Re Mark Francis, 2026 CanLII 4227

Re: Mark Francis

ORB File No: 6854

Hearing held on: Friday, November 14, 2025

Place of hearing: North Bay Regional Health Centre – North Bay Site

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

Before:

Alternate Chairperson: Mr. J. Weinstein

Members: Dr. K. Hand Dr. G. Stones Mr. D. Sandor Mr. A. Bouvier

Parties Appearing:

Accused: Mark Francis Counsel: Mr. C. Bracken

The person in charge of hospital: Representative: Mr. P. Trenker

Attorney General of Ontario: Counsel: Ms. M. Mazurski

REASONS FOR DISPOSITION

(Dated January 19, 2026)

Introduction:

1. On November 2, 2015, Mr. Mark Fracis was found not criminally responsible on account of mental disorder, on a charge of criminal harassment, contrary to the Criminal Code of Canada (“Criminal Code”).

2. Mr. Francis is subject to a Disposition of the Ontario Review Board (the “Board”), dated November 5, 2025, which orders that he be detained at the Forensic Program of the North Bay Regional Health Centre – North Bay Site (“North Bay”). This Disposition provides him with certain privileges, including living in the community within the catchment area of North Bay, in supervised accommodation approved by the hospital.

3. On November 14, 2025, the Board convened a hearing at North Bay to conduct the annual review of the current Disposition.

4. Mr. Francis was present at the hearing and was represented by his counsel, Mr. C. Bracken.

5. A Hospital Report, dated September 12, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. The issues at this hearing were whether Mr. Francis is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code, and, if so, the necessary and appropriate Disposition in the circumstances, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

7. For the reasons set out below and based on the expert evidence and opinions before us, the Board concluded that Mr. Francis continues to represent a significant threat to the safety of the public. The Board ordered that the necessary and appropriate Disposition in the circumstances is the continuation of the existing Detention Order.

Current Psychiatric Diagnoses:

8. Schizoaffective Disorder, Bipolar Type, Mild Intellectual Disability

Index Offence:

9. The circumstances giving rise to the Index Offence are extracted from last year’s Board Reasons, as follows:

“On Sunday September 13th, 2015 at approximately 4:00 p.m., the accused attended the Tim Horton’s coffee shop located at 975 McKeown Avenue in City of North Bay where the victim was working a supervisor shift from 2:30 p.m. to 10:30 p.m. The accused stayed there until approximately 10:00 p.m. and then left the store. At approximately 10:30 p.m. the victim finished her shift and began walking to the Sobey’s grocery store across the street. She picked up a few groceries and then left the store at which time she observed the accused standing outside. She proceeded to walk across the parking lot to the lights at Algonquin Avenue and the by-pass, crossed the street and began walking down Oakwood Avenue towards her residence. The accused proceeded to follow her approximately one kilometer from her place of work and was heard screaming words at the victim in a female voice, including “help me.” The victim feared for her safety and began to walk at a fast pace towards her residence. She lost sight of the accused approximately 100 feet from her residence. The victim was too scared to contact police at this time, but she told her roommate, Nathan Janes, about the incident the next day. On Tuesday September 15, 2015, at approximately 3:30 a.m., the accused attended back at the Tim Horton’s. At this time, he requested to speak with a female employee Melonie Morin. The accused told her that he was “in love with an employee named Taylor” and gave her a gold necklace to give to the victim and then he left the store. Nathan Janes, who is also an employee at the store, proceeded to tell the victim about the incident that had occurred at Tim Horton’s and gave her the necklace. The victim, in fear of her safety, contacted the North Bay Police Service.”

Personal History:

10. Mr. Francis’ personal history is outlined in the Hospital Report, and it is accurately summarized in last year’s Reasons:

“Mr. Francis is of West Indian/Canadian descent, born in Toronto. He has half-sisters and a half-brother residing in Jamaica. His behaviour is reported to have required special education from grade two until his final year of education, grade ten, due to intellectual difficulties. It is reported that his behaviour changed when he was in his mid teens, and he was expelled from school. Mr. Francis was in a short relationship in 2012 and has a daughter, who is now living in North Bay. It is reported that his daughter , who is now 21, visited him twice a couple of years ago. Mr. Francis held the delusional belief that she was his niece, and the visit was destabilizing to him. There have been no further visits. Mr. Francis has a criminal record that includes the following convictions: 2001 uttering threats; 2005 criminal harassment, utter threats, sexual assault, and fail to comply with probation; and 2008, assault causing bodily harm and mischief.

He has a long psychiatric history with multiple hospital admissions spanning the years 1992 up to a month prior to the index offence.

Following his NCR finding, his mental illness remained active and treatment resistant. He was transferred to the Forensic Rehabilitation Unit in 2016 where his condition slowly improved, although chronic psychotic symptoms remained. In 2020 he was discharged to the Dual Diagnosis Transitional Rehabilitative Housing Program which provides 24-hour supervision and support. Unfortunately, his mental condition began to deteriorate, and he was readmitted to hospital in May 2020.

Course Since Last Disposition:

11. Mr. Francis’ course since his last Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:

“Despite reliable adherence to treatment with numerous antipsychotic and mood stabilizing medications within this controlled environment, Mr. Francis’ illness has been largely treatment resistant for many years.

Mr. Francis’ fragile mental state has continued to be extremely susceptible to any medication adjustments, and it has been a delicate balance over the course of this reporting period to maintain Mr. Francis’ psychiatric treatment needs whilst ensuring his physical stability.

Mr. Francis’ fragile mental status is also particularly susceptible to stressors. He requires structure and consistency. Destabilizers include interactions with some peers, personal finances, ongoing confinement, change in routine and/or schedule, high acuity on the unit, poor sleep, sensory deprivation, and challenge of his delusional belief system. At times, Mr. Francis is impulsive and he has limited frustration tolerance.

His mental status continues to be closely monitored and adjustments to medication will continue as appropriate. Nonetheless, it is evident that Mr. Francis is clearly benefiting from treatment with clozapine and several staff members have indicated that this is the “best he’s been in years.”

Mr. Francis has been able to generally manage some limited indirectly supervised hospital and grounds privileges appropriately. There have been some occasions where he has required additional teaching on the importance of returning to the unit on time.

Mr. Francis is in receipt of passport funding through Developmental Services Ontario (DSO). Mr. Francis has an assigned passport worker and enjoys an additional community outing once per week. There have been no management concerns reported during their outings.

Mr. Francis has a strong work ethic and recognizes that being productive helps to regulate his mood significantly. He has continued to do well in his vocational role at the local McDonald’s restaurant as a dining area attendant every Thursday from 11:00 a.m. to 2:00 p.m., supported by his assigned occupational therapist.”

Position of the Parties:

12. Counsel for the Hospital, counsel for the Attorney General, and counsel for Mr. Francis advised that this was a joint submission: all adopted the Hospital’s recommendation of a continuation of the existing Detention Order Disposition.

13. For the purposes of this hearing, counsel for Mr. Francis advised that significant threat was not in dispute.

Evidence at the Hearing:

14. The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Gagnon and from Mr. Mark Francis.

Testimony of Dr. Gagnon:

15. Dr. Gagnon co-authored the Hospital Report. He testified as follows:

a) Mr. Francis has shown slow but steady improvement under psychiatric care, making significant progress over the past reporting year. The introduction of Clozapine could be described as a “game changer,” leading to gradual symptom improvement.

b) Though there were initial complications with priapism, this condition is being carefully managed going forward. Medication dosage has been increased very slowly, and the treatment team has seen a corresponding improvement in Mr. Francis’ symptoms.

c) Mr. Francis still has problems adhering to rules, but his overall progress has been positive.

