Ontario Review Board
Re: Marlene Roest
ORB File No: 6542
Hearing held on: Friday, April 24, 2026
Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. P. Capelle
Members: Dr. M. Attia Dr. S. Wiseman Ms. M. den Haan Mr. T. Wall
Parties Appearing:
Accused: Marlene Roest Counsel: Ms. L. Shafran
The person in charge of hospital: Counsel: Ms. J. Szabo
Attorney General of Ontario: Counsel: Ms. Nancy MacDonald
REASONS FOR DISPOSITION
(Dated June 1, 2026)
Introduction
On September 5, 2014, Marlene Roest was found not criminally responsible on account of mental disorder (NCR) on charges of threatening death (x2), charges of criminal harassment (x2), and charges of failing to comply with court order (x2), all contrary to the Criminal Code of Canada.
Ms. Roest is currently subject to a Disposition of the Ontario Review Board dated February 3, 2025, by which she was ordered to be detained at the Forensic Program of Ontario Shores Centre for Mental Health Sciences (“Ontario Shores” or the “Hospital”) with a number of prohibitions and privileges, up to and including to live in the community in supervised accommodation approved by the person in charge.
On Friday, April 24, 2026, the Ontario Review Board convened a hearing at Ontario Shores pursuant to s. 672.81(1) of the Criminal Code of Canada to conduct the annual review of Ms. Roest’s Disposition. Ms. Roest attended the hearing, represented by her counsel, Ms. Shafran. Ms. Roest’s mother and sister were also in attendance at the hearing to support Ms. Roest.
As a preliminary issue, parties discussed whether the Victim Impact Statement of Ingrid Pfaff dated December 28, 2025 should be admitted as an exhibit because most of its content was outside the scope of what is permitted under the Criminal Code. The Hospital and counsel for Ms. Roest agreed that it should not be admitted, and Ms. MacDonald left the decision to the panel. The panel agrees that the content of the Victim Impact Statement is outside the scope of what the Criminal Code permits as addressed by the Ontario Court of Appeal in Klem, Re, 2016 ONCA 119.
A Hospital Report dated January 14, 2026 (the “Hospital Report”) was entered into evidence as Exhibit 1.
Positions of the Parties
The parties were canvassed for their initial positions at the beginning of the hearing. Counsel for the Hospital indicated that the Hospital was recommending no change to the current Disposition. Counsel for the Attorney General supported the position of the Hospital.
On behalf of Ms. Roest, Ms. Shafran conceded that significant threat was not contested for the purposes of the hearing. She indicated that her client’s position after the evidence would likely be to support the Hospital’s recommendation. She noted that her client says that she does not wish to live in a long-term care facility (LTC).
Index Offences
- The index offences are taken from last year’s Reasons for Disposition as follows:
“The accused dated the victim’s brother when they were in high school about 30 years ago; the victim’s brother then moved out of the province and has not had contact with the accused for over 30 years. The accused has attended the victim’s home for the past 15 years, leaving cards at the house for the victim’s brother.
The accused left a Christmas card at the victim’s home dated December 1, 2013. It is addressed to the victim’s brother and says, “From Marlene Roest”, part of the note reads, “don’t come to Toronto you will be killed, I mean it. Phone Ingrid Pfaff and Mike Pfaff (your brother and sister) to sell the house and move to where you are in Vancouver. I worry about their safety”. This is the first card with a threatening message the victim received. On another letter dated April 20, 2014, again addressed to the victim’s brother, saying “From: Marlene Roest”, part of the message reads “I’ll burn down your house Ingrid Pfaff and Mike Pfaff if I can’t see your brother Mark Pfaff. I’ll cut your heads off (Mike Pfaff and Ingrid Pfaff and Mark Pfaff). In a letter dated April 27, 2014, addressed to the victim’s brother saying, “love always Marlene Roest”, part of the message reads “I might have your head cut off and your body dissected. In an Easter card that isn’t dated, the card says, “love Marlene”, part of the card reads, “If I don’t see you tonight, I’ll burn down your house…”.
When the victim received the card on December 1, 2013, she contacted the accused mother, who asked the victim to send her a copy of the card so she could make the accused counselors aware of the situation. The cards stopped until April 6, 2014. The victim contacted police on April 6, 2014, to report the threatening cards from the victim. On that date, the victim saw the accused at her address leaving a card. After reading the card, the victim contacted the police. Officers spoke with Marlene on the telephone and cautioned her about leaving these threatening cards with the victim. Since that time, 4 more threatening cards have been left at the home, which has caused the victim to become very fearful of her safety. On Monday April 28, 2014, the accused was arrested and charged with Uttering Threats against the victim. The accused was released on Bail on May 1, 2014.
On May 3, 2014, the victim, Ingrid Pfaff was inside her home in the city of Toronto. At approximately 1 p.m., she heard the lid of her metal mailbox lift open and then slam shut. By the time the victim opened her door she could not see anyone in the area. When she checked the mailbox, she found a single envelope addressed “To Mark (care of Ingrid Pfaff and Mike Pfaff)”. Inside the envelope was a birthday card. The message written inside stated; “Hi! Mark Pfaff from Marlene Roest. Now listen, I love you and miss you! Mark I miss you and if we don’t meet I’ll have to put you on the cross. Love Always from me to you”. Upon reading the contents of the card, the victim immediately called the police. On Sunday May 4, 2014, officers attended at her boyfriend’s address and located her. She was placed under arrest, advised of her rights to counsel and transported to 42 Division where she was investigated and held for a show cause hearing.
On May 23, 2014, the victim was at her home in the city of Toronto. The accused approached the victim and said, “I know I am not supposed to talk to you but here it’s a nice one”, then handed the victim a card. The card was addressed to Mark Pfaff which Is Ingrid’s brother and care of Ingrid and Mike Pfaff. The card read “Hey babe, how’s it going. It was love at first sight, eh Mark. How could you forget that great party I had for you? Remember that nite-you held me so tight and when you put your penis inside remember how great that felt. Do it gently from the front – you know the vagina. I need to see you – or otherwise I will blow your head off. Remember you’re the King of the world and I’m the Queen. See ya. From: Marlene Roest. When the victim saw the accused, she immediately called police.”
Diagnoses
- Schizoaffective Disorder, Bipolar Type
Dependent Personality Disorder
Amphetamine Type Substance Use Disorder, moderate, in sustained remission
Cocaine Use Disorder, in sustained remission
Background
Ms. Roest’s personal background and psychiatric history are detailed in the Hospital Report in evidence and need not be repeated in detail. The following highlights are of note.
Ms. Roest is currently 65 years old and receives Old Age Pension. The Public Guardian and Trustee acts as Substitute Decision Maker (SDM) for property. Ms. Roest’s sister acts as SDM for treatment decisions.
Ms. Roest has a significant history of cannabis and crack cocaine use. Ms. Roest had two significant relationships as an adult. One of the partners had significant substance use issues, and Ms. Roest engaged in prostitution to purchase drugs for both of them.
As noted in last year’s Reasons for Disposition:
“[Ms. Roest’s] first psychiatric hospital admission was in 1991 with three more in 2003. She reported hearing voices in her 40s claiming she was "Queen of the World". During states of acute psychosis, Ms. Roest experienced grandiose and erotomanic delusions, ideas of reference, impulsive and reckless behavior, and extreme disinhibition. Behaviors of concern included physical intimidation (lunging), sexually explicit/vulgar language/demands, disrobing (which began in 1990), and threats of physical violence.”
Following the finding of NCR on September 5, 2014, Ms. Roest eloped from hospital on several occasions and in 2015 dropped off letters at the residence of the victim’s sister. In 2016 she dropped off threatening letters for the victims of the index offences. In the past, Ms. Roest has also written threatening letters to the victims which were intercepted by the Hospital.
Ms. Roest’s mental status has remained stable, but symptoms of her illness persist, such as erotomanic delusions and disinhibition. These symptoms cause her to remove her clothing and make inappropriate statements. The intensity of the symptoms varies depending on Ms. Roest's stress level. In addition to medication, some symptoms are managed through behavioral therapy and support from members of the treatment team.
A graduated privilege program was instituted in June 2024 for Ms. Roest, which was suspended after an elopement on July 5, 2024. Ms. Roest was found off hospital grounds, which Dr. Chuong attributed to impulsivity rather than psychotic symptoms. Her privileges were re-instated in October 2024.
Evidence at the Hearing
Dr. Chuong is Ms. Roest’s treating psychiatrist and testified that there were no significant updates since the date of the Hospital Report. Ms. Roest has been designated as discharge-ready for approximately one year and the Hospital is satisfied that the risk that Ms. Roest poses to public safety can be appropriately managed in the community. Dr. Chuong, the Hospital Administrative Director, and the social worker met with Ms. Roest and her family to discuss possible housing options. They explored the possibilities of independent living in 24-hour supervised accommodation, retirement homes with additional supervision, a subsidized apartment with supervision, returning to the family home with 24-hour support, and LTC.
Dr. Chuong stated that additional supervision is required for all non-24-hour supervised housing due to Ms. Roest’s significant history of elopement. As noted at page 68 of the Hospital Report, over the last year and a half, Ms. Roest has been progressing through a privilege ladder toward community access. On September 18, 2025, Ms. Roest was found walking off hospital grounds when she only had in-hospital privileges. This led to her privileges being held for one week. In October 2025, Ms. Roest’s privileges were again held when she was found at the hospital gift shop when she was signed out on indirectly supervised privileges to attend recreational activities. Although Ms. Roest is doing well, in Dr. Chuong’s opinion, there is still risk because in the past when Ms. Roest has eloped, she has attempted to contact the victims of the index offences in breach of her Disposition.
The option of group homes was also explored. In February 2026, the Hospital presented Ms. Roest as a candidate to the group homes within the Ontario Shores catchment area, but she did not meet their eligibility criteria. The treatment team discussed the option of group homes outside the Hospital catchment area, which the family has the option of exploring. If there is a group home outside the area that agrees to take Ms. Roest, a transfer to a hospital in that catchment area will likely be required.
Cognitive screening was completed in June 2025 and no concerns were identified. Over the year, the treatment team will ensure that medication is optimized, and work will continue with allied health professionals including behavioural therapists as Ms. Roest exercises indirectly supervised community privileges.
In response to a question from Ms. Szabo about the differences between LTC and the Hospital, Dr. Chuong noted that they are similar in that there is round the clock staffing in both, which is absolutely necessary to manage Ms. Roest’s risk. Applications for LTC are required with supporting documentation from a psychiatrist or medical doctor. In Dr. Chuong’s opinion, Ms. Roest may have increased liberties in an LTC setting as she may have more opportunities for access to the community than she currently does on the locked general ward.
Within a month, the treatment team will be providing the family with written information summarizing their discussions on the available housing options and possible financial support and will continue to collaborate to find suitable housing.
In response to questions from Ms. MacDonald, Dr. Chuong reiterated that any suitable residence must provide 24-hour supervision due to Ms. Roest’s history of elopement. It is also necessary to continually monitor Ms. Roest’s mental and physical health, especially during stressful periods, as stressors lead to decompensation in her mental health. Decompensation significantly increases the risk to the victims of the index offences, since in the past when she has eloped, she has contacted or attempted to contact the victims. To her credit, she has not done so in one and a half years.
In response to questions from Ms. Shafran, Dr. Chuong agreed that Ms. Roest tries to be social with her peers and gets along well with others. Due to Ms. Roest’s Dependent Personality Disorder, she needs consistent, stable interactions with those who set clear boundaries. In response to Ms. Shafran’s suggestion that Ms. Roest needs peers and distraction to keep her from drawing heavily on staff resources, Dr. Chuong noted that Ms. Roest has always relied on staff and tries to get along with everyone in her setting. She agreed that it was possible that limited peer relationships might lead to increased maladaptive, attention-seeking behaviour, including elopement attempts, but delusional statements and disrobing have decreased in frequency over the past reporting year.
Dr. Chuong stated that some reasons that group homes decline to accept patients include a patient not meeting age criteria or having an insufficient privilege level. She is unaware if there are group homes for people over 60 years of age but thinks it is possible. She is not familiar with group homes outside the Ontario Shores catchment area. If Ms. Roest and her family independently pursue a suitable group home outside the area, the treatment team could plan for transfer to another hospital. The Hospital would not recommend a transfer to the care of another hospital for an out-of-area group home because in Dr Chuong’s opinion, the Hospital can meet Ms. Roest’s needs and there are many housing options in the area. Many of the housing options other than LTC require private funding.
Ms. Roest visited some LTC facilities and Dr. Chuong was told that she enjoyed the visits. Dr. Chuong does not think that it would be an issue if many of the co-residents in any accommodation were older than Ms. Roest.
In response to a question from the Alternate Chair, Dr. Chuong reiterated that the main concern for risk management is that Ms. Roest requires 24-hour supervision but agreed that the least restrictive, best standard of living is being considered. Ms. Roest would likely have more access to the community in LTC (albeit accompanied access) since currently the maximum privilege available to her in hospital is 30 minutes outside the hospital within sight of the hospital entrance. She would also be permitted to move freely inside the LTC facility, whereas in the Hospital she is on a locked ward.
The risk posed by Ms. Roest to public safety would continue to be low under a detention order even after transition to appropriately supervised housing, whether it is LTC or other 24-hour supervised housing. In the case of a conditional or absolute discharge, the risk would be moderate. All options other than group homes in the Ontario Shores catchment area remain on the table for consideration, allowing Ms. Roest the maximum freedom possible. Ms. Roest would not meet criteria for a locked unit in LTC as she does not exhibit any behaviour which typically requires such a placement.
Final Submissions of the Parties
At the conclusion of the hearing, counsel for the Attorney General and for Ms. Roest indicated that they supported the position of the Hospital for no change to the current Disposition.
Ms. Szabo noted that Dr. Chuong’s evidence is clear that although LTC is one of the options available for suitable housing, it is not the only option available or being considered. A retirement home, the family home, and a private apartment would be possible with enhanced supervision. If Ms. Roest’s family locates a group home outside the catchment area that will accept Ms. Roest, the Hospital is open to discussions. Meetings with the family will continue after they receive the written summary of the options. Dr. Chuong’s evidence was also clear that in her opinion Ms. Roest is doing well in her progression on the privilege ladder with only a few incidents, and Ms. Roest makes friends everywhere.
Ms. MacDonald noted that on the evidence, Ms. Roest does not need to be in hospital to manage her risk. While the Board heard evidence of Ms. Roest’s preference of where she does or does not want to live, she may (at least temporarily) need to accept a placement which is imperfect in her mind. The Hospital’s obligation is to ensure that Ms. Roest has access to the least onerous and least restrictive conditions which also mitigate the risk to public safety.
Ms. Shafran submitted on behalf of her client that change is a stressor for Ms. Roest, and her preference of housing may impact her behaviours and consequently her risk to the public. She acknowledged the Hospital’s evidence that Ms. Roest and her family will continue to be part of the dialogue with the Hospital about housing options.
Analysis and Conclusion
- Significant risk was not at issue in the hearing; however, the panel has independently considered whether the legal threshold under s. 672.5401 of the Criminal Code is met and finds based on the evidence that Ms. Roest does continue to present significant risk to public safety. While Ms. Roest has had a mostly very positive year, as noted at page 71 of the Hospital Report:
“Ms. Roest’s primary criminogenic risk factors include her major mental illness, history of violence, personality disorder, history of substance use, and treatment or supervision response. Her major mental illness has remained stable largely due to her good adherence with her medications as well as the treatment team’s ongoing support. The presence of some personality traits in the cluster C realm have contributed to her ongoing risk, as she has a preference to default to maladaptive coping strategies, and act impulsively.”
- In terms of the necessary and appropriate Disposition based on the evidence at the hearing, the panel agrees with the joint submission that the current detention order Disposition is necessary and appropriate in the circumstances and that the risk cannot be managed with a conditional discharge. As noted at page 72 of the Hospital Report:
“Ms. Roest’s progression under the Ontario Review Board has been on a positive trajectory over the past review period. This is in large part due to adherence to her psychiatric medications, abstinence from intoxicating substances, and engagement in a substantial number of therapeutic programs. She possesses multiple strengths and protective factors such as her supportive family, stable finances, and a prosocial attitude. Of particular importance is the fact that Ms. Roest worked towards going outside of the hospital building while indirectly supervised without significant episodes of elopement, which had been a challenge for several years previously. However, Ms. Roest still requires close monitoring by professional services for any signs and symptoms of decompensation of her mental health and proper adherence to her treatment. Furthermore, the clinical team requires the ability to approve housing and to rapidly readmit her should medication non-adherence, substance use, or signs of decompensation emerge. It is the opinion of the team that civil commitment measures would not adequately address these risks.”
The evidence is clear that Ms. Roest has been ready for community living for more than one year, and this includes readiness for more freedom within a 24-hour supervised environment. It is obvious to the panel that a housing option outside the Hospital will provide her with more freedoms than are currently available to her, as she has a maximum privilege of 30 minutes outside within sight of the Hospital entrance due to her elopement risk.
As Dr. Chuong testified, LTC is one of many options canvassed with Ms. Roest and her family. LTC provides the required 24-hour supervision to mitigate the risk to the public without any need for private funding and would allow Ms. Roest considerable freedoms that she does not currently have available. The panel is confident that LTC is one of many options that the Hospital continues to explore, and that Ms. Roest and her supportive family are part of the community housing discussion. Public safety, which is the paramount concern, and providing Ms. Roest with the maximum possible freedoms, are goals shared by the Hospital and the family.
In reaching our decision, the Board has considered the safety of the public, Ms. Roest’s mental condition, her reintegration into society, and her other needs.
DATED this 1st day of June 2026, at the City of Toronto, in the Region of Toronto.
Ms. M. den Haan
Legal Member
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Office of the Registrar
Ontario Review Board