Re Matthew McLean, 2025 CanLII 108891

Re: Matthew McLean

ORB File No: 7898

Hearing held on: July 22, 2025

Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street

Pursuant to: Section 672.81(1) of the Criminal Code

Before: Alternate Chairperson: Ms. T. Mann Members: Dr. A. Park Dr. G. Kerry Mr. D. D’Intino Ms. C. Plyley

Parties Appearing: Accused: Matthew McLean Counsel: Mr. P. Boushy

The person in charge of hospital: Counsel: Ms. L. Barney

Attorney General of Ontario: Counsel: Ms. C. Gzik

REASONS FOR DISPOSITION

(Dated October 20, 2025)

Introduction

1. On June 9, 2021, Mr. McLean was found not criminally responsible on account of mental disorder, on two charges of aggravated assault, all contrary to the Criminal Code of Canada (“Criminal Code”).

2. He is currently subject to a Disposition from July 29, 2024, which detains him at St. Joseph’s Healthcare Hamilton (SJHH) and provides privileges up to residing in the community in accommodation approved by the person in charge of the Hospital.

3. On July 22, 2025, a panel of the Ontario Review Board (ORB) convened in person and a hearing was held at SJHH. The purpose of the hearing was to determine if Mr. McLean continues to represent a significant threat to the safety of the public as defined in the Criminal Code of Canada, and if so, the necessary and appropriate disposition.

4. For the reasons set out below, the Board unanimously finds that Mr. McLean continues to meet the threshold for significant threat to the safety of the public and that the necessary and appropriate Disposition is a Conditional Discharge.

Current Psychiatric Diagnoses:

5. Delusional Disorder

6. Cannabis use disorder – in sustained remission, in a controlled environment.

Index Offences:

7. The facts giving rise to the index offences were described in last year’s Reason for Disposition:

"On February 25th at 4:01 am, Hamilton Police responded to 440 Glover Road, Glanbrook, Maple Leaf Foods, for a stabbing that had occurred. The victim [N-U] was sitting in the workplace cafeteria area of Maple Leaf Foods with fellow coworkers while the accused MCLEAN was sitting at a table beside her for approximately 10 minutes. For unknown and unprovoked reasons, MCLEAN suddenly got up, grabbed [N-U] and stabbed her in the upper back. While [N-U] attempted to fight off the attack she suffered numerous cuts and stabs to her right forearm as well as stab wounds to her hands, back, neck and head. [K] ran into the cafeteria area and was confronted by MCLEAN at the doorway where he stabbed her twice in the abdomen area. [K] then fell to the ground into a ball and MCLEAN stabbed her in the upper back before fleeing. Other employees attempted to control MCLEAN who was able to break free and leave in his vehicle. Fellow employees and witnesses were able to provide responding officers with the name of the accused as Matthew MCLEAN.

The Hamilton Police responded to MCLEAN'S home address of 1830 Main St West apartment #602 and located his vehicle in the underground parking lot. Officers saw blood in the interior of the vehicle and it was secured at this time.

Officers attended the 6th floor of the building as MCLEAN was exiting his apartment. He was arrested at 5:12 am and police located a large hunting style knife attached to his belt and a second folding knife clipped to the outside of his pocket. MCLEAN had changed his clothes and there was no blood on what he was wearing. He was carrying a large backpack and search incident to arrest showed clothing, a hatchet, water tablets, survival blanket and other items associated to fleeing. Numerous medications as well as cannabis was found in the backpack..”

Without Prejudice Position of the Parties:

8. At the commencement of the hearing, the parties were canvassed for their initial positions.

9. The Hospital took the position that Mr. McLean continues to meet the threshold for significant threat to the safety of the public and that the necessary and appropriate Disposition was a Conditional Discharge with terms and conditions.

10. Counsel for the Attorney General reserved their position until the conclusion of the evidence at the hearing.

11. Counsel for the accused supported the position of the Hospital.

Evidence at the Hearing:

12. The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Y. Naidoo, who is Mr. McLean’s attending psychiatrist.

13. He testified that in the past reporting year, Mr. McLean has been volunteering two to three hours per week and has been spending more time exploring the community, reading and working on his fitness and his health.

14. The treatment team has been encouraging Mr. McLean to pursue employment and while an inpatient, he completed a welding program and did quite well. However, Mr. McLean struggles with visual-spatial skills which may impact his performance in the workplace.

15. Dr. Naidoo explained that Mr. McLean is very logical and strategic in how he speaks. This appears to be his communication style – he can come across as being abrupt– but if there is no improvement in this domain, the treatment team may have to consider a switch of medication as it could signal that Mr. McLean is experiencing some residual paranoia.

16. Dr. Naidoo explained that Mr. McLean’s insight is developing – for example, they can have frank discussions and Mr. McLean does not become defensive or irritable. He wants to see further development in Mr. McLean’s insight into the index offences, as he still views same as a product of stress and not due to his mental illness.

17. Dr. Naidoo testified that at present, there is no evidence of Mr. McLean experiencing delusional beliefs, in respect of the people surrounding him. Mr. McLean does not present with any baseline personality pathology currently and has not expressed any desire to change or discontinue his treatment.

18. Dr. Naidoo explained that prior to his NCR finding, Mr. McLean did not have any history of involvement with the civil mental health system which is unusual. Since his entry into the forensic system, Mr. McLean has always been cooperative with coming in for appointments, has never been aggressive and has never submitted a urine drug screen (UDS) that was positive.

19. Dr. Naidoo concluded his in-chief evidence by opining that the provisions of the Mental Health Act would be sufficient under a Conditional Discharge to manage Mr. McLean in the community and that he would likely meet the “Box B” criteria for readmission to Hospital if required.

