Ontario Review Board
Re: Nicolas Hamel
ORB File No. 5227
Hearing Date: September 12, 2025
Hearing Location: St. Joseph’s Healthcare, Hamilton, West 5th Campus
Pursuant to: Section 672.81(2.1) Criminal Code of Canada;
Before:
Alternate Chairperson: Mr. C. MacIntyre
Members: Dr. P. Prendergast
Dr. G. Nexhipi
Mr. A. Mete
Mr. K. McKenna
Parties Appearing:
Accused: Nicolas Hamel
Counsel Mr. A. Confente
The Person in charge of Hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Ms. C. Gzik
REASONS FOR DECISION
(Dated October 15, 2025)
Introduction
Mr. Hamel was found not criminally responsible (NCR) on December 3, 2008, for the criminal code offence of uttering a threat. He is currently subject to a Disposition dated April 2, 2025, which detains him at St. Joseph’s Healthcare, Hamilton, West 5th Campus (St. Joseph’s), and provides privileges that extend to community living in accommodation approved by the person in charge. He is also prohibited from the use of alcohol or drugs and must provided urine samples for analysis.
St. Joseph’s advised the Board by letter dated June 23, 2025, that Mr. Hamel was readmitted to hospital on June 3, 2025. He was discharged from the Hospital on July 21, 2025.
Mr. Hamel has been residing at the Indwell Perkins Centre in Hamilton since 2011. On July 21 he returned to this residence.
On September 12, 2025, a panel of the Ontario Review Board (the panel) convened this hearing to determine if the restriction to Mr. Hamel’s liberty, his readmission to hospital to the date of the hearing, was necessary and warranted in the circumstances pursuant to s. 672.81(2.1) of the Criminal Code.
At the commencement of the hearing, the Hospital and Crown Counsel submitted that the restriction to his liberty was necessary. Counsel for Mr. Hamel submitted that the readmission to hospital was unnecessary.
This restriction of liberty hearing was initially scheduled for July 25, 2025. Mr. Hamel did not attend. Counsel for Mr. Hamel advised the panel that Mr. Hamel usually attends his hearings, and that his absence is likely an oversight. The hearing was adjourned to September 12, 2025.
After hearing the evidence, the panel concluded that the admission on June 3rd was warranted and necessary, but the evidence did not support Mr. Hamel being detained in Hospital beyond 9 days from the date of admission.
Evidence
The panel heard testimony from Dr. Prat, Mr. Hamel’s treating psychiatrist, and was provided with a Restriction of Liberties Report dated July 18, 2025, and a Hospital Report dated March 11, 2025.
Mr. Hamel is diagnosed with Schizophrenia, Stimulant Use Disorder, Attention-Deficit/Hyperactivity Disorder, predominantly inattentive presentation. Dr. Prat, however, is not certain about diagnosis of Schizophrenia. In August 2024, the antipsychotic medication was reduced with no recurring psychotic symptoms, and then in December 2024, the medication was entirely eliminated. Dr. Prat is of the opinion that the preferred diagnosis may be drug induced psychosis rather than a primary psychotic disorder such as Schizophrenia.
Regarding the Index offence, on August 3, 2008, Mr. Hamel attended an Avondale convenience store and had difficulty operating an ATM machine. Mr. Hamel approached the store clerk, and told him to get another machine to the store. Mr. Hamel stated that he had a laser pointed at the clerk, and during the entire conversation, Mr. Hamel had his hands concealed inside the pockets of his hooded sweatshirt. The store clerk called the police. Mr. Hamel refused the officer’s demand to remove his hands from his pocket, and he was ultimately taken to the ground and arrested.
Mr. Hamel was born in Quebec, and raised in what is described as a dysfunctional environment. The child welfare authorities were involved with the family. He last worked in 2008 when he began experiencing symptoms of a mental illness.
Mr. Hamel reported that he started using crystal methamphetamine in or about 2004. He has also used cannabis, alcohol, and cocaine, but predominantly used crystal methamphetamine.