d) The treatment team noticed that Mr. Francis’ symptoms increase in the evening, with a reoccurrence of delusional thinking and more agitation.

e) Mr. Francis works weekly at McDonalds where he is supported by an occupational therapist. His ability to work and motivation to work are viewed as protective, positive factors.

f) Mr. Francis’ privileges have been gradually increased; he is now enjoying indirectly supervised privileges on hospital and grounds for up to four hours.

g) Mr. Francis does encounter setbacks with respect to his privilege levels, because of his trouble respecting boundaries.

h) Mr. Francis has ongoing challenges understanding, and respecting, social boundaries, particularly in interactions with women. There have been incidents in which he approached, or pursued, female peers inappropriately, requiring staff intervention and reminders that such behavior is not acceptable. For example, he was reminded not to approach women and to avoid making comments like: “You look good in those jeans” to nurses. While he has shown the ability to learn and to stop such behaviors when corrected, the concern remains that he does not always recognize these issues independently and needs external cues.

i) The treatment team continues to engage Mr. Francis and coach him on social skills and boundaries, and they have seen noticeable improvement in these areas.

j) Mr. Francis demonstrates persistent behavior. For example, he called a potential employer repeatedly, despite having been told there were no job openings, to the point that the employer threatened to call the police. This persistence is seen as both a positive (motivation to work) and a challenge (difficulty stopping when asked).

k) Mr. Francis sometimes struggles to follow rules related to his privileges (e.g., not bumming cigarettes from other patients, not rapping in communal areas). When he breaches these boundaries, his privileges are temporarily reduced, and then gradually restored, as he demonstrates improved behavior. This cycle of “one step forward, one step back” is a recurring theme in his progress.

l) Despite these issues, Mr. Francis is described as coachable and teachable. He responds well to concrete explanations and reminders, and his ability to respect boundaries has improved over time. However, his progress is slow, and he continues to require supervision, and frequent reminders, to maintain appropriate boundaries.

m) The treatment team continues to see persistent delusions – including fantasies that he is a famous rapper, such as Eminem, or other celebrities. These delusions are sometimes playful, and he can admit that it is not true that he is a celebrity; however, at other times, he becomes more agitated and fixed in these delusional beliefs when challenged.

n) Mr. Francis attended community events, such as his daughter’s wedding, under supervision, with no significant issues.

o) There have been no recent concerns regarding substance abuse.

p) Future housing options are being considered, with a preference for settings offering substantial support and supervision.

q) In response to a question from a panel member, Dr. Gagnon agreed that Mr. Francis does suffer from a mild intellectual disability. This disability, coupled with his extremely low adaptive functioning, complicates his treatment and requires the treatment team to adapt their approach.

r) Mr. Francis is on the Sex Offender Registry for life, which requires annual check-ins with police. This process has been adapted to minimize his agitation, by having caregivers/hospital staff provided this information to the police, instead of requiring Mr. Francis to interact directly with law enforcement.

Testimony of Mr. Francis:

16. Mr. Francis testified on his own behalf, as follows:

a) He has a strong work ethic, and he described his various jobs and volunteer activities in detail.

b) He denies hearing bad voices, but he does acknowledge having racing thoughts from time to time; he uses these thoughts to channel his energy into his music.

c) He maintains that he is a low risk to society and capable of independent living.

d) He does not understand why he is being kept in hospital, as he did not commit the offence, his twin brother, who passed away, did.

e) He is frustrated because he has been wrongfully accused and is misunderstood.

17. No other evidence was called.

Analysis and Conclusion:

18. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: Mr. Francis remains a significant threat to the safety of the public.

19. In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Gagnon, in addition to the documentary evidence before us.

20. There has been very little change in Mr. Francis’ risk profile from his previous reporting year. He requires the intensive support, and supervision afforded him by the Board’s detention disposition, which remains necessary and appropriate to ensure public safety.

