Re: Brian Drepaul
ORB File No: 5845
Hearing held on: Wednesday, April 8, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Fromstein
Members: Hon. N. Kozloff
Dr. J. Kis
Dr. A. Kerry
Mr. S. Doherty
Parties Appearing:
Accused: Brian Drepaul
Counsel: Ms. A. Szigeti
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION
(Dated May 21, 2026)
Introduction
On April 11, 2011, Mr. Brian Drepaul was found not criminally responsible (“NCR”) on account of mental disorder, on charges of mischief - endanger life (x2), assault with a weapon (x2), and weapon dangerous, all contrary to the Criminal Code of Canada (“Criminal Code”).
Mr. Drepaul is subject to a Disposition of the Ontario Review Board (“the Board” and “ORB”), dated April 9, 2025, detaining him at the General Forensic Unit of the Centre for Addiction and Mental Health, Toronto, with conditions and privileges up to and including “to live in the community of the Greater Toronto Area in accommodation approved by the person in charge.” That Disposition was amended pursuant to an ORB Order dated May 30, 2025, rectifying the inadvertent failure to include a “refrain from contact and communication” clause.
On April 8, 2026, the Board convened a hearing at the Centre for Addiction and Mental Health (“CAMH”), hereinafter also referred to as the hospital, to conduct the annual review of the current Disposition.
Mr. Drepaul was not present at the hearing and was excused from attending by the Board. He was represented by counsel, Ms. A. Szigeti, who appeared at her request and with the permission of the Board by Zoom.
The issues to be decided at this hearing were whether Mr. Drepaul continues to represent a significant threat to the safety of the public, and, if so, what was the necessary and appropriate Disposition in the circumstances, having regard to the factors set out in s. 672.54 of the Criminal Code.
For the reasons set out below, the Board concluded that Mr. Drepaul continues to represent a significant threat to the safety of the public, and that the necessary and appropriate Disposition in the circumstances is that he be detained subject to the same terms and conditions as contained in the current Disposition.
Positions of the Parties
At the outset of the hearing the parties were invited to provide their initial without prejudice positions.
Counsel for the hospital submitted that Mr. Drepaul continues to pose a significant threat to the safety of the public, and, that a continuation of the current detention order on the same terms and conditions as the current disposition is the necessary and appropriate, least onerous and least restrictive disposition to protect the public in the circumstances.
Counsel for the Attorney General supported the hospital position.
Counsel for Mr. Drepaul stated that she was also in support of the continuation of the current Disposition, which effectively created a joint submission for the status quo.
The Evidence
- The evidence at the hearing included the Hospital Report dated March 24, 2026, (Exhibit 1) and the testimony of Dr. A. Igoumenou.
Personal Background
- Mr. Drepaul’s personal history is chronicled in considerable detail in the Hospital Report. The relevant details are well summarized in last year’s Reasons for Disposition and set out below:
“Briefly summarized, Mr. Drepaul is currently 51 years of age and was born in Guyana. He came to Canada in 1983 when he was 9 years old. He lived with both of his parents throughout his childhood.
Mr. Drepaul has two brothers and a sister. One of his brothers has schizophrenia and resides in the GTA. His other brother has been deported to Guyana, apparently on account of not having Canadian citizenship and having accrued a significant criminal record involving break and enters and drug dealing.
Mr. Drepaul is a Canadian citizen. He enjoys a close relationship with his mother who has been actively involved with him and ensures that he makes it to his medical appointments and attends at the Brampton outpatient clinic for his long-acting antipsychotic injection. His father passed away in 2003.
Mr. Drepaul dropped out of high school in Grade 9. From the time he was 17, he worked as a hardwood floor sander/varnisher. He also worked at a Chrysler Plant as an industrial cleaner. More recently, while residing in the community, Mr. Drepaul worked as a furniture mover on occasion. He is now financially supported by ODSP.
Mr. Drepaul was married in March 1993. He has two teenaged daughters from this union. In addition, his wife had a daughter from a previous relationship who Mr. Drepaul helped raise from infancy. After he and his wife separated in approximately 2002, he played an active role in rearing all three children. At the time of his arrest for the index offences, two of the children were living with him.
Mr. Drepaul’s relationship with his wife became negatively affected by his experiences of paranoia. He was always suspicious that his wife was having an affair. The relationship ended after Mr. Drepaul picked up a knife and demanded to know whether his wife was cheating on him. Mr. Drepaul maintains relationships with his ex-wife and his three children.
With respect to substance use, Mr. Drepaul has used cannabis since he was 15 years old and continues to use to this day. The frequency of his use is unclear as his own accounts will vary. He has previously failed to follow through with substance use programming. He does not regard his cannabis use as problematic; he has identified it as being an important element in his adherence to Rastafarianism.”
Psychiatric History
- The relevant details concerning Mr. Drepaul’s psychiatric history are excerpted from the Hospital Report:
“Mr. Drepaul was diagnosed with schizophrenia, paranoid subtype in 1996. Early symptoms of illness emerged in 1995: these included persecutory ideation, suspicions that his wife was cheating on him, suspecting that people could see him through the television, thought broadcasting and a belief that life forces were being transmitted through light in the form of rays similar to x-rays and that these rays were influencing his mind and body. Later in his illness, he went on to hear voices which did not tell him to hurt himself or anyone else, but which were critical of him.
Following the incident where Mr. Drepaul grabbed a knife in front of his wife and accused her of infidelity, he was admitted to METFORS in 1999 and was psychotic at the time. When police arrived on the scene, he refused to drop the knife, a refusal he later said was driven by the hope that the police would shoot him. They in fact did shoot him in the leg. As a result of the ensuing admission to METFORS, he appears to have developed the paranoid belief that the METFORS staff caused permanent alteration to his facial features.
Mr. Drepaul was treated with Risperidone from the outset of his illness with good effect. He has been admitted to hospital approximately five times with care on most occasions provided by the Peel Memorial Hospital in Brampton. From the outset of his illness, outpatient care has been provided by community psychiatrist, Dr. Acharyya.
Mr. Drepaul’s mother reported past instances of noncompliance with medication, estimating that he has stopped his Risperidone on about “five or six occasions.” She explained that he unplugs everything in his apartment and turns off all the lights whenever he has stopped his medication. She also said that he would turn furniture upside down and break mirrors because he did not want to look at himself. She recalled that he had stopped his medication in 2010, prior to the index offences.”
Index Offences
- The circumstances giving rise to the Index Offences are set out in the Hospital Report, as follows:
“Counts 1 & 2, both Mischief Endangering Life
On Tuesday June 29, 2010, at approximately 7:00 am the witness, Cameron Beattie was in his residence at K[…] Road, Brampton. At this time, he heard a loud crash outside his unit and went outside and found an air conditioner unit in his ground floor enclosed backyard.
At approximately 11:30am the witness heard another similar crashing sound from outside again as another air conditioner unit was thrown out from above. This time witness Catherine Beattie saw the accused, Brian Drepaul, looking over his seventh-floor balcony and asked him if he threw the A/C unit over his balcony to which the accused responded “yes.”
At 11:50am police were called and arrived at 11:54am.
At approximately 12:00pm the accused was apprehended under the Mental Health Act as his behaviour indicated he was a danger to people around him. He was subsequently transported to Brampton Civic Hospital for psychiatric examination.
At 2:52pm at Brampton Civic Hospital the accused was arrested for mischief endangering life contrary to section 430(2) of the Criminal Code of Canada.
Count 4: Weapons Dangerous
Count 6: Assault with a Weapon
Count 8: Assault with a Weapon
On Tuesday June 29, 2010, at 11:50am police were called to K[…] Rd, Brampton in response to a male party wielding a hammer and making threats. Drepaul was in a very agitated state. He refused orders from police to drop the weapons in his hands. He crossed K[…] Ave. He enticed officers, yelling at them to shoot him and lunged at officers.
Drepaul struck Cst. Michael Devilin at least once to his left upper arm with the red metal pole and scratched his right chin area. Cst Devlin suffered minor abrasions to his right chin area as a result of the assault. Drepaul struck Cst Brandon Krane 3 to 4 times on his left forearm with the red metal pole. Cst Krane suffered minor abrasions, cuts and bruising along his left forearm.”
Offence(s) Subsequent to the Index Offence
- The circumstances surrounding an incident that took place in February 2025 are set out in last year’s Reasons for Disposition under the sub-heading “Evidence at the Hearing”:
“On February 24, 2025, the hospital was informed that Mr. Drepaul had been charged with choking his daughter while she was at his apartment. He was arrested, charged and taken to the station where he was processed. Mr. Drepaul contacted his case manager to report the charge and was then brought to hospital emergency.
With respect to the incident leading to the criminal charge, Dr. Igoumenou testified that Mr. Drepaul reported that he had had several calls with his daughter Monica that day, that she was irritable and verbally abusive with him and that she wanted to come to his apartment to pick up her cats which she did so at 9:00 p.m. that night. Mr. Drepaul was with his brother. After collecting her cats, Monica would not leave and Mr. Drepaul claims that there was a physical altercation to get her out, and that following this, she contacted the police.
Dr. Igoumenou maintains that the decision to bring Mr. Drepaul in was the least onerous decision to deal with the heightened risk brought about by this incident and the fact that Mr. Drepaul was presenting with some psychotic symptoms. The hospital is still trying to address those symptoms and optimize medication, as well as to assess him without cannabis use. Mr. Drepaul has been using cannabis on a very regular basis and the hospital believes that it does impact his mental health.”
Diagnoses
- Mr. Drepaul’s ’s diagnoses are set out in the Hospital Report as follows:
“Schizophrenia, in partial remission
Mr. Drepaul experiences positive symptoms of his condition despite treatment compliance. When non-compliant and acutely unwell, Mr. Drepaul becomes paranoid and agitated, and also experiences auditory and olfactory hallucinations, which have caused him to behave in ways that have seriously compromised public safety. When compliant with medication, these symptoms are reduced.
Cannabis Use Disorder
Mr. Drepaul’s ongoing positive psychotic symptomatology is partially attributable to his daily chronic cannabis use, and without changes in his cannabis consumption, he is likely to continue to experience residual psychotic symptoms. An increase in cannabis use could precipitate a deterioration of his mental state, even with medication compliance, resulting in an acute elevation in risk of violence.”
Course Since the Current Disposition
- Mr. Drepaul’s course since the finding of NCR is set out in considerable detail in the Hospital Report. For the purposes of these reasons, relevant excerpts from his most recent course (since the making of the current disposition) are reproduced here:
“CAMH: LGUA B and FOPS March 2025 to March 2026
Mr. Drepaul was inpatient on Forensic General Unit B until his discharge to the community on July 27, 2025. Since then, he remained an outpatient under the care of Dr. Igoumenou (psychiatrist) and Laticia DiBernardo (Case Manager). He resided at his Peel Living apartment in Brampton.
Course on Forensic General Unit B
Mr. Drepaul continued to evidence residual symptoms of schizophrenia. Specifically somatic delusions. The auditory hallucinations and referential delusions were not prominent. Additionally, he did not incorporate individuals in his proximity into his delusions.
He maintained clinical stability on FGUB and adhered to the every 12-week long-acting injectable form of paliperidone; he attended the outpatient clinic to receive his injections.
Mr. Drepaul also attended psychotherapeutic programs within the hospital's therapeutic neighbourhood and began 1:1 counselling.
Apart from his daughter, Monika, he maintained contact with his family.
He also attended to his activities of daily living independently.
There were no concerns around substance use or absconding events. As well, there were no episodes of violence or self-harm during the hospitalization. The week prior to discharge, he utilized an overnight pass to attend his residence with no concerns.
Course in the community with FOPS input
Since being discharged to the community in July 2025, Mr. Drepaul remained an outpatient, received support from FOPS, and continued individual and group therapy. He met with his psychiatrist at least monthly and with his Case Manager twice a month. There have been no incidents of aggression or violence. He complied with prescribed medications. He continued smoking cannabis.
Mental health summary
Mr. Drepaul continued to have poor insight into his mental illness, his need for ongoing treatment, and the impact of his cannabis use on his mental state. At times, he would acknowledge having schizophrenia and at times comment that he is not mentally ill. He continued experiencing delusions about psychiatry and how it had altered his physical appearance.
During his latest inpatient admission, he attended the CBT and DBT programs offered, to address interpersonal issues, specifically coping with stress and boundaries with family members. Since his discharge from hospital, he continued to attend FORCAT individual sessions and the IMR group. Originally, he attended individual therapy weekly, and starting in February 2026, attended on a biweekly basis. There has been positive feedback with his participation in the group and attending individual sessions with FORCAT therapist.
Substance use summary
Mr. Drepaul resumed cannabis use immediately after his discharge from FGUB. He continued to use cannabis daily. He has been open about his cannabis use with the team. At times, he has tried to reduce his consumption.
Social and family support summary
Mr. Drepaul generally has the support of his mother, children, and grandchildren. Mr. Drepaul played an important role in his family by providing emotional support to his daughters and grandchildren.
Overall strengths
Mr. Drepaul continued to participate in FORCAT individual sessions and the IMR group since his discharge from hospital.
The family provides collateral information and collaborates well with the team.
Mr. Drepaul values his role in supporting his family (grandchildren, children, and mother).
Salient challenges
Mr. Drepaul has no interest in stopping cannabis.
Mr. Drepaul has limited insight into his illness, the need for ongoing treatment, the impact of cannabis use on his mental state, and related risks.
Mr. Drepaul wants to have contact with his daughter Monika. The team wants to support a healthy relationship with his daughter but also ensure there are no safety concerns.
Emerging treatment goals
Mr. Drepaul will continue to attend individual sessions with FORCAT and attend the IMR group to address coping with stress and self-control.
The team will work on a plan with Mr. Drepaul to support having a relationship with his daughter Monika, and to ensure there are no safety concerns.”
Risk
- The details concerning Mr. Drepaul’s risk assessment and risk management are set out in the Hospital Report. The following excerpts summarize the opinion of the clinical team:
“Risk Assessment
The following Historical Items were deemed present and relevant: history of problems with violence, other antisocial behaviour, relationships, employment, substance use, major mental disorder, traumatic experiences, violent attitudes, and treatment or supervision response.
The following Clinical Items were present and relevant: recent problems with insight, symptoms of a major mental disorder, instability, and treatment or supervision response. Additionally, violent ideation or intent was deemed possibly/partially present. All Clinical Items were deemed highly relevant.
In the context of living in the community with the recommended disposition, Risk Management Items were deemed present and highly relevant: future problems with treatment or supervision response, and with stress or coping. Additionally, future problems with personal support are possibly/partially present and of high relevance.
Clinical Risk Factors/Risk Management
Major Mental Illness
Mr. Drepaul has a diagnosis of schizophrenia. Mr. Drepaul needs to take antipsychotic medication in perpetuity. This should continue to be administered in long-acting injectable format, on account of the multiple past occasions in which Mr. Drepaul’s noncompliance with oral medication led to psychotic deteriorations.
Cannabis Use Disorder
Mr. Drepaul continues to opine that he has a right to continue using cannabis and that cannabis is therapeutic, in contrast to the team’s opinion that cannabis use is exacerbating his schizophrenic illness and, in conjunction, his risk of violence. His team requires the ability to monitor his recreational substance use through urine drug screening. The team will also attempt to provide ongoing education about the risks associated with cannabis use, in the hopes of improving his insight and motivation to modify his cannabis use. Mr. Drepaul’s risk of violence is best managed by abstinence from cannabis and other recreational substances (in combination with antipsychotic medications) in perpetuity.
Lack of Insight
Mr. Drepaul’s insight into his schizophrenic illness is partial at best. Throughout this reporting period, he has expressed a belief that his symptoms are not psychotic in nature hence not part of a psychotic illness or require antipsychotic treatment. His compliance with long-acting antipsychotic medication is due to external controls and monitoring. Similarly, he has poor insight into the negative impact of cannabis use on his mental state.
Stress
Mr. Drepaul is often subject to a considerable degree of stress due to his financial situation and relationships with family members. During the current reporting period, Mr. Drepaul has faced additional stress in the form of ongoing conflict with his daughter, who resided in his apartment till November 2024, and who was the victim of the latest incident dated February 24, 2025. Psychosocial stress is a risk factor for psychotic relapses, and increasing substance use as a means of coping. The team will continue to support Mr. Drepaul in managing stress and using alternative coping skills (rather than using cannabis).
In risk assessment, one of the best predictors is a patient’s history of violence. Mr. Drepaul’s history of violence spans many decades and includes threatening use of a knife in front of his wife in 1999, the index offences, and physical altercations with his daughter in more recent years.
Housing
Given Mr. Drepaul’s history of psychiatric instability in response to stressors related to his housing and family relationships, having suitable living arrangements is essential to his psychiatric stability and risk management plan. This is particularly pertinent over the upcoming reporting period, given Mr. Drepaul’s latest charges involving his daughter and his most recent admission to CAMH, but also his mother’s recent move to the same building as Mr. Drepaul’s daughter, Monika Drepaul. As such, the treatment team requires the ongoing ability to assess the suitability of his living situation, provide approval for suitable living arrangements, and intervene if his living environment becomes risk-enhancing.
Re-Offence Scenario
If Mr. Drepaul were to re-offend, it would likely flow from some combination of ongoing use of cannabis in the context of either under-treatment or non-compliance with antipsychotic medication. If Mr. Drepaul were not subject to external controls, he would likely stop antipsychotic medication and continue to use cannabis, as has been his stated preference throughout this reporting period. He would become increasingly psychotic and agitated, resulting in an elevated risk of violent behaviour towards others, as has been the case for him in the past.
Composite Assessment of Risk
Mr. Drepaul continues to pose a significant risk to the safety of the public, for the reasons explained above in the Re-offence scenario.”
Team Review of Recommendation
- The recommendation of the clinical team is set out in the Hospital Report:
“Team Review of Recommendation
The clinical team is of the opinion that Mr. Drepaul continues to represent a significant threat to the safety of the public, and as such is not a candidate for consideration of an absolute discharge.
Mr. Drepaul’s relative stability is predicated on his compliance with psychiatric medication. His insight into his illness and need for treatment adherence is partial at best. If he were no longer under the supervision of the ORB, it is likely that he would become non-adherent with medication and may also use increasing amounts of recreational substances. When sub-optimally treated, his illness is subject to the emergence of increased symptoms, such as irritability, paranoia, and perceptual disturbances, which increase his risk of violence towards others.
It is the opinion of the treatment team that Mr. Drepaul’s relative clinical stability over the past year has been a direct result of the team’s ability to monitor and manage him under a Detention Order, and that his current disposition is the least onerous and least restrictive disposition to manage his risk in the community. A continuation of his current disposition will ensure that the team can adequately monitor his clinical status in the community and intervene rapidly and appropriately if his risk of violence is increasing. It is also imperative that the team be able to assess the suitability of his living situation, provide approval for suitable living arrangements, and intervene if his living environment becomes risk-enhancing.”
- Mr. Drepaul’s request is also set out in the Hospital Report:
“Patient’s Request
Mr. Drepaul wishes to disengage from the forensic psychiatric system, stop taking antipsychotic medication, and use cannabis as he desires.”
Evidence at the Hearing
Dr. A. Igoumenou testified at the hearing. He is a Forensic Psychiatrist in the Forensic Service at CAMH and one of the authors of the Hospital Report.
Asked for any updates to the Hospital Report, he advised that Mr. Drepaul has recently been in contact with his daughter Monika twice, initially when he was helping his mother move to new accommodation and subsequently when the family had Easter dinner together. (Note: These contacts were in breach of para. 4(d) of the current disposition which orders that he “refrain from contact or communication with daughter, Monika Drepaul, without the approval of the person in charge.”)
Dr. Igoumenou explained that Mr. Drepaul had volunteered the information about his first contact with Monika “to us yesterday.” (He had previously told his psychologist about the other meeting.) Mr. Drepaul reported that he had a verbal altercation with his daughter when he raised his voice to his mother, and Monika interrupted him and told him not to speak to his mother that way. There were no incidents at the Easter dinner. The doctor added that Mr. Drepaul knew the meetings were in violation of his Disposition.
Regarding the ongoing necessity of that “no contact” condition, Dr. Igoumenou advised that it was “necessary for the time being” to give the hospital the opportunity to assess and assist with the reconciliation between Mr. Drepaul and Monika.
Regarding housing, Mr. Drepaul is being evicted from his residence. The process began in the summer of 2025 after Peel Housing learned that Mr. Drepaul had been permitting his daughter and his brother to live there without authorization and increased his rent to full price following a court hearing. The CAMH team and Mr. Drepaul’s case manager appealed but a decision in April 2026 confirmed the loss of his rent subsidy. He now owes over $6000 in back rent and his eviction is apparently set for May although he had received nothing in writing as of the time of this hearing.
The team met with Mr. Drepaul on the day prior to the Board hearing to discuss his housing options. Mr. Drepaul wants to stay in Brampton to be close to his family. The team has referred him to SHIP which offers 24-hour support; a bachelor flat will be coming available in the next month or so and Mr. Drepaul’s name is first on the wait list so it is hoped this issue will resolve albeit the arrears he has incurred and the additional cost of his new rent.
Regarding Mr. Drepaul’s mental state, his medication helps him have partial remission. He continues to have somatic delusions but is less paranoid than he would be without it. He has continued to use cannabis since his discharge in July of 2025: all his UDS results have been positive, and he acknowledges daily use with no plans to stop.
Dr. Igoumenou opined that his cannabis use negatively impacts Mr. Drepaul’s mental status which he noted has declined since he resumed using following his release in July 2025 after six months as an inpatient at CAMH. While in hospital Mr. Drepaul’s symptoms had lessened. He was less preoccupied and less disturbed by them.
Mr. Drepaul has maintained engagement with therapeutic programming. While an inpatient in 2025 he received both DBT and CBT, and he has continued with individual therapy since his discharge. He also attends a recovery group and although his attendance has recently deteriorated, he says he will continue to attend and complete it. Dr. Igoumenou indicated this was a first for Mr. Drepaul and to his credit.
The focus for the year to come will include encouraging Mr. Drepaul to take his long-term injectable medication which he receives 4 times annually and which he is not internally motivated to take but does take because of the ORB and pressure from his family. The team will also continue to address his insight. His one-to-one therapy sessions are a very important aspect of his treatment, focussing on the management of his illness, his cannabis use, and his relationships and how stress impacts on them.
Regarding the strength of the cannabis he uses and the frequency of his use, Mr. Drepaul has reported that he purchases his cannabis from dispensaries and that he has tried to cut down on the frequency of his use from daily use to about 3 times per week currently.
Regarding emergent treatment goals, the team will attempt to support his relationship with daughter Monika.
Asked what observable stress management skills Mr. Drepaul has learned, Dr. Igoumenou cited how he used his skills to manage the stress of dealing with the laborious LTB and appeal court processes, including the multitude of documents he had to supply and the good communication he had with his case manager.
The doctor reiterated that Mr. Drepaul is open to moving to his new SHIP accommodation which will provide him with 24/7 support and allow him to live in close proximity to his family.
Asked what Mr. Drepaul does with his time Dr. Igoumenou replied, “Not much.” He spends time with his family supporting his mom and likes to look after his grandchildren. He attends the outpatient clinic once every 2 weeks for group and one-on-one therapy and sees his case manager every 3 to 4 weeks.
Mr. Drepaul is transparent about his cannabis use, which he enjoys and which he believes is his right notwithstanding it is in breach of the abstention clause in his Disposition. The concern of the team is that Mr. Drepaul is passionate and has a short fuse and cannabis can increase his predisposition to respond with aggression and violence. The doctor also noted that Mr. Drepaul has residual symptoms of psychosis despite being medicated.
Dr, Igoumenou acknowledged that his cannabis use is a violent risk factor. However, hospitalizing Mr. Drepaul for breaching his abstention clause would only manage the risk while he is an inpatient and he can’t be an inpatient for life. Thus, it remains an unmanaged risk factor for violent behaviour. The Board will have to consider whether to retain or remove the abstention clause. The doctor is not recommending removal of the clause as it allows the team to monitor his use and discuss it with him.
When it was put to him that increased reporting would allow the team to more closely monitor the impact of his cannabis use even if it won’t deter him from using, the doctor replied that the team does not follow a schedule. Mr. Drepaul is seen by the doctor and by his case manager and while attending at group programming and one-on-one counselling. The team will see him more frequently if the Board so directs but Mr. Drepaul remains fixated on his cannabis use.
Mr. Drepaul’s counsel observed that he was hospitalized for 5 months in 2025 and that he has been reasonably stable since his discharge, including participation in group programming and one-on-one counselling, that residing in the community is very important to him, and that it was up to the Board to consider the removal of the cannabis prohibition while leaving the UDS testing provision in place so that he could still be effectively monitored.
Regarding the efficacy of an increase in reporting frequency on his cannabis use, Dr. Igoumenou replied that his cannabis use is not dependent on how often he reports. While the current Disposition requires that he report “as requested but not less than once every 3 months” Mr. Drepaul reports every 3 to 4 weeks and sees his case manager 3 times per month. The doctor observed that more frequent reporting did not deter his cannabis use in the past and will not deter him now: he has been breaching the abstinence clause for 10 years.
It was put to the doctor that there is an apparent pattern of rule-breaking by Mr. Drepaul that includes not just breaching his abstinence clause, but also the violation of his lease agreement and the breach of the no contact clause. The doctor explained that following the allegation of choking his daughter, Mr. Drepaul moved out of the apartment to his mother’s residence leaving his daughter there, and that his brother moved in while he was hospitalized. Mr. Drepaul had explained that he could not have predicted that Monika would be there when his mother moved but chose not to leave when she was, that at the Easter dinner everything went well, and that family gives him strength.
The doctor also noted that Mr. Drepaul is on ODSP and that he can work as he did in the past moving furniture but apparently chooses not to.
Dr. Igoumenou acknowledged that if Mr. Drepaul moves to the SHIP accommodation, he will be expected not to use cannabis at the residence and may face eviction if he does use.
A change of his medication to Clozapine was discussed with Mr. Drepaul while he was an inpatient. He was not interested which ended the conversation as it is taken orally and he must be committed.
Because his mother and his daughter Monika now live in the same building it has been made clear to Mr. Drepaul that he is not to meet with her and that if he is at his mother’s and Monika attends, he is to leave.
When it was put to him that increased reporting would allow the team to more closely monitor the impact of his cannabis use even if it won’t deter him from using, the doctor replied that the team does not follow a schedule: Mr. Drepaul is seen by the doctor and his by his case manager and while attending at group and one-on-one programming. The team will see him more frequently if the Board directs that, but Mr. Drepaul remains fixated on his cannabis use.
Final Submissions
Counsel for the hospital noted that this has been a challenging year for Mr. Drepaul and that there are issues - housing including the likelihood of eviction and a move to a new residence in particular - that will require careful close monitoring by the team. The disposition must address Mr. Drepaul’s current circumstances including his substance use, housing issues, and relationship with his daughter. During the past 5 years under Board supervision, he has been readmitted to hospital on 4 occasions with increases in duration of stay each time. At the same time, Mr. Drepaul is now engaged in group programming and one-on-one counselling and sees his doctor monthly and his case manager more often. The team knows him and the markers that impact his risk, and is alert to respond when he refuses his medication or fails to attend for appointments. A detention order remains necessary and appropriate for the hospital to have the ability to oversee housing and ensure it is appropriate to meet his needs and to rapidly readmit him as in February 2025 should that be necessary. She requested a change in the reporting condition to “as requested, but not less than once per month.”
