Ontario Review Board
Re: Marc Cook (formerly Marc Caron)
ORB File No: 6835
Hearing held on: Monday, March 30, 2026
Place of hearing: Brockville Mental Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. G. Beasley
Members: Dr. Y. Alatishe Dr. W. Loza Ms. M. Chamberlain Mr. S. Duffy
Parties Appearing:
Accused: Marc Cook (formerly Marc Caron) Counsel: Mr. M. Bird
The person in charge of hospital: Representative: Dr. R. Linthorst
Attorney General of Ontario: Counsel: Mr. K. Schultz
REASONS FOR DISPOSITION
(Dated May 13, 2026)
Introduction
On October 6th, 2015, the accused, Marc Cook (formerly Marc Caron), was found not criminally responsible on account of mental disorder on a charge of uttering threats to cause death or bodily harm, contrary to the Criminal Code of Canada.
Mr. Marc Cook (formerly Marc Caron) is currently subject to a disposition of the Ontario Review Board dated April 17th, 2025, which detains him at the Secure Forensic Unit of the hospital, with privileges up to and including living in the community in accommodation approved by the person in charge.
On March 30th, 2026, the Ontario Review Board convened a hearing at the Brockville Mental Health Centre, hereinafter referred to as the hospital, to conduct Mr. Marc Cook (formerly Marc Caron)’s annual review hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Marc Cook (formerly Marc Caron) was in attendance at his hearing and was represented by his counsel, Mr. M. Bird. The Board had before it Exhibit 1, the hospital report dated February 27th, 2026, and a letter from Marvin Phair was entered as Exhibit No. 2.
The issues to be determined at the hearing were whether Mr. Marc Cook (formerly Marc Caron) continues to represent a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, what was the necessary and appropriate disposition which was also the least restrictive and least onerous take into account the factors set out in section 672.54 of the Criminal Code.
Preliminary Matters
- During his evidence, Mr. Marc Cook (formerly Marc Caron) informed the hearing that he had his name legally changed and that he now goes by Marc Cook. For the purposes of these Reasons, we will be referring to Mr. Caron as Mr. Cook.
Position of the Parties
- At the outset of the hearing Dr. Linthorst stated that the recommendation of the hospital was for a continuation of the current detention order but with an amendment to allow Mr. Cook passes into the community to be increased from 72 hours to seven days. Mr. Schultz supported the recommendation of the hospital with respect to the continuation of the detention order but reserved his position with respect to extending the timeline of the passes. Mr. Bird supported the recommendation of the hospital as submitted by Dr. Linthorst.
Index Offence
- The circumstances of the index offence are set out in the hospital report and summarized as follows:
“The following synopsis of the Index Offence has been provided to this facility by the Brockville Crown Attorney's Office:
The accused before the courts, Marc Caron, at the time of this offence was serving a sentence in an unrelated matter. Caron volunteered to serve his sentence at the St. Lawrence Valley Correctional and Treatment Centre. During his stay at the facility, Caron was seeking treatment from Dr. C. Cameron.
Dr. C. Cameron, when speaking with Marc Caron, learned that Caron, since early childhood, has had homicidal thoughts to kill his mother, Barbara Caron. Dr. Cameron indicates that these urges are so ingrained that, not only does he think about them daily, he also dreams about it at night. Caron has described to Dr. Cameron that he will kill his mother, cut her up into pieces, cook her and eat her. Caron indicates he will not actively pursue his mother but, if he were to cross her path by random chance, he would not be able to control these urges. Although Caron indicates he would not actively pursue his mother, he did reveal to Dr. Cameron a recently thought out plan to perhaps kill his brother, Chris Caron, or sister, Tiffany Caron and, when his mother attended their funerals, he would ambush his mother and kill her.
Members of Leeds County OPP attended the St. Lawrence Valley Correctional and Treatment Centre and spoke to Marc Caron, advising him of his rights and cautioning him. Caron provided a statement, indicating in no uncertain terms he would kill his mother; it would only be a matter of time.
On February 20, 2015, Marc Caron was arrested and charged with Uttering Threat to Cause Death and given a court date of February 27, 2015, in Brockville Court. At the time, it was believed that Caron would be released February 25, 2015.
The victim, Barbara Caron, has not been located as yet to advise her of this threat and it is believed it is due to previous knowledge of his urges in a similar incident, and she has chosen to stay unattainable from her son.
On February 5, 2015, the Ontario Provincial Police documented the following General Occurrence Report, which provides greater insight into Mr. Caron's disclosures to Dr. Cameron:
On February 3, 2015, B. Perkins, Security Manager for the St. Lawrence Valley Treatment Correctional Centre, called police regarding a patient at the facility that is due to be released February 25, 2015. Perkins [is] seeking police assistance regarding a Marc Caron, who is having homicidal thoughts towards his mother.
On February 5, 2015, PC Onstein attended the St. Lawrence Valley Treatment Correctional Centre and met with 8. Perkins and Dr. C. Cameron to review the case file of inmate, Marc Caron (December 22, 1984). Investigation revealed that Caron was serving a six month sentence for drug related charges at the St. Lawrence Valley Treatment Correctional Centre, which started September 2014. During this time, Caron has been a model inmate, with only one physical altercation with another inmate while in custody, which was deemed not his fault.
Dr. C. Cameron reports, while treating Caron over the previous six months, he has disclosed homicidal thoughts towards his mother, Barbara Caron.
He reports three previous incidents where he tried to kill her:
At age 9, he stabbed her multiple times after his mother had removed him from a loving home, where he had been living with his aunt;
At age 19, he stabbed her with a screwdriver in the back after bumping into her by chance on the street;
At age 26, he and his sister, Tiffany Caron, apparently conspired to kill their mother. During this incident, Tiffany invited her mother over and called Marc to notify him when she got there. Marc then came over with the intention to kill his mother, sneaking through a window, but inadvertently made some noise, which alerted his mother and she was able to escape.
Dr. Cameron reports that, while treating Caron, he has disclosed almost daily fantasies of locating his mother, chopping her up and then masturbating and ejaculating on her deceased body. Mr. Caron continues to indicate through these interviews that he would kill his mother if he could get away with it. The only reason he does not act is because he does not know where she is and he questions whether he could do it and get away with it; he does not want to go to jail for the rest of his life. Mr. Caron has recently disclosed a new onset of fantasies to kill his brother Chris, or his sister Tiffany, to get his mother out of hiding so she could come to the funeral, where he could kill her. He admits, however, that he does not really wish to kill his siblings.”
Current Diagnosis
Antisocial Personality Disorder (ASPD)
Post Traumatic Stress Disorder (PTSD)
Cannabis Use Disorder -by history, in controlled (hospital) remission
Amphetamine Use Disorder – by history, in remission
Sexual Sadism Disorder – by history, in remission
Background History
Mr. Cook’s psychosocial history, as well as his progress under the jurisdiction of the Board, is amply set out in the Hospital Report dated February 27th, 2026, which was filed as an exhibit at the hearing. As such, the contents need not be repeated in detail. The areas most pertinent to his current assessment of risk will be reviewed here in brief.
Mr. Cook previously reported that his father raped his mother and, because he had a similar appearance to his father, his mother rejected him. From the age of six months to nine years old, Mr. Cook was raised by his paternal aunt and uncle, Thelma and Tony Somer. He apparently believed that his aunt and uncle were his parents, and his cousins Tracy, Amie, Doug, and Sean were his siblings. It was reported that, when his mother reappeared in his life and took him away at the age of nine, he did not want to leave the home of his aunt and uncle and protested by kicking and screaming and was physically restrained and forced to live with his parents for a few months. Mr. Cook said he was physically abused primarily by his brother, Tommy. No charges were laid as a result of this reported abuse. Mr. Cook previously said that his mother was cruel and made him sleep in a closet. Mr. Cook began to entertain homicidal thoughts toward his mother and father starting at the age of nine and resulted in him stabbing his mother with a screwdriver and hitting his father with his skates. He said he was sent to the Child and Parent Resource Institute (“CPRI”) in London, where he stayed for three years until the age of 12.
Mr. Cook said he was sexually abused while he was at CPRI. He previously stated that he was "tortured and molested sexually ... beaten up" by co-patients and physically by staff. He said he was molested by both male and female nurses, who touched him and made him touch them. He said there were about 100 occurrences, which happened mostly at night. He stated they ''put their dick in my mouth" and ejaculated. He spoke of females having "got me to rub their tits" and having been taken down to the "rubber room". Mr. Cook said that other "inmates", who were usually older than him, made him touch them and this happened at least 50 times. He said he was beaten by the hand on his buttocks and dragged downstairs, which led to bruises and injuries. Mr. Cook said his aunt witnessed this. He said he never disclosed this to a psychiatrist and a psychologist, who he saw on a regular basis because, " ... did not think they would believe me ... I did tell my aunt, and she wanted [him] to lay charges". He said that, over the last few years, others came forward and complained about abuse and there were nurses who were charged criminally for beating somebody suffering from autism.
Mr. Cook displayed various and extensive behaviour problems during his youth, including stealing, fighting, lying, running away from home, fire setting, cruelty to animals, challenging authority, breaking rules, and vandalism. He has talked about flicking matches around the house, having burnt down a garage by accident, burnt down a few houses that were abandoned by people in Morrisburg, killed at least 12 cats and harmed up to 100 other cats, shot a dog in the head with a gun, cut his neighbour's cat open and placed it on the porch, playing with cats and throwing them about, picking up mice and putting them in a microwave to watch them suffer, taking a gun to school, hitting cats with a golf club and a baseball bat, holding cats down and chopping them.
In terms of intimate relationships, Mr. Cook has a history of several mostly short-term romantic relationships which were tumultuous and characterized by violence in sexual and non-sexual contexts. He has several children but does not appear to have maintained a relationship with them.
Mr. Cook’s work history prior to being found NCR was inconsistent and impacted by periods of incarceration. He reported having worked at a pizza restaurant and a blueberry factory, the latter for a 3-year period between 2006 and 2009.
As for substance use, Mr. Cook has a lengthy history of use of intoxicants including alcohol, cannabis, LSD, crystal methamphetamine, opiates, cocaine in addition to, in his words, “anything [he] could get his hands on.” However, his substance of choice was crystal methamphetamine.
Criminal History
Mr. Cook has a criminal record which is set out in detail in the hospital report. There are numerous entries both in the Youth and the Adult symptoms, including offences of violence and multiple breaches of court orders. Drug offences also appear with significant periods of custody imposed in a reformatory system.
As a result of Mr. Cook's 2009 Sexual Assault conviction, he is a registered sex offender and required to report to the Lambton Ontario Provincial Police within seven days of his release or transfer.
Evidence at Hearing
The evidence on behalf of the hospital was presented by Dr. Linthorst. At the outset of his evidence in response to a question from the Alternate Chairperson, Dr. Linthorst stated that Mr. Cook’s spouse Ms. Cook, had achieved approved person status. She was present in the hearing along with her daughter. Dr. Linthorst stated that Mr. Cook is a 43-year-old male who had been found not criminally responsible with a diagnosis of Schizophrenia. He stated that this diagnosis has since been rescinded and at the present time, in his opinion, Mr. Cook suffers from ASPD, with a Psychopathy Checklist – Revised (“PCL-R”) score of 32. He also an amphetamine use disorder and a sexual sadism disorder, in remission. Mr. Cook suffers from Post Traumatic Stress Disorder which is controlled by medication.
Dr. Linthorst stated that Mr. Cook has demonstrated a good clinical progress from May 25th of 2025 up to about two months ago. At that time, he returned the first of three positive Urine Drug Screens (“UDS”) for methamphetamines. There have been two negative screens since the three positives. Dr. Linthorst stated that the testing procedure indicates a pattern of repeated use of methamphetamines. As a result of the positive tests along with some decompensation in his mental status presenting by way of increased verbal aggression, on March 17th Mr. Cook’s passes were revoked. Mr. Cook’s ability to obtain passes was due to be reinstated on April 8th, 2026. Dr. Linthorst stated that the reason for the passes being revoked was an increase in risk tied to the substance use.
Dr. Linthorst stated that with Ms. Cook now being an approved person, the treatment team’s plan is for a gradual increase in passes which will ultimately lead to overnight passes at her residence. This plan to “titrate” the passes is contingent on Mr. Cook continuing to return negative urine drug screens.
In response to questions from Mr. Schultz, Dr. Linthorst stated that prior to the suspension of passes, Mr. Cook had level six privileges which gave him full access to the community. Since the passes were suspended on March 17th, he has not had the opportunity to exercise any privileges. Dr. Linthorst stated that Mr. Cook denies that he has engaged in any substance use and suggested that the positive results were caused by his inhaler. When asked about the testing, Dr. Linthorst stated that the positive results were from immunoassay testing which is considered more accurate and more comprehensive than the rapid screens. As an example, Dr. Linthorst said that rapid screening has an accuracy of approximately 80 percent or one in five false positives or negatives. The immunoassay screening has an accuracy of about 95 percent or 1 in 20 false positives or false negatives. There is a more accurate and definitive testing which is available in the scientific community but not available to the hospital. Dr. Linthorst stated that in his opinion incidental contact would not result in the positive results which Mr. Cook has provided.
Dr. Linthorst stated that the Mental Health Act of Ontario would not be sufficient to manage Mr. Cook’s risk in the community. Dr. Linthorst stated that Mr. Cook has not demonstrated any decompensation to psychosis in any of the alleged substance use incidents.
Dr. Linthorst was asked if Mr. Cook were not under the jurisdiction of the Ontario Review Board would he voluntarily agree to continue with treatment. Dr. Linthorst said that it is possible that Mr. Cook would agree but that would depend upon his relationship with the treatment team. Dr. Linthorst stated it would depend on whether or not Mr. Cook perceived the treatment team as working towards the same goals as he had for himself. He added that notwithstanding how it might appear from the hospital report, he believed that the treatment team and Mr. Cook were both working towards his reintegration into the community, particularly his ability to live in the community with his wife. Dr. Linthorst reiterated that from May of 2025 until very recently Mr. Cook had made positive steps towards his reintegration.
Mr. Schultz asked in light of the three positive substance tests, why the hospital team were recommending an increase in privileges. Dr. Linthorst stated that he attributed the positive steps to a relapse in Mr. Cook’s substance use diagnosis. He said that slips of this kind are not unexpected and that in fact total abstinence for persons addicted to substances is the exception rather than the rule. With the acknowledgement that these were “slips” Dr. Linthorst said that Mr. Cook is at a “fork in the road” moving forward in his reintegration.
Mr. Schultz asked whether or not Mr. Cook’s changing exculpatory comments about his previous history should be taken into account in assessing his risk. Dr. Linthorst agreed that over time self-report does tend to change. He said that makes it difficult to weigh the importance of the explanations and agreed that the hospital should consider whether or not Mr. Cook is engaging in impression management. Dr. Linthorst stated that Mr. Cook is capable of making treatment decisions and has capacity to decline medications such as antipsychotics. The treatment team are not concerned that he refuses to continue taking Abilify after the change in diagnosis. This followed the change in diagnosis which he outlined at the commencement of his evidence with respect to the earlier finding of schizophrenia. Dr. Linthorst confirmed that it had been a longstanding goal of Mr. Cook to marry Ms. Cook and to ultimately reside with her in the community. The treatment team support Mr. Cook’s gradual transition to seven day passes to enable him to reside with Ms. Cook during the upcoming report year. Dr. Linthorst said there is no direct evidence that Mr. Cook has ever engaged in substance use with Ms. Cook. Finally, Dr. Linthorst said that Mr. Cook’s risk arises from his high PCL-R score combined with his substance use disorder.
In response to questions from Mr. Bird, Dr. Linthorst agreed that prior to the suspension of privileges, Mr. Cook was spending his full day passes in the community at Ms. Cook’s residence. In the absence of any positive UDS screens, Dr. Linthorst agreed that it was a natural progression to increase the length of the passes from 72 hours to seven days. Dr. Linthorst confirmed that Mr. Cook denies any substance which might result in the positive drug screens. Dr. Linthorst agreed that the specificity of the test used was about 95 percent which could lead to a 1:20 false positive or false negative. However, Dr. Linthorst stated that with two positive tests the odds of both being in error increase significantly and that with the third positive test it is a virtual certainty that Mr. Cook was using substances. Dr. Linthorst agreed that Mr. Cook did not demonstrate any psychosis in the time period that the tests were performed. He stated that Mr. Cook did become more irritable and had a number of increased scores of verbal aggression. Ms. Cook was asked about Mr. Cook’s substance use by the social worker and she denied both any knowledge of Mr. Cook’s use and any use of substances by herself.
Dr. Linthorst agreed that the intention of the treatment team is to move to one-week passes as a test towards Mr. Cook’s eventual reintegration to reside in the community. The purpose of the gradual increases is to mitigate the risk to the safety of the public. Mr. Bird asked if without the recent positive tests, the treatment team might have recommended a conditional discharge. Dr. Linthorst stated that a conditional discharge might eventually be the recommendation of the hospital but only after Mr. Cook has spent some time residing in the community under the restrictions of a detention order.
With respect to diagnosis, Dr. Linthorst stated that it remains PTSD by history and ASPD. Dr. Linthorst would not diagnosis any depression at this time. When asked by Mr. Bird as to the biggest concern of the treatment team with respect to risk, Dr. Linthorst stated that it is the combination of substance use plus the high PCL-R score which defined the risk.
Dr. Linthorst stated that Ms. Cook appears to be a positive influence for Mr. Cook which is why she has recently become an approved person. At this time, Mr. Cook takes his prescribed medication willingly. Until two months ago, Dr. Linthorst stated that he would have agreed that Mr. Cook presents as being stable in his mental status.
In response to questions from members of the Board, Dr. Linthorst stated that he had become Mr. Cook’s most responsible physician (“MRP”) six months ago. Dr. Linthorst was asked about Mr. Cook’s previous use of substances and earlier positive tests and stated that those are all documented in the hospital report from a time prior to his becoming the MRP. He reiterated that Mr. Cook has adamantly denied any substance use leading to the most recent positive tests. Dr. Linthorst stated that this denial was a risk factor in Mr. Cook moving forward to his full reintegration into the community. Once again, Dr. Linthorst stated that Mr. Cook was at a “fork in the road” with respect to his reintegration. During the time that Mr. Cook does have access to the community, Dr. Linthorst stated that he understands that goes to the YMCA or go shopping while he is out in the community. Most of the time he spends with his wife, Ms. Cook.
Once again, Dr. Linthorst stated that the primary risk represented by Mr. Cook is a result of the substance use and his ASPD. A Board member asked whether it was possible to test Mr. Cook on a random basis while he is in the community on a seven-day pass. Dr. Linthorst stated that at the present time the hospital does not have the ability to conduct random testing in the community while a patient is on an extended pass.
In response to questions from another Board member, Dr. Linthorst agreed that Mr. Cook has elevated scores on both the Violence Risk Appraisal Guide (“VRAG”) and PCL-R risk assessment tools. He stated that although the hospital report states that Mr. Cook is a moderate to high risk, in the event of substance use it would rise to a high risk. He stated that substance use is the leading indicator of risk. Dr. Linthorst stated that Mr. Cook agrees with the diagnosis of ASPD but not with a characterization of psychopathy. Dr. Linthorst stated that Mr. Cook does understand the supervision and monitoring requirements of someone with his diagnosis in reintegrating him into the community, but he does not agree with the need for the restrictions imposed by the hospital.
When asked if Mr. Cook had any insight into substance use, Dr. Linthorst stated that on the basis of the last several months his answer would be no. Dr. Linthorst was asked if Mr. Cook would likely agree to return to the hospital for urine drug screens if granted a seven-day pass. He stated that Mr. Cook has historically complied with the requests for UDS in the past.
Dr. Linthorst was asked a number of questions about the sequence of the urine drug screens which ultimately led to the decision to suspend Mr. Cook’s passes on March 17th, 2026. He stated that the three positive test results were from testing which took place on February 27th, March 2nd, and March 12th, 2026. A decision was made not to confront Mr. Cook with the initial positive test result from the February 27th test due to his elopement after a positive test result in June of 2025. Following the suspension of privileges, Mr. Cook has since tested negative on March 19th and March 24th, 2026. Those tests took place when Mr. Cook had only access to the exercise yard at the hospital. Dr. Linthorst acknowledged that there was at least one member of the treatment team that believed that all of the earlier tests represented false positive results.
Dr. Linthorst was asked directly by a Board member if any return to community privileges, including the proposed seven day passes to reside with Ms. Cook, was contingent or conditional on his acknowledging substance use. Dr. Linthorst stated that it was not but again at this “fork in the road” the treatment team would be highly vigilant with respect to any positive UDS results moving forward. Dr. Linthorst stated that if the proposed increase to seven- day passes was implemented and Mr. Cook demonstrated a successful reintegration into the community without any positive UDS results, then it was possible that he might move to a discharge from the hospital to the community in this reporting year under the terms of the proposed detention order.
Mr. Cook gave evidence on his own behalf. He asked that the Board not judge him on his past record but instead consider the efforts he has made to reintegrate himself into the community recently. He strongly denied that he had used any drugs which led to the positive test results. Mr. Cook said that if he used drugs, he would admit it. He also stated that when he used drugs he would typically go “all in” and there would be little doubt as to the fact that he had consumed some form of substance.
In response to questions from Mr. Bird, Mr. Cook stated that he has employment lined up at an automobile oil change facility in Brockville. He also acknowledged the attendance at the hearing of an Elder from the Church which he attends on a regular basis and where he engages in Bible studies. Mr. Cook stated that his sole focus now is to return to the community to spend time with his family.
Ms. Cook also gave evidence on behalf of Mr. Cook. She testified that Mr. Cook is working very hard to re-establish his life in the community and that in her opinion he would not do anything to jeopardize that opportunity. He stated that she has always wanted to “be on the team” in working towards what is best for Mr. Cook. Ms. Cook stated that she would not tolerate any substances present in her home and has made that clear to Mr. Cook. Ms. Cook stated that she has noticed a deterioration in Mr. Cook’s physical health since he has been restricted to the hospital following the positive substance results. Ms. Cook stated she is fully supportive of the proposed recommendation in the hospital report to increase the opportunity for Mr. Cook to spend time with her in the community. As an approved person, she agreed that she was prepared to act in Mr. Cook’s best interest in fulfilling that role.
No other evidence was presented.
Submissions of the Parties
Mr. Schultz was asked to lead off the submissions to the Board at the conclusion of the hearing in order to give both Dr. Linthorst and Mr. Bird the opportunity to respond to the position of the Attorney-General. Mr. Schultz stated that the Attorney-General was in support of the recommendation of the hospital with respect to the continuation of the detention with the amendment to permit seven day passes to the community. However, he submitted that if the seven-day passes were granted, then it would be necessary and appropriate for there to be a condition that Mr. Cook present himself to the hospital for the purposes of providing a UDS upon request by the hospital during the term of any such passes. Mr. Schultz submitted that it was clear from the record that Mr. Cook represented a significant threat to the safety of the public and that at this time the necessary and appropriate disposition was a detention order in order to protect the safety of the public as Mr. Cook reintegrated into the community. Dr. Linthorst agreed with the submissions of Mr. Schultz.
Mr. Bird also stated that this was a joint submission and that it provided Mr. Cook with the opportunity to move forward in his reintegration into the community. In particular, Mr. Bird noted that on the evidence of Dr. Linthorst, there was a realistic possibility that Mr. Cook would be discharged from the hospital to the community sometime in the next reporting year.
Analysis and Dispositions
- The threshold issue for the panel to determine is whether or not Mr. Cook continues to represent a significant threat to the safety of the public. The “significant threat” standard is an onerous one. There must be both a likelihood of a risk materializing and the likelihood that serious harm will occur. An accused is not to be detained based on mere speculation; the Board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the accused to deny them an absolute discharge. As set out in Winko (1999] 1999 CanLII 694 (SCC), 2 S.C.R. 625) the threat must be:
(1) More than speculative in nature and must be supported by the evidence;
(2) Significant in the sense of there being a real risk of physical or psychological harm to individuals in the community and in the sense that this potential harm must be serious; and
(3) The conduct creating the harm must be criminal in nature.
As stated by McLachlin, J. (as she then was) at para. 69
“it is for the court or Review Board, acting in an inquisitorial capacity, to investigate the situation prevailing at the time of the hearing and determine whether the accused poses a significant threat to the safety of the public. If the record does not permit it to conclude that the person constitutes such a threat, the court or Review Board is obliged to make an order for unconditional discharge.”
The Ontario Court of Appeal re-emphasized the onerous test in Re: Gibson 2022 ONCA 527, per Lauwers J.A. at para. 9:
“Huscroft J.A. said in Carrick (Re), 2015 ONCA 866, 128 O.R. (3d) 209, at para. 17, that “the ‘significant threat’ standard is an onerous one”. He added that “[t]he board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the appellant in order to deny him an absolute discharge.” Mere speculation is insufficient. See also, Sim (Re), 2020 ONCA 563, at paras. 63-65, per Strathy C.J.O., Marmolejo (Re), 2021 ONCA 130, 155 O.R. (3d) 185, per Tulloch J.A., at paras. 33-37”.
- At the outset of the hearing, the Board was presented with a joint submission from the parties that Mr. Cook continues to represent a significant threat to the safety of the public. The Board is obliged to consider the joint submission, but at the same time to make an independent assessment of the evidence with respect to the issue of significant threat. The Board is unanimous in finding that the joint submission of the parties is well supported by the evidence found in the hospital report and the oral evidence from the hearing. Mr. Cook has had a complex background and suffered significant trauma in his childhood. His criminal history speaks to Mr. Cook’s potential propensity for violence and risk to the safety of the community. The circumstances of the index offence alone and its historical roots are indicative of the level of risk Mr. Cook represents to the safety of the public. The hospital report contains significant details with respect to clinical assessments of the level of Mr. Cook’s risk along with the clinical observations of the treatment team. At page 131 of the hospital report the risk scenario is set out as follows:
“Based on this assessment, the most likely scenario(s) involving risk of violence would be Mr. Caron becoming destabilized related to acute stressors, interpersonal conflict causing emotional dysregulation, or relapsing back towards substance use (last positive UDS in 2024). In any of these scenarios, he might become disinhibited and behave in a manner similar in the past where he might attempt to harm his mother or other person towards whom he expresses a grievance (e.g., less likely but possibly wife, neighbour, or co-worker following acute on chronic conflicts). The manner would be most similar to the past instances of violence outlined by Dr. Bolton in her previous report. His most likely victim would be his mother due to longstanding animosity (see Index Offence), though in the past reporting period he does not report active thoughts of killing her. Any violent act, in my opinion, could feasibly extend to other individuals towards whom he has a strong enough grievance. This would be made more likely if occurring alongside sufficient destabilizers such as substance use, emotional dysregulation, or psychosocial stressors. Given the longstanding history between himself and his mother, however, there is significantly higher risk towards her.”
The Board unanimously finds that Mr. Cook represents a significant threat to the safety of the public.
Once a finding of significant threat is made, the obligation of the Board is to consider all the provisions of section 672.54 in drafting the necessary and appropriate Disposition. None of the parties to the hearing submitted that the Board should consider the possibility of a conditional discharge disposition. As set out in the hospital report, Mr. Cook continues to have several current dynamic and static risk factors for future violence outlined in the violent risk assessment. His score on the VRAG from 2025 placed him in BIN 9 out of 9 which is the 99th percentile. Persons who score in this category reoffended at the rate of 76 percent within five years and 90 percent within 15 years. Since static risk factors do not change from year to year, Mr. Cook remains at a high actuarial risk of reoffending.
However, with the exception of the positive urine drug screens in late February and early March of this year, Mr. Cook has demonstrated progress in his reintegration into the community. He has spent significant time in the community with his now wife, Ms. Cook, and up until March 17th, took full advantage of his available pass privileges. He does not demonstrate a clinical picture consistent with the former schizophrenia diagnosis. His symptoms of PTSD have been fully controlled throughout the reporting period. There has been no evidence of psychotic symptoms even with the complete cessation of antipsychotic medications. There have been no reports of any criminal activity or violence. Mr. Cook testified that he has been able to secure employment once he is able to exercise privileges in the community. Overall, Mr. Cook has had a positive year which resulted in the recommendation of the treatment team for an increase in his pass privileges to allow him up to seven days of overnight visits with his spouse.
Mr. Cook’s progress was interrupted by the loss of all privileges on March 17th, 2026. The decision to restrict his passes came after Mr. Cook had three consecutive positive UDS results on tests taken on February 27th, March 2nd, and March 12th, 2026. On the basis of these positive results for methamphetamines, the decision was made to suspend Mr. Cook’s privileges until April 8th, 2026. Since the suspension of privileges, Mr. Cook has provided two negative results for tests taken March 19th and March 24th, 2026. Mr. Cook denies using methamphetamine or any substance at the time of the UDS samples which returned positive results.
Dr. Linthorst candidly acknowledged that at least one member of the treatment team accepted Mr. Cook’s assertion that he had not consumed methamphetamine and that the results were false positives. However, Dr. Linthorst testified that the statistical likelihood of three consecutive false positives on the immunoassay test was unlikely and that it was “a virtual certainty” that the tests were accurate.
Notwithstanding the positive tests, Dr. Linthorst stated that the treatment team intended to move forward with the proposed increased privileges to gradually transition Mr. Cook back into the community. Initially this would be passes to permit him to stay for up to seven days with Ms. Cook. Dr. Linthorst agreed that it was possible that Mr. Cook might be discharged to reside in the community within this reporting year. However, the team will be closely monitoring Mr. Cook for substance use and his return to both passes and eventual discharge will be conditional on negative UDS screens.
The provisions of s.672.54 mandate that the “paramount consideration” for the Board in drafting a disposition is the safety of the public. The Board must also consider the mental condition of the accused and the reintegration of the accused into society. As set out above, Mr. Cook has made real progress in the past reporting year. Significantly, his mental status has been stable, even in the face of stressors such as an incident at his former place of employment, threats from former patients, the positive tests, and the resulting loss of privileges. There have been no incidents which have resulted in threats to the safety of the public. He has otherwise made full use of his privileges in an entirely appropriate manner. The Board is unanimous in finding that the necessary and appropriate disposition that is also the least onerous and restrictive is a continuation of the Detention Order with the increase in passes to seven days as recommended by the hospital.
In his evidence Dr. Linthorst testified that it is not administratively possible for the hospital to conduct UDS screening while Mr. Cook is on a seven-day pass in the community. The Board accepts that substance use is a major component of Mr. Cook’s risk. The three positive UDS results in March of this year cannot be ignored. Therefore, the Board is unanimous in ordering that Mr. Cook be required to return to the hospital, if directed to do so, during any extended pass for the purpose of providing a UDS sample.
Dated this 13th day of May, 2026, at the City of Toronto, in the Toronto Region.
Mr. G. Beasley
Alternate Chairperson
Office of the Registrar Ontario Review Board