Re: Pierre Vezina
ORB File No: 3881
Hearing held on: Tuesday May 12, 2026
Place of Hearing: St. Joseph’s Healthcare Hamilton West 5th Campus
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. S. Clapp Members: Dr. J. Kis Dr. G. Nexhipi Ms. N. Nathanson Mr. S. Doherty
Parties Appearing: Accused: Pierre Vezina Counsel: Mr. A. Rai
The Person in Charge of Hospital: Counsel: Mr. S. O’Brien
Attorney-General of Ontario: Counsel: Mr. B. Adsett
REASONS FOR DECISION
(Dated June 8, 2026)
Introduction
On December 4, 2003, Pierre Vezina, now 62 years old, was found not criminally responsible on account of mental disorder (“NCR”) on a charge of possession of a weapon for a purpose dangerous to the public peace, contrary to the Criminal Code. Mr. Vezina was most recently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated June 2, 2025 pursuant to which he was ordered detained at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“SJHH” or “the Hospital”), subject to various conditions and privileges, up to and including community living within the catchment area of the Hospital in accommodation approved by the person in charge.
On Tuesday, May 12, 2026, a panel of the Board convened in person at the Hospital to review Mr. Vezina’s Disposition and make a new Disposition. The issues at the hearing were whether Mr. Vezina represents a significant threat to the safety of the public as that term is defined in s. 672.5401 of the Criminal Code and, if so, to determine the necessary and appropriate Disposition that is also the least onerous and least restrictive, considering the factors in s. 672.54 of the Code. Mr. Vezina attended the hearing.
Positions of the Parties
- At the commencement of the hearing, counsel for all parties advised that they were jointly recommending a Detention Order with no changes to the Disposition dated June 2, 2025. Mr. Rai indicated that he was not contesting the issue of significant threat to the safety of the public. The parties maintained their positions at the conclusion of the evidence. Accordingly, the panel was presented with a joint submission.
Findings
- For the following Reasons, the panel accepted the joint recommendation and made an independent finding that Mr. Vezina represents a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Detention Order containing the same terms included in the Disposition of June 2, 2025.
Index Offence
- The circumstances surrounding the index offence are taken from pp.3-4 of the Hospital Report, dated April 8, 2026 which was exhibit 1 at the hearing and the Reasons for Disposition, dated July 7, 2025, and are reproduced as follows:
“The Crown Brief Synopsis and victim witness statements indicate that the charge for which Mr. Vezina was found Not Criminally Responsible arose out of an incident in which he went to his parents' home and threatened his father with a knife. It is also documented that on the evening prior to the commission of the offence, Mr. Vezina had tried to visit his sister but was denied entry because she did not trust him because of past behaviour. Mr. Vezina apparently started screaming at her and stated that he hated his sister and wished she was dead.
Then, on November 1, 2003, when her husband was outside washing windows, Mr. Vezina's sister observed him taking a pocketknife out and was talking to her husband and telling him he was "a crazy, stupid bastard". Apparently, the husband ignored Mr. Vezina's comments and in fact returned to the inside of the house. However, given his past behavior, the sister had already called 911 asking for assistance. Once that call was made, she contacted her parents to make sure that they were okay. Mr. Vezina's sister also had indicated that she did not want Mr. Vezina around any of the family, as everyone was afraid of him as he had been threatening towards them too many times.
The Crown Brief Synopsis documents state that on November 1, 2003, at approximately 10:50 hours the accused waved a jack knife (Swiss Army knife) with a blade of about two inches in length, approximately 12 inches away from his father's throat. While waving the knife back and forth he stated, "it’s a small knife but it could go deep". Mr. Vezina, Sr. feared for his safety.
As a result, the accused was arrested at 11:50 hours for having in his possession a weapon for a dangerous purpose. The knife was seized and submitted into property. The accused was then brought to police headquarters where at 1245 hours he spoke with his lawyer and then was lodged awaiting a video bail on November 2, 2003.
The witness statement of Mr. Vezina, Sr. indicates that his son had been showing him a knife which he had just bought, but when he started doing a slashing motion in front of his father's face, his father had tried to stay calm so that his son wouldn't get mad. It is also indicated that Mr. Vezina, Sr. had tried to talk about other things so that his son would stop moving the knife around.
Further information received from the witness statement of the patient's mother indicates that on October 31, 2003, Mr. Vezina had gone to their residence asking for food and drink. She gave him a Pepsi and a coffee but he didn't want that and wanted his father to take him out for coffee. His father really wasn't keen on this, but as the accused seemed to be getting agitated and in fact had taken the telephone book and ripped pages out of it and then banged it on the table, his father complied and went for coffee with him. The mother's statement further indicates that between 1:00 a.m. and 7:00 a.m. on November 1, 2003, her son called their residence on six different occasions.”
Diagnoses
- • Schizoaffective Disorder, Bipolar Type
- Alcohol Use Disorder, in remission in controlled environment
- Cannabis Use Disorder, in remission in controlled environment
- Antisocial Personality Disorder
Background Information
Mr. Vezina’s background is set out in detail in the Hospital Report. As the Hospital Report was made an exhibit, it’s contents form part of the evidence and the background need not be extensively restated here. The following brief summary is excerpted from last year’s Reasons.
Mr. Vezina was born and raised in the area of Sturgeon Falls, near North Bay, where he lived with his parents and five siblings. He completed grade 11, then left school to work with his uncle at a sawmill until 1987, when he became unemployed. Since that time, his income has been a disability pension related to his mental illness.
Records indicate that Mr. Vezina started using street drugs at approximately 13 years of age and has reportedly used them consistently since then. He consumed both marijuana and hashish, as well as excessive amounts of alcohol.
Mr. Vezina is single and has never been married, but has been involved in at least three common-law relationships, all of which reportedly involved what the Hospital Report characterizes as “domestic discord” (at p. 7).
Prior to the index offence, Mr. Vezina had a history of threatening and intimidating his family members, as a result of which they are very fearful of him.
Mr. Vezina’s criminal record consists of approximately 50 convictions prior to the index offence. His first conviction was in 1979 when he was 16 years old. His record includes a variety of property offences including breaking and entering, many breaches of court orders, offences of violence including assault causing bodily harm, uttering threats, and criminal harassment. His last convictions prior to the index offence were on February 25, 2003, when he received a global six-month custodial sentence for assault, mischief under $5,000.00, failing to comply with a recognizance, and theft under $5,000.00.
Psychiatric History Prior to the Index Offence
Mr. Vezina has an extensive history of involvement with psychiatric services beginning in the early 1980’s. His records indicate that over the years, he has had admissions to the Sudbury Algoma Hospital and the (former) Clarke Institute of Psychiatry, as well as the North Bay Psychiatric Hospital. Starting in 1984 when he was 21 years old, Mr. Vezina has had approximately 24 admissions to the North Bay Psychiatric Hospital (now known as North Bay Regional Health Centre - North Bay Site), including his initial stay there following his NCR verdict. On four of these occasions, he was admitted to the Forensic Program as a result of involvement with the criminal justice system. On three occasions he entered on a judicial order for assessment of either fitness to stand trial or criminal responsibility, and on the other occasion he entered on a Medical Temporary Absence Pass from the North Bay Jail.
Regarding his other pre-NCR admissions to the North Bay hospital, in most circumstances, Mr. Vezina was brought by the police as a result of being physically aggressive, violent or threatening to other individuals. On four occasions, Mr. Vezina was admitted as a result of suicidal behaviour. It is documented that he overdosed on prescription medication, not in an attempt to harm himself but rather to get high.
Notably, during Mr. Vezina’s multiple admissions, his behaviour was consistent in that he was demanding, lacked insight and judgment, was sarcastic, showed disrespect for ward rules and programs, lacked motivation to engage in honest discussion, and was intimidating and aggressive. During 11 admissions, he spent most of his time in seclusion. On three of those occasions, he required transfer to the Forensic Program so that he could be more appropriately managed.
Mr. Vezina’s lengthy history under the Board’s authority is set out at pp. 2-3 of the Hospital Report. In brief terms, he was initially detained at the North Bay Psychiatric Hospital (NBPH), later referred to as the North Bay Regional Health Centre (NBRHC) until the Ontario Review Board ordered on October 13, 2016, that he be transferred to the Waypoint Centre for Mental Health Care (“Waypoint”). After approximately seven months at Waypoint, the ORB ordered that Mr. Vezina be transferred to the Secure Forensic Unit at St. Joseph’s Healthcare Hamilton. Mr. Vezina was admitted to SJHH from July 6, 2017, to August 22, 2018, before returning to the North Bay Regional Health Centre pursuant to a Board Disposition dated July 18, 2018. On January 22, 2021, the Board ordered that Mr. Vezina be transferred back to SJHH. He was admitted to Harbour North 3 on September 3, 2021, under the care of Dr. Sutton.
It is noted that a community living privilege was included in Mr. Vezina’s Disposition following his 2005 ORB hearing. Despite this, Mr. Vezina made little rehabilitative progress for several years and engaged in antisocial behaviour and repeated breaches of the hospital’s rules of conduct. His behaviour included intimidating other patients into giving him money. Successive behavioural plans were implemented. His treatment team observed that his behaviour demonstrated the severity of his diagnosed antisocial personality disorder. He also experienced fluctuations in his mental state along with threats to harm staff or co-patients. Following a period of gradually increased indirectly supervised privileges for community employment assignments, Mr. Vezina was discharged to a TRHP (Transitional Rehabilitative Housing Program) home in June of 2015.
During the summer of 2015, while he appeared to be adjusting well to the home, he had trouble maintaining his medication compliance, appearing to mix up his morning and evening doses. He was readmitted to the hospital in early September for stabilization due to observed decompensation. He was again discharged in February 2016 but again readmitted in March, due to reported threats of bodily harm to another resident. It does not appear that he has lived in community accommodation since then.
Mr. Vezina was using indirectly supervised community privileges in the spring/summer of 2016, though he was still experiencing delusional thoughts, volatile mood, and continued his pattern of intimidation of co-patients. At the beginning of August, because of a report by a co-patient, a police search in a wooded area on hospital grounds revealed two hunting knives with six-inch stainless-steel serrated blades, some disposable razors, plastic bottles of urine, a cosmetic bag full of cosmetics, and an empty cigarette package with Mr. Vezina’s name printed on it. Mr. Vezina admitted to police that the knives were his and that he had hidden a switchblade knife in the dirt outside the hospital’s horticultural centre. Police located this knife. As a result of these discoveries and other reports of Mr. Vezina’s activities, including selling drugs to co-patients, he was transferred to Waypoint as noted above.
Mr. Vezina was transferred to SJHH in 2017 after it was determined that he could be managed in a less secure facility than Waypoint. His behaviour at SJHH was characterized by “. . . a repeating pattern of complying with rules for a period of time until he gains a higher level of privilege, then after a short time he breaches the rules that apply to that level of privilege” (Hospital Report, p. 64).
Evidence at the Hearing
In addition to the Hospital Report, the panel heard the oral evidence of Dr. W. Sutton who has been Mr. Vezina’s attending psychiatrist since 2021, when Mr. Vezina returned to SJHH.
“Over the past year there have been multiple rule infractions for bringing contraband onto the unit and smoking in his room, which has resulted in limited indirect access to the hospital and community. What is perhaps more concerning is Mr. Vezina’s volatility over the past year. Although Mr. Vezina’s difficulties with anger management and frustration tolerance are longstanding, his limited indirect privileges over the past year has fueled increased frustration, which has resulted in numerous instances of agitation, verbal aggression, and physical aggression towards property. Mr. Vezina required overnight seclusion on March 25-26, 2026 due to escalating agitation culminating in him swearing and threatening nursing staff, and violently slamming his door multiple times. Similar instances of agitation have occurred with more frequency over the past year.
The clinical team remains unanimously of the opinion that Mr. Vezina remains a significant risk to the safety of the public. Although symptoms of his Schizoaffective Disorder have been well controlled for many years, deeply entrenched antisocial personality features continue to hinder progress, and contribute to inertia with respect to Mr. Vezina’s rehabilitation and recovery. Even in the highly structured, predictable setting of the inpatient unit, Mr. Vezina continues to experience difficulty with frustration tolerance, which has led to numerous instances of agitation, verbal aggression, and occasionally, physical aggression towards property. What is more, Mr. Vezina struggles with taking responsibility for his actions, as he often externalizes blame to others when he engages in rule violations or demonstrates inappropriate behaviour towards co-patients or staff. In the absence of the structure and support offered by the forensic program, Mr. Vezina’s difficulties with anger management and emotional volatility would intensify, increasing the risk of aggression towards others. Although substance misuse has not featured prominently over the past year, a relapse with respect to drug use would serve to further amplify risk to others.” (p. 120-121, Hospital Report)
The Hospital Report pp. 115-117 outlines a number of notable incidents over the past year. These include acts of verbal aggression, physical aggression toward property, and sexually inappropriate behavior.
A risk assessment was conducted in 2025 and its results continue to remain valid. Mr. Vezina’s risk for reoffending is in the low-moderate range with the current terms of the Detention Order Disposition, without which he is likely to engage in antisocial behaviors, and medication discontinuation leading to psychiatric decline and violence.
Dr. Sutton reported that the year had been characterized by “ups and downs”. When his privileges permitted, Mr. Vezina participated in community volunteer activities at the Good Shepherd and intermittently attended leisure activities. However, in the past 6 to 8 months, he has experienced more frequent periods of agitation and has had a few periods of seclusion. Mr. Vezina is sensitive to periods of stress and lack of sleep. Dr. Sutton was of the view that these were likely the source of his behavioral issues this year. Mr. Vezina has had difficulty maintaining his privileges due to his behavior. He recently lost privileges due to rule-breaking. Dr. Sutton acknowledged that the treatment team struggles at times to figure out what support will help Mr. Vezina move forward.
Dr. Sutton stated that Mr. Vezina represents a significant risk to public safety and if anything, his risk might have increased slightly. He did, however, note that Mr. Vezina has demonstrated less physical aggression than in previous years. On the other hand, he has increasingly damaged property, made threats and yelled. Dr. Sutton noted that all of these instances have occurred in the context of a supportive structured setting. In the absence of this structure, Dr. Sutton indicated that he would be very concerned.
Substance use has been a serious issue in Mr. Vezina’s history. The issue has not represented a concern this year although Dr. Sutton noted that, in the absence of Board oversight, Mr. Vezina would relapse in his substance use.
Mr. Vezina has been adherent with his oral medication but he “bargains” with staff about taking it. Dr. Sutton is of the opinion that Mr. Vezina does not have much appreciation regarding the need to take medication. In the absence of Board oversight, he would be concerned about Mr. Vezina’s adherence to medication. In cross-examination, Dr. Sutton noted that Mr. Vezina’s insight fluctuated. He knows he has an illness that requires medication.
Mr. Vezina is on a waitlist for supportive housing. He will be considered for transition to community housing when a bed becomes available and he demonstrates consistent rule compliance and appropriate use of passes. In 2024, an offer of community housing was rescinded as it was determined that he posed an increased risk to take advantage of vulnerable people within the residence.
In response to questions, Dr. Sutton noted that Mr. Vezina has grandiose and unrealistic ideas about who his parents are and what he may have done years ago. Mr. Vezina works fairly well with the treatment team but problems arise when he is frustrated. His conduct follows a pattern: when he loses privileges, he does not take responsibility and externalizes blame, and this leads to overt agitation or aggression.
In response to questions from Mr. Rai, Dr. Sutton agreed that Mr. Vezina’s rule noncompliance could be attributed to his frustration with having been under the jurisdiction of the Board for more than two decades.
In response to questions from the Board, Dr. Sutton indicated that Mr. Vezina’s sleep is unpredictable and this may be a contributing factor to his misattributions such as the misidentification of who his parents are and Mr. Vezina’s belief that he had been sexually assaulted by staff in the night. Although, Dr. Sutton is not certain why these occur. Mr. Vezina later admitted the assault did not occur.
When asked whether Mr. Vezina is at a treatment impasse, Dr. Sutton indicated that the treatment team was hopeful that a strategy could be developed for Mr. Vezina to regain and maintain his privileges. When he is on the unit, without privileges as he is now, he becomes bored.
Analysis and Conclusions
The panel reached an independent conclusion that Mr. Vezina represents a significant threat to the safety of the public. Mr. Vezina has a long-standing diagnosis of a serious mental illness which is further exacerbated by a severe antisocial personality disorder and substance abuse challenges. He has a very extensive and serious criminal history with numerous convictions for violent offences. He also has a history of medication non-compliance when living in the community.
The index offence involved the use of a knife as a weapon and with which he threatened his father. In 2016, he was transferred from the North Bay Regional Health Centre to the Provincial Programs Division of Waypoint after purchasing large hunting knives in contravention of his Disposition, that prohibited the possession of weapons. He had hidden these knives, along with a switchblade knife, on the hospital property in North Bay.
Over the past 6 to 8 months, Mr. Vezina has experienced more frequent periods of agitation, characterized by verbal aggression, threatening comments and property damage leading, in some cases, to seclusion. In past years he engaged in similar behavior as well as physical aggression. There was less physical aggression this year but the other behaviors increased.
From a risk assessment perspective, it is concerning that even in the highly structured, supportive environment of the inpatient unit, Mr. Vezina has demonstrated verbal aggression, sexually inappropriate behaviour and, at times, physical aggression towards property.
Mr. Vezina has limited insight into his behaviour and externalizes blame when he violates the rules or otherwise engages in conduct that causes him to lose privileges. Mr. Vezina’s insight into the need for medication is limited.
Based on the evidence, the panel finds that without the structure provided by a Detention Order, Mr. Vezina would likely become non-compliant with his medications, leading to decompensation in his mental state and a substantial likelihood that he would engage in serious criminal activity.
The panel accepts Dr. Sutton’s evidence, and concurs with the joint submission in finding that a Detention Order is the necessary and appropriate Disposition. There is room within Mr. Vezina’s current Disposition for him to progress, including to community living when appropriate. In making this decision, the panel has considered all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition, his reintegration into society and his other needs, the necessary and appropriate Disposition is a Detention Order, upon the terms as recommended by the Hospital.
DATED this 8th day of June 2026, at the City of Toronto, in the Toronto Region.
Norine Nathanson Legal Member
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Office of the Registrar Ontario Review Board