Re Okevie Williams, 2026 CanLII 51038

Re: Okevie Williams

ORB File No: 6780/6883

Hearing held on: Monday, April 20, 2026

Place of hearing: Centre for Addiction and Mental Health

Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code

Before:

Alternate Chairperson: Mr. M.D. Segal

Members: Dr. T. Verny

Dr. S. Wiseman

Ms. A. Israel

Mr. S. Doherty

Parties Appearing:

Accused: Okevie Williams

Counsel: Mr. J. DiCecca

The person in charge of hospital: Counsel: Mr. K. Dow

Attorney General of Ontario: Counsel: Ms. K. Kirec

REASONS FOR DECISION AND DISPOSITION

(Dated May 29, 2026)

Introduction

1. On June 10, 2015, Okevie Williams was found not criminally responsible by reason of mental disorder (“NCR”) on charges of assault, and assault with a weapon. On November 25, 2015, Mr. Williams was found not criminally responsible by reason of mental disorder on charges of assault with a weapon, and assault causing bodily harm, all contrary to the Criminal Code of Canada (the “Criminal Code”). Mr. Williams is subject to the terms of a Disposition of the Ontario Review Board (the “Board” and the “ORB”) dated May 5, 2025, which orders that he be detained at the Centre for Addiction and Mental Health (“CAMH” and the “Hospital”).

2. Pursuant to s. 672.56(2) of the Criminal Code, CAMH notified the Board by letter dated December 29, 2025, that Mr. Williams’ liberty had been restricted: Mr. Williams was residing in the community in approved accommodation. On February 10, 2026, the Board held a hearing to review the decision of the hospital to significantly increase the restrictions of liberty of Mr. Williams. The Board concluded that the decision of CAMH to significantly increase the restrictions of liberty was warranted, and in the circumstances of the case, represented the least onerous and least restrictive decision, and found that the existing Disposition remained appropriate.

3. Mr. Williams was discharged to the community on March 16, 2026. He was subsequently readmitted to the hospital on March 26, 2026. Pursuant to s. 672.56(2) of the Criminal Code, CAMH notified the Board by letter dated April 9, 2026, that Mr. Williams’ liberty had once again been restricted.

4. A Hospital Report dated March 26, 2026 (the “Hospital Report”) was entered as 1. An ROL correspondence was entered as Exhibit 2. And (i) an earlier Hospital Report dated January 22, 2026, (ii) an admission note and (iii) a progress note signed by Dr. O’Sullivan were collectively entered as Exhibit 3.

5. When a hospital significantly restricts the liberty of an accused for more than seven days, it has an obligation, under s. 672.56(2)(b) of the Criminal Code, to provide notice to the Board as soon as possible. Under s. 672.81(2.1), the Board is then required to convene an ROL hearing to review the hospital’s decision, also as soon as is practical. Since Mr. Williams’ annual hearing was scheduled for April 20, 2026, it was agreed that his annual review and the ROL would happen concurrently.

6. On April 20, 2026, the Board convened a hearing at CAMH to conduct the annual review of the current Disposition and to conduct a restriction of liberty (“ROL”) hearing.

7. Mr. Williams was present at the hearing and was represented by his counsel, Mr. DiCecca.

8. For the ROL, the issues at this hearing were:

a) whether the decision made by the person in charge to significantly increase the restriction of liberty on Mr. Williams was warranted and necessary, as well as the least onerous, and least restrictive, option in the circumstances, at the time of its onset, on March 26, 2026, and

b) whether it continues to be so.

9. For the annual review, the issues at this hearing were:

a) whether Mr. Williams is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code, and

b) if so, what is the necessary and appropriate disposition in the circumstances, bearing in mind the factors annunciated in s. 672.54 of the Criminal Code.

10. For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that the initial restriction of liberty was warranted, necessary and appropriate, as is the ongoing restriction of liberty. The Board found that these restrictions were necessary for public safety, and they represented the least onerous and least restrictive, interventions available.

11. For the reasons set out below and based on the evidence before us, the Board concluded that Mr. Williams continues to represent a significant threat to the safety of the public. The Board found that the necessary and appropriate disposition in the circumstances is a continuation of the existing Detention Order with an amendment agreed to by all the parties to expand the provision of living in the community to the Greater Toronto Area (the “GTA”).

Current Psychiatric Diagnoses

12. Schizophrenia and Cannabis Use Disorder

Index Offences

13. The circumstances giving rise to the index offences are extracted from last year's Board Reasons as follows:

“Index Offence 1:

July 21, 2014 Mr. Williams attacked a man who was using a walker for mobility. The victim was knocked down and Mr. Williams used the walker to strike him. The victim suffered injuries.

Index Offence 2:

September 30, 2014 Mr. Williams pushed a person at a public library and then used a chair as a weapon to strike the victim. The victim suffered injuries.”

Reasons for the Restriction of Liberty

14. A series of progress notes from Dr. O’Sullivan set out the reasons for Mr. Williams’ readmission to CAMH.

“Following EFOPS clinic review he was transferred to ED on April 1 and admitted to CCC3.

Collateral: Concerns raised by housing staff and case manager over past 3-4 days of deterioration from baseline in association with THC use.

Presentation: currently off baseline with noted changes in behaviour, mood, energy, sleep, TC (paranoid), FTD (increased significantly) and changes in presentation suggestive of relapse in context of likely THC use.

Risk: not been aggressive in past few days however historically has shown propensity to become floridly unwell and aggressive relatively rapidly. This risk is currently increased. On basis of collateral from housing, he has been using THC in breach of his disposition.

Plan:

Admit to ED. Form 49 if required. Likely need period of stabilization of at least 5-7d, may be suitable for general mental health unit. Will review next week with CM and liaise with inpatient team for updates and plan.”

Background

15. Details of Mr. Williams’ background are taken largely from the detailed reasons for disposition of last year.

16. Mr. Williams first exhibited signs of psychiatric illness including delusions at the age of 19. In his early twenties, he appeared to be suicidal. He was admitted to Scarborough hospitals on multiple occasions and received diagnoses including schizoaffective disorder, crack cocaine abuse, and marijuana dependence. Mr. Williams’ first hospitalization in 2007 occurred after he threatened his mother with a knife, believing that she was an imposter who had poisoned him. There were at least 3 other incidents in which Mr. Williams was admitted to hospital by police after threatening his mother. In 2012, he was admitted after he broke his television and destroyed property in his room. At that time, he believed he was ill with cancer, and he was treating himself with crack cocaine and marijuana. Historically, Mr. Williams has not complied with medication and treatment providers in the community. Mr. Williams also was admitted to CAMH on four occasions once in 2012 several times in 2014 and finally in October 2014 following the index offences.

17. Prior to the index offences, Mr. Williams has a criminal record including convictions between 2005 and 2007 for offences including robbery disguise with intent, mischief and failing to comply with bail and probation orders. In addition, information in the hospital report references 2012 offences of theft and possession of stolen property,

18. In 2014 Mr. Williams was found unfit to stand trial on the index offences and was admitted to CAMH. At that time, Mr. Williams was markedly thought disordered, paranoid and perplexed. His mental health improved due to treatment, and he did not present a management problem. He remained in hospital and NCR findings were made in 2015. Mr. Williams showed improvement in his mental state and was able to use passes appropriately. Unfortunately, in March of 2016, a change in medication led to significant deterioration with Mr. Williams becoming overtly psychotic by the end of that month. He was sexually inappropriate. He had no insight into his actions or illness, and he continued to assert that he had acted in self-defence. Thereafter Mr. Williams continued to make some progress but also suffered setbacks, once due to medication error, but also due to the significant negative effect of cannabis use. In 2017 his mental health further improved, and he was discharged from hospital. Unfortunately, substance abuse and its negative effects led to both a lengthy readmission in October 2018 and to readmission again in 2019 within a week of discharge. Mr. Williams progressed and was transferred to high support 24-hour supervised accommodation in January 2022, where he did well. However, a missed injection due to a scheduling error affected his mental health and he and a co-resident were involved in a physical altercation. Mr. Williams was not accepted for return to the home and was readmitted to hospital in September 2022 Mr. Williams progressed in hospital but in January 2023 there was an unexpected change in his mental state, despite him being medication compliant. Symptoms included persecutory misperceptions, impulsivity and agitation. He was easily provoked to anger and had to enter seclusion on one occasion. He did not recognize the changes in his mental state. With treatment, he gradually improved and returned to baseline health by early February 2023.

Course since last Disposition

19. Following his ORB hearing on April 10, 2025, his minimum reporting frequency was reduced from not less than once per week to not less than biweekly. In July 2025, his Extended Forensic Outpatient Team (“EFOPS”) transferred from Dr. Juliette Dupré to Dr. Owen O’Sullivan. In the community, he was reviewed by his MRP every 2-4 weeks. He met his case manager, Lily Li, every week. There were no significant issues regarding missed appointments. He continued to reside in a bachelor apartment at Oakwood Arch (Operated by CommunitiCare Health, this is a high support housing with 24-hour staff, medication supervision, and meals provided). Between April and December 2025, Mr. Williams’ mental health was largely stable albeit with some fluctuations in his mood and energy levels. There were no episodes of significant mood disturbances, psychosis or aggressive behaviour. He engaged well with his EFOPS treatment team, without any significant conflicts.

20. In mid-December 2025, his housing provider reported various concerns. Mr. Williams demonstrated a period of behavioural disturbance (agitation, verbal aggression, argumentativeness, disorganization), mood disturbance (irritability), thought disorder, and demonstrated increasingly paranoid ideation (regarding his supportive accommodation staff engaging in poisoning). He also showed impaired insight into his mental state having deteriorated. This occurred in the context of him having reported alcohol and cannabis use. No medication compliance concerns were raised.

21. On December 20, 2025, and following issuance of a Form 49, he was admitted to CAMH. He was conveyed to the Emergency Department by Toronto Police Services after initially declining to attend. On presentation to ED, he was described as irritable, agitated and thought disordered (with frequent neologisms). His presentation in the initial phases of his admission was characterized by affective instability, irritability, thought disorder (rambling though content) and impaired insight. He did not accept his diagnosis of schizophrenia. He reported drinking alcohol (1 shot of brandy each day for several days) to ED, despite telling EFOPS team he does not drink. In addition, he reported to staff using cannabis weekly. He attributed his hospitalization partly to having recently felt dizzy and having had a blood pressure issue. He spoke of having recently switched religions from Christianity to Islam. He stated he smoked cannabis on the day of admission and was vague otherwise about use. He said he also drank alcohol but was inconsistent and later denied this. He was adamant he was permitted to smoke cannabis despite his ORB disposition. He did not recognize the authority of his disposition.

22. On December 24 and 25 2025, there were incidents where Mr. Williams tried to grab a nurse’s hand when she was administering medications and hold it. He then made inappropriate comments asking the nurse for a “Christmas present” while looking at her lower body and inappropriately smiling. Mr. Williams was dismissive after the nurse set boundaries with him, but incident did not re-occur. On January 6, 2026, there was a verbal altercation between Mr. Williams and a co-patient. This co-patient had been racially abusive to Mr. Williams. Mr. Williams attempted to use furniture as a weapon by lifting the lounge sofa, however, staff intervened. Neither restraint nor seclusion were required.

23. His care was initially in CCC3, and he later transferred to PRT8 and, ultimately, FGUC. Following his transfer, Mr. Williams remained cooperative with the care team, compliant with prescribed medications, and engaged in rehabilitation programming. Given his recent substance use and relatively rapid decompensation and increase in risk, he benefited from a period of abstinence from substances, optimization of his medication regime, and close monitoring and exploration of his mental state to ensure a return to his baseline. These all served to decrease his risk of re-offending and support him to safely achieve discharge back to his supportive accommodation. He was discharged March 16, 2026, and followed up by the EFOPS team.

24. In terms of psychiatric medication, the mainstay of his regime was the LAI zuclopenthixol decanoate 400 mg intramuscular every 2 weeks. In early December 2025, shortly prior to his admission, his LAI dose was reduced briefly to 350 mg every 2 weeks because of these side effect symptoms. Following admission, and pharmacy consultation, this dose was reverted to 400mg.

25. In terms of therapeutic interventions and programming, in the community and prior to hospitalization, Mr. Williams attended several recreational groups. In addition, he worked part-time in the LCBO until his admission as a cleaner. In December 2025, his CMHA Employment Support Worker contacted his EFOPS Case Manager to report the LCBO manager did not want Mr. Williams to return to work as he often arrived late to work, left early, and did not clean thoroughly. This role was terminated. In hospital, Mr. Williams participated in various rehabilitative programs through the Therapeutic Neighbourhood, as well as unit activities and community outings. Mr. Williams progressed through the privilege ladder at an accelerated rate to support a timely return to the community. He used all privileges appropriately, and his urine drug screens were negative. Following discharge, he described limited motivation to engage with programming. He declined to engage in any groups that were suggested following discharge and stated, ‘I’m fully engaged already’ despite having recently lost his role at LCBO.

26. Mr. Williams has remained independent in managing his activities of daily living and negotiating public transit.

27. In terms of supports, he has maintained regular contact with his brother and mother. A request for an overnight with his mother, Uda Haines, was approved in April and August 2025 and both went well with no concerns voiced. He reported having friends and spends time at the library and with his friends over the weekend.

28. Mr. Williams has remained on a waitlist for an independent housing unit. His longer-term goals remain to live independently and be conditionally discharged. Mr. Williams identified the following as recovery activities that have supported with abstaining in the community: visiting friends and family, participating in activities/programs, and employment.

29. Overall, his insight fluctuated regarding his acceptance of having a mental illness, the need for medication, his ability to accept and recognize relapse signs, the risks associated with substances and relapse, and the role of the ORB and his associated legal obligations. At times, he has expressed that he does not have a schizophrenia, nor did he require medication. He demonstrated limited insight into the basis for his recent three-month hospitalization, and this has persisted. During his admission, for example, he maintained at various points that he was, indeed, permitted to use cannabis by the ORB. Following discharge, he was minimizing and deflective. He denied that his behaviour and presentation changed in December 2025. He maintained he was not unwell and that it was merely a ‘misunderstanding’ on behalf of his housing staff. Mr. Williams’ insight into substance use patterns and the associated risks has remained partial. At times, he had been highly motivated to abstain from cannabis but has also described the cultural views of wanting to smoke cannabis as well as the challenges of growing up with a parent that had an addiction to substances.

Positions of the Parties

30. Counsel for the Hospital, counsel for the Attorney General and counsel for Mr. Williams advised that this was a joint submission, with respect to the restriction of liberty: all parties agreed that the initial restriction of liberty was warranted, necessary and appropriate, as is the ongoing restriction of liberty.

31. With respect to the annual disposition, all parties advised that this was also a joint recommendation: the continuation of the existing Detention Order is the necessary and appropriate disposition, with the recommendation to expand the conditions to live in the community of the GTA in accommodation approved by the person in charge.

32. Counsel for Mr. Williams advised that, for the purpose of this hearing, significant threat was not in dispute.

Evidence at the Hearing

33. Dr. O’Sullivan testified as Mr. Williams’ treating psychiatrist. He has been involved in Mr. Williams’ care since July 2025, having taken over from Dr. Dupré, and saw Mr. Williams every two to four weeks while he was living in the community. Dr. O'Sullivan confirmed he authored the Hospital Report dated March 26, 2026, and the restriction of liberties materials, and he adopted the content of those documents as true and accurate for the purpose of the hearing.

34. Dr. O’Sullivan testified that Mr. Williams was discharged to the community on March 16, 2026, and was seen in clinic two days later presenting at baseline with no acute risk concerns. By the end of March, collateral information from Mr. Williams’ housing described deterioration in behaviour and mental state, including disorganization, roaming in the halls, over familiar and disruptive behaviour (including playing loud music late at night), louder speech, less coherent thought processes, and accusations that housing staff were lying. Dr. O’Sullivan testified that housing staff also reported concerns that Mr. Williams had been using cannabis. Dr. O’Sullivan reviewed Mr. Williams in clinic on April 1, 2026, and found him to be markedly off baseline, with disorganization, mild elation, and paranoid ideation regarding housing staff. Mr. Williams did not recognize changes in his mental state. Dr. O’Sullivan, in consultation with the case manager and outpatient manager, determined that readmission for assessment and stabilization was appropriate. Dr. O’Sullivan testified that urine drug screening supported cannabis use on April 1, 2026.

35. Dr. O’Sullivan testified that Mr. Williams was admitted to CCC-3, a civil/general acute unit, as it was the first available bed and was suitable for stabilization needs. Dr. O’Sullivan further testified that, on April 1, 2026, a general forensic unit bed would not have been appropriate given the acuity of presentation and Mr. Williams’ history of rapid decompensation, including episodes requiring seclusion and restraint.

36. Dr. O'Sullivan testified that allowing Mr. Williams to remain in the community on April 1, 2026, would have increased the risk of harm to the public. He described Mr. Williams as capable of long periods of stability but prone to rapid decompensation and stated that the presentation was reminiscent of Mr. Williams’ mental state around the index offence (2014), supporting the need for swift intervention.

37. Dr. O’Sullivan described Mr. Williams’ current inpatient course as relatively uneventful: there were no behavioural incidents and no seclusion or restraint. Medications remained unchanged. Dr. O’Sullivan observed improvement in coherence over the first week, which he suspected related to cannabis leaving Mr. Williams’ system.

38. Dr. O’Sullivan testified that, as of his assessment on April 8, 2026, the primary ongoing concern was Mr. Williams’ minimal insight into (i) the risk of cannabis, (ii) the role of the Board in his current context, and (iii) the prohibition on cannabis in his Disposition. Dr. O’Sullivan described inconsistent accounts by Mr. Williams regarding substance use which impeded open discussion of triggers and risk mitigation planning. Dr. O'Sullivan also testified that Mr. Williams maintained that housing staff were lying or conspiring against him, including disputing the urine drug screen results by asserting staff were lying.

39. Dr. O'Sullivan confirmed Mr. Williams remains on long-acting injectable zuclopenthixol 400 milligrams intramuscularly every two weeks and has been on that medication for several years. He testified a brief dose reduction in December had been reversed back to 400 milligrams every two weeks. Dr. O’Sullivan characterized Mr. Williams’ illness as chronic with an element of treatment resistance while noting Mr. Williams can attain meaningful periods of stability with relatively subtle residual symptoms. No medication changes were anticipated at the time of the hearing, though medications would be kept under review. Dr. O’Sullivan testified that following a period of stabilization, the plan was to transfer Mr. Williams to Tower 1 (general forensic rehabilitation unit) when a bed becomes available which is anticipated within approximately 10 days. Mr. Williams has begun escorted privileges on hospital grounds, with progression contingent on stability and absence of incidents. Dr. O’Sullivan testified that Tower 1 programming is more specialized and rehabilitation-focused, with emphasis on substance-related programming, psychoeducation, understanding the ORB/Disposition requirements, and vocational/community reintegration supports. He testified that robust insight into substance use should not be treated as a precondition to community return, as that would be too high a bar; however, the present lack of insight was a significant concern for safe discharge planning.

40. Dr. O’Sullivan testified that Mr. Williams’ community placement at Oakwood Arch (a 24-hour supported accommodation placement) remained available and that the plan for Mr. Williams was to return there when clinically appropriate. He emphasized that Mr. Williams historically does best in the community when he has structured activities and work; Mr. Williams’ loss of employment at the LCBO and reduced engagement in programming contributed to a lack of structure, which Dr. O’Sullivan identified as a factor in vulnerability to relapse, alongside substance use.

41. Dr. O’Sullivan testified that the current Disposition remained appropriate to manage risk. He recommended one amendment: to broaden the community-living provision from “live in the community” to “live in the community of the GTA,” to assist future housing planning. He indicated this was planning focused and not urgently expected to occur within the next 12 months.

42. In response to questions from counsel for Mr. Williams, Dr. O’Sullivan testified as follows:

a) With respect to the plan between now and discharge, Dr. O’Sullivan testified the immediate plan is a period of stabilization followed by a transfer to Tower 1 when a bed becomes available; thereafter, the focus is on re-engagement with specialized programming and rehabilitation supports, with a view to eventual return to Oakwood Arch when clinically appropriate.

b) With respect to privileges and the “privilege ladder” Dr. O’Sullivan testified that privilege progression is generally based on absence of incidents, stability and engagement in programming. He confirmed Mr. Williams has been granted level 1 (escorted grounds privileges) and testified he may not necessarily need to complete every step sequentially; however, he expected it would take at least a few weeks before indirect privileges on hospital grounds would be considered, while acknowledging it is a reasonable goal given stability over the prior two weeks.

c) Dr. O’Sullivan agreed with counsel’s characterization that, notwithstanding the setback, there had been no overt threats or violence, and the concern prompting admission was deterioration in mental state.

43. In response to questions from the panel, Dr. O’Sullivan testified:

a) Dr. O’Sullivan testified Mr. Williams’ insight at baseline is limited but fluctuates. When insight is better, Mr. Williams can acknowledge the Board's role, the consequences of substance use, and express motivation to abstain; when insight is poorer (as recently), he disputes the Boards's role, disputes that cannabis is prohibited and denies associated risks. Dr. O’Sullivan referenced past admissions (including 2019) where Mr. Williams stabilized quickly but required a longer period focused on psychoeducation and rebuilding limited insight, after which he pursued goals and activities. He emphasized that, in the prior two weeks, Mr. Williams’ stance would make community discharge unsafe because he would likely resume substance use promptly.

b) Dr. O’Sullivan agreed there is an element of treatment resistance but added that Mr. Williams can nonetheless attain meaningful stability with relatively subtle residual symptoms when treated.

c) Dr. O’Sullivan testified substance use is the most prominent antecedent. He added that, historically Mr. Williams has done best when he is busy and structured.

d) Dr. O’Sullivan testified it is unlikely Mr. Williams would move to different housing within the next 12 months. He explained the GTA wording is a planning measure: Mr. Williams has been on a waitlist for a more independent placement, and if an opportunity arises it may be elsewhere in the GTA. He testified that these placements are competitive and time-sensitive, and having a broader geographic term helps the team respond quickly if an opening arises. He emphasized there is no urgency to move now, and the team’s preference would generally be for housing closer to CAMH, but broader GTA flexibility supports future options.

Analysis and Conclusions

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

45. 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. O’Sullivan, in addition to the documentary evidence before us.

46. In particular, the Board relies on the Clinical Risk Factors/Re-offence Scenario, set out in the Hospital Report:

“Criminogenic risk factors include:

• Major Mental Illness (schizophrenia with relapses)

• Problems with Insight into mental condition and its symptomatology

• Substance Use (cocaine, alcohol and marijuana)

Mr. Williams has an established diagnosis of schizophrenia. His illness had its onset in his late teens. Its clinical course has been chronic relapsing and remitting as evidenced by multiple hospital admissions. It has been complicated by substances (cocaine, THC), and compliance issues. At baseline, Mr. Williams has demonstrated elements of mood instability. In addition, he can intermittently present as more talkative and disorganized in his thinking, e.g., using neologisms (i.e., made up words or jargon). His baseline insight into symptoms, offences and violence risk was limited; whereas his insight into his need for treatment and substance use risks was more developed. When acutely unwell, he has become overtly psychotic over a rapid timeline, and this florid presentation has included aggression, agitation, impulsivity, persecutory beliefs and further impaired insight.

In risk assessment, one of the best predictors is a patient’s history of violence. He had an offending history prior to the index offences but not for serious violence. He has engaged in assaultive/threatening behaviour directed towards family members over the years leading up to his index offences, and in the last year leading up to the index offences, directed at members of the public, apparently in the context of non-compliance with psychiatric treatment and possible substance use. His index offences related to a series of assaults on members of the public (July & Sept 2014). One victim was a man using a mobility walker and the second was assaulted with a chair in a public library. In 2022, he was involved in a physical altercation with a co-tenant that resulted in the loss of his housing. His behaviour appears to be attributable to mental decompensation precipitated by medication delay. Substance use was associated with this also. In early 2023, he displayed signs of mental deterioration despite medication compliance and was aggressive towards clinical staff.

If Mr. Williams were to re-offend, this would likely transpire in the following way: the most likely scenario involves Mr. Williams discontinuing treatment with his psychotropic medication because of his limited insight and/or returning to substance use. In either scenario, his risk of rapid mental state deterioration and acute re-emergence of psychosis would be high. In the context of active psychotic symptoms, he is likely to exhibit the same type of aggressive behaviour towards family members and/or members of the public that has characterized past episodes of acute psychotic decompensation.”

47. The Board agrees that a restriction of liberty has taken place, pursuant to the decision of the Ontario Court of Appeal in R v. MLC (2010 ONCA 843), as well as in Regina v. Campbell (2018 ONCA 140). The Board has also concluded, based on the evidence before us, that the hospital's decision to significantly restrict Mr. Williams’ liberty, by readmitting him on April 1, 2026, and his ongoing restriction, were warranted and necessary.

48. In consideration of all the evidence, submissions of the parties at the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Williams, his reintegration into society and his other needs, the necessary and appropriate disposition is to continue with a Detention Order, with the amendment agreed to by all the parties.

DATED this 29^th day of May, 2026, at the City of Toronto, in the Toronto Region.

Ms. A. Israel

Legal Member

__________________

Office of the Registrar

Ontario Review Board