BRITISH COLUMBIA REVIEW BOARD
ALEXIS, Ronald - January 8, 2003
IN THE MATTER OF
PART XX.1 (Mental Disorder) OF THE CRIMINAL CODE
R.S.C. 1985 c. C-46, as amended 1991, c. 43
THE BRITISH COLUMBIA REVIEW BOARD
IN THE MATTER OF
THE DISPOSITION HEARING OF
PURPOSE OF HEARING
These are the reserved reasons in the matter of Ronald Alexis. On January 8, 2003, the Review Board conducted an order review. This was Mr. Alexis' fifteenth Review Board hearing. Mr. Alexis was last before the Review Board on October 21st, 2002, at which time the Review Board granted a short custody order reviewable by January 21st, 2003. The short order was made to allow counsel, on behalf of the accused, the opportunity to develop and present a discharge plan to the Review Board.
NCRMD Finding/Index Offences
Mr. Alexis comes under the jurisdiction of the Review Board by way of an NCRMD finding made on November 2nd, 1995. That finding pertained to one charge of "assault of a police officer", contrary to Section 270(1)(a), which assault occurred on April 19th, 1995. The assault arose when Mr. Alexis resisted arrest and swung a mop at the arresting officer. The NCRMD finding also pertained to a charge of "mischief in relation to property", contrary to Section 430(4), which occurred on May 1st, 1994. This incident involved Mr. Alexis throwing a block of wood inside a house causing damage to some property.
In a report to the presiding judge, dated October 31st, 1995 (Exhibit 9), Dr. Murphy states the index offences were likely a result of an acute state of schizophrenia and possibly elements of acute drug or alcohol abuse. This was in addition to Mr. Alexis' low IQ. Dr. Murphy states that it was a combination of these factors, plus the fact that Mr. Alexis was off his medications when the index offenses transpired, that led him to commit the index offences. In these circumstances, Dr. Murphy recommended a finding of NCRMD.
Personal, Criminal and Psychiatric History
Mr. Alexis' background is detailed throughout the disposition material. However, for a comprehensive summary of his personal, criminal and psychiatric history reference should be made to Exhibit 21, Review Board reasons pertaining to a November 29th, 1995 hearing, his first hearing.
Very briefly though, Mr. Alexis, who is of aboriginal decent, has a longstanding history of schizophrenia. This illness is complicated by the use of solvents from an early age, a pattern of non-compliance with prescribed medications and a pattern of elopement from residential environments. Mr. Alexis also has a history of violent behaviour at an early age with a conviction, as an adult, for assault causing bodily harm in 1989.
Prior Review Board Hearings
A review of Mr. Alexis' prior Review Board hearings indicates that, for the most part, Mr. Alexis has been maintained on a custody disposition with the exception of a conditional discharge granted on October 1st, 1996, July 19th, 2001 and July 5, 2002. His conditional discharge dispositions were curtailed by Mr. Alexis violating terms of his disposition order. For instance, in 1997 Mr. Alexis consumed marijuana while on a visit leave to Anahim Lake, resulting in a decompensation in his mental, state and a return to hospital. The return triggered a mandatory hearing, which initially resulted in a short custody disposition. The custody disposition was reinstated at the next series of hearings because of ongoing concerns with illicit substance use; AWOLs (1997, 1999); an altercation with a co-patient (1999); and the lack of an appropriate resource to discharge Mr. Alexis to.
It was not until July 19th, 2001 that Mr. Alexis received his next conditional discharge, to reside with his sister, Tina Alexis, in Prince George. The Director did not approve of this plan, instead it was proposing placing Mr. Alexis in a 24-hour supervised residence. The Review Board concluded that placement in a home of his family, under the supervision of Forensic Outpatient, was more appropriate and that, ultimately, there were "not significant differences or unassumable risks in attempting to reintegrate Mr. Alexis into his sister's home with the anticipated support". It is noteworthy that the Review Board's decision in July of 2001 was not unanimous, a dissenting member would have granted an absolute discharge.
At Mr. Alexis' next Review Board hearing, on July 5th, 2002, the decision was, again, not unanimous. The majority once again granted a conditional discharge. The dissenting member, again would have granted an absolute discharge. The evidence before the Review Board was that the last year was largely a positive one for Mr. Alexis, he had made a reasonably successful transition into the community, living in Prince George, with his sister. However, there was a slight set back, in January of 2002, when Mr. Alexis started living at Activator's Society, a 24-hour staffed facility in Prince George. Within a few weeks of this transition he started showing symptoms of deterioration and a return to marijuana use. After adjusting his medications Mr. Alexis was restablized and returned to live with his sister, where he was residing at the date of the Review Board hearing. The majority found that since Mr. Alexis had only been in the community for one year, following a fairly lengthy incarceration at FPH, that the ongoing jurisdiction of the Review Board was warranted for a further period.
Unfortunately, Mr. Alexis's conditional discharge status was curtailed on September 16th, 2002, when an Enforcement Order was issued against him for going AWOL from Activators Society on September 5, 2002. Mr. Alexis was moved back to Activators on August 23, 2002, after it appears, concerns arose with his accommodation at his sister's home. In any event, Mr. Alexis was ordered to return to FPH. The return triggered the Review Board hearing of October 21st 2002. The evidence before that Review Board was that there were ongoing issues of substance abuse. This combined with his recent AWOL, evidence that he had missed his last anti-psychotic injection, as well as lack of a viable community placement, gave the Review Board no other choice but to make a custody disposition. As stated in the outset a short order was made to allow counsel for Mr. Alexis the opportunity to prepare a detailed discharge plan.
POSITION AND EVIDENCE OF PARTIES
The Director, in its opening position, was recommending a broad custodial order, with visit leaves for up to sixty days. Crown Counsel reserved. Counsel for Mr. Alexis stated that her client wanted an absolute discharge. She stated the evidence would show that there were sufficient resources and family support in place to keep Mr. Alexis safe in Anahim Lake, where he would be returning. In the alternative, she said her client was requesting a conditional discharge, with a provision allowing him to reside where he wanted to, but not to change his address without prior notice to the Director.
EVIDENCE OF THE DIRECTOR
In terms of the reports provided by the Director for the hearing, the Review Board had before it the material before the last Review Board, namely a September 23rd, 2002 report from Ivy Verigin, at Exhibit 75, and an October 9th, 2002 report from Dr. Meldrum, at Exhibit 76. In addition to these reports the Review Board heard directly from Dr. Meldrum, Ivy Verigan and Carla McCully (the last two testified via tele-conference).
Dr. Meldrum both in her report and her oral testimony reviewed at length Mr. Alexis' historical and clinical variables and concluded that, in light of these factors, Mr. Alexis was an unacceptably high risk of harm to the public through physical aggression. Dr. Meldrum suggested that the only way to manage Mr. Alexis was in a supervised setting, either in the hospital or in the community, where his mental state and behaviour are carefully monitored. Dr. Meldrum recommended a broad custodial order.
If granted a custody disposition, Dr. Meldrum said their treatment plan would involve:
- Keeping Mr. Alexis on A3 where he would have escorted access to the community;
- Commence one to one sessions with the alcohol and drug counsellor;
- Continue his current medication regime; and
- Explore options for supervised living arrangements, either in Prince George, Williams Lake, or in any other community Mr. Alexis was willing to consider.
Dr. Meldrum was asked to address the discharge plan advocated on behalf of Mr. Alexis, specifically, "Plan 3" as outlined in Exhibit 80. This plan envisioned Mr. Alexis returning to live in Anahim Lake. Dr. Meldrum responded that their own investigations, through Ms. McCulley, into the resources in Anahim Lake led them to conclude that Mr. Alexis could not be safely managed in that community. Furthermore, Dr. Meldrum highlighted that when Mr. Alexis had been to Anahim Lake in the past, he engaged in "binge pattern" substance abuse, and his family members were not cooperative in preventing or even disclosing the same. Dr. Meldrum explained that Mr. Alexis needed to make further gains, in terms of understanding the implications of drug and alcohol use, before they could consider his return to a setting such as Anahim Lake. Dr. Meldrum suggested that treatment in a facility such as the Steven Krueger House, on Riverview grounds, is what Mr. Alexis needs. She explained that this is a long-term residential program, which offers intense treatment for drug and alcohol abuse. Dr. Meldrum said their plan would be to refer Mr. Alexis to this facility and if he made some gains they would then consider a return to Anahim Lake. However, she insisted that to allow him to return to Anahim Lake at this point would only be setting him up for failure.
Counsel for Mr. Alexis proposed to Dr. Meldrum the option of alcohol and drug counselling programs closer to Mr. Alexis' home. Dr. Meldrum responded that counselling was not the issue, but rather it was the intensity of the program that was important. In her opinion, the Steven Krueger Program was the most appropriate one for Mr. Alexis, at this point, where he would be living with individuals with dual diagnosis.
Also, in response to questions from counsel for Mr. Alexis, Dr. Meldrum admitted that the last time Mr. Alexis acted out with any form of serious physical aggression was in 1989, when he was convicted with assault causing bodily harm. Since being in the forensic system, Dr. Meldrum admitted that there has been nothing of any serious consequence.
Ms. McCulley also testified, via tele-conference, and she advised that she had recently spoke to Gary Holt, the family representative, about the resources available in Anahim Lake. Mr. Holt had advised her of the following:
- There were a number of job opportunities available on the reserve;
- There was a new program called Eagle Heart;
- They now had a medical van;
- There was a medical clinic on the reserve;
- There was a police detachment on the reserve, operating full time;
- Many family members were willing to take Mr. Alexis in; and
- The Band's office would act as a message number.
In addition, to the resources on the reserve, Ms. McCulley testified that she would be able to, personally travel to Anahim Lake, at least weekly, subject to approval by her supervisor. Furthermore, Dr. Tomita would come up quarterly and, therefore, be able to see Mr. Alexis once every three months.
EVIDENCE ON BEHALF OF MR. ALEXIS
Counsel had requested, at the last Review Board, an opportunity to present a detailed discharge plan for the next Review Board hearing. Indeed, her presentation was very comprehensive, in the form of at least a dozen people, most of them from the Anahim Lake region, family members and members of the Band, who had travelled down to the Review Board hearing to show their support. From this large group of people a handful were selected by counsel to testify. Their evidence is briefly narrated below.
Evidence of Gary Holt, Representative of Band and Counsellor
Mr. Holt testified that the following resources were in place at Anahim Lake:
- Drug and alcohol counsellor:
- The counsellor is available five days a week; and
- The counsellor can arrange to set up people in a residential treatment program, which is culturally based, should the need arise.
- Medical Clinic:
- There is a medical clinic, on the reserve, where a nurse is available 24 hours. In addition, they have an ambulance, a medical van, and two van drivers.
- Health Centre:
- They have a health centre with two nurses, one from the band.
- They are hiring a mental health worker as of January 20th, 2003.
- There is a police detachment with four constables all of who live very close to the reserve and monitor the reserve on a daily basis.
- Band Counsellors:
- The band counsellors are available to monitor the reserve. They hold council meetings every week.
- Centres and Programs:
- They have recently built a youth centre and an elders centre;
- They have a program called the 'Sage Program', set up by the Band, and this program works with people who have alcohol and drug problems;
- They have a program called 'Eagle Heart', which is a collaboration of four bands who offer counseling, such as anger management, and spend time at each reserve.
- Housing Program:
- They have a government funded housing program whereby the government puts up $38,000.00 and the band member puts up $5,000.00 towards a new trailer.
- Mr. Alexis would be eligible for this housing.
- The roads from Anahim Lake to Williams Lake were now paved.
Mr. Holt testified that, compared to 1995, when the index offences occurred, the resources outlined were much more comprehensive. Mr. Holt explained that the Band had acquired a third of the lumber mill, which generated a cash flow allowing them to substantially upgrade the resources in the community, in all aspects.
In response to whether there were any concerns around Mr. Alexis' return to the community, Mr. Holt responded that the subject of Mr. Alexis' return had been discussed at length and people were well aware of the situation. Mr. Alexis had a lot of relatives who were willing to provide him with a place to stay, at least the homes of three different relatives, where he could stay immediately. Everyone felt that Mr. Alexis deserved a chance. Mr. Holt stated that if Mr. Alexis were to decompensate or require intervention they would contact the necessary counsellors, family members, and police, whatever was required in the circumstances. He himself did not believe anyone was at risk of undue harm from Mr. Alexis.
Evidence of Shirley Jack, Mental Health worker
Ms. Jack testified that she had been hired in 2002 as a mental health worker for the people in Anahim Lake. She explained that her duties involved conducting workshops around various issues, ranging from self-esteem, life skills, and suicide. She would be able to work in conjunction with Eagle Heart. She would also be able to work in conjunction with Leona, the drug and alcohol counsellor.
Ms. Jack testified that, in her opinion, given the comprehensive level of resources in place at Anahim Lake, that the community had the ability to deal with the sort of psychiatric issues presented by Mr. Alexis.
Evidence of Tina Alexis, sister of Mr. Alexis
Tina Alexis testified that when her brother was staying with her in the community, in Prince George, he was very happy. It was only after he was placed in Activators Society that problems surfaced. She expressed that she was not afraid of her brother, and that, in her opinion; he was not an aggressive person. She was confident that he would never hurt anyone. Ms. Alexis was adamant that her brother needed to be around people that he respected and that the Review Board should "let the Band deal with the problem…The band needs to step in to take care of its own people". If things got out of hand, she stated that the drug and alcohol counsellor could intervene and even the RCMP if necessary. She was advocating for an absolute discharge on behalf of her brother.
Evidence of Beverly Moody, aunt of Mr. Alexis
Ms. Moody stated that her nephew, Mr. Alexis, was recently with her during his AWOL in September of 2002. He stayed with her for one week and during that time he was doing well and she was not afraid of him. She testified that she was willing to have him back and have him stay with her and her dad again. She explained that her home was only two miles away from the Band office and the Band clinic. She said she would encourage Mr. Alexis to take his medications and stay away from marijuana.
Evidence of Victor Alexis, uncle of Mr. Alexis
The uncle testified that if Mr. Alexis were to return to Anahim Lake he was confident that the community could take him care of. He explained there was a community health association, which would be able to meet with Mr. Alexis and make sure he was okay. This association was only a couple of doors down from him.
Evidence of Mr. Alexis
Mr. Alexis also testified at the hearing. He stated he wanted to live in Anahim Lake at either his Aunt Beverly or Aunt Vivian's home. He stated he would stay on his medications, would attend AA, and even a residential program if required. He stated he was comfortable talking to Shirley Jack. Furthermore, if required and told to go to the hospital he would do so.
As for his symptoms, if he were to decompensate, Mr. Alexis said he would start to hear voices, start talking to himself a lot and spend a lot of time alone. If he started to decompensate he said he would let others around him know that he was getting sick.
As for the option of staying in hospital and attending the Steven Krueger House, Mr. Alexis responded that he did not want to go to another boarding home. Mr. Alexis was clear that he wanted to return to Anahim Lake.
The Director maintained its opening recommendation in support of a broad custodial order.
Crown Counsel, responding to the request for an absolute discharge, stated that even though Mr. Alexis has not committed a serious offence in recent years, he has a long-standing mental illness and history of aggressive behaviour. The situation intensifies with the use of illicit substances. Crown Counsel submitted that there are concerns with Mr. Alexis' discharge plans, mainly that they are quite recent and not fully explored by the hospital. In addition, previous returns to Anahim Lake have not been successful. Therefore, in these circumstances, Crown Counsel supported the recommendation of the hospital.
Counsel on behalf of Mr. Alexis highlighted the following points in favour of an absolute discharge:
- The index offences, at Exhibits 2 and 3, occurred almost eight years ago.
- Although Mr. Alexis does have a prior conviction for assault causing bodily harm in 1988, there is no other serious incident since then. Although, he has had altercations with co-patients while in the hospital, his last physical act of aggression, of any significance, was in 1988.
- Since being under forensic care no one has complained of aggressive behaviour by Mr. Alexis when he has been in the community.
- While on his medications his mental state is stable.
- On occasion, with drug abuse, there have been some signs of decompensation but he has never deteriorated to the point of serious aggression.
- Drug and alcohol counselling can be addressed in Anahim Lake.
- Mr. Alexis can receive his depot injection in Anahim Lake.
- Mr. Alexis has the whole community behind him at Anahim Lake.
- Mr. Alexis has the overwhelming support of the Band and his family, none of whom have any fears or concerns for his return.
- The community has more resources in place now compared to 1995 when the index offences occurred.
In light of these factors counsel submitted that Mr. Alexis was not a significant threat to the public safety. Alternatively, counsel advocated for a conditional discharge with a clause allowing Mr. Alexis to reside wherever he wished to, but not to change his address without prior notice to the Director.
REASONS AND FINDINGS OF REVIEW BOARD
In making a decision that is the least onerous and least restrictive, the Review Board is governed by Section 672.54 of the Criminal Code. Section 672.54 enumerates the factors to be considered by the Review Board in making its disposition. The factors are:
- the need to protect the public from dangerous persons;
- the mental condition of the accused;
- the reintegration of the accused into society; and
- the other needs of the accused.
If after taking into account these factors the Review Board concludes that the accused is not a significant threat to the public safety the Review Board must order an absolute discharge. Winko v. British Columbia (Forensic Psychiatric Institute), a 1999 decision of the Supreme Court of Canada reviews the definition of significant threat. Applying that definition and the criteria above, the majority concluded that Mr. Alexis was a significant threat to the public safety. Below is our assessment on each criterion.
I. The Need to Protect the Public From Dangerous persons.
With respect to this criterion, the majority found that:
- The violent behaviour Mr. Alexis engaged in when a youth did not play a significant part of our assessment. We found that, with the passage of time, this historical factor played a small role in our finding.
- The index offences, which took place in 1995, occurred in Anahim Lake where it is proposed that Mr. Alexis return;
- Although the resources in Anahim Lake are currently very comprehensive, compared to 1995, past returns to Anahim Lake have not been without problems. For instance, the 1997 return resulted in a relapse to marijuana use, mental state decompensation and a return to hospital. Also, during his recent AWOL to Anahim Lake, in September 2002, Mr. Alexis again consumed marijuana, apparently, unbeknownst to those around him. Accordingly, the majority found that the support and supervision of Forensics was required during this delicate transition back to Anahim Lake. The additional monitoring of Forensics will ensure that the comprehensive resources and support network detailed at the hearing is, in fact, effective.
- The majority found that to sever all contact with forensics and grant an absolute discharge would put Mr. Alexis in a situation of "too much too soon". In such circumstances, Mr. Alexis may succumb to the stresses, resort to elicit substances and engage in behaviour similar to the index offences.
- The resources currently in place at Anahim Lake, consisting of a fully staffed police detachment, a band counsel, together with supervision of Forensics are more than sufficient to protect the public.
II. The Mental Condition of the Accused.
With respect to this criterion, the majority found that:
- Mr. Alexis suffers from schizophrenia but is currently mentally stable.
- Mr. Alexis' recent custody order arose partly from concerns with his compliance to medications. Mr. Alexis is currently compliant with his medications in the hospital.
- Mr. Alexis' recent custody order also arose from concerns with illicit substance use. Mr. Alexis continues to have difficulties in abstaining from marijuana.
- Consumption of illicit substances is known to impact Mr. Alexis' mental state negatively, his mental state decompensates.
- Mr. Alexis has been tried in a number of drug and alcohol programs and they have had limited effect. Accordingly, we doubt the proposal of the Director to place Mr. Alexis at Steven Krueger House will have a significant impact on Mr. Alexis.
- The resources currently in place at Anahim Lake in the form of a medical clinic; mental health clinic; mental health worker; drug and alcohol counsellor; an ambulance; medi-vans; and connections to outside resources, together with the support and monitoring of Forensics are more than sufficient to address Mr. Alexis's mental health needs.
With respect to the third criterion the majority found that:
- Mr. Alexis does well in a supportive family environment. For instance, when he resided with his sister, Tina, in Prince George he was happy, settled, compliant in taking his medications, he make genuine attempts to abstain from illicit substance use, and generally maintained good mental stability.
- When Mr. Alexis was placed in Activators Society, a boarding home, things took a turn for the worse. Mr. Alexis relapsed quite significantly into abusing illicit substances, including cocaine. When one considers the nature of this facility, one that house federal parolees, it is not too surprising that the gains made by Mr. Alexis were quickly eroded and he was eventually returned to FPH. The shift away from his sister's home to the boarding home, as a step towards independent living, did not work for Mr. Alexis. It is clear that being around family is critical for his reintegration. A return to Anahim Lake where his family and band are, while being monitored by Forensics, would indeed be facilitating his "true" reintegration.
IV. Other Needs.
With respect to the fourth criterion the majority found that:
- It is clear from the distances people travelled and the large group of people at the hearing, that there is a lot of support for Mr. Alexis' return to Anahim Lake, to "their community".
- Allowing Mr. Alexis to return to Anahim Lake would address Mr. Alexis' unique cultural background, and would be sensitive to the desire of Mr. Alexis' band to have an opportunity to help "one of its own".
- To keep Mr. Alexis in custody while attempts are made to find a supervised boarding house placement simply ignores this facet. The attempt to place Mr. Alexis in Activators Society was clearly illustrative of this.
- The band has clearly revised and improved their support network and resources, therefore, the majority agrees that the people of Anahim Lake should be given the opportunity to help Mr. Alexis, but while under the supervision of Forensics.
In summary, for all the preceding reasons, the majority found that a period of time under the purview and monitoring of Forensics would assist Mr. Alexis in making a successful transition to living in Anahim Lake, where it is proposed that he will eventually be set up to live independently in his own trailer. For these reasons we made a conditional discharge disposition.
In closing, we comment that we were impressed with the support shown by the people of Anahim Lake, the friends and relatives who travelled a great distance to attend Mr. Alexis' hearing. Their presence and support was noteworthy.
Ronald Alexis (Dissent) (Walter)
In arriving at a dissenting opinion as to the appropriate disposition for Ronald Alexis, I have independently reviewed the historic disposition information as well as the new evidence brought forward for, and in the course of the January 8, 2003 hearing. I have also read the majority reasons of my colleagues.
My own summary of highlights of the evidence follows.
Mr. Alexis' social history is described and commented upon in numerous documents and assessments. It is well summarized in the Reasons for Disposition of November 29, 1995: Ex. 21.
Of particular note are the accused's isolated, deprived, impoverished childhood within an extended family context of serious alcohol exposure and abuse; early exposure to and engaging in solvent abuse; behavioural difficulties including aggression, explosive outbursts of temper and loss of self control.
By 1985 (age 15) the accused was assessed as schizophrenic, solvent addicted, conduct disordered and "probably" borderline retarded: Ex. 11, 13, 14. He spent a considerable period of time at Maples Adolescent Treatment Centre between 1985 and April, 1987.
The index offences of mischief (May 1994) and assault of a peace officer (April 1995) have also been the subject of repeated comment. The first offence consisted of the accused, in the context of a family argument, throwing a block of wood or a chair and damaging a wall. The second offence occurred when the accused was confronted in his own residence by police officers engaged in the execution of an arrest warrant. The accused, who functions at a borderline intellectual level, was apparently confused and disoriented. He picked up a floor mop and struck a peace officer on or about the right shoulder or face, with the 'string' portion of the mop, whereupon he was subdued with pepper spray and cuffed. No injuries ensued.
The Review Board has characterized these index offences as "relatively minor", without intending to diminish Mr. Alexis' history which involves more serious violence while he was a youth: Ex. 21. For example, we have evidence at Exhibit 7 of two 1989 convictions for assault causing bodily harm which would have been committed while the accused was a youth. Not much information is available regarding the circumstances of these offences but they appear to have involved staff at the accused's group home residence.
It has also been considered indicative of Mr. Alexis' historic and potential dangerousness that at age 13 he apparently tied up an eight year old boy and tortured him for 60-90 minutes by burning him with the end of a smouldering piece of rope. There were other children involved in the incident. I take the view that this event occurred in the distant past more than half a lifetime ago, when the accused was functionally a very young child.
He has at times been aggressive and at least once assaultive while detained.
Notably, the transcript of the accused's Provincial Court NCRMD hearing (November 2, 1995), indicates that it was always intended that the accused would be cared for by, and remain in, his own community. Unforeseen, extraneous circumstances conspired to cause him to be initially committed to FPI.
Despite initially maintaining Mr. Alexis' custodial status, the Review Board and his treatment team have throughout recognized, acknowledged and agreed with Mr. Alexis' singular and intense interest, desire, indeed longing to return to his extended family and home community to which he remains deeply attached (as partially demonstrated during several AWOL's). The goal of his repatriation has in the past remained unrealized because the level of Mr. Alexis' needs for significant structure, supervision, services and monitoring, as assessed by his treatment providers and the Review Board, have exceeded what was available or realistic in his community: Ex. 21, P. 3.
Nonetheless as early as May 1996 his community, the Ulkatcho First Nation, has asserted that the accused could be repatriated, rehabilitated and cared for in his community: Ex. 31.
Once lodged at FPI and consistently treated, the accused's co-operation, behaviour and mental state settled and ameliorated. His symptoms remitted, he stabilized and began to participate in Drug & Alcohol and anger management programs. His separation from family and community remained a source of stress for him. Over time his risk to public safety has consistently been linked to non-compliance to treatment; relapse to substance use, and the absence or withdrawal of structure and supervision.
Within a year the accused was discharged to reside in the supported environment of Willingdon House. Mr. Alexis was unhappy in group care. Unfortunately in the spring of 1997 it was discovered that Mr. Alexis had used marijuana while on a visit leave to Anahim Lake. He had apparently also been regularly using marijuana at his Willingdon Residence.
On June 30, 1997 the accused eloped to Quesnel where he indulged in marijuana and alcohol. On July 26, 1997 he was returned to FPI pursuant to an Enforcement Order: Ex. 38. On re-admission he made it clear he had no long term intention to cease his substance use. According to his treatment providers the consistency and prominence of his commitment to substance use rendered him an unsuitable candidate for residential treatment programming.
Mr. Alexis' relapse to substance use and return to the restrictive environment of FPI marked the onset of a more defiant, oppositional behaviour pattern, including ongoing marijuana use and physical aggression. He remained in custody until July, 2001 despite continuing efforts to identify appropriate, alternative community based resources in Williams Lake and Prince George.
With the passage of time Mr. Alexis' demeanour and attitude improved somewhat but he maintained his rather predictable pattern of marijuana use interspersed with periodic Unauthorized Absences (escapes from custody) for days or weeks. During the May 1999 to 2000 period he was involved in a fight with a co-patient.
Despite the initial misgivings of his clinicians, Mr. Alexis successfully completed a 28 day residential treatment program in Williams Lake. Unfortunately thereafter he again eloped on two occasions to Vancouver, where he engaged in binges of substance abuse, including cocaine. On readmission his mental state had not appreciably deteriorated but his future abstinence was considered highly unlikely.
On July 19, 2001 Mr. Alexis once again achieved a conditional discharge to a 24 hour supervised residence in Prince George, the plan being to slowly integrate him into the home of his sister in that city. In making that disposition one member of the Review Board in dissent would have absolutely discharged the accused, noting that despite some altercations in hospital (1996, 2000), and his frequent relapses to substance use, Mr. Alexis had remained non-violent even while intoxicated and on U/A.
While in Prince George the accused was supported by the services of numerous community agencies and resources including Adult Community Living Services (MCFD) and Community Mental Health Services: Ex. 70, P. 8. An independent psychological assessment opined that Mr. Alexis could at some point forseeably function in a supported independent living environment. His extensive array of supports rendered it possible to maintain him in the community despite a deterioration in mental status to psychosis, secondary to marijuana use, in February 2002.
In July 2002 a further disposition of Conditional Discharge ensued. Once again one panel member dissented in favour of absolutely discharging the accused.
Shortly thereafter, on August 6, 2002, the accused again tested positive for marijuana and cocaine. The Prince George team decided to initiate Mr. Alexis' return to FPI.
As a result of concerns about the quality of his care at his sister's residence, the accused was placed at the "Activators" residence in Prince George in August, 2002. In retrospect that was not a wise case management choice.
On September 16, 2002 the accused was remanded to FPI due to further marijuana use and Unauthorized Absence from Activators: Ex. 77. Though not apparently mentally decompensated on admission, Mr. Alexis admitted to using up to 6 joints of marijuana per day. He also acknowledged psychotic phenomena and considerable stress.
No full hearing was convened until January 8, 2003.
During his re-admission to FPI Mr. Alexis has continued to use drugs. In December, 2002 he eloped for 4 days seeking drugs (marijuana and rock cocaine) and was returned under police escort.
Although she recommended a further period of detention, Dr. Meldrum continues to be open to opportunities for Mr. Alexis to return to his community or elsewhere, despite her belief that if inadequately supervised, he would quickly relapse to substance use, become medically non-compliant and possibly pose a threat to others due to his disinhibited, disorganised behaviour.
As an interim measure, Dr. Meldrum proposed placement on a visit leave basis at Krueger House, an intensive dual diagnosis program.
In the course of the January 8, 2003 hearing we heard that there are now high levels of Band and family support as well as a potential job opportunity for Ronald Alexis at Anahim Lake. A representative of Mr. Alexis' Band council provided evidence that Mr. Alexis could be managed in his community through a combination of Drug and Alcohol counselling/supervision; medical monitoring; residential accommodation and local police resources. Ronald Alexis would initially reside with one of two aunts on the Ulkatcho Reserve and work as a security guard at an elders complex. He would also be provided with regular 1-1 Drug and Alcohol counselling, and mental health follow-up and other programs: see Majority Reasons p. 7, evidence of Gary Holt.
In coming to a disposition on a matter before it the BC Review Board is required to gather evidence which addresses or satisfies the criteria set out in S672.54 of the Criminal Code. In its analysis of that evidence the Board must determine whether the accused is a current or foreseeable "significant threat", i.e. a real risk of serious physical or psychological harm to a member of the public. If the Board's analysis does not lead it to conclude that the accused is a "significant threat" to the safety of the public it must absolutely discharge the accused. If it concludes that the accused is a "significant threat" it must chose the least onerous and least restrictive disposition: either discharge subject to conditions, or detention in custody: WINKO,  2 S.C.R. 625.
In determining the critical legal issue of "significant threat" the Review Board is invited, indeed required, to consider a broad range of relevant information including, inter alia, the past, current and expected course of the accused's illness, condition and treatment; the accused's own plans; the various social, professional, vocational and other protective supports available to the accused in the community; the assessments and recommendations of clinical expert witnesses who have treated or examined the accused: WINKO (supra) Par. 61.
The accused's past offending behaviour may be useful in identifying a pattern of behaviour which can help predict future risk; however, it is not by itself evidence of future threat: WINKO, Par. 60.
This description of the Board's role should not suggest that predicting whether or not an accused poses a significant threat is a simple or straightforward task: it involves probabilities and estimations including moral, interpersonal, political and even arbitrary criteria and considerations: WINKO, Par. 56. It is at the end of the day a legal, not a clinical, test and determination. It may not be quantifiable: PECKHAM, (1994) 19 O.R. (3d) 766; DAVIDSON (1993), 87 C.C.C. (3d) 269.
Nevertheless despite their inherent uncertainty, we cannot be timid in our assessments or yield to the temptation to routinely over-predict risk in the interest of guaranteeing perfect public safety, to the detriment of the rights accorded the accused.
The point is that the specific situation of each individual accused must always be considered and evaluated in its entirety: WINKO, Par. 60.
These cautions and admonitions require that our assessment of Ronald Alexis considers his circumstances in their entirety, including his familial, cultural, and social history; the history and trajectory of his mental and substance disorders; his early, index and subsequent offending behaviours, and his likely future environment including its protective and supportive capacities.
In conducting my analysis of the evidence I have seen fit to rely upon and perhaps extend the analogy first drawn in the case of PECKHAM (1994) 19 O.R. (3d) 766, that a hearing of the British Columbia Review Board is procedurally akin to a sentencing process.
I also consider that in order to satisfy WINKO's requirement to undertake highly individualized and broadly based evaluation and assessment, for this particular accused, it is not only entirely appropriate, but indeed necessary to include in the analysis the unique, historic, cultural, political, and systemic components of his aboriginal heritage and traditions: See R. v. GLADUE,  1 S.C.R. 688. Mr. Alexis' circumstances are unique and different from those of other NCRMD accused.
Following this approach I must therefore take notice in particular of the following historic constructs and concepts of Mr. Alexis' First Nations culture:
- the traditional role of the family and extended family;
- the broad meaning of community;
- the responsibility of and the accused's role within his First Nations community;
- the impact on first nations individuals and communities of structural poverty and reduced social, educational and employment conditions and opportunities: GLADUE, Par. 65.
- the historic impact on First Nations cultures and upon individuals of dislocation and removal from their communities;
- the impact of substances on the functioning of First Nations communities;
- the healing initiatives that First Nations communities have and are undertaking;
- First Nations' understanding of "mental illness"; the role of traditional spirituality in responding thereto; and the effectiveness of mainstream mental health treatment in that context;
- the concepts of sanctioning, healing, rehabilitation and restoration in a First Nations community's world view and understanding of substantive and procedural justice;
- First Nations communities' thresholds or tolerance of behavioural deviation and responses to violence;
- First Nations communities' interests in and capacities to marshal protective and restorative responses and professional interventions.
Such considerations are indeed mandated in the sentencing of aboriginal offenders: s. 718.2 C.C.C. Such considerations would also appear entirely consistent with and correspond to or further the criteria in s. 672.54 C.C.C., especially given the PECKHAM analogy: see also GLADUE (supra), Par. 82, 83, 84, 85.
Relying again on Winko (in particular Par. 56), I believe that these considerations are therefore available to the Review Board in its assessment of risk involving an aboriginal NCR accused except if to do so would expose the accused's community to unanticipated or unacceptable, (in its definition), risk.
Applying these considerations to the case before me I have concluded that:
- Mr. Alexis' serious violence is now more than half his lifetime in the past; he has been free of serious violence (including the index offence) for more than a decade, even when AWOL, despite consistently resorting to substances;
- available interventions, including detention, have not successfully diminished his attraction to substances; indeed he has, since undergoing residential treatment, added cocaine to his menu of substances of choice;
- his attempts to abscond from or to avoid the confines of forensic supervision have consistently and until very recently led him to seek refuge and comfort in his home community; his goal to return home has never wavered;
- his home community has now developed its resources to the point where it is willing, able and prepared to provide both service and protective responses in order to resume its responsibilities over one of its own;
- Mr. Alexis' home community is prepared to assume an informed responsibility for his supervision as well as for any residual risk or threat he may pose to its members. It would be paternalistic and indeed chauvinistic to assume that Mr. Alexis' community is less concerned about the safety of its members than any other community.
- In any realistic service provision environment the Forensic Psychiatric Service and this tribunal must be able to rely upon collateral resources, beyond the strict purview of Forensic Psychiatric Services, in considering the matter of public safety: LAJOIE, P.Q.C.A., Feb 18, 1994.
I therefore conclude, on the basis of the foregoing assumptions and analysis, that Mr. Alexis does not currently pose a significant threat to his community such as warrants the ongoing supervision of this Tribunal. I would therefore have absolutely discharged him.
Kamaljit Kaur Lehal prepared reserved reasons
for the majority with N. Collins concurring
B. Walter dissenting
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