Derek Skillings (Re), 2026 CanLII 53926

Ontario Review Board

Re: Derek Skillings

ORB File No: 8885

Hearing held on: Monday, May 11, 2026

Place of Hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas

Pursuant to: Section 672.47 (1) of the Criminal Code

Before: Alternate Chairperson: Mr. J. Weinstein Members: Dr. R. Kunjukrishnan Dr. P. Wright Mr. E. Siebenmorgen Mr. A. Mete

Parties Appearing: Accused: Derek Skillings Counsel: Mr. G. Negro The person in charge of hospital: Counsel: Ms. J. Zamprogna Attorney General of Ontario: Counsel: Ms. K. Dalrymple

REASONS FOR DISPOSITION (Dated June 3, 2026)

Introduction

1On October 15, 2025, Derek Skillings was found not criminally responsible on account of mental disorder (“NCR”) on charges of theft not exceeding $5,000.00, assault, uttering a threat to cause bodily harm, and assaulting a peace officer, all contrary to the Criminal Code. The trial court did not make a Disposition and Mr. Skillings continued to be subject to his pre-trial release order pending the making of a Disposition by the Ontario Review Board (“ORB” or “the Board”).

2On Monday, May 11, 2026, a panel of the Board convened in person at the Southwest Centre for Forensic Mental Health Care (“Southwest Centre” or “the Hospital”) , to conduct Mr. Skillings’ initial hearing, as required pursuant to s. 672.47 (1) of the Criminal Code. There were two basic issues before the Board. First, the Board had to determine whether Mr. Skillings represented a significant threat to the safety of the public within the meaning of s. 672.5401 of the Code and the governing judicial authorities. If so, the Board was required to address the second issue: to determine the necessary and appropriate Disposition, pursuant to s. 672.54 of the Code. Mr. Skillings was present for his hearing and was represented by his counsel, Mr. Negro. Mr. Skillings’ mother also attended.

Evidence for the Hearing

3On February 17, 2026, the Board ordered an assessment of Mr. Skillings’ mental condition, on an out-of-custody basis, for the purpose of determining an appropriate disposition. The hearing evidence included the resulting out-of-custody report dated April 6, 2026 (the “Assessment Report”) along with an Update to that report dated April 30, 2026. In addition, Dr. Ajay Prakash, who authored the Assessment Report, gave evidence summarizing and supplementing the documentary evidence.

Positions of the Parties

4At the start of the hearing, counsel for the Hospital, supported by counsel for the Attorney General and by counsel for Mr. Skillings, advised that it was recommending a Conditional Discharge on the terms listed in the Assessment Report. The issue of “significant threat” was undisputed. The terms of the proposed Disposition included a minimum of twice monthly reporting to the Southwest Centre, a “consent to treatment” provision pursuant to s. 672.55 of the Criminal Code, and a requirement for the provision by Mr. Skillings of breath and/or urine samples for testing. Notably, the Hospital’s recommendations did not include a substance use abstention requirement, for reasons explained in the Assessment Report, and the parties were asked to address this during the hearing.

5As the hearing proceeded, panel members raised questions concerning the potential need for a substance use abstention clause, Young¹ clauses, and a clause specifying Mr. Skilling’s place of residence. These matters were addressed in closing submissions. All parties expressed a lack of opposition to the inclusion of Young and residence clauses. They maintained their initial positions in relation to the other aspects of the proposed Disposition, including that a substance use abstention clause was not necessary.

Findings

6For the following Reasons, the panel found that Mr. Skillings represents a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Conditional Discharge. The panel decided to include, in addition to the conditions jointly recommended by the parties, the following terms that were determined necessary to safely manage the public safety risk in this case:

• a residence condition directing Mr. Skillings to live at his mother’s home;

• a condition requiring that Mr. Skillings abstain absolutely from the non-medical use of alcohol or drugs or any; other intoxicant;

• a condition requiring that Mr. Skillings immediately attend at the Hospital and participate in a psychiatric assessment if directed to do so by the person in charge or their designate; and

• a condition requiring that Mr. Skillings immediately comply with a direction to submit to admission to hospital from the person in charge of the Hospital, or their designate, and remain hospitalized until discharged by the person in charge or their designate.

The Index Offences

7The index offences are described in an Agreed Statement of Facts filed as an Exhibit at the court proceedings. To ensure that this Statement of Facts is preserved for future hearings, it is reproduced in its entirety, save for the removal of personal information, including information tending to identify the victim, [who instead is simply referred to as “the store clerk” or “the clerk”], as follows:

On Sunday the 2nd of February 2025, Derek Matthew KILLINGS [personal information redacted] entered a variety store in Woodstock, Ontario. SKILLINGS walked to where the energy drinks were within the store and grabbed two. SKILLINGS attempted to walk out the store with them where store clerk confronted SKILLINGS advising him that he had to pay for the drinks.

SKILLINGS became confrontational and called the store clerk “goof”, and as the clerk came around the counter SKILLINGS viciously attacked him punching him multiple times pushing him against the counter. The clerk attempted to stop the Assault by pushing SKILLINGS away. SKILLINGS continued to Assault the clerk by punching him while the clerk ran to the back of the store to get away. SKILLINGS followed him to continue the Assault where the clerk left the store and using his keys locked SKILLINGS inside the store while contacting the Woodstock Police Service.

At 10:45 Hrs. Woodstock Police Service were dispatched to an Assault at the store. Police were advised that a male who was locked inside the store assaulted the clerk.

Police arrived on scene and were advised by the clerk that the male was still inside the store.

Police looked through the glass door and could see SKILLINGS behind the counter, loading up his backpack with property from behind the counter. The clerk opened the door for Police where SKILLINGS was confronted about stealing. SKILLING advised the police that he was “taking shit” and zipped up his backpack. Police walked around the counter and advised SKILLINGS to drop the backpack.

At 10:50 Hrs. Police arrested SKILLINGS for Assault and Theft. While cuffing SKILLINGS to the back, SKILLING looked at the clerk and stated, " You called the cops on me?" and then stated, "You're fucking dead, you hear me" Police advised SKILLINGS to stop talking where he stated, " when I get out, you’re going to get it". Police advised SKILLINGS that he was now under arrest for Uttering Threat.

On Sunday February 02, 2025, police were dispatched to The Quality Inn &Suites located at 580 Bruin Boulevard in the city of Woodstock. Information contained in the call text stated that Derek Matthew SKILLINGS (1986-03-20) was in the lobby of the hotel and was refusing to leave.

Police attended the lobby and located SKILLINGS sitting in the lobby. Police advised SKILLINGS that hotel staff wanted him out of the lobby and off the premise.

SKILLINGS told officers that he was waiting for his wife to attend the hotel, as she was staying there. Hotel staff explained to officers and SKILLINGS that his wife was not staying there. SKILLINGS refused to listen to staff and continued to demand to stay to see his wife.

SKILLINGS then requested a cab to attend "The Inn" but did not have money for a cab. SKILLINGS then advised that he would walk to "The Inn" and began to walk away towards the street. Officers remained on scene to ensure that SKILLINGS did not return to the property.

SKILLINGS got to the corner of Bruin Boulevard/Juliana Drive and then began to walk back to the hotel.

Officers advised SKILLINGS multiple times to not return to the hotel but he kept walking towards the hotel.

SKILLINGS began to yell and swear at officers and advising that he is returning to the hotel. Officers again advise him to not return, SKILLINGS refuses to listen.

SKILLINGS then takes a bladed stance and takes 3 quick steps towards PC Pearson. To prevent SKILLINGS from assaulting officers, SKILLINGS is taken to the ground. While on the ground, SKILLINGS used his right fist to strike PC Pearson in the left side of the jaw. To prevent any further assault, officers used distractionary strike to gain physical control of SKILLINGS.

At 21:44 hours, SKILLINGS was placed under arrest for Assault a Peace Officer. SKILLINGS is taken to car 2102 and is read rights to counsel and caution. SKILLINGS indicated that he understood and did not wish to call a lawyer.

During lodging process, the accused advised officers that he was diabetic and needed insulin. EMS were requested. On EMS’s arrival the accused was observed administering insulin shot to himself, under supervision of EMS.

Overview of Background Information

8As the Assessment Report and the Update are in evidence, the information therein need not be exhaustively reviewed for the purpose of these Reasons. Those portions that provide helpful context for the index offences and the issues at this hearing are highlighted below.

9Mr. Skillings was 40 years of age at the time of the hearing and just under 39 at the time of the index offences. He is separated from his wife, having reportedly been married from the ages of 25 to 34. He has three children whom he now sees regularly and reportedly enjoys an amicable relationship with his ex-wife.

10Mr. Skillings had been essentially unhoused for a few weeks prior to the index offences. Although he had been staying for a time in his mother’s home, he was no longer welcome there as of early January of 2025 due to his deteriorating mental health and associated behaviour. He was staying at a local shelter in Woodstock.

11Despite some reluctance on her part, his mother allowed him to return home following the index offences and a period of hospitalization, treatment with antipsychotic medication, and stabilization. He continued to reside with his mother and stepfather pending his trial and following the NCR verdict, to the time of the Board hearing.

12Mr. Skillings’ current diagnoses are:

• Bipolar Disorder, Type I;

• Cannabis Use Disorder, in remission; and

• Cognitive Impairment.

Social, Substance Use and Psychiatric History

13Mr. Skillings was born in Woodstock. His early years were spent on his family’s farm, where he lived with his parents and younger sister. His father died suddenly a few months before Mr. Skillings’ sixth birthday. His mother reported that the family struggled through the grieving process. Although Mr. Skillings did not initially demonstrate an emotional response to his father’s death, he began to show signs of distress some seven months later, including bedwetting, fear of falling asleep, and frequent episodes of crying at night. After his father's passing, Mr. Skillings reportedly also became increasingly attached to his grandfather, who lived next door. His passion for the family farm was evident in his ability to direct neighbouring farmers who came to assist, instructing them on feeding routines and animal care.

14Mr. Skillings’ mother stated that she met her current husband approximately a year after the death of Mr. Skillings’ father. The children readily welcomed their new stepfather and Mr. Skillings' mother recalled her son once asking whether his father would be upset if he liked his stepfather. His mother consistently reassured him as he navigated these conflicting emotions.

15Mr. Skillings himself reported having had a generally positive relationship with his family during his childhood. However, these relationships became strained during his adolescence, due to his substance use (discussed further below). Between grades 6 to 8, Mr. Skillings was involved in numerous physical altercations, which he attributed to unresolved grief and emotional distress following the death of his father. He described himself as frequently angry and reported difficulty forming friendships during that time. He also stated, as confirmed by his mother, that he was bullied in grade 8, contributing to further peer conflict.

16Mr. Skillings reported that he began to consume both alcohol and cannabis when he was 14 years old, and on one occasion was suspended from school after consuming alcohol with friends during the lunch break. His mother identified this incident as the beginning of regular truant behavior. Mr. Skillings was reportedly physically assaulted on a few occasions during high school and dropped out in grade 10. He worked in various part-time positions between the ages of 14 and 16.

17Mr. Skillings continued to live at home until the age of 18. By this time, his consumption of alcohol and cannabis was supplemented by cocaine and crack cocaine, and he was asked to leave the home. He stayed with his paternal grandparents but was asked to leave their home for similar reasons after approximately a month. He then lived in a Salvation Army shelter in London for approximately six months, and then in an apartment with a roommate for about two years. He worked at a fast-food restaurant in London but his substance use also continued. He also accumulated his first five criminal convictions (two for uttering threats) in London, prior to his 19th birthday.

18When he was 20 years old, Mr. Skillings returned to Woodstock and moved back in with his mother and stepfather. He completed his high school credits at an adult learning centre by age 24. He returned to employment at age 26, and at age 28, established and operated his own landscaping business, which he managed for four years. Thereafter, he held a series of shorter-term positions until approximately 2022. According to Mr. Skillings, he was married from age 25 to age 34, living with his wife during that interval. He and his wife had three children, fraternal twin sons and a daughter. Following their separation, his ex-wife obtained custody of the children and Mr. Skillings again returned to live with his mother and stepfather.

19Mr. Skillings accumulated several criminal convictions from the time of his return to Woodstock until 2011 (approximately the year of his marriage, by his report), including two for assault and one for uttering threats. He was then free of additional convictions until May of 2018, when he was convicted of ten offences, including assault, assault with a weapon, two counts of uttering threats, and several convictions for failing to comply with various court orders. By his report, his substance use continued during this period. He has acknowledged becoming violent while intoxicated.

20Mr. Skillings’ psychiatric history overlaps to some extent with his history of substance use. He reported experiencing memory difficulties beginning in high school, which he had initially attributed to significant cannabis use. He later reported that these issues became more pronounced following a motor vehicle accident in early adulthood, at which point he began experiencing notable memory lapses even in the absence of substance use. Documentation revealed that Mr. Skillings first began experiencing symptoms of depression in the summer of 2002, at which time he was prescribed antidepressant medication by his family doctor. He also reported experiencing anxiety attacks. There is a history of suicidal ideation and one suicide attempt during his adolescence.

21Collateral information from his former spouse indicated that Mr. Skillings' psychiatric symptoms often intensified when he was under the influence of drugs and alcohol. She also noted that there were times when he appeared mentally unstable without using any substances. She reported that between 2008 and 2020, Mr. Skillings experienced approximately four episodes that she described as “mental breaks from reality”. In April of 2012, Mr. Skillings was referred for crisis intervention following his attendance at the Emergency Department of the Woodstock General Hospital. Information provided by his family indicated that his symptoms had emerged two days earlier, when he reportedly broke into a neighbor's home under the belief that it was his own, shouted incoherently at his fiancée, and became confused about the vehicle he was driving. During his assessment, Mr. Skillings expressed a sense of detachment, stating that he “felt like [he] was living someone else's life”. He could not recall his fiancée’s name and could not tell his case worker when their relationship had begun. Mr. Skillings reported daily cannabis use and expressed concern that his cannabis had been laced with another substance. However, toxicology results were positive only for THC.

22Mr. Skillings’ first recorded psychiatric admission occurred in early February of 2018. He attended at the Emergency Department at Grand River Hospital accompanied by police following their response to a domestic disturbance at his residence. Medical records indicated that he had been discharged from the Emergency Department earlier that day with a follow-up appointment scheduled for the following week through the Concurrent Disorders Program. The documentation noted that Mr. Skillings and his spouse had separated two days earlier. Mr. Skillings appeared disorganized and delusional upon assessment, exhibiting signs consistent with a formal thought disorder. Collateral information from his mother revealed that in the days leading up to this hospitalization, she had brought him to his family physician after he accused her of attempting to kill him, alleging that she was involved in drug trafficking. Mr. Skillings reported the daily use of cannabis, dab, and shatter in the period leading up to his admission and stated that he had also consumed cocaine two days earlier. Toxicology screening returned positive results for both cannabis and cocaine.

23Mr. Skillings was first formally diagnosed with bipolar disorder during admission to the Woodstock hospital from October 5-10, 2020. He attended the Emergency Department on his own after sending text messages to his spouse in which he expressed suicidal intent. Upon assessment, he reported that approximately 3 weeks earlier, he had been involved in a motor vehicle collision in which he “T-boned another driver” while under the influence of alcohol. A review of collateral history provided by his spouse indicated that he experienced episodic periods of agitation, grandiosity and increased energy that met the criteria for mania. He participated in group therapy sessions during his admission and was treated with antipsychotic medication. Following stabilization, he was discharged to outpatient care and prescribed a long-acting injectable antipsychotic medication.

24Mr. Skillings was followed by the Woodstock Hospital Mental Health Outpatient Clinic from November of 2020 to the end of April, 2024. He received injections of his prescribed antipsychotic medications every four weeks. He reported intermittent use of cannabis and alcohol but denied any related concerns. After two years of stability, his dose of injectable medication was reduced, and then reduced further due to tardive dyskinesia. He was transitioned to a different antipsychotic medication in oral form. He discontinued follow-up following an appointment in April of 2024. He reported that he discontinued his oral antipsychotic medication by or in the month of December of 2024 and began to experience manic symptoms, including increased energy, decreased need for sleep, flight of ideas, and grandiose and paranoid delusions.

25Mr. Skillings attended at the Woodstock Hospital Emergency Department (ED) on December 30, 2024 and again on January 2, 2025 (on both occasions accompanied by his mother) due to worsening symptoms (including confusion, agitation, erratic driving, and lighting candles throughout the family home as a form of “spiritual therapy” to “eliminate germs”. On each occasion, he was discharged to his mother’s home following assessment.

26On January 3, 2025 (the day following his most recent hospital attendance), Mr. Skillings again attended the ED. It was reported that he had an argument with his mother, following which he was informed that he could no longer stay in the family home. He was admitted to the hospital and discharged on January 9. Upon admission, he stated that in the days prior to his attendance, he had been consuming between two and twelve “tall boy” cans of beer daily and was also using cannabis daily, including the use of a “shatter pen” [a small vape device that dispenses a concentrated and highly potent form of cannabis]. He declined an injection of a long-acting antipsychotic medication (paliperidone) in hospital and was ultimately discharged with a plan to follow up for medication management.

27Mr. Skillings was released following the index offences pending his court attendance. However, on the following day (February 4, 2025), he was brought by police to the ED at the Woodstock Hospital in a state of acute agitation. He was admitted and eventually discharged on February 18 after agreeing to receive recommended long-acting injectable antipsychotic medication (paliperidone). His course in hospital is summarized in some detail in the Assessment Report. Some details are notable. On the day of his admission, he expressed a homicidal threat to his mother, stating that he would burn down her house with her in it. Further, he was rambling, yelling and threatening to staff in the ED and took a swing at a nurse when staff tried to assess him. He was administered antipsychotic and antianxiety medication and placed in a seclusion room in view of his presentation.

28After several days of discussion, Mr. Skillings agreed on February 10, 2025 to receive paliperidone in the injectable form. He had continued to exhibit symptoms to this point. By February 12, he was able to participate in a family meeting with his mother, a social worker, nursing staff, and Dr. Syed, his attending psychiatrist. Mr. Skillings stormed out of the room upon being told that he remained unwell and needed to remain in the hospital longer for his treatment. It was also noted that his mother was under significant caregiver stress: she became tearful and stated that she had had “immense difficulty” managing her son for the last 25 years.

29By February 18, Mr. Skillings’ mother reluctantly agreed to a discharge plan under which he would return to her home. She was anxious about his discharge in light of the history. The plan, however, included: a 100-mg injection every four weeks; follow-up with outpatient psychiatry; connecting with the unit social worker about post-discharge drug addiction services; and a meeting with Canadian Mental Health Association (CMHA) services.

30Mr. Skillings’ psychiatric follow-up in the community, following his discharge from the Woodstock Hospital, is chronicled in the Assessment Report. In general, he has been seeing his community psychiatrist, Dr. Syed, approximately every two months and continues to receive his antipsychotic medication, by injection, from a nurse each month. He initially stayed overnight in a local shelter, with his days being spent at his mother’s home, but eventually moved into the family home full-time. Mr. Skillings reported using cannabis on the day prior to his first outpatient appointment but as of May of 2025, reported that he was no longer using it. He reported occasional alcohol consumption. Mr. Skillings has also attended monthly appointments with his assigned CMHA worker. He reportedly drives himself to his appointments.

31Mr. Skillings’ primary personal supports are his mother and stepfather. His mother reported that her son has remained at his baseline mental state since his discharge from hospital in February of 2025. Mr. Skillings also reported a good relationship with his sister and stepsiblings, whom he sees on special occasions. He socializes with friends and has a long-time friend, Matt, whom his mother confirms is a good support for Mr. Skillings. He also reportedly gets along well with his ex-wife, who lives in Kitchener, and his children, whom he visits every two weeks or monthly, either at their home in Kitchener or at his parents’ home.

32The Update to the Assessment Report states that Mr. Skillings denies any plans to leave the family home, although he has been on a waitlist for local subsidized housing since 2025. His mother reported that there have been no issues since her son returned home and that he is welcome to stay there as long as he needs to if it is safe for him to be there.

33Mr. Skillings had reportedly been attending community employment services and attended a job interview in March but was not called back thereafter. He maintains structure to his day by doing chores around the house, obtaining groceries for the family, spending time with family and friends, and playing recreational sports, including with his stepfather.

34The Assessment Report and its Update comments briefly on Mr. Skillings’ insight into his awareness of his mental condition and need for medication. He is aware of and accepts his diagnosis of bipolar disorder and its symptoms, along with the medications needed for his mental condition. He reportedly agrees that his past instability was largely related to drug use and in the early years, an undiagnosed and untreated mental condition.

Evidence at the Hearing

35Dr. Prakash advised the panel that Mr. Skillings has done well in the community since the time of the index offences. He stated that Mr. Skillings has stable housing with his parents, who know to whom to reach out for assistance.

36Dr. Prakash adopted the risk assessment in the Assessment Report and reaffirmed the Hospital’s recommendation for a Conditional Discharge. He advised that he had discussed this earlier on the hearing date with Mr. Skillings’ community psychiatrist, Dr. Syed, who was accepting of the recommendation. Dr. Prakash confirmed that he would be liaising with Dr. Syed going forward.

37Dr. Prakash briefly addressed the rationale for the absence of a recommendation for a substance use abstention requirement. He adopted the explanation given in the Assessment Report and stated that the intent is to test Mr. Skillings’ stated commitment to stay away from drugs. In the Assessment Report, Dr. Prakash wrote that Mr. Skillings’ cannabis use likely contributed to his mental health decompensations and resulting violence. He noted that there was no violence or decompensation from November of 2020 to December of 2024, despite the use of cannabis, while Mr. Skillings was adherent to antipsychotic medication. Dr. Prakash opined that given Mr. Skillings’ recent stability, an abstention clause is not currently necessary or appropriate. He stated that as far as he knew, Mr. Skillings had been (from his self-report) abstinent from substances since March of 2025, although he had been subject to no requirement to submit samples for testing. Counsel for the Attorney General orally advised the panel that Mr. Skillings’ pre-trial release terms did not include an abstinence requirement.

38Mr. Skillings’ counsel asked Dr. Prakash about the most significant risk factor for decompensation for his client. Dr. Prakash replied that a switch to oral medication or a return to cannabis use, or potentially a change in Mr. Skillings’ housing, could bring about such a change. In the event of a decompensation, the intervention would take the form of increased visits with Mr. Skillings to support his treatment. Asked by a panel member what would happen if such a situation recurred under the terms of a Conditional Discharge, Dr. Prakash said that the police would be called and Mr. Skillings would be taken to the Woodstock Hospital, where he would potentially be admitted.

39Dr. Prakash was asked by a panel member about Mr. Skillings’ criminogenic risk and potential personality issues in light of the record of criminal convictions that began in 2005. The doctor replied that he had turned his mind to a potential personality disorder but concluded that from his history, Mr. Skillings was likely suffering from an undiagnosed mental health condition for some years prior to his formal diagnosis in 2020.

40In response to a panel member’s questions, Dr. Prakash confirmed that the current arrangement whereby Mr. Skillings lives with his family was put in place prior to his involvement, which began after the Board ordered a risk assessment. During the two interviews for this assessment, Mr. Skillings and his mother were interviewed together. No one from the Southwest Centre visited the family home as part of the assessment. Dr. Prakash confirmed that though Mr. Skillings’ mother denied the existence of any issues in the family home, she was hesitant to have her son living there without the support of a forensic team.

41Panel members questioned Dr. Prakash about his opinion that Mr. Skillings’ risk could be managed by a Conditional Discharge. In Dr. Prakash’s opinion, the major issue in the past was a reluctance by his previous treatment provider to move away from Abilify as the main antipsychotic medication. He said that the current medication, which over the past year has appeared to be administered in a sufficient dosage, addresses Mr. Skillings’ major criminogenic risk factor (his mental disorder), and this was solved by the Woodstock General Hospital after the index offences. While Mr. Skillings could well go off of his medications (he is currently being managed on the assumption that he is capable of consenting to his treatment), there are other risk mitigation supports, particularly his mother.

42Asked by panel members what might need to be in place in the event that Mr. Skillings’ condition deteriorated but did not qualify for admission under the Mental Health Act (MHA), Dr. Prakash said that he would not be opposed to the inclusion of Young clauses (for assessment and for admission) as terms of a Conditional Discharge. He believed that under the MHA, if Mr. Skillings began to use cannabis but showed no sign of mental status decompensation, he could possibly issue a Form 1 and have Mr. Skillings brought to the Hospital for assessment. He would work with Dr. Syed in determining next steps, which could also include increasing Mr. Skillings’ medication or calling for an early Board hearing.

43Asked by a panel member directly whether cannabis use was a risk factor at all for Mr. Skillings, Dr. Prakash responded that there were occasions when Mr. Skillings remained mentally stable despite using cannabis (when he was taking prescribed medication) and other occasions when his mental state did deteriorate. He agreed that there could be a heightened risk if the cannabis came from a street dealer as distinct from a dispensary. He also acknowledged that a return to cannabis use would be a risk-enhancing factor even if Mr. Skillings remained compliant with his long-acting injectable medication.

44In explaining the rationale for not recommending that Mr. Skilling’s residence be specified in his Disposition, Dr. Prakash endorsed the Assessment Report, which includes an opinion that such a condition is neither necessary nor appropriate. The opinion cites as reasons the relatively recent stability of Mr. Skilling’s housing situation, mental condition, and the absence of any reported incidents of concern since his return to his parents’ home. Dr. Prakash acknowledged the history of Mr. Skillings being asked to leave their residence and the fatigue experienced by his mother from trying to care for him. He confirmed that if Mr. Skillings moved away from the residence and the place of his residence was specified in the Disposition, the Hospital could call for an early Board hearing.

45Dr. Prakash also confirmed that there had been no formal psychotherapy provided to Mr. Skillings’ family. After a Disposition was in place, the Hospital could provide such support, in a manner similar to the process that would be engaged for prospective Approved Persons.

46Following the conclusion of questions of Dr. Prakash from panel members, the parties were informed by the alternate chairperson that from the panel members’ questions, it should be apparent that the panel was not necessarily in agreement with the proposed joint submission as to the terms of a Conditional Discharge or even that a Conditional Discharge was the necessary and appropriate Disposition. The parties were then invited to ask any questions arising from the panel’s questions.

47Only Mr. Skillings’ counsel had further questions. He asked Dr. Prakash what the primary destabilizer for Mr. Skillings would be if he continued to be compliant with his medication. Dr. Prakash replied that if Mr. Skillings were employed and became stressed, this could prompt decompensation. He also said that cannabis use could increase this risk.

48No further evidence was led following that of Dr. Prakash.

49In closing submissions, all parties continued to agree that a Conditional Discharge was adequate to manage Mr. Skillings’ risk and was the least onerous and least restrictive Disposition. Counsel for the Hospital submitted that there existed a link between his bipolar disorder, his substance use, and his history of violence and that his historical risk pointed toward an uncertain future. Counsel noted Mr. Skillings’ abstinence from the use of substances but stated that he was still in the early stages of his recovery. His ability to maintain his stability and abstinence needed to be monitored and assessed. Counsel noted that while no psychoeducation has yet been provided to Mr. Skillings by the local Woodstock Hospital program, he enjoys good community supports. Counsel also stated that while the Mental Health Act would be effective to bring Mr. Skillings back to hospital if necessary, Southwest Centre would not be opposed to either a Young clause or a residence specification in the Disposition. She submitted, in accordance with her preliminary position, that a term requiring Mr. Skillings to submit samples for testing would be adequate for the purpose of testing his commitment to abstinence.

50Hospital counsel submitted, in the alternative, that if the Board were inclined to make a Detention Order, Mr. Skillings should have the full panoply of standard privileges, including community living in approved accommodation. Counsel for the Attorney General adopted the Hospital’s position in its entirety and made no additional submissions.

51In submitting that a Conditional Discharge is the least onerous and least restrictive Disposition, counsel for Mr. Skillings emphasized his client’s good insight, his medication compliance to date, and his recent abstinence from substances. He stated the Mr. Skillings was not opposed to the inclusion of a residence specification and a Young clause. He shared the other parties’ positions in relation to a Detention Order as an alternative Disposition.

Analysis and Conclusions

Significant Threat

52The panel found that Mr. Skillings represents a significant threat to the safety of the public. There is a real risk that if granted an Absolute Discharge, he would again fall away from treatment, including community mental health services and medication for his major mental disorder, and return to substance use. His housing would once again become unstable. Manic symptoms of his illness would emerge and he would likely engage, as he has in the past in criminally assaultive and threatening behaviour that would result in serious physical or psychological harm. As noted above, this issue was undisputed.

53Mr. Skillings suffers from a major mental illness that was first formally diagnosed in 2020 but, on the evidence, was likely active since 2002. His illness is exacerbated by a longstanding cannabis use disorder. Mr. Skillings also has a significant history of alcohol use and by his own admission, he has become violent when intoxicated.

54Mr. Skillings’ active symptoms had been well-controlled by antipsychotic medication, taken in long-acting injectable form, from approximately November of 2020 to early 2023. From then until he stopped taking his medication in December of 2024, he was receiving it in oral form. In the weeks leading up to the index offences, he was actively symptomatic and using cannabis. Of note, in providing his expert opinion on the issue of criminal responsibility, Dr. Wu of St. Joseph’s Healthcare Hamilton expressed the following view:

“In my opinion, his actions towards the clerk and the officer were primarily a function of the manic agitation and hyper-arousal and that these symptoms deprived him of the ability to emotionally regulate and choose a non-violent approach in response to his frustrations.”

55The index offences included assaults that carried the potential for serious physical injury and the utterance of a death threat. Within two days thereafter, while actively symptomatic and having consumed cannabis, he threatened to kill his mother by burning down her house with her in it. While being assessed in hospital, he attacked a nurse and had to be secluded. These incidents are set in the context of a criminal record, including convictions for multiple assaults and threats, dating to 2005.

56To his credit, Mr. Skillings has been adherent to his prescribed medication, has by all accounts maintained abstinence from the use of cannabis, and has remained stable since his discharge from hospital following the index offences. However, these are very early days in his recovery and his ability to maintain his current trajectory requires support and monitoring from the forensic system.

The Disposition

57The panel was satisfied that the degree of risk in Mr. Skillings’ case can be managed under the terms of a Conditional Discharge. As previously noted, the parties agreed that this was the necessary and appropriate Disposition. Mr. Skillings, through counsel, agreed to a “consent to treatment” condition pursuant to s. 672.55 of the Criminal Code. In addition, when the issue of a Young condition was raised through questions from the panel, neither Dr. Prakash in his evidence nor the parties in their submissions voiced concerns around such a condition. The panel is satisfied that the overall combination of the treatment condition, a Young clause (divided into two separate conditions as described below), specification of Mr. Skillings’ residence, together with provisions requiring both substance use abstention and testing for same is necessary and appropriate for managing his risk under a Conditional Discharge, as distinct from a Detention Order with a community living term.

58Mr. Skillings can live in the community as long as he is permitted to live with his parents at their home. His mother and stepfather have been his primary supports in the community during Mr. Skillings’ life as he struggled with substance use, his mental illness, relational challenges, and encounters with the criminal justice system. Much to their credit, they continue to be supportive of him despite experiencing the associated fatigue. While they provide a stable and caring foundation for Mr. Skillings’ reintegration into the community, this foundation requires the consistent support and monitoring provided by the forensic system. Public safety also requires this.

59Should Mr. Skillings exhibit early signs of substance use or mental health deterioration, observed either by his parents or the forensic outreach team, it is necessary that there be a ready mechanism by which his mental status and risk can be assessed by a forensic team familiar with his history. Should a period of hospital admission be necessary to manage any elevated public safety risk, the Hospital must have a means of effecting such an admission that is independent of the strictures of the Mental Health Act, which is beyond the jurisdiction of a review board² under Part XX.1 of the Criminal Code. The Young conditions, pursuant to which Mr. Skillings is required to attend the Hospital for assessment and, following assessment, admission if so directed by the person in charge of Southwest Centre or their designate, can achieve this. There is some reason, on the evidence, for confidence that Mr. Skillings would attend and submit voluntarily if so directed.

60As previously suggested in these Reasons, Mr. Skillings’ residence at his parents’ home and his mother’s ability to observe him on a day-to-day basis is in many ways a linchpin for his risk management plan. Should that residence no longer be available, as has occurred on several occasions including immediately prior to the index offences, or should Mr. Skillings decide to seek other accommodation, it may be necessary to review the Disposition in its entirety. An actual or proposed change in his residence must be brought to the Board’s attention. For these reasons, the panel ordered that Mr. Skillings’ current residence be specified in his Disposition.

61The panel appreciates that the parties jointly submitted that the Disposition need not contain a requirement that Mr. Skillings abstain from the consumption of intoxicants. The panel does not lightly reject this submission. As the Court of Appeal for Ontario stated in Hassan (Re), 2011 ONCA 561 at para. 24, the Board “ought to tread cautiously” before making an order that restricts the accused’s liberty beyond that which the hospital and Crown think necessary. However, at para. 25 the Court went on to say:

“However, the Board does not necessarily err because it declines to follow a hospital’s or Crown’s recommendation. Automatically adhering to the position of a hospital or Crown would mean abdicating its own role.”

62The Court of Appeal in Osawe (Re), 2015 ONCA 280 was clear in making the point (at paras. 33-34) that the Board has a duty to reject a joint submission that does not meet the requirements of s. 672.54 of the Criminal Code. In the present case, it is clear on the evidence that substance use enhances Mr. Skillings’ risk to public safety. By his own admission, he has been violent when intoxicated (whether by alcohol or other substances was not specified). Cannabis use has exacerbated the symptoms of his illness in the past. In addition, on several occasions, his substance use has resulted in being asked to leave the family home. His mother and stepfather are opposed to his use of cannabis.

63The panel finds that over the course of at least the next reporting period (which is his initial term under the Board’s jurisdiction), while Mr. Skillings adjusts to his forensic outreach team and the Hospital’s expectations for regular appointments and other matters, it is essential to maximize the likelihood of maintaining his housing stability, personal supports, and supporting his vocational goals (returning to gainful employment). While it is encouraging that Mr. Skillings has largely abstained from substance use since the time of the index offences (to some extent confirmed by the absence of reported issues in the household), Mr. Skillings has not yet had the benefit of psychoeducation, including in relation to the importance of remaining substance-free for his continued mental health stability. The panel agrees with the Hospital’s submission that Mr. Skillings’ historical risk factors, including cannabis use, are indicative of an uncertain future. In the interest of minimizing public safety risks over the next reporting period and maximizing the opportunity for building on Mr. Skillings’ stability and setting him up for successful reintegration in the longer term, his stated commitment to abstinence needs to be reinforced by a substance use prohibition in the Disposition.

64The panel wishes to congratulate Mr. Skillings on his cooperation with his community psychiatrist’s recommendations and his ongoing work with his CMHA worker. It is hoped that over the coming year, he will continue on his positive trajectory, including developing a collaborative therapeutic relationship with his new forensic team.

65In approaching this matter, the panel has considered the evidence through the lens of all the factors in s. 672.54 of the Criminal Code.

Footnotes

1. 1Named after Re Young, 2011 ONCA 432.
2. 2Ramos (Re), 2025 ONCA 820, 179 O.R. (3d) 126, at para. 34.