20. In response to questions from the Crown Attorney, Dr. Naidoo explained that Mr. McLean understands that his diagnosis of Delusional Disorder is a lifelong diagnosis, but struggles to understand how it applies to him. He still believes that the index offences resulted from stressors and not from his mental illness.

21. Dr. Naidoo further testified that Mr. McLean is slow to warm up to people, is selective of who he wants to share certain types of information with and may be viewing the staff of Emmaus Place as “underskilled”, hence the Hospital Report mentioning that he has on occasion terminated his meetings with those staff early. Dr. Naidoo explained that when he has met with Mr. McLean, the latter has never requested that their meetings terminate early.

22. Mr. McLean and Dr. Naidoo have discussed the former returning to work and Mr. McLean is aware that under a Detention Order, he must disclose his forensic status to would-be employers, but under a Conditional Discharge such disclosure is optional. Dr. Naidoo does not believe that returning to work is “front-of-mind” for Mr. McLean at present.

23. For Dr. Naidoo, the main distinction, practically speaking, between the Detention Order and a Conditional Discharge is that on the latter the Hospital could not readmit Mr. McLean as they see fit. Under a Conditional Discharge – with a Young clause ordered – the Hospital could bring Mr. McLean back in for an assessment if he breaches his conditions.

24. When asked by Crown Counsel how soon Mr. McLean would decompensate in the event of medication non-compliance, Dr. Naidoo opined that, given Mr. McLean is receiving an injectable medication (Invega Trinza), the literature suggests it could take over a month before any signs of significant changes to his mental health presented themselves.

25. However, Dr. Naidoo also noted that the patient and the treatment team have a very good relationship and that the team would notice any changes in Mr. McLean’s presentation. For example, if he were to become reclusive, paranoid or have changes in his habits, these would indicate a decompensation in his mental status and the team would address that.

26. In response to Panel questions, Dr. Naidoo confirmed that Mr. McLean has not presented with any residual psychotic symptoms since his switch to Invega Trinza. No changes to his other medications are contemplated right now and Mr. McLean is currently on the lowest therapeutic dose of the Invega, but the team will consider a higher dose of risperidone in the future if needed.

27. Dr. Naidoo explained that Mr. McLean has demonstrated a bit less of an understanding of the index offences lately, which he described as “interesting” and that the team will closely monitor Mr. McLean for any signs of a loss of insight.

28. Dr. Naidoo testified that Mr. McLean has decided to prioritize volunteering over substance abuse counselling, and the Doctor gets the sense that this is because Mr. McLean didn’t get much out of the counselling he completed already. That being said, in the opinion of Dr. Naidoo, Mr. McLean needs to continue to develop insight into the impact of substances on his mental health and continue to remain abstinent for the long term.

29. Mr. McLean does require further structure to his time according to Dr. Naidoo, but the treatment team is not concerned about any impact on his risk level as a result of his current schedule.

30. In order to address the deficits in Mr. McLean’s insight into his mental illness and need for both medication adherence and abstinence from substances, Dr. Naidoo testified that Cognitive Behavioural Therapy for Psychosis (CBTp) will be recommended again to Mr. McLean.

31. Lastly, Dr. Naidoo agreed that should Mr. McLean’s delusional beliefs re-emerge, they would not be easily detectable and any mental status decompensation could “fly under the radar”, in part because Mr. McLean has good cognitive abilities and is very intelligent. That said, while Mr. McLean does not exhibit frank manic symptoms when unwell, he does become loud and irritable which the team would pick up on.

32. At the conclusion of the evidence, the counsel for the Hospital and for the accused maintained their Conditional Discharge position, and Crown counsel joined them in that recommendation.

Analysis and Conclusions

33. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. McLean does meet the threshold for significant threat to the safety of the public and finds that a Conditional Discharge is the least onerous and least restrictive, necessary and appropriate Disposition in the circumstances.

34. A significant threat to the safety of the public cannot be speculative. It must entail a real risk of serious physical or psychological harm arising from conduct that is both serious and criminal in nature.

35. In determining whether Matthew McLean represents a significant threat to the safety of the public the Board has carefully analyzed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.

36. Mr. McLean suffers from a psychotic disorder which is well treated by his current medication regime and the structure and supports of the forensic mental health system but his insight into the connection between his mental illness, his substance abuse and the index offences remain underdeveloped.

37. Mr. McLean has had an unusual entry into the forensic mental health system, in the sense that he had no prior involvement in the civil mental health system until the index offences. Those offences were incredibly violent and seemingly occurred without warning.

38. Similar to last year’s Reasons for Disposition, Mr. McLean had another good reporting year where he has been medication adherent, his mental status has been stable and he has been involved in volunteering pursuits. He has been residing independently in the community at Emmaus Place without any reported difficulties.

39. However, the Hospital Report notes that Mr. McLean remains skeptical of the forensic mental health system, did not engage in psychoeducational programming within the current reporting year and has a tendency not to rely on positive social support to manage his stressors. Mr. McLean remains guarded in discussing his mental health but does maintain a good relationship with his treatment team. His insight into what led to the index offences and the contributions of illicit substances to same, are lacking and underdeveloped.

40. The most recent risk assessment for Mr. McLean deems him to present a moderate to high risk of future violence in the absence of psychiatric follow-up and medication adherence. The evidence before us however, establishes that Mr. McLean’s risk to the safety of the public can continue to be managed in the community, albeit pursuant to a Conditional Discharge disposition with appropriate terms and conditions.

41. Those terms and conditions are:

(a) reside at Emmaus Place or other accommodation supported by the Good Shepherd of Hamilton;

(b) report to the person in charge of St. Joseph's Healthcare Hamilton, West 5th Campus or their designate, