Re: Gavin Bowles, 2026 CanLII 48368

Re: Gavin Bowles

ORB File No: 6477

Hearing held on: Tuesday April 14, 2026

Place of hearing: Waypoint Centre for Mental Health Care (Via Zoom)

Pursuant to: Section 672.81(2.1) of the Criminal Code

Before: Alternate Chairperson: Mr. D. Sandor Members: Dr. P. Prendergast Dr. G. Nexhipi Ms. M. den Haan Mr. A. Mete

Parties Appearing: Accused: Gavin Bowles Counsel: Ms. C. Francis Person in charge of Hospital: Counsel: Mr. J. Thomson Attorney General of Ontario: Counsel: Ms. K. Staats

REASONS FOR DECISION

(Dated May 13, 2026)

Introduction:

1On January 29, 2014, Gavin Byron Bowles was found not criminally responsible on account of mental disorder on a charge of assault with a weapon, contrary to the provisions of the Criminal Code of Canada. Mr. Bowles is currently subject to a Disposition of the Ontario Review Board, dated November 5, 2025, detaining him at the High Secure Provincial Forensic Program of the Waypoint Centre for Mental Health Care (hereinafter referred to as “the Hospital”). That Disposition grants Mr. Bowles privileges up to and including that of being permitted by the person in charge to exercise hospital and grounds privileges, beyond the Hospital’s secure perimeter, escorted by staff.

2On March 5, 2026, the Ontario Review Board received notice from the Hospital, pursuant to section 672.56(2) of the Criminal Code, that Mr. Bowles’ entered seclusion on February 25, 2026, and had been in that state for a period exceeding 7 days. The Board convened a hearing on April 14, 2026, via Zoom audio-visual technology to review the restriction of Mr. Bowles’ liberty, pursuant to the provisions of section 672.81(2.1) of the Criminal Code. Mr. Bowles by that time had been released from seclusion and chose not to attend the hearing. His lawyer, Ms. Francis, was sufficiently instructed to proceed in his absence. Leave to do so was granted pursuant to section 672.5(1) of the Criminal Code. An order appointing Ms. Francis as counsel for Mr. Bowles was also granted, pursuant to section 672.5(8) of the Criminal Code.

3The record for the hearing included the following documents:

• The Notice of Hearing
• The 672.56(2) Notice of Restriction of Liberty (mentioned above)
• The Board’s response to that Notice of Restriction of Liberty
• The most recent Disposition (also noted above)
• The Reasons for that Disposition
• A Hospital Report dated August 20, 2025.

On the consent of all parties, a Restriction of Liberty Hearing Report dated March 30, 2026, was entered into evidence as Exhibit 1.

4The parties were canvassed for their initial positions. All agreed that Mr. Bowles had experienced a restriction of his liberty from February 25, 2026, through to March 18, 2026, when he was released from seclusion. Counsel for the Hospital took the position that the restriction was justified and necessary and represented the least onerous and least restrictive option available to the Hospital at the time undertaken. Counsel for the Hospital maintained that the restriction continued to be justified and necessary and to represent the least restrictive option available to the Hospital under the circumstances.

5Ms. Staats, lawyer from the Crown Attorney’s office representing the Attorney General agreed with the Hospital’s submission.

6Ms. Francis, for Mr. Bowles, expressed the position that her client’s restriction of liberty did not represent the least onerous and least restrictive option available to the Hospital at the time initiated. She expressed her client’s position that the Hospital’s alleged failure to utilize stepdown procedures would have helped stem the onset of hallucinations in the form of attacking shadow spirits such that Mr. Bowles’ period in seclusion would have ended sooner than March 18, 2026. She explained her client’s position that his delusional experiences were caused by the seclusion and that, had staff de-escalated him “properly,” the delusions would either not have had the chance to take hold or would have been briefer in duration.

7For the following reasons, the Board agrees that Mr. Bowles experienced a restriction of liberty when placed in seclusion for a period exceeding 7 days. The Board has concluded that the restriction was justified and necessary at the time initiated, given the rapid deterioration of symptoms experienced by Mr. Bowles and the efforts made by the Hospital to manage the risk he was posing to staff, himself and others. The Board has further concluded that the restriction continued to be necessary and appropriate and to represent the least onerous and least restrictive option available to the Hospital through to March 18, 2026. In this regard we note the Hospital’s attention to practices associated with seclusion relief and the review of the decision to seclude that they employed throughout the period in question.

Evidence at the Hearing

8The evidence for the hearing came from the Restriction of Liberty Hearing Report and from the viva voce evidence offered by Dr. C. Hudson, Mr. Bowles’ treating psychiatrist. The Board was also mindful of important contextual considerations found in the most recent Reasons for Disposition. To summarize, Mr. Bowles has a significant history of violence as evidenced by a lengthy criminal record that includes assaults, weapons charges and the index offence of attempted assault with a weapon. He struggles with schizophrenia, polysubstance abuse (in sustained remission in a controlled environment) and anti-social personality disorder.

9While Mr. Bowles is highly intelligent, he has experienced longstanding emotional and interpersonal difficulties. His major mental illness is refractory, and he continues to wait on important treatments that, to the date of this hearing, have still not been provided by the Hospital. The importance of this factor cannot be understated and warrants a repeating of what the last panel indicated in its Reasons for Disposition:

45. …Mr. Bowles’ somatic delusions regarding traditional methods have been a significant barrier to his acceptance of this potentially beneficial medication, and the Board acknowledges that a more accessible method of blood monitoring could significantly reduce his anxiety and increase the likelihood of improving treatment outcomes.

46. However, the Board is also mindful that the implementation of a point-of-care blood monitoring system at Waypoint has been subject to delays due to competing fiscal priorities. While the Board understands the challenges and complexities involved in implementing new treatment technologies, we are deeply concerned about the potential impact of these delays on Mr. Bowles’ treatment optimization, and overall well-being.

47. The following paragraphs were contained in the 2024 Board’s findings, analysis and conclusions, supporting the anticipated trial of clozapine based on Mr. Bowles’ willingness to try, providing he has access to the finger-prick blood monitoring system: There is no doubt that Mr. Bowles has had a good year overall, relative to past years under the jurisdiction of the Board. The Board nevertheless agrees that Mr. Bowles’ improvement is incomplete due to the treatment refractory nature of his psychotic illness which leaves him with long-standing symptoms of disorganized thought, hyper-religiosity, grandiose, somatic and persecutory to his own treatment. The nature of his somatic delusions poses a formidable barrier to treatment. However, it is an extraordinarily positive development that he is now agreeable to a trial of clozapine, provided he has access to a blood testing system which will allow for finger prick testing [emphasis in original].

None of the above is meant to detract from the good progress that Mr. Bowles has made over the past year. The Board encourages Mr. Bowles to continue to work cooperatively with his treatment team so that he may continue the positive trajectory which has been evident to the Board over the review period. The Board shares Dr. Hudson’s hope for the future, now that a clear path to a trial of clozapine is available in the not-too-distant future, bringing with it the possibility of resolving Mr. Bowles’ long-standing symptoms, as well as deepening his engagement in therapeutic pursuits and recreational activities. It is hoped that clozapine treatment will prove to be of benefit to Mr. Bowles and will ease the pain and distress that is so clearly and eloquently expressed in his writings (para 40).

48. The Board strongly encourages the Hospital to exercise their due diligence in their duty to advocate for the implementation of the proposed blood-testing system so as to enhance positive outcomes and reduce any barriers to treatment for Mr. Bowles.

49. Understandably, the implementation of new technologies can be a complex and time-consuming process. Notwithstanding, the Board expects the Hospital to be prepared to answer questions regarding the progress of the implementation of a finger-prick blood testing system, by June 1, 2026. Information should include explanations about any issues with the evaluation and/or integration processes, status of engagement with diverse stakeholders, adequate IT support and staff training.

10The panel raises this given that the evidence was clear that Mr. Bowles’ treatment has not been optimized. It has been recommended that Mr. Bowles take Clozapine, an anti-psychotic medication that requires blood-testing. Unfortunately, the form of testing described by the last panel is still not available at the Hospital, though it is available at other institutions in Ontario. The previous panel, noting potential systemic or funding barriers impeding prompt implementation of this form of testing for Mr. Bowles, provided the Hospital with some runway, setting time-limits for either implementation or the convening of a pre-hearing conference to discuss how that issue may impact the next annual review hearing. Had it not been for that panel’s direction, this panel may well have been obliged to reconsider whether Mr. Bowles’ restriction of liberty could be characterized as “least onerous and least intrusive” in light of a treatment accommodation that may well have minimized the onset of symptoms that gave rise to this hearing. It is encouraging that Dr. Hudson explained that Hospital staff is not being trained on the “Pronto system” of testing in association with Clozapine prescriptions. Dr. Hudson is hopeful that the system will make its way into implementation at the Hospital shortly.

11Turning then to Exhibit 1, it describes Mr. Bowles’ decompensation while in the Hospital. Throughout the evening of February 25, 2026, Mr. Bowles was oppositional to direction, agitated, irritable and unwilling to follow direction. He unexpectedly lunged at staff and attempted to strike them in the head with a closed fist. He was returned to his room, refused a prn of Lorazepam and a seclusion order was obtained.

12Dr. Hudson expanded on these circumstances over the course of his evidence. He explained that Mr. Hudson’s behaviour was highly unusual. He explained that staff attempted to talk him down and to negotiate with him prior to his elevating to the point of violence directed to Hospital Staff. This led to his being escorted back to his room. It was clear to Hospital staff that Mr. Bowles was responding to internal stimuli.

13Dr. Hudson described the challenge staff faced in those moments. While step-down techniques were employed, Mr. Bowles experiences delusions that incorporate staff. He believes that Dr. Hudson and the Hospital staff have placed monitoring devices in his body. This made it difficult to engage him with the de-restraint process. Efforts normally employed by staff did not serve to de-escalate Mr. Bowles, whose aggressivity obliged the Hospital to place him in seclusion for the protection of Hospital staff and other patients.

14Dr. Hudson placed this incident in the larger context of Mr. Bowles major mental illness coupled with his high level of intelligence. Mr. Bowles is the only individual in the Hospital’s history that has managed to escape past two barbed wire fences, making it into the woods adjacent to the Hospital grounds. Dr. Hudson described Mr. Bowles as being “truly a maximum-security patient.” He explained that both Mr. Bowles recent aggressivity and the escape mentioned were driven by severe paranoia. Interestingly, Mr. Bowles remained cognitively intact throughout both incidents. This has led to a need for Mr. Bowles to be escorted wherever he goes in the Hospital.

15Dr. Hudson described the efforts made by Hospital staff to avoid hands-on techniques with Mr. Bowles. Staff have been taught to de-escalate, avoid intrusion and engage in sometimes protracted negotiation with Mr. Bowles. Over the course of his seclusion, the Hospital maintained protocols associated with seclusion relief and review. Exhibit 1 notes that all seclusion consultations opined that Mr. Bowles’ seclusion was necessary to mitigate risk. He was offered seclusion relief nearly daily. His participation in seclusion relief varied. On 7 occasions Mr. Bowles participated in seclusion relief. On 8 occasions he refused. On those occasions, Mr. Bowles was offered seclusion relief multiple times over the course of the day. Dr. Hudson explained that Mr. Bowles was secluded to his room as opposed to a seclusion suite.

16Exhibit 1 details Mr. Bowles’ progress while in seclusion. Up until he agreed to take his regular injection, Mr. Bowles was aggressive, showed lack of insight, refused treatment, and described symptoms that included light-headedness and continuous delusions. He described seeing his “shadow brother” in his room with a sword trying to stab him. He required that the “spectre be shut off.” At one point he was heard screaming “staff are stabbing me and shooting me. Help me…” He had difficulty settling up until he received Lorazepam and Nozinan on March 17, 2026. On March 18, 2026, Mr. Bowles was assessed for discontinuation of his seclusion. He received health teaching and instruction on behavioural expectations. Based on his receptivity to the discussion, his seclusion was terminated.

Submissions

17At the end of the hearing, the parties renewed their submissions as at the outset. The Hospital and the Attorney General highlighted evidence of efforts undertaken with Mr. Bowles to manage the presenting risk without resorting to seclusion. They noted that seclusion terminated as soon as Mr. Bowles was brought to baseline, without waiting to see whether the abatement of Mr. Bowles’ psychotic symptoms would be sustained following his receipt of anti-psychotic medications and education.

18Counsel for Mr. Bowles argued her client’s position that the Hospital could have incorporated other techniques prior to placing him in seclusion. She expressed her client’s position that he felt more could have been done by the Hospital to move him through seclusion more expeditiously.

Analysis and Conclusion

19As mentioned, the Board has concluded that Mr. Bowles experienced a restriction of his liberty when he was moved to seclusion for the period spanning from February 25, 2026 to March 18, 2026. Over that period of time his liberty norm changed from one where he enjoyed specified privileges in the Hospital to one where he was confined to a specific space. While every restriction of liberty warrants careful examination, this is particularly the case where an individual experiences seclusion, which is the height of intrusion on the liberty interest. The greater the restriction comparative to a patient’s pre-existing liberty norm, the greater the care to be exercised by a reviewing panel.

20In the case of Mr. Bowles, the initial question to be answered is whether the restriction of his liberty in moving him to seclusion was justified and necessary. In our view, it was. Mr. Bowles was manifesting irritability and aggressivity leading to assaultive behaviours directed towards staff who as a matter of context informed the delusions he experiences as part of his major mental illness. Hospital staff represent part of the public that have a right of assurance of safety pursuant to the primary objective set out in s. 672.54 of the Criminal Code. Mr. Bowles was resistant to redirection and negotiation. This all corresponded with both suboptimal treatment for his major mental illness and opposition on his part to recommended medication in lieu of the optimal treatment the Hospital is in the process of putting into place. Under the circumstances, the Hospital had no other option but to place Mr. Bowles in seclusion.

21The second question is whether the move to place Mr. Bowles in seclusion was the least onerous and least restrictive option available to the Hospital at the time. Mr. Bowles has associated the increase in delusional symptoms he experienced with the stresses associated with the restriction of his liberty. While this may have been an aggravating factor, it must be noted that his symptoms increased up until he accepted recommended medication. It is also noted that the acute stressors he experienced leading up to the restriction of his liberty led to violence of the same kind as were manifest when he was experiencing delusional episodes while in seclusion. In his testimony, Dr. Hudson gave a detailed account of the efforts made by Hospital staff to employ less intrusive measures before moving Mr. Bowles to seclusion. These measures were not successful. Having exhausted all other options, the decision was made to place Mr. Bowles in seclusion until such a time as he returned to his baseline.

22The next question deals with the duration of the restriction of Mr. Bowles’ liberty. Dr. Hudson outlined the protocols for seclusion review and the way they were implemented for Mr. Bowles’ benefit from February 25, 2026 to March 18, 2026. Mr. Bowles’ seclusion was reviewed daily. He was offered daily seclusion relief. His symptoms were monitored. Continuous efforts were employed to prevail upon him to take recommended treatment whose goal was to return him to his baseline. Notwithstanding his violent conduct, committed in a context where his delusions have incorporated Hospital staff, Mr. Bowles’ liberty norm was restored on the first indication of his return to his baseline functioning. The expeditious nature of this restoration is strong evidence that the Hospital was attentive to Mr. Bowles’ liberty interest and was looking for opportunities to remove him from seclusion.

23Under the circumstances, the Board agrees then that while Mr. Bowles experienced a restriction of his liberty, that restriction was justified and necessary from February 25th, 2026 to March 18, 2026, and represented the least onerous and least restrictive measure available to the Hospital at that time.

24The Board thanks all who have participated in this hearing for their assistance and looks forward to hearing of developments in the Hospital’s efforts to optimize Mr. Bowles’ treatment leading up to his next annual review.