Ontario Review Board
Re: Shawn D. Alfredson
ORB File No: 5851
Hearing held on: Thursday, September 11, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M.D. Segal
Members: Dr. P.E. Cook Dr. S. Wiseman Hon. C. Nelson Ms. R. Chopra
Parties Appearing:
Accused: Shawn D. Alfredson Counsel: Mr. M. Schloss
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated October 9, 2025)
Introduction
Shawn D. Alfredson, aged 49, was found not criminally responsible on account of mental disorder on March 24, 2011, on charges of aggravated assault and possession of a weapon for a purpose dangerous, contrary to the Criminal Code.
On September 11, 2025, Mr. Alfredson, who is subject to a Detention Order with privileges up to and including living in the community in approved accommodation, appeared before the Ontario Review Board (the “Board”) at the Centre for Addiction and Mental Health (the “hospital”) for his annual hearing.
The Board had before it as Exhibit 1, the Hospital Report dated August 21 of 2025, and by way of background, letters regarding incidents of absconding.
In preliminary positions, the hospital advised that there should be no change to the current Disposition. Crown counsel and the patient’s counsel agreed. Significant threat to the safety of the public was not in issue. By the conclusion of the hearing, the Board, having reviewed the evidence, agreed that the current Disposition was appropriate.
Diagnoses
- Schizophrenia Cocaine Use Disorder Antisocial Personality Traits
Index Offences
- The circumstances giving rise to the index offences are extracted from last year’s Board Reasons, as follows:
“On Sunday, August 14, 2005, at approximately 12:10 PM, Mr. Alfredson was at his place of employment, Tim Horton’s with the victim, and his co-worker, Parag Masih. As Mr. Alfredson was leaving work, he attacked Mr. Masih, who was helping the manager unload boxes from the vehicle. He kicked the victim and slashed his face deeply with a knife. The knife also cut the victim on the throat. Mr. Alfredson then fled. The victim required 28 stitches to close the face wound, and in addition, he required medical follow-up for dental, and nerve damage. The attack was witnessed by the manager and another employee. It occurred without provocation, or prior warning.”
Background
- Mr. Alfredson was born in Vancouver. Mr. Alfredson has a son who lives in British Columbia but acknowledges that he has no relationship with him. Mr. Alfredson was admitted to the hospital in 2011. In April 2015, he was discharged to live in the community. In 2020 and since then there have been several readmissions and Restrictions of Liberty primarily because of ongoing substance use, inconsistent reporting to the treatment team, and disruptive behaviour at supervised residences. Mr. Alfredson became aggressive as a teenager, directing his acts against his mother and his stepbrother. In later years, he worked as a dishwasher. Mr. Alfredson first started seeing a psychiatrist when he was 11. Starting in 2017, Mr. Alfredson began taking substances, mainly alcohol, cocaine and crack cocaine.
Evidence at Hearing
Dr. B. Robertson, a Resident in Forensic Psychiatry, testified. He began to supervise Mr. Alfredson’s care in July. Dr. Robertson noted that Mr. Alfredson was at Level 0 on the privilege ladder. There have been three incidents of absconding in the last 12 months, the most recent one in July. In July, Mr. Alfredson was accompanied by staff and another patient but still managed to leave hospital grounds to secure substances. Very recently, with the patient’s agreement, he was started on a substance anti-craving medication. In past, Mr. Alfredson had taken to that medication well. While the patient is incapable of consenting to treatment generally, he is capable of consenting to the administration of the anti-craving medication. Mr. Alfredson has recently expressed his agreement to attend an inpatient residential treatment facility in the community. The application will be drafted in the next week or so. To secure admission to the inpatient treatment program, it will be necessary for Mr. Alfredson to begin a successful climb up the privilege ladder.
Dr. Robertson noted the two main issues that the team had to deal with were substances and antisocial personality traits.
Mr. Alfredson has shown a general disregard for the authority of the Board. Mr. Alfredson has not concerned himself with consequences. When breaching his Disposition, he minimizes and externalizes.
It would be anticipated that the residential treatment program might involve a stay of several weeks. It may take a few months to secure an admission.
Mr. Alfredson’s substance of choice is crack cocaine.
Mr. Alfredson’s PCL-R score is 12 out of 40. According to the doctor, that result appears out of sync with what has been observed. The hospital plans on retesting in future as not much was known about the patient when the initial testing was administered.
Despite the reliance on substances, Mr. Alfredson has not exhibited any violence under the Board. When he returned from absconding in May, under the influence, he was paranoid, argumentative, irritable and dishevelled. The concern is that if Mr. Alfredson used substances more, or for a prolonged period, his mental state would be compromised, and violence would occur. No changes in medication are contemplated. There is one more step to titrate up the anti-craving medication.
Mr. Alfredson has been participating in many groups and 1:1 therapy.
Mr. Alfredson is on a long-lasting anti-psychotic injection.
It is unlikely that Mr. Alfredson’s poor insight will improve. Mr. Alfredson does not see a link between substance use, his mental health and the risk of violence.
Mr. Alfredson has no supports in the community.
It appeared that Mr. Alfredson is at a crossroads. His forensic team has been working hard to help him through pharmacology and therapy. To the patient’s credit, he agreed to seek admission to a residential treatment program provided he can climb the privilege ladder. If, for any reason the latest plan fails, the hospital may be looking at increasing his security at CAMH or at another forensic hospital.
Analysis
- The Board was presented with a joint submission. The treatment plans outlined by the hospital and accepted by the Crown counsel and the patient’s counsel as a joint submission was considered by the panel as a sensible approach in the circumstances. This past year has been difficult. There were multiple incidents of absconding and substance use. Mr. Alfredson is at a crossroads. The hospital is working very hard to assist Mr. Alfredson. It is time for Mr. Alfredson to apply himself and enter a residential treatment program. To do so, it will be crucial for him to demonstrate he can work his way up the privilege ladder. The evidence filed and heard satisfied the Board that Mr. Alfredson is a significant threat to the safety of the public and that the current Disposition is the least onerous and least restrictive means to manage his risk. We wish Mr. Alfredson well as he works toward qualifying for a residential program.
DATED this 9^th^ day of October 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
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Office of the Registrar Ontario Review Board