In 2005, Mr. Hamel was convicted of a very serious assault on a female companion.
He has been in the forensic system for 17 years. A consistent pattern developed with Mr. Hamel being discharged from hospital to live in the community, and then readmitted to hospital after using methamphetamine and experiencing a decline in his mental condition.
In 2010, Mr. Hamel was given a conditional discharge which was changed to a detention order the following year after a readmission to hospital. In April 2019, he was again granted a conditional discharge which was changed to a detention order in 2022.
Over the years, Mr. Hamel has been discharged to live in the community and then readmitted to hospital on 15 occasions. The readmissions have consistently been the result of methamphetamine use and the consequential decline in his mental health.
Prior to the readmission which is under consideration at this hearing, Mr. Hamel was hospitalized from May to December 2024, after consuming crystal methamphetamine. In the hospital he was displaying increased verbal aggression, and was described as oppositional and argumentative.
The evidence also indicates that Mr. Hamel is very adept at tampering with his urine samples. He has no insight into the harmful effects substance use has on his mental health.
Mr. Hamel is fairly reclusive preferring to not engage with co-patients or residents at Indwell. Mr. Hamel is very apprehensive in groups or in a social setting. He has not participated in addiction counselling, and becomes anxious when the subject of therapeutic programming is discussed.
His admission to hospital on June 3rd followed an assessment at the Forensic Outpatient Clinic. Staff immediately observed that Mr. Hamel’s presentation deviated from his baseline. Dr. Prat confirmed these observations when he later assessed Mr. Hamel. He exhibited manic-like symptoms, including pressured and rapid speech and grandiose ideas. He also demonstrated twitching movements of the neck, and had difficulty understanding some of the questions he was asked. Mr. Hamel was not able to appreciate the concerning nature of his presentation. Dr. Prat indicates in the Restriction of Liberties Report that he has not previously observed Mr. Hamel with such severe symptoms. It is the opinion of Dr. Prat and the outpatient team, that the symptoms resulted from substance use.
During Mr. Hamel’s visit to the outpatient clinic, he provided 2 urine samples that appeared diluted and of low volume. He refused to provide a 3rd sample, stating that he needed to leave and pay some bills. He was told that a proper sample was required and that the police would be called if he left. He was heard to say that “he would fight”, which he later denied saying.
Mr. Hamel accused Dr. Prat of fabricating evidence and expressed his desire for another psychiatrist. He was agitated and waving his arms in a manner that staff perceived as threatening.
He was placed in seclusion for 48 hours due to the persistent symptoms, and was observed to be responding to internal stimuli. He refused to provide a urine sample for 2 days while in seclusion, and refused to take antipsychotic medication. Mr. Hamel insisted that he was not psychotic.
He did not exhibit any abnormal, aggressive, or threatening behaviour after he was released from seclusion. In the opinion of Dr. Prat, this confirmed that the earlier behaviour resulted from substance use.
The hospital decided that a slow and gradual reintroduction of privileges was appropriate given that Mr. Hamel had been sober for 6 months, and that the risk of relapse is highest in the initial days. He did not experience any issues or relapse for the duration of his stay in hospital; to July 21st.
Mr. Hamel has limited social supports and does not have contact with his family.
Dr. Prat testified that when Mr. Hamel was admitted to the hospital, the staff were concerned for their safety.
In answer to questions from Mr. Confente, Dr. Prat confirmed that Mr. Hamel had been stable for 6 months prior to the hospital admission. Mr. Hamel declined antipsychotic medication that was offered.
Dr. Prat indicated that the rapid speech, grandiosity, and the twitching of his neck, were symptoms he had not previously seen.
Dr. Prat advised that the effects of crystal methamphetamine can last for approximately 12 hours, and that it can be detected in a person’s urine for aa few days after consumption.
Dr. Prat stated that Mr. Hamel has been a challenging patient for his case manager. He is proficient at providing altered urine samples. He was described as very antagonistic at the time of admission.
