Re William Spencer, 2026 CanLII 53903

Re: William Spencer

ORB File No: 8669

Hearing held on: Tuesday, April 21, 2026

Place of hearing: Centre for Addiction and Mental Health

Pursuant to: Section 672.81(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: William Spencer Counsel: Mr. R. Sherman

The person in charge of hospital: Counsel: Ms. J. Meaney

Attorney General of Ontario: Counsel: Ms. R. Weinberg

REASONS FOR DISPOSITION

(Dated June 2, 2026)

Introduction

1On October 29, 2024, Mr. Spencer was found not criminally responsible on account of mental disorder on charges of mischief under $5000, and arson - reckless disregard for human life, contrary to the Criminal Code of Canada ("Criminal Code").

2Mr. Spencer is currently subject to a Disposition of the Ontario Review Board (the "Board") dated April 29, 2025, which detains him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto ("CAMH" or the "Hospital"), with privileges up to and including to live in the community in accommodation approved by the person in charge.

3On April 21, 2026, a hearing was convened at CAMH to review that Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Spencer was in attendance at his hearing and was represented by counsel.

4A Hospital Report dated March 22, 2026 (the "Hospital Report"), was entered into evidence as Exhibit 1.

5The issue at this hearing is whether Mr. Spencer is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

6At the outset of the hearing, the parties were canvassed as to their recommendations to the Board. The Hospital recommended that Mr. Spencer's existing detention disposition continue without changes. This position was supported by counsel for the Attorney General. Counsel for Mr. Spencer requested a conditional discharge.

7For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that Mr. Spencer continues to present a significant threat to the safety of the public. The Board further ordered the continuation of the existing detention disposition without changes.

Current Psychiatric Diagnoses

[8] Schizophrenia (late onset), multiple episodes, in full remission; Alcohol Use Disorder.

Index Offence

9The details of the index offence are set out in last year's Reasons for Disposition as follows:

"Amongst the documents filed at the hearing was a Board Ordered Assessment dated March 29, 2025, which sets out the fact that on February 9, 2023, Toronto Fire Services were alerted to a fire at 502 Eastern Avenue, Toronto. The alarm was activated inside unit #302, Mr. Spencer's apartment. 502 Eastern Avenue is a four-story building with apartments on each level. The building functions as affordable housing for men with psychological issues. At the time of the fire, 17 apartments of 19 were occupied.

Two residents, a neighbour and Mr. Spencer were taken to the hospital having suffered smoke inhalation. It was reported that Mr. Spencer started the fire in his unit because he was hearing voices. A total of 27 Toronto fire vehicles and 89 fire personnel were dispatched to the scene. Mr. Spencer has admitted to starting the fire."

Background

10Mr. Spencer's background is outlined in the Hospital Report, and is accurately summarized in last year's Reasons:

"Mr. Spencer was born in Collingwood, Ontario. He is almost 52 years old. He reports that he had a normal childhood. He moved to Toronto at age 16 for work. His father died when he was young and he has not seen much of his mother over the years. When he moved to Toronto he resided with a maternal uncle who died in his early 50s. Mr. Spencer has an older brother whom he has not seen in about 35 years. Mr. Spencer also has a daughter, born in 1992. He has seen her only once when she was about 14.

Mr. Spencer did not graduate from high school. He completed a general education program while incarcerated at Maplehurst Correctional Facility. He reports that around 12 years of age he broke into someone's premises and took money. At 16, he broke into a car and stole an "eight-track".

His employment was mainly in construction and he also worked for moving companies including one for about 12 years. He had two romantic relationships with women. Both lasted about 10 years. Mr. Spencer has had a history of consuming alcohol, cannabis, cocaine, crystal methamphetamine and opioids. He started consuming alcohol at about age 19 and cocaine about 15 years ago. A report from St. Michael's Hospital in 2023 indicated that Mr. Spencer was a "heavy drinker".

Mr. Spencer first saw a psychiatrist in 2023. His history is devoid of manic symptoms or depressive episodes, self-harm or suicide ideation. In February 2023, he attended at the emergency department of Toronto Western as he was experiencing auditory hallucinations and hearing threatening voices coming from his television set. Regarding the index offence, he expressed regret and stated he had no intention of harming anyone but set his apartment on fire in a desperate attempt to save himself from the voices that were threatening to kill him. The voices interfered with his sleep. By April, the voices had faded in intensity, after Mr. Spencer initiated clozapine medication. A neurological consultation in February 2023, indicated a medical history of asthma, hyperactive gastroesophageal reflux disease and a transient ischemic attack.

The Board Ordered Assessment contains information about Mr. Spencer's past criminal activities. There are nine convictions dating from 1992 with the longest time served being 18 months. None of his crimes involved violence.