21. While the Hospital Report does indicate that Mr. Francis’s insight into his in his mental illness and his need for medication have improved, this improvement has occurred only while in an inpatient setting. Mr. Francis has a significant history of non-compliance with both treatment follow up and medication, while living in the community. If he were absolutely discharged, it is highly likely that he would disengage from mental health supports and become non-compliant with treatment, which would result in a decompensation of his mental status. When in a decompensated state, it is highly likely that Mr. Francis would engage in behaviours similar to the Index Offence, making him a real risk of serious psychological, or physical, harm to members of the public.

22. In particular, the Board relies on the Assessment of Risk set out in the Hospital Report:

Factors Indicative of Significant Threat

1. Mr. Francis suffers from a serious and persistent mental illness, Schizoaffective Disorder, Bipolar Type. When unwell, he becomes acutely psychotic expressing grandiose, paranoid and persecutory delusions, agitated, very socially disinhibited/intrusive, and predisposed to bizarre, threatening and aggressive behaviour.

2. Mr. Francis has an extensive history of admissions to psychiatric facilities; there are 18 documented admissions since 1992.

3. He has a history of non-adherence to psychiatric treatment in the community.

4. He has a history of alcohol and illicit substance misuse.

5. He has limited insight into his legal status, mental illness, and the need for ongoing pharmacological treatment.

6. He has a history of criminal conduct including youth criminal convictions, which resulted in incarcerations and probation orders. As a consequence of convictions on charges that Mr. Francis incurred while manic in 2005 by purportedly harassing, threatening, stalking, obstructing and forcing unwanted embraces and kisses upon female victims in North Bay, he was placed on the Ontario Sex Offender Registry for life.

7. He is incapable to consent to treatment and incapable to manage his property.

8. He has never been gainfully employed and has limited education (completed grade 10).

9. There are no records to indicate that he has participated in or completed an addiction treatment program.

10. Mr. Francis was subject to a Community Treatment Order (CTO) prior to his admission, which was to expire in February 2016. This measure, which outlined the requirement that Mr. Francis adhere to medication and attend meetings with his community support team, was not sufficient in ensuring reliable medication compliance. Although collateral sources indicate that Mr. Francis was compliant with his psychopharmacological treatment administered via intramuscular injection, he did not adhere to his oral medication regime. He did not adhere to his treatment plan and often would not make himself available for appointments with his community psychiatrist or support team.

11. Mr. Francis continues to claim that he has been wrongfully charged, blaming a fictitious twin brother for committing the Index Offence.

12. In light of the Board’s finding of significant threat, it is charged with shaping a Disposition for the coming year. It is clear from the Hospital Report that the hospital needs to approve Mr. Francis’ housing and that he requires supervised accommodations. Mr. Francis continues to lack insight into the level of intensive support he requires to ensure his successful community reintegration.

13. In particular, the Board relies on the following from the Hospital Report as to why a Conditional Discharge Disposition is not appropriate in these circumstances:

“The Hospital recommends that the ORB should not grant a Conditional Discharge. The evidence points to the need for high levels of supervision that could only be provided under the authority of a Detention Order. The level of risk is such that it is necessary for the Person in Charge of the Hospital to retain the authority to exercise discretion in the granting of privileges, as well as approve any future placement in the community. Considering the serious nature of Mr. Francis’ index offence, the complexity of his psychopathology and his limited insight into his mental illness and the need for ongoing psychopharmacological adherence, it would be inadvisable from a forensic psychiatric risk management perspective to consider such a Disposition in the current circumstances.”

26. In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the current mental condition of Mr. Francis, his reintegration into society and his other needs, the necessary and appropriate Disposition is to continue with a Detention Order.

DATED this 19th day of January 2026, at the City of Toronto, in the Region of Toronto.

Mr. J. Weinstein Alternate Chairperson

Office of the Registrar Ontario Review Board