Counsel for the Attorney General adopted the hospital submissions including the increased frequency in reporting. He submitted that more frequent monitoring is required given his track record of readmissions and the detrimental effects of chronic cannabis use on his mental stability. The abstinence clause should be retained to give the team an option to address it should that becomes necessary.
Counsel for Mr. Drepaul advised that she had no instructions regarding the proposal for an increase in the frequency of reporting, while observing that Mr. Drepaul is currently seen and monitored more frequently that once every 3 months. She commended the hospital team for its approach to his management, asserted that his candidness regarding substance use is a positive, and suggested that removing the abstention clause would bring his Disposition in line with the reality of his use.
Analysis and Conclusions
Significant Threat
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. Igoumenou in addition to the Hospital Report and other documentary evidence before us. We note that the issue was not in dispute at this hearing.
On the totality of that evidence, the Board is unanimous in finding that Mr. Drepaul remains a significant threat to the safety of the public.
Mr. Drepaul suffers from a major mental illness – Schizophrenia – which is only in partial remission due to ongoing symptoms. Mr. Drepaul has minimal insight into his major mental illness and has repeatedly stated that he would stop taking treatment if not required to do so by his Disposition.
He needs to take antipsychotic medication in perpetuity. It should continue to be administered in long-acting injectable format, on account of the multiple past occasions in which Mr. Drepaul’s noncompliance with oral medication led to psychotic deteriorations.
Mr. Drepaul is also diagnosed with Cannabis Use Disorder. He continues to opine that he has a right to continue using cannabis and that cannabis is therapeutic, in contrast to the team’s opinion that cannabis use is exacerbating his schizophrenic illness and, in conjunction, his risk of violence. His team requires the ability to monitor his recreational substance use through urine drug screening, associated with cannabis use, in the hopes of improving his insight and motivation to modify his cannabis use.
Mr. Drepaul has been involved in incidents of verbal and physical aggression since the index offences. An incident in 2025 involving his daughter Monica resulted in a criminal charge against him, and there was a subsequent verbal altercation between them at Easter.
Mr. Drepaul’s risk of violence is best managed by abstinence from cannabis and other recreational substances (in combination with antipsychotic medications) in perpetuity. The team will also attempt to provide ongoing education about the risks associated with cannabis use, in the hopes of improving his insight and motivation to modify his cannabis use. Mr. Drepaul’s risk of violence is best managed by abstinence from cannabis and other recreational substances (in combination with antipsychotic medications) in perpetuity.
Necessary and Appropriate Disposition
In light of our finding of significant threat, the Board must determine a Disposition for the coming year. In doing so, our paramount consideration must be the safety of the public, but we must also take into account the needs of Mr. Drepaul pursuant to s. 672.54 of the Criminal Code.
We reiterate what was opined by the authors of the Hospital Report in the Team Review of Recommendation, which opinion we accept and upon which we rely:
“It is the opinion of the treatment team that Mr. Drepaul’s relative clinical stability over the past year has been a direct result of the team’s ability to monitor and manage him under a Detention Order, and that his current disposition is the least onerous and least restrictive disposition to manage his risk in the community. A continuation of his current disposition will ensure that the team can adequately monitor his clinical status in the community and intervene rapidly and appropriately if his risk of violence is increasing. It is also imperative that the team be able to assess the suitability of his living situation, provide approval for suitable living arrangements, and intervene if his living environment becomes risk-enhancing.”
- Accordingly, the Board is unanimous in accepting the hospital’s recommendation and in finding that the necessary and appropriate, least onerous and least restrictive Disposition to effectively manage the risk posed by Mr. Drepaul to the public while still meeting his needs is the existing Detention Order Disposition subject to a variation increasing the reporting requirement - condition 4(f) - from “as requested, but not less than once every three months” to “as requested, but not less than once per month.”
DATED this 21^st^ day of May, 2026, at the City of Toronto, in the Region of Toronto.
Hon. N. Kozloff
Legal Member
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Office of the Registrar
Ontario Review Board