Re: I. (M.)
ORB File No: 2558
Hearing held on: Wednesday, May 13, 2026
Place of hearing: Ontario Shores Centre for Mental Health, Via Zoom Video Conference
Before: Alternate Chairperson: Mr. P. Capelle Members: Dr. S. Wiseman Dr. P. Prendergast Mr. A. Mete Ms. K. Weisbaum
Parties Appearing: Accused: I. (M.) Counsel: Ms. A. Szigeti
Person-in-charge of the hospital: Counsel: Ms. J. Szabo
Attorney General of Ontario: Counsel: Ms. N. MacDonald
*Pursuant to s. 672.501(1) of the Criminal Code, the Ontario Review Board prohibits the publication, broadcasting, or other transmission of any information that could identify a victim in this matter or a witness who is under 18 years of age.
REASONS FOR DECISION
(Dated June 1, 2026)
I. Introduction
A panel of the Ontario Review Board (the “Board”) met on May 13, 2026, to review the restriction on Mr. I. (M.)’s liberties beginning on March 9, 2026, and continuing as of the day of the hearing on May 13, 2026. The Board’s task was to determine if the restriction of liberty imposed on Mr. I. (M.) was necessary and appropriate, as well as the least restrictive and least onerous intervention in the circumstances, both at the time it was imposed and throughout its duration.
For the reasons set out below, the Board concluded that the initial restrictions on Mr. I. (M.)’s liberties were necessary and appropriate, as well as the least restrictive and least onerous intervention in the circumstances at the time it was imposed and for a portion of the total duration. However, as of the day prior to the hearing, the restrictions were no longer necessary and appropriate and were not the least onerous and least restrictive options available to the hospital.
II. Preliminary Matters
For clarity, the Alternate Chair confirmed with the parties that the restriction of Mr. I. (M.)’s liberty was deemed to have started on March 9, 2026, as in the hospital’s correspondence, when his indirect privileges were withheld, with further formal suspensions on March 16, 2026, continuing when he was transferred from the general unit (FTU) to the secure unit (FAU) on April 14, 2026.
All parties acknowledged they had received a letter the day before the hearing from the Board with respect to clarification of periods of restrictions and specifically the start and stop dates of the periods of seclusion. Ms. Szabo said that Dr. Pytyck would give evidence regarding dates that would be responsive to the Board’s letter with respect to a number of seclusions (including trials in and out of seclusion) that were referenced in the restriction of liberty report dated May 6, 2026, in order to clarify start and end dates of various seclusion events.
III. Without Prejudice Positions of the Parties
At the commencement of the hearing all parties were canvassed as to their initial recommendations to the Board.
On behalf of the hospital, Ms. Szabo stated the hospital’s position that the initial and ongoing restriction of liberty were necessary and appropriate in the circumstances.
On behalf of the Attorney General, Ms. MacDonald stated that the Crown supports the hospital’s position on both the original and ongoing restriction of liberty.
On behalf of her client, Ms. Szigeti stated that Mr. I. (M.), who was present for the hearing, says he should not have been moved to the secure unit, that cancelling all his privileges was more restrictive than necessary and that both the conditions of his ongoing restriction of liberty on the secure unit and the fact that the restrictions are ongoing without him regaining his privileges are more onerous and restrictive than necessary for the protection of the public. In short, Mr. I. (M.) contests all aspects of his restriction of liberty, beginning on March 9, 2026, up to and including the day of the hearing.
IV. Issues
- The Board’s task was to determine if the restriction of liberty imposed on Mr. I. (M.) as a result of his readmission to the hospital was necessary and appropriate, as well as the least restrictive and least onerous intervention in the circumstances, both at the time it was imposed and throughout its duration. Pursuant to the decision of the Ontario Court of Appeal in Regina vs. M.L.C. (2010 ONCA 843), the Board must consider not only the reason for the restriction and the initial decision to impose a restriction but also the ongoing circumstances of the accused for the period of time that the restriction remains in place including up to the time of review. The initial restriction of liberty and ongoing restriction of liberty must be the least onerous and least restrictive necessary for public safety and for the accused.
V. Background
Details regarding Mr. I. (M.)’s index offence and related to his background, history and current diagnoses are included in the most recent Reasons for Disposition dated January 29, 2026, following his annual review on January 12, 2026, and the most recent hospital report dated January 12, 2026, and are not repeated here.
With respect to the restriction of liberty, details are included in the restriction of liberty report to the Board dated May 6, 2026. Briefly, Mr. I. (M.)’s behaviour showed signs of deterioration beginning March 6, 2026, and were linked to medication non-adherence, leading to psychosis and aggression. The hospital gradually suspended his privileges and community access when the restriction of liberty began on March 9, 2026, due to escalating risks. Short periods in and out of seclusion were also trialed.
Despite efforts to stabilize him and after repeated incidents of aggression, psychosis, and non-adherence to medication, Mr. I. (M.) was transferred from the FTU to the FAU on April 12, 2026. Medication adjustments, including increases in his long-acting injectable antipsychotics and improved adherence to his oral medication regimen, and the stable environment of the FAU have led to stabilization, with recent reports indicating improved calmness and organization.
As noted in the restriction of liberty report on May 6, 2026, Mr. I. (M.) was expected to be ready to return to a less restrictive setting within weeks.
VI. Oral Evidence at the hearing
Oral Evidence of Dr. Pytyck
In response to Ms. Szabo’s questions, Dr. Pytyck said there were no significant updates to the written evidence. Dr. Pytyck reviewed Dr. Wang’s note of May 12, 2026, which indicated that Mr. I. (M.) was more settled and would likely return to the general unit within a week of the hearing, as noted at page 4 of the restriction of liberty report.
Many relevant details about Mr. I. (M.)’s initial restriction are set out in the restriction of liberty summary. Mr. I. (M.) showed signs of decompensation and recurrence of symptoms of his major mental illness: beginning on March 6, 2026, he was labile, yelling and tearful. On March 9, 2026, he refused medications and was disorganized, irritable, off his baseline and aggressive. These behaviours were well known to staff, as Mr. I. (M.) had been on the FTU for several years.
Mr. I. (M.) continued to accept his long-acting injectable medication. He has had several medication combinations in recent years. His oral medications augment the long-acting injectable medication; Dr. Pytyck said he needs both to remain stable because his illness is somewhat treatment resistant. Without the oral medication, as occurred in March, his illness becomes unmanageable. For greater stability, he also requires an oral mood stabilizer.
Dr. Pytyck noted that Mr. I. (M.) refused oral olanzapine (an anti-psychotic) on March 11 and 12, and Epival (a mood stabilizer) on March 9, 11, 12 and 16. During a search of Mr. I. (M.)’s room on March 13, staff found what appeared to be partially dissolved olanzapine, indicating that he had “cheeked” the medication.
At first, the reasons for his decompensation were unclear. Staff hoped he would resume taking his medication, regain stability, and resume using privileges; however, he continued to refuse oral medication despite accepting his long-acting injectable medication and became increasingly unwell, labile, and aggressive.
Dr. Pytyck clarified that Mr. I. (M.)’s privileges are “accompanied” (i.e., one to multiple patients per staff), which includes “escorted” (i.e., two patients per staff). Both were placed on hold on March 20, 2026, and reinstated on April 10, 2026.
Dr. Pytyck said Mr. I. (M.) was placed in seclusion because of verbal aggression and the incidents outlined at page 2 of the restriction of liberty report, including threatening behaviour, yelling, physical agitation and aggression, and grabbing a staff member’s wrist during medication administration, together with clear evidence of decompensation. Between March 13 and 20, 2026, active seclusion orders were in place for Mr. I. (M.). At times, the seclusion order was discontinued for a few hours to assess how he managed out of seclusion. Mr. I. (M.) was again secluded, all while on the FTU, on March 23 from 2:00 to 10:00 p.m.; March 24 from 9:30 a.m. to about 2:00 p.m.; March 25 from 2:00 p.m. until the morning of March 26; April 3 from 10:15 a.m. to 5:40 p.m.; and April 4 from 11:40 a.m. to 1:50 p.m.
Dr. Pytyck said that despite staff efforts and increased frequency of his long-acting injectable medication, Mr. I. (M.) was not returning to baseline. His olanzapine dose was increased, but he refused medication because of concerns about ankle swelling. He was not improving quickly, and concerns arose that he might not stabilize. Staff and other patients were at risk. Because of concerns about covert non-adherence to his oral medication and ongoing instability, staff decided to move him to the secure unit.
Despite the efforts of staff and Dr. F. Alioglu, a forensic fellow who worked closely with Mr. I. (M.), he was not returning to baseline quickly. Multiple interventions were tried: the frequency of his long-acting injectable medication was increased, additional PRN medications were added, and his clonazepam dosage was increased. He initially appeared to respond to prescribed loxapine, but later refused it because he believed it was causing his ankles to swell. His mental condition then deteriorated again. Mr. I. (M.) did not appear to be improving quickly enough. There were concerns that he would continue to require seclusion. The FTU milieu was becoming increasingly unsettled, with conflicts between Mr. I. (M.) and other patients, who reported feeling unsafe and antagonized. Staff were increasingly concerned for their own safety. As a result, Mr. I. (M.) was transferred to the FAU for closer observation and more structure. There were also concerns about covert medication non-adherence, as it was unclear why he was not restabilizing. He was initially admitted to the psychiatric intensive care area because of his instability before being transferred to the FAU.
After the move to the FAU, Dr. Alioglu and Dr. Pytyck reassessed Mr. I. (M.)’s capacity and found him marginally capable to consent to treatment. Dr. Wang, a clinician on the FAU, later reached the same conclusion. Mr. I. (M.) is currently considered capable of consenting to or refusing medication.
Mr. I. (M.) is now back to baseline. He is less irritable, more settled, consistently taking his oral medication, and receiving his long-acting injectable medication. He will be transferred back to the FTU as soon as a bed becomes available. His accompanied privileges were never cancelled, only withheld, and are no longer on hold. This includes accompanied community privileges.
Dr. Pytyck stated that with respect to Mr. I. (M.)’s reasons for not taking his medication, Mr. I. (M.) had said he did not need the medication, felt better for not taking it, and that it was not necessary for his stability
Ms. MacDonald had no questions.
In response to Ms. Szigeti’s questions, Dr. Pytyck clarified that Mr. I. (M.) had indirect community access privileges until March 9, 2026, when they were placed on hold. When not on hold, those privileges allowed him to smoke at the edge of the hospital grounds, where smoking is permitted. During a search of Mr. I. (M.)’s room on March 9, staff found contraband cigarettes and a lighter. He became agitated and aggressive during the search. His privileges were then withheld because of the contraband and a marked change in his mental status. When asked by Ms. Szigeti, Dr. Pytyck confirmed that nicotine withdrawal and the loss of smoking-related privileges may have contributed to Mr. I. (M.)’s agitation, anxiety and frustration, and that being unable to go out to smoke was also a psychological factor.
Dr. Pytyck clarified that Mr. I. (M.)’s indirectly supervised privileges were cancelled on March 16, 2026, while accompanied privileges were not cancelled but remained on hold.
Dr. Pytyck had known Mr. I. (M.) for several years and became his most responsible physician when his previous psychiatrist left Ontario Shores. Dr. Alioglu provided most of the day-to-day care. She believed that Mr. I. (M.)’s early March decompensation resulted from covert non-compliance with the oral medication needed to augment the long-acting injectable. She agreed that direct supervision of that oral medication would reduce the likelihood of recurrence. Even with direct supervision, patients can sometimes cheek medication. Supervision would not eliminate the risk of decompensation due to substance use, but it would reduce the risk of further decompensation.
Dr. Pytyck said substance use appeared to be a less significant factor in Mr. I. (M.)’s early decompensation in March 2026. Urine found in his room on March 9 raised the possibility that the samples he had submitted were not genuine, so she could not rule out substance use as a factor. She confirmed there had been no positive urine screen for cannabis.
Before his transfer to the FAU, Mr. I. (M.) became physically intimidating. He threw objects and kicked and punched doors and the nursing station. He also verbally threatened to kill staff and, at one point, put his hand on a nurse. To Dr. Pytyck’s knowledge, no one had specifically asked Mr. I. (M.) about the incident with the nurse.
Dr. Pytyck disagreed with Ms. Szigeti’s submission that moving Mr. I. (M.) from the FTU to the FAU had the potential to destabilize him by removing him from his usual care team. She said that, at the time of transfer, Mr. I. (M.)’s relationship with the team was extremely strained. Staff were cautious around Mr. I. (M.). He had been consistently verbally threatening and unpredictable. He was extremely difficult to manage. His interactions with other patients were also concerning, and there were concerns that other unwell patients were becoming more destabilized because of his dysregulation on the unit. After his transfer to the FAU, he stabilized more quickly than he had on the FTU.
Once moved to the FAU, Mr. I. (M.) settled down within a couple of weeks. She agreed that during the two to three weeks prior to the hearing, he has not been a management concern. About 10 days before the hearing, the team first concluded that Mr. I. (M.) would be suitable to return to a general unit, when Dr. Wang noted that he was improving and would likely be able to return to general if his stability continued. Dr. Pytyck agreed that Mr. I. (M.) was calm at the hearing. Based on information from Dr. Alioglu and Dr. Wang, she agreed that Mr. I. (M.) had returned to baseline.
Dr. Pytyck said she had no concerns about Mr. I. (M.) returning to the FTU. She noted that the FTU team might feel apprehensive about his return, given “how much our milieu was unsettled, and we do still have those unwell patients who were feeling frustrated by Mr. I. (M.),” but added that this was “a bit of a separate issue.” She noted that there can be a benefit in moving patients to a different unit for a fresh start. However, if Mr. I. (M.) were transferred back to the FTU, staff would provide him with the best care possible, and there was nothing in his current clinical condition that would affect staff’s ability to manage him.
Dr. Pytyck added that the FAU manager confirmed that Mr. I. (M.) attended a staff-accompanied bank outing two days before the hearing and had accompanied grounds privileges, which he had not used. The manager also told Mr. I. (M.) the day before the hearing that staff-accompanied privileges remained available both on hospital grounds and in the community, which was the highest level of privilege available to him, and staff were encouraging him to use them. He was also offered a gym outing, but declined. Before March 9, Mr. I. (M.) also had indirectly supervised access to the community and hospital grounds.
Questions from the Panel
In response to questions from the panel, Dr. Pytyck said that the FTU is a general forensic unit. Dr. Wang’s recent notes indicate Mr. I. (M.) has re-stabilized, that 10 days prior to the hearing it appeared he would soon be able to return to the FTU and that he was ready to return as of the day before the hearing. Although Dr. Wang referred specifically to the FTU in his notes, Dr. Pytyck interpreted this as applying more broadly to any general forensic unit, not just the FTU. No formal transfer order has been made yet because transfer orders are only written once a bed is available. Dr. Pytyck could not confirm which unit Mr. I. (M.) is currently being considered for, but said that bed managers are aware that he is ready for transfer and that he should be moved in the near future. In Dr. Pytyck’s opinion, because FTU staff are feeling somewhat apprehensive about Mr. I. (M.)’s return, and co-patients have been troubled by Mr. I. (M.) in the past, it may be better for Mr. I. (M.) to return to a general unit other than the FTU. However, if no other bed becomes available and Mr. I. (M.) returns to the FTU, staff will still provide him with appropriate care.
With respect to privileges, Dr. Pytyck clarified that references made earlier to “direct” refers to “accompanied” and “indirect” refers to “unaccompanied”.
Questions Arising
Ms. Szabo had no further questions.
In response to a question from Ms. MacDonald, Dr. Pytyck confirmed that some other patients are fearful of Mr. I. (M.), as his presentation while on the unit was previously quite disruptive. This is a factor that is considered whenever decisions are made about where to return a patient.
Ms. Szigeti had no further questions.
Oral Evidence of Mr. I. (M.)
In response to questions from Ms. Szigeti, Mr. I. (M.) stated that no one had ever told him that other patients were apprehensive about his presence on the unit. If given the choice, which he said he had not previously been offered, he would prefer to transfer to another unit. However, he would return to the FTU (“7-2,”, which is Dr. Pytyck’s unit) if that were the only option.
Mr. I. (M.) stated that he did not recall ever grabbing a nurse’s wrist. No such issue had arisen in 30 years and he believed he would remember if it had occurred. With respect to smoking, he stated that he last smoked approximately three months earlier and described addiction as “a serious matter” that affects a person emotionally, psychologically, and physically. If he wanted a cigarette, he had to ask for one, and being unable to obtain one was “annoying” and “frustrating.”
Regarding privileges on the FAU, the escorted trip to the gym that Mr. I. (M.) was offered the day before the hearing was the first time anyone had spoken to him about privileges or explicitly offered him one. When he asked whether he was eligible for privileges, he was told that he was, but that the forensic director (“Kathy”) had not yet “signed off.”
In response to a question from Ms. MacDonald regarding the search of his room, the medication found, and staff concerns that he was cheeking medication, Mr. I. (M.) stated, “I don’t take the clozapine drug”, that neither smoking nor taking his medication had been problematic and that he understood the pros and cons, as well as the advantages and disadvantages, of his medications, although he still becomes upset at times. When asked whether smoking or taking his medication was more important to him, Mr. I. (M.) responded that he did not understand the question and that the two could not be compared. He stated that he takes medication for schizophrenia “because I was told it is good for me.”
Ms. Szabo had no questions.
In response to a question from a panel member, Mr. I. (M.) clarified that he had gone on a bank outing two days before the hearing and had been offered the opportunity to attend the gym the day before the hearing, as described earlier in his evidence to Ms. Szigeti. He stated that he had no other outings sI. (M.) being transferred to the FAU.
Mr. I. (M.) stated that he objected to medication he believed had been administered without his consent, resulting in blood clots and hospitalization. He acknowledged that in her oral evidence, Dr. Pytyck acknowledged his swollen ankles, but he wished to emphasize his belief that the medication had been given without consent.
Mr. I. (M.) stated that “I wasn’t having any problems with anyone” and that his problem was only about the drug that caused the reaction. He realizes that, as a singer, he can be loud in his speech and manner, but that does not mean he is mentally ill. He reiterated that he wanted the freedom to smoke cigarettes occasionally.
There were no further questions and no further evidence was called.
VII. Final Submissions
Ms. Szabo submitted that both the initial restriction of liberty beginning on March 9, 2026, and the ongoing restrictions up to the hearing were necessary and appropriate to protect public safety. Initially, Mr. I. (M.)’s indirectly supervised passes were maintained and later cancelled. His directly supervised passes were then suspended. This gradual escalation of restrictions was necessary in response to worsening symptoms. The treatment team had hoped Mr. I. (M.) would respond to treatment and return to baseline, but this did not occur. Efforts to stabilize him on the general unit and address covert non-compliance were unsuccessful, and as his symptoms escalated—including physical and environmental aggression, verbal aggression, and threatening behaviour—further restrictions became necessary, resulting in his transfer to the secure unit for the safety of staff and patients.
Ms. Szabo further submitted that the restrictions imposed while Mr. I. (M.) was in the FAU remained necessary and appropriate to stabilize him, which occurred relatively quickly. His accompanied passes were never permanently cancelled, rather, those were temporarily suspended and then reinstated on April 10, 2026. The treatment team now plans to return him to a general unit once a bed becomes available. By the day before the hearing, the team was satisfied that he had stabilized and was ready for transfer. He has now returned to baseline.
Ms. MacDonald submitted that the Crown agreed with the hospital’s position. While healthcare staff necessarily tolerate certain behaviours, they are not required to accept physical or verbal assaults. Regarding the allegation that Mr. I. (M.) grabbed a nurse’s hand, she noted that Mr. I. (M.) stated he could not remember the incident and said that such behaviour was not typical of him. She further noted that the entries at pages 3 and 4 of the hospital report describing Mr. I. (M.)’s criminal record include assaultive behaviour. Public safety was taken very seriously in the decision to progressively restrict Mr. I. (M.)’s privileges and ultimately transfer him to the secure forensic service. Accordingly, the original restriction of liberties was necessary and appropriate. She added that the evidence indicates Mr. I. (M.) has now essentially returned to baseline and is awaiting an available bed.
Ms. Szigeti submitted that her position was informed by a broader concern that the forensic mental health system lacks sufficient urgency in reducing restrictions and restoring liberties. Mr. I. (M.) is now back to baseline and ready for fewer restrictions, but staff concerns about returning him to his original unit have not been discussed openly with him. While returning him to that unit (the FTU) may not be ideal, there is currently no clear plan for his return to a general unit. Mr. I. (M.) should have been returned to a general unit once stabilized and should now be housed on such a unit, as continued detention in the secure unit (the FAU) is more restrictive than his clinical condition or public safety requires.
Ms. Szigeti further submitted that Mr. I. (M.)’s privileges should have been restored once he stabilized. His privileges could be individualized and the failure to return him to his privilege level prior to March 9, 2026, is no longer reasonable, necessary, or justified on public safety grounds. Additionally, his indirectly supervised privileges did not contribute to his decompensation, which was instead linked to covert medication non-compliance. Once he returned to baseline there was no reason not to restore his prior off-unit privileges. While accompanied off-unit privileges technically remained available to Mr. I. (M.) and were reinstated on April 10, 2026, this was not communicated to Mr. I. (M.) in a timely way given the length of his stabilization. He still does not have the full range of privileges he previously enjoyed, which should already have been reinstated. Although the trial outings from seclusion were not ideal, Mr. I. (M.)’s primary concerns related to his passes, the security level of his detention, and access to cigarettes. Concerns remain regarding the security level and conditions of Mr. I. (M.)’s detention, the lack of passes, the delay in restoring his previous level of liberty and the need to develop a concrete plan for his transition. Staff should engage Mr. I. (M.) more directly in planning and communicate candidly with him, as he may well agree with the proposed approach. Mental health professionals should be able to facilitate a patient’s return to the ward milieu through explanation, discussion and regular communication.
In summary, Ms. Szigeti reiterated that Mr. I. (M.) contests all aspects of the restrictions and asked the Board to assess each stage of the increased restrictions separately and determine whether each was proportionate to the need to protect public safety.
VIII. Analysis
In considering each issue, the Board reviewed the most recent hospital report (January 26, 2026), the Reasons for Disposition (January 29, 2026), the restriction of liberty report (May 6, 2026) and carefully considered the viva voce evidence of Dr. Pytyck and of Mr. I. (M.).
The Board is satisfied that the initial restriction of liberty that began on March 9, 2026, was necessary and appropriate, as well as the least restrictive and least onerous approach. According to Dr. Pytyck’s evidence, beginning on March 6, 2026, Mr. I. (M.) showed signs of decompensation, including being labile and yelling. By March 9, Mr. I. (M.) was refusing medication necessary to maintaining stability. He was disorganized, irritable, off baseline, and aggressive, all of which were behaviours well known to staff as indicators of decompensation in Mr. I. (M.). He became agitated and aggressive during the search of his room on March 9. Overall, there had been a marked change in mental status together with behavioural dysregulation. Evidence of his medication noncompliance, including partially dissolved olanzapine found in his room, supported the conclusion that he was not receiving the oral medication required to augment his long-acting injectable. Restrictions were initiated as a result on March 9. His illness then became unmanageable resulting in his transfer to the FAU on April 12, 2026.
The Board is further satisfied that the initial restrictions were the least onerous and least restrictive options. The hospital did not move immediately from no restriction to long-term seclusion or placement on a secure unit, but instead adopted an incremental approach. Of note, Mr. I. (M.) was trialed in seclusion multiple times between March 13 and April 4. Despite various interventions—including increased frequency of his long-acting injectable medication, an increased olanzapine dose, added PRN medications and higher clonazepam—he did not return to baseline quickly. His condition continued to deteriorate, raising concerns about ongoing instability, possible covert medication noncompliance and the need for continued seclusion if on the FTU. Because the FTU environment was becoming increasingly unsettled and both patients and staff reported safety concerns due to Mr. I. (M.)’s behaviours, he was transferred to the secure unit for closer observation and more structure. SI. (M.) the transfer, Mr. I. (M.) has returned to his usual baseline and is now considered capable of consenting to treatment. All of these factors convI. (M.)d the panel of the need for the restrictions imposed initially and during the early part of Mr. I. (M.)’s placement on the FAU.
However, the Board is not satisfied that the ongoing restriction of liberty remained necessary and appropriate throughout. Mr. I. (M.) appeared to have been on a trajectory toward transfer back to a general unit during the two to three weeks prior to the hearing. The panel had significant concerns that Mr. I. (M.) may have been ready for transfer as early as ten days before the hearing, concurrent with a clinical note by Dr. Wang and Dr. Pytyck’s interpretation of the note, although across all of the clinical notes there was no clearly identified and precise point at which Mr. I. (M.) became ready for transfer.
The evidence also showed that, while awaiting transfer, the hospital should have taken further steps to lessen the practical burdens of the restriction. This included restoring or facilitating available privileges while on the FAU and clearly communicating those privileges to Mr. I. (M.). The hospital could have addressed the impact of the restrictions far more proactively, including attending to the effects of smoking deprivation and nicotine withdrawal, ensuring that Mr. I. (M.) understood and was able to exercise the privileges available to him pending transfer and communicating clearly with him about the anticipated transfer. On this point, Ms. Szigeti’s suggestion—that regular discussion with Mr. I. (M.) may help prevent future incidents—is certainly worth consideration.
Conclusion
The Board finds that the restriction placed on Mr. I. (M.)’s liberties occasioned by restrictions beginning on March 9, 2026, until sometime after his return to baseline while on the FAU was necessary and appropriate, as well as the least onerous and least restrictive intervention available to the hospital in the circumstances. However, the restrictions ceased to be necessary and appropriate at some point within the ten days prior to the hearing, and undoubtedly by the day before the hearing. Mr. I. (M.) should therefore be transferred back to a general ward. There is certainly no basis for maintaining the restriction, particularly where less restrictive measures and available privileges should be enabled.
The Board acknowledges the contributions made by Mr. I. (M.) during the hearing and wishes him well as he moves forward.
In making this decision, the panel has considered the need to protect the public from dangerous persons, Mr. I. (M.)’s current mental state, his reintegration into society and his other needs.
DATED this 1^st^ day of June 2026, at the City of Toronto, in the Toronto Region.
Ms. K. Weisbaum Legal Member
Office of the Registrar Ontario Review Board