a correctional officer and explained that he did so in response to voices telling him to hit staff.
In August of 2018, some months after being admitted to the Hospital following the NCR finding, Mr. Pillar became violent and attacked a nursing station to which a female staff member had retreated from him after he became angry with her. He had engaged in significant environmental damage and continued to fixate on the staff member, stating that he wanted to kill her. He also threatened to stab someone in the eye and kill them if he gained weight from his injection of antipsychotic medication. He was placed in seclusion and later tried to grab a female staff member through an opening in the seclusion room door. He was later charged with uttering threats to cause death or bodily harm arising from the incident that led to his seclusion. He was convicted of this offence on June 25, 2019 and placed on 12 months’ probation.
Mr. Pillar continued to display unpredictable and angry behaviour through his initial reporting period following his NCR finding. He often glared angrily at staff, was observed responding to internal stimuli, and acknowledged experiencing both auditory and visual hallucinations. In November of 2018, he was started on clozapine. His mental state gradually improved and Mr. Pillar reported that his hallucinations gradually ceased after he started receiving clozapine.
Mr. Pillar experienced a relapse in May of 2019. He was glaring into the nursing station with clenched fists, was experiencing restlessness and difficulty settling at night, and was anxious and preoccupied in his thoughts. During this time, he was tapered off one of his antipsychotic medications (clopixol). However, he eventually tested positive for methamphetamines and later admitted its use during the period of the behavioural changes described.
Mr. Pillar’s clozapine dose was increased in October of 2019 after he impulsively attacked and repeatedly punched another patient with a closed fist. The victim sustained multiple blows to the head and bruising and edema to the right eye and cheek. On January 5, 2021, Mr. Pillar was convicted on his plea of guilty to a charge of assault in relation to this incident.
Mr. Pillar managed to return negative urine drug screens through the 2020-2021 reporting period and completed the Relapse Prevention Program with Addictions Services of Thames Valley.
While Mr. Pillar remained compliant with his antipsychotic medication, there were occasions in 2020 and 2021 when his clozapine levels were low. When this happened, he was noted to be glaring at staff and exhibiting pressured speech. It was observed that in the past, his glaring behaviour had been followed by verbally or physically aggressive acts. The August 30, 2021 risk assessment by Dr. J. Quinn included the following statement concerning Mr. Pillar’s schizophrenia:
“His illness is brittle, and slight alterations in his clozapine levels (due to vomiting, for example) over the years have led to rapid recurrence of symptoms, into which he has limited in-the-moment insight. However, with professional observation (in suitable supportive housing, or in hospital, for example), this risk factor will be mitigated via expeditious intervention.”
On November 11, 2021, Mr. Pillar began to reside at the Steele Street Rehabilitation Group Home and was formally discharged from the Hospital’s inpatient program on January 11, 2022. After arriving at the home, he was initially isolative but became more comfortable and developed positive relationships with select peers. No problems with his memory or cognition were noted. He responded appropriately during conversations and interactions with both staff and peers.
Mr. Pillar continued to experience occasions when his clozapine levels were low. It was learned that he was smoking upwards of 15 cigarettes per day (more than the 10 per day that he represented to his treatment team). Following repeated incidents of fluctuations below therapeutic levels, Mr. Pillar’s clozapine dose was increased. His affect and presentation changed significantly when his levels were low. During such times, his posture became intense with a puffed chest, rigid arms and stance when interacting with peers and staff. He was noted to "glare" at staff to the point of staff feeling intimidated and fearful. His glare was noted to be intense, and staff felt that he was looking through them. His answers would be short and curt with increased irritability. His eye contact was intermittent during interactions when he was unwell.
After beginning to live in the community, Mr. Pillar began to attend the St. Thomas YMCA with peers three to four times per week. He also joined a boxing club and attended three nights per week. He also had regular 72-hour passes with his mother in Windsor, which he utilized without reported issues.
Mr. Pillar’s clozapine levels continued to fluctuate during the 2023 reporting period. It was noted that his illness and symptoms remain brittle and that his mental state remains in need of constant observation. Two incidents of intense staring at staff were reported. It was also noted, in the August 2023 Clinical Assessment of Risk, that his insight into his mental illness is rapidly lost with the recurrence of symptoms. Following his move to an independent apartment at the Indwell program on July 31, 2023, Mr. Pillar was placed back onto a supervised medication administration program and his fluctuating clozapine levels returned to a therapeutic range.
Despite the above-noted challenges, Mr. Pillar continued to make progress into his community reintegration. He maintained his sobriety and all drug screens returned negative results. He visited his family in Windsor on 10 occasions during the reporting period, including for a week-long pass in December of 2022. His mother and brother were both Approved Persons. His sister, who lives in the United States, also visited in Windsor on several occasions to see her brother. Mr. Pillar’s father, who lives in Montreal, has also visited Windsor during Mr. Pillar’s passes.
On August 2, 2024, at Mr. Pillar’s request and with the team’s agreement, he started self-administering some of his medications with the exclusion of his bedtime medication. It was reported that Indwell nursing staff observed him taking his clozapine at bedtime.
The Hospital Report summarized, as follows, Mr. Pillar’s management of his substance use issues during the 2024 reporting period:
“During the reporting year, Mr. Pillar submitted random drug and alcohol screenings. To date, they have all returned negative. He denied any cravings or triggers for using substances. Of note, there has been ongoing substance use at the building as Indwell’s housing program operates under a harm reduction model. Living within this environment has not triggered a relapse. He also expressed that his mother and brother have the occasional alcoholic beverage when he is home visiting and denied this being triggering. He did ask his treatment team whether he would ever be able to have a glass of wine with his family on special occasions. Education was provided and he agreed that partaking in any alcohol use (when his disposition permits) could be a ‘slippery slope’. As a proactive measure, he attends N.A. meetings at his building weekly, speaks to the addictions worker onsite on occasion, and attends Celebrate Recovery (CR) every Sunday. He shared that he sometimes speaks at these sessions and finds it fulfilling. He reported speaking of being proud of his five-year sobriety and showed his team the five-year coin he received from the group.”
- Notably, Mr. Pillar’s insight into his violence risk was summarized as follows in the Hospital Report for the 2024 reporting period:
“Mr. Pillar appeared to have reasonable to good insight into his risk for violence. He acknowledged that, when decompensating, his auditory hallucinations are commanding in nature and that he would tend to adhere to those commands. He noted that he would “tell any staff” if he began to experience symptoms of his illness because he would be “worried they would tell [him] to do something”, which would result in “getting in trouble”. He also reported that he becomes violent when he uses substances and does not want to be considered a violent person. When asked to assess his future risk of reoffending, he voiced that he does not believe he would become violent again because he consistently takes his medication and remains abstinent from substances.”
Evidence for the Current Reporting Year and at the Hearing
Mr. Pillar remained at his Indwell apartment until June 27, 2025 when he transitioned to a one-bedroom apartment in a quadraplex in St. Thomas through the Forensic Supportive Housing Program (FSHoP). This is subsidized housing, allowing Mr. Pillar to remain there at a monthly cost of $600.00 to himself.
Dr. Ajay Prakash, who gave evidence at the hearing to supplement the information in the Hospital Report, took over Mr. Pillar’s care on July 24, 2025. He stated that Mr. Pillar is supported at his residence by a forensic housing worker, who would remain engaged even following Mr. Pillar’s potential discharge from the forensic system. Mr. Pillar has from time to time needed that support. Dr. Prakash also confirmed that Mr. Pillar’s current residence would continue to be available to him even after being absolutely discharged.
Mr. Pillar has reportedly adapted well to independent living. He reported no associated stress and there were no observed mental status changes. Since settling into his new home, he has shown meaningful initiative in pursuing his community-based goals, including developing daily structure, engaging in his employment search, and maintaining his abstinence. Significantly, it is reported that he continues to demonstrate notable stability supported by pro‑social peer relationships and a caring, involved family network.
Mr. Pillar consistently denied experiencing any positive symptoms of his illness and has reported experiencing no hallucinations since 2021. Neither did he display any evidence of hallucinations or responsiveness to internal stimuli. His thinking remained logical, coherent, and goal-directed, without indications of paranoia or delusional content. He consistently described his mood as positive and stable, rating it between 8/10 and 10/10 and expressing that he feels “pretty much free.” He denied any symptoms of anxiety, and his social anxiety disorder appeared to be well controlled. No episodes of instability were observed. Mr. Pillar identified several effective strategies for coping with stress, including watching YouTube videos related to his interests, listening to music, and talking with his personal and professional supports. He also described physical activity, especially boxing and exercise, as a significant source of stress relief.
Mr. Pillar now administers his oral antipsychotic medications independently. He has reportedly remained fully compliant with all prescribed oral medications and reported using a phone reminder to support his adherence. FSHoP staff completed weekly medication counts, and Mr. Pillar remained agreeable to this form of monitoring. He attended the Southwest Centre for his injection every two weeks and to complete his required clozapine bloodwork every four weeks. His clozapine levels have remained stable throughout the reporting period. Mr. Pillar’s levels of insight into his illness, need for treatment, and violence risk are detailed in the Hospital Report, which states that overall, his insight reflects recognition of the protective role of abstinence and medication adherence, as well as the connection between symptom relapse and increased risk.
In his oral evidence, Dr. Prakash stated his opinion that Mr. Pillar’s adherence to his medication is largely internally motivated, in that he wants to remain well and in the community. He continues to be influenced by thoughts that his medications result in weight gain and sedation. Those thoughts, together with his and his mother’s concerns about polypharmacy, have resulted in ongoing conversations about potentially reducing his medications. In Dr. Prakash’s opinion, there are too many risks to make major changes to his medications, and thus far, Mr. Pillar has been accepting of Dr. Prakash’s advice. Mr. Pillar has required such education and instruction for years and Dr. Prakash thought it was reasonable to think that this need for repeated information comes from Mr. Pillar’s illness.
The Hospital Report describes Mr. Pillar’s insight into his substance use as follows:
“Mr. Pillar demonstrates well‑developed insight into his history of substance use and the associated risks. He remained abstinent from all substances throughout the reporting period and noted that he achieved five years of sobriety on December 5, 2025. He consistently acknowledged that substance use, particularly methamphetamine, could significantly destabilize his mental status. He frequently expressed pride in his ability to avoid substances in the community, describing instances where he encountered drugs on the ground and chose to leave them and continue with his day. He denied any temptation to use stating, ‘My mom tells me not to do drugs,’ and when asked about his own perspective, he responded, ‘I don’t like crystal, I don’t want to use it again, I don’t want to be dope sick the day after.’ He further demonstrated understanding of the relationship between substance use and psychiatric symptoms, noting, ‘I believe you [staff] when you say it can exacerbate my voices… I haven’t had voices for a long time.’”
Dr. Prakash stated that the treatment team is seeking to prepare Mr. Pillar for discharge from the forensic system, ad is therefore recommending a removal of the “abstain” clause from his Disposition. To be clear, the treatment team prefers that Mr. Pillar not use substances, so Dr. Prakash sees the coming reporting year as an important time of testing for him. There have been some indications that Mr. Pillar may wish to use alcohol or cannabis. In Dr. Prakash’s opinion, decompensation would be quick if he were to use either substance.
Dr. Prakash reminded the panel that Mr. Pillar’s mental state is also sensitive to changes brought about by fluctuations in his clozapine levels, which can be affected by his smoking. He stated that smoking can affect his clozapine levels by 30% to 50%. While Mr. Pillar does not seem to be able to abstain from smoking, he has limited it to 10 cigarettes per day and if he does so, his therapeutic clozapine level can be maintained at his current dose of 600 mg per day. He purchases them by the carton to get the best deal for his money. In response to a panel member’s question, Dr. Prakash said that he would be happy to have a conversation about using e-cigarettes as an alternative to tobacco, although Mr. Pillar may be concerned about the relative expense of these options.
Dr. Prakash said that if Mr. Pillar were to decompensate, this would occur in a matter of days, as distinct from weeks or months. If his clozapine levels were to be reduced, signs of decompensation that would be expected in the initial stages are intense staring, irritability, pacing, and responding to internal stimuli.
Dr. Prakash confirmed that Mr. Pillar was reporting twice monthly to the Hospital, on the occasions when he attended for his injectable medication. Asked by the panel about the monitoring in place for Mr. Pillar’s substance use, the doctor replied that currently, drug screening occurs one to two times monthly, on the occasion of Mr. Pillar’s scheduled appointments when he receives his injectable medication. He agreed that the testing could be made more random and more frequent, although he is also considering the post-forensic system period, where there would be no mandatory testing. He acknowledged that while cannabis may remain in the urine for some considerable time and may be detected from regular (scheduled) drug screens, alcohol use could be more readily detected with random screening. He also acknowledged that testing, with the removal of the clause requiring substance abstention, could also inform ongoing assessments of Mr. Pillar’s mental state.
Dr. Prakash was asked about the proposal to extend the threshold for notifying the treatment team about his absences from his residence. He noted that this is a standard notification requirement under conditional discharge dispositions. While he was open to extending this beyond 24-hour absences, he also cautioned about Mr. Pillar’s vulnerability to quick mental status fluctuations and the presence of signals that he may wish to use substances. He agreed with Ms. Carnelos’ suggestion that the removal of a 24-hour absence notification clause for the coming year might, in addition to removing the “abstain” clause, also be seen as in some respects a test for Mr. Pillar. Thus far, all of his overnight passes have been for the purpose of visiting his mother in Windsor, with the exception of one overnight camping trip with his brother. These passes, which have not required the advance approval of the treatment team, have all gone well and have all involved absences exceeding 24 hours.
Dr. Prakash confirmed that while Mr. Pillar maintains significant relationships with his family and travels to Windsor to visit them, he wishes to settle for the longer term in his current community in St. Thomas. Dr. Prakash said that it would be “nice” for the treatment team to know where Mr. Pillar is when not at his residence.
The Hospital Report states that Mr. Pillar’s finances continued to be managed by his mother as she was made statutory guardian in 2021, but the team now believes that he is financially capable. A panel member asked Dr. Prakash whether Mr. Pillar uses his Developmental Services (DSO) Passport funding to support his boxing activities. Dr. Prakash understood that Mr. Pillar used his Passport funding for his purchase of a bicycle, a gym membership, and for public transit. He pays for his boxing out of his own funds. Asked whether the team would be formally re-assessing Mr. Pillar’s financial capacity, Dr. Prakash stated that there was nothing stopping this, although usually a capacity assessment would occur earlier during a patient’s hospitalization.
A panel member referred Dr. Prakash to the re-offence scenario in the Hospital Report for the current reporting period, which reads as follows:
“ In the absence of supervision, Mr. Pillar may experience increased difficulty maintaining consistent engagement with treatment. Reduced support could limit his ability to cope adaptively with stress, increasing the likelihood of returning to past patterns of non‑adherence and substance use. Such a decline could elevate his risk of relapse into psychosis and, in turn, heighten the potential for serious violence associated with untreated symptoms. Continued forensic involvement therefore remains an important protective factor in supporting his stability and reducing risk until non-forensics supports can be established.”
Dr. Prakash stated that he would add the word “likely” to the words “may” and “could” in the above-quoted formulation [thereby signifying a greater degree of certainty as to the re-offence scenario].
- No further evidence was led following the questioning of Dr. Prakash.
Analysis and Conclusions
Dealing 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. Pillar represents a significant threat to the safety of the public. He suffers from a serious mental disorder and has a significant history of non-compliance with treatment, including pursuant to Community Treatment Orders, prior to the index offences. While unwell and untreated, Mr. Pillar committed a serious act of interpersonal violence that could well have had lethal consequences. His history includes several other incidents of interpersonal violence and threats of violence, including threats to kill. Even after commencing treatment with antipsychotic medication and while in hospital following the NCR verdict, he continued to be symptomatic and violent and was convicted of two criminal offences.
The active symptoms of Mr. Pillar’s illness finally came under control with the optimization of his clozapine medication. However, his illness is very vulnerable to changes in his clozapine levels, and has been described as “brittle” in previous risk assessments. The panel finds that this descriptor continues to be apt. With persuasion from his treatment team, Mr. Pillar has been able to keep his smoking of cigarettes to a level that allows his clozapine to remain at a therapeutic level. However, absent this ongoing encouragement and support, his smoking could easily increase to the point that his clozapine loses its therapeutic effect.
As Mr. Pillar’s history demonstrates, a resurgence of active symptoms, resulting from medication ineffectiveness or non-adherence, substance use, or all three, is likely to have very serious consequences. That history, including but not limited to the index offences, involves acting on command hallucinations directing him to harm or kill people. As noted at para. 29 above, Mr. Pillar himself admitted during his 2024 reporting period that “his auditory hallucinations are commanding in nature and that he would tend to adhere to those commands”.
Mr. Pillar has significant strengths. He appears to have a strong therapeutic relationship with his current professional support team. He also has strong family support. He is adherent to his medication regimen and is noted as having either good or fair insight across the various domains, including his violence risk. Notably, he has remained abstinent of intoxicating substances for over five years, including the past reporting year. These are significant accomplishments for which Mr. Pillar is to be commended. His violence risk profile has shown a gradual lowering of his risk over the last several years. Nevertheless, the panel finds that at this juncture, Mr. Pillar will require the ongoing support provided by his forensic team to maintain and build upon these strengths so that his risk can be managed. Absent that support, there is a substantial likelihood that he would engage in criminal conduct that is likely to result in serious physical or psychological harm.
Turning to the matter of disposition, the panel is satisfied that Mr. Pillar’s risk can be safely managed under the terms of his current Conditional Discharge, amended by the removal of the provision requiring that he abstain from intoxicating substances. There is now significant evidence that his abstinence is significantly motivated by factors internal to Mr. Pillar.
This is not, however, to minimize the significance of substance use as a factor contributing to Mr. Pillar’s risk. Plainly, it is a very important factor. As his history as reviewed in these Reasons demonstrates, Mr. Pillar’s past was characterized by the very heavy consumption of substances, and in particular alcohol, cannabis, and methamphetamines. Against this history, even modest consumption of alcohol or cannabis can trigger decompensation, and the panel accepts Dr. Prakash’s evidence in this regard.
Clearly, the coming reporting year will be an important time of testing of Mr. Pillar’s resolve to maintain his abstinence. For this to be effective, both for the purpose of determining whether Mr. Pillar engages in any alcohol or cannabis use (he has indicated some interest in using these in small quantities in social settings) and for the purpose of assisting the treatment team in assessing the impact of any such use on his mental condition, the requirement for the submission of samples for analysis is necessary. In addition, the panel would underscore that the Hospital is obligated, under the terms of the Disposition, to require Mr. Pillar’s samples to be provided on a random basis, and not merely at pre-scheduled appointments.
The panel would also underscore that Mr. Pillar needs to be seen by members of his treatment team at least twice monthly, and at least in the early period following the issuance of his new Disposition, likely more frequently to ensure appropriate mental status monitoring.
The panel would maintain the requirement that Mr. Pillar advise the person in charge of Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London or his or her designate, in advance, of any absence from his residence of 24 hours or more. Ms. Carnelos submitted that notifying of an intended absence of 48 hours or more would be sufficient. However, as pointed out by Ms. Zamprogna for the Hospital and by Mr. Huber for the Attorney General, the removal of the abstention clause comes with a certain risk of decompensation which can occur quickly. In addition, the panel notes the evidence that Mr. Pillar wishes to settle in his current community of St. Thomas for the longer term. He has the freedom, provided by his Disposition, to visit socially with friends and other acquaintances in the community, including for overnight visits. While he should not be restricted in these visits, such social interactions can increase the likelihood that he will be in places where alcohol and/or cannabis are consumed. It is not merely “nice” (as Dr. Prakash put it) for the treatment team to know where Mr. Pillar is. In the panel’s view, it is necessary, so that the team can effectively intervene should Mr. Pillar begin to place himself into situations in the local community that elevate his risk to the safety of others.
Furthermore, as Ms. Zamprogna pointed out, should it ever become necessary to resort to the Criminal Code’s mechanisms for returning Mr. Pillar to the Hospital, it will be important for the treatment team to be able to notify the police, with some degree of precision, of his expected location. The panel does not consider Mr. Pillar’s notification requirement to be onerous, in his overall context.
Prior to concluding these Reasons, the panel would make the following observation. Based on Dr. Prakash’s evidence as to the potential for the Hospital to recommend an Absolute Discharge as soon as the next scheduled review, it may be helpful for the treatment team to conduct a formal assessment of Mr. Pillar’s financial capacity in advance of that review. In this regard, the panel notes the information in the Hospital Report concerning the treatment team’s opinion that he does possess this capacity.
In approaching this matter, the panel has considered the evidence through the lens of the factors in s. 672.54 of the Criminal Code. The panel wishes to commend Mr. Pillar on his progress to date, including in particular his adherence to his medication, his demonstrated commitment to abstinence from substances, including his utilization of community supports to maintain his abstinence. We also note his cooperative attitude in relation to those who are seeking to support him both professionally and personally. It is hoped that his positive trajectory will continue through the year ahead.
DATED this 15th day of April 2026, at the City of Toronto, in the Toronto Region.
Eric Siebenmorgen
Legal Member
Office of the Registrar
Ontario Review Board