Dr. Prat testified that Mr. Hamel had returned to baseline after 3 days, but still experienced some residual elements of pressured speech for a few more days.
Dr. Prat stated that he was concerned with the possibility of a relapse, and wanted to observe Mr. Hamel for a period of time before discharging him from the hospital. Dr. Prat indicated that the only appropriate option at the time was to readmit Mr. Hamel.
In answer to questions from the panel, Dr. Prat advised that the team did consider an earlier discharge, but they were concerned with a relapse in his condition. For some time, Mr. Hamel had requested a transfer of his care to another psychiatrist. Dr. Prat felt that there was a therapeutic impasse, and arrangements were made to transfer Mr. Hamel’s care to Dr. Shariati upon Mr. Hamel’s discharge. To ensure that he was stable for the transfer to Dr. Shariati may have accounted for a delay in his discharge until July 21.
Dr Prat was asked if a residential treatment program had been considered. He responded that Mr. Hamel refuses to acknowledge a substance abuse problem, so a residential treatment program would not be of assistance.
Dr. Prat testified that Mr. Hamel becomes floridly psychotic after substance use.
Mr. Hamel testified. He stated that he had not consumed substances prior to his readmission. He believed the computer was faulty with the positive analysis of his urine. He also stated that Dr. Prat is lying. He indicated that his comment to the case manager was “I’ll fight you in court”. He denied there was a twitching of his neck, and the pressured speech was him being very emotional. He denied tampering with his urine sample. Mr. Hamel denied that his behaviour deviated from his baseline.
In answer to a question from the panel, Mr. Hamel stated that he does not have a problem with substances.
Submissions
The Hospital submitted that there were two concerning urine samples before Mr. Hamel was readmitted. He was displaying symptoms of mania, and was observed to be responding to internal stimuli when in seclusion. The Hospital took a cautious approach to the timing of Mr. Hamel’s discharge because of Mr. Hamel’s history of relapsing after his condition returned to baseline. The Hospital also referred to the fact that Mr. Hamel was not taking antipsychotic medication, so the stay in hospital until July 21 was appropriate to monitor his condition.
The Crown supported the submissions of the Hospital.
Counsel for Mr. Hamel submitted that the readmission was unnecessary. The rapid speech was indicative of anxiety, and Mr. Hamel denies that he took crystal methamphetamine prior to the readmission.
He further submitted that Mr. Hamel had reached his baseline after 6 days and should have been discharged at that time.
Analysis
After considering the evidence, the panel accepts that the restriction to Mr. Hamel’s liberty, the readmission to hospital, was warranted and appropriate.
The outpatient team and hospital staff are very familiar with Mr. Hamel. He has been in the forensic system for 17 years, and they are able to recognize a change in condition from his baseline. On June 3, 2025, the case manager with the outpatient team recognized a decline in his condition which was most likely the result of substance use. The observations were later confirmed by Dr. Prat. The case manager also suspected that Mr. Hamel had tampered with his urine sample, which he has done repeatedly over the years.
At the time of the readmission, Mr. Hamel displayed rapid and pressured speech, a twitching of his neck, and grandiosity. His response to the suggestion that the police may have to be called if he left the outpatient clinic was to use the word “fight.” His demeanor and the waving of arms had the staff concerned for their physical safety. While in seclusion he was observed to be responding to internal stimuli.
Dr. Prat testified that Mr. Hamel returned to baseline after 3 days, but the Hospital was concerned that there may be a relapse, so it was cautious reinstating his privileges, including the community living. This approach is understandable, but only for a reasonable length of time. The evidence does not support Mr. Hamel being hospitalized until July 21. The evidence suggests that a reasonable length of time to observe Mr. Hamel in the hospital for any signs of relapse would have been 9 days after his readmission.
DATED this 15th day of October 2025, at the City of Toronto, in the Region of Toronto.
Kevin McKenna
Legal Member
Office of the Registrar
Ontario Review Board