Mr. Spencer has been on bail since February, 2023. He has been living in the community without incident. In terms of supervision, he attends a bail program every Thursday. He reports mood stability and being "content." He also reports having "a couple of beer" daily. He states that he does not have any special health problems. He feels he has turned a corner.

Mr. Spencer's current residence has been obtained through Toronto Community Housing and is rent geared to income. ODSP pays Mr. Spencer's rent directly.

With respect to Mr. Spencer's mental health, we note that the Board Ordered Assessment states that the behaviours associated with the index offence likely flowed from his experience of auditory hallucinations and delusions. In the context of active psychotic symptoms, he evidenced poor judgment associated with his behaviours at the time of the index offence and lacked insight into his symptoms. These symptoms residually persisted despite treatment with multiple antipsychotic medications. His current diagnoses are schizophrenia (late onset), multiple episodes, in full remission."

Evidence at the Hearing

11Mr. Spencer's treating psychiatrist, Dr. Jaiswal, adopted the contents of the Hospital Report and provided the oral evidence for the Hospital.

12Dr. Jaiswal testified that Mr. Spencer's clinical course over the reporting year was marked by initial stability followed by a re-emergence of psychotic symptoms in or about October 2025, consisting primarily of auditory hallucinations that became derogatory and, historically, can progress to command hallucinations and threats. He advised that, despite treatment with a long acting injectable antipsychotic at the outset of the year, Mr. Spencer continued to experience symptoms even after a dose increase, and a second antipsychotic was trialed with some symptomatic benefit but problematic weight gain; accordingly, the treatment team transitioned him to a higher potency medication, zuclopenthixol, first orally to establish tolerability and, as of April 13, 2026, as a long acting injectable (300 mg every two weeks), with the prior long acting injectable discontinued.

13Dr. Jaiswal testifies that it remains early in the transition and that months, and potentially the full reporting year, may be required to determine whether the current regimen will produce sustained remission, particularly as the prior medication continues to wash out. Dr. Jaiswal noted that at present, Mr. Spencer continues to report auditory hallucinations, though reduced in frequency and intensity such that he is often unable to discern their content and is generally able to ignore them.

14With respect to etiology, Dr. Jaiswal testified that investigations have reduced concern that the index events were explained by a transient ischemic attack or seizure activity, noting a stroke clinic assessment and EEG were not supportive, and he therefore expressed increased confidence in a diagnosis of schizophrenia notwithstanding the relatively late age of onset. Dr. Jaiswal described Mr. Spencer's insight as limited: while he accepts that medication is prescribed for the voices and has noticed some improvement, he hopes to discontinue medication once symptoms resolve and does not demonstrate a robust appreciation of the chronic nature of his illness or the need for ongoing treatment and monitoring. He further testified that Mr. Spencer's insight into alcohol related risk is also not robust; while his reported alcohol use has been stable at approximately three to four tall cans of beer weekly, the team is reliant on self-report, and Dr. Jaiswal's concern is that any escalation in alcohol use could exacerbate psychosis and impair judgment, particularly in the context of active symptoms.

15In addressing risk and the appropriate disposition, Dr. Jaiswal opined that in the early stages of a deterioration, and even when symptoms are only partially remitted, Mr. Spencer would not necessarily meet the criteria for involuntary admission under the Mental Health Act; consequently, in the event of a conditional discharge, the available statutory tools would not permit timely intervention to manage risk at the point it becomes clinically concerning. He explained that the risk to public safety arises not from homicidal ideation per se, but from behaviour undertaken in response to persecutory or threatening hallucinations, referencing the index offence circumstances (including barricading and setting a fire) as illustrative of how decompensation can lead to unsafe conduct.

16Dr. Jaiswal also testified that continued hospital authority to approve housing remains important, given the role of housing stability as a protective factor and his understanding that stressors within Mr. Spencer's prior residence may have contributed to decompensation; he expressed concern that destabilizing housing circumstances could increase risk, particularly in light of the episode of psychosis during the reporting year.

17Finally, Dr. Jaiswal outlined treatment goals for the coming year, including monitoring response to the new long-acting medication with further optimization as required, and continued efforts to engage Mr. Spencer in programming, particularly 1:1 therapy, to improve insight, support sustained stability, and address substance related risk on a harm reduction basis.

18In response to questions from Crown counsel, Dr. Jaiswal confirmed that Mr. Spencer is approximately 53 years old and that schizophrenia is most commonly diagnosed in late adolescence or early adulthood; while a diagnosis in a person in their 50's is uncommon, it is not unheard of. He clarified that, although Mr. Spencer has recently been transitioned to a new antipsychotic regimen, the treatment team remains in the early stages of assessing its effectiveness, and more than eight days - potentially months and up to a full reporting year - will be required to determine whether the current medication will provide sustained symptom control and whether symptoms may worsen over time. Dr. Jaiswal explained that the change from oral medication to a long-acting injectable was primarily to promote and confirm adherence; he started with oral dosing to ensure tolerability and then move to an injectable administered every two weeks, noting there had not been adherence problems with tablets but that injections allow the team to verify dosing. With respect to rehabilitation and insight, Dr. Jaiswal advised that programming, including 1:1 therapy, has been offered throughout the reporting year but Mr. Spencer has generally declined and prefers his established community routine. Dr. Jaiswal stated that the team will continue to encourage participation by emphasizing its important and a Board recommendation could assist in promoting engagement. Dr. Jaiswal further addressed the relationship between alcohol and Mr. Spencer's illness, explaining that prior clinical opinion has been that excessive alcohol may precipitate or exacerbate psychosis and, independently, alcohol can have a disinhibiting effect that may impair judgment in the context of active psychotic symptoms. He indicated that antipsychotic medication provides a protective effect by treating psychosis and thereby mitigating risk associated with alcohol related exacerbation. Finally, he testified that 1:1 counseling may assist Mr. Spencer in recognizing early warning signs and seeking support sooner, though he could not state definitively that it would result in improved insight.

19In response to questions from counsel for Mr. Spencer, Dr. Jaiswal agreed that, during the reporting year, Mr. Spencer has generally reported symptoms to the treatment team. However, he emphasized that this occurred within the structured supports and supervision of the Forensic Service, including regular contact with a case manager. Addressing whether a conditional discharge with increased reporting (e.g., weekly rather than biweekly) would sufficiently reduce risk, Dr. Jaiswal testified that while more frequent reporting would assist monitoring, it would not remedy the central concern that, at the early stages of deterioration or while symptoms are only partially remitted, Mr. Spencer may not meet the threshold for involuntary admission under the Mental Health Act, limiting timely intervention if risk escalates. He acknowledged that voluntary admission could occur if Mr. Spencer accepted recommendations to present to hospital but opined that consistent follow through would be less likely, particularly if psychosis worsened and insight diminished, noting past circumstances in which Mr. Spencer sought discharge before full treatment optimization.

20In response to a question from the panel, Dr. Jaiswal confirmed that Mr. Spencer has chronic medical conditions, including dyslipidemia and hypertension, but no acute medical issues, and that his family physician manages these conditions. In addressing Dr. Verny's questions about cardiac safety, Dr. Jaiswal acknowledged that an electrocardiogram has not yet been obtained and agreed to arrange an EKG and monitor Mr. Spencer's cardiac status, particularly considering the recent prescription of zuclopenthixol (300 mg long acting injectable) and the potential for alcohol use to compound cardiac and respiratory risks. Dr. Jaiswal noted that while the team relies primarily on Mr. Spencer's self-report for alcohol consumption, the treatment team also monitors his clinical presentation at appointments for signs of intoxication or other changes.

21In response to a question from the panel about the nature of the risk, Dr. Jaiswal clarified that, when Mr. Spencer experiences command hallucinations, they may encourage self-harm, and that other hallucinations may be experienced as threats directed at Mr. Spencer; he emphasized that his concern is not that Mr. Spencer forms homicidal intent, but that, in attempting to protect himself from perceived threats during an acute episode of psychosis, Mr. Spencer may engage in unsafe "protective" behaviour that can endanger others, as illustrated by the index offence circumstances involving barricading and setting a fire.

22With respect to alcohol Dr. Jaiswal did not accept that Mr. Spencer had "severely" reduced consumption, describing use as stable at approximately three to four tall cans weekly, and he reiterated that the team is taking a harm reduction approach while maintaining concern that escalation could exacerbate psychosis and impair judgment. He stated that the relationship between alcohol and symptoms is not strictly 1:1, but that increased consumption has previously been associated with worsening psychosis.

23Dr. Jaiswal further confirmed that there had been no suggestion of medication noncompliance and that Mr. Spencer has been forthcoming with the team, and he agreed that Mr. Spencer can recognize and report that he is hearing voices, though he maintained that insight remains limited in relation to the chronic nature of the illness and the need for long term treatment. He advised that group programming and 1:1 therapy remain available and may assist with insight, relapse recognition, and substance use management; he also indicated that community-based services, including substance related programs near Mr. Spencer's residence and potentially a hybrid/virtual therapy approach, could be explored, and that psycho educational materials could be provided.

24Finally, in clarifying the report's risk formulation, Dr. Jaiswal testified that assessment of moderate to high risk on an absolute or conditional discharge (as compared to low to moderate risk under a detention order) was not based solely on insight, but also on the re-emergence of psychotic symptoms during the year, the uncertainty regarding optimal treatment response, and the historical patterns of symptoms preceding the index offence, together with the need for the hospital to have authority to intervene and, where necessary, re-hospitalize independent of the availability of the Mental Health Act.

Final Submissions

25In final submissions, the Hospital commended Mr. Spencer for completing the reporting year without major incidents of violence or aggression and without readmission. They recognize that Mr. Spencer maintained a positive rapport but the treatment team; however, submitted that a Detention Order remains the necessary and appropriate, and least onerous and least restrictive, disposition because Mr. Spencer's risk continues to require the Hospital's statutory tools. The Hospital emphasized that Mr. Spencer has only very recently been transitioned to a new long-acting injectable antipsychotic, and its effectiveness remains uncertain and requires ongoing assessment and possible further optimization. It also relied on evidence that Mr. Spencer continues to consume alcohol contrary to the Disposition and lacks robust insight into the impact of alcohol on his illness, and that his insight into the chronic nature of his illness and the need for ongoing treatment remains limited. The Hospital further submitted that Mr. Spencer's pattern of deterioration can include command auditory hallucinations and diminished ability to reality test, and that, at the early stages of decompensation or when the symptoms are partially remitted, he may not meet criteria for involuntary admission under the Mental Health Act. Accordingly, continued authority to intervene pre-emptively and approve housing remains crucial, particularly given the gravity of the index offence and the evidence that housing stressors may be destabilizing.

26The Crown supported the Hospital's position, highlighting the late onset of Mr. Spencer's illness and the relatively short period of time since the index offence with NCR finding, which, in its submission, limits the ability to discern a stable pattern and adds to uncertainty, particularly considering the recent medication change. The Crown also pointed to noncompliance with the abstinence condition as reflected in failed alcohol screens and submitted that a conditional discharge is premature.

27Defence counsel maintained the request for a conditional discharge as the least onerous disposition, submitting that Mr. Spencer has remained in the community for an extended period without new offences, has reported symptoms and complied with medication, and has not required hospitalization despite the return of some symptoms. Counsel argued that a more tailored community disposition, including enhanced (weekly) reporting, would address public safety, and submitted that the Board should align conditions with a harm reduction approach to alcohol rather than an abstinence requirement that has not been achievable.

Analysis and Conclusions

28Having heard and considered the entirety of the evidence as well as submissions from the parties, the Board agrees with the position of the Hospital and the Crown that Mr. Spencer remains a significant threat to the safety of the public.

29In 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 examine the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Jaiswal, in addition to the documentary evidence before us.

30Mr. Spencer has a major mental illness, a history of substance use, limited insight into his illness and need for medication, and experiences stressors from housing which may be destabilizing. The re-offence scenario is described at page 29 of the Hospital Report:

"In the absence of ORB involvement, Mr. Spencer is likely to fall away from treatment, excessively consume alcohol, and experience a mental state decline. Flowing from psychotic symptoms, in the absence of adequate supports, he is likely to exercise poor judgement and engage in behaviours like the index offence. Hence the threshold for significant threat to public safety is met, on balance, in his case. The Mental Health Act, as is currently the case, is unlikely to be applicable in the context of early stages of decompensation and ongoing consumption of alcohol. Additionally, the Mental Health Act is unlikely to difficulties with insufficient housing.

Taking into account the above noted re-offence scenario and assessment of risk, Mr. Spencer's risk is moderate to high in the context of an Absolute and a Conditional discharge. His risk in the context of a Detention Order falls in the low to moderate range."

31The panel agrees with the submission of the treatment team and the Crown that a conditional discharge is not appropriate at this time. Mr. Spencer's need to optimize treatment, mitigate the risk associated with alcohol use, the need to engage in psychoeducation regarding insight limitations and the seriousness of the index offence, the panel agrees that the hospital requires the ability to quickly readmit Mr. Spencer if he experiences mental deterioration in the community. He is treatment capable, but has limited insight into his illness, and therefore the Mental Health Act would be insufficient to manage Mr. Spencer's risk in the community.

32In consideration of all the evidence, the submissions of the parties, and the criteria set forth in s. 672.54 of the Criminal Code, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Spencer, his reintegration into society and his other needs, we conclude that the necessary and appropriate disposition is to continue with the existing Detention Order disposition without change.

33The panel acknowledged that Mr. Spencer has a great rapport with the doctor and the team. The panel encouraged Mr. Spencer to listen a bit more carefully about whether he should take up some 1:1 therapy sessions, noting it is not meant to be a punishment. The panel indicated that it is important to consider so that he can be better equipped to deal with some of the things he has been facing on his own for so long. The panel wished Mr. Spencer well and wished him continued success in terms of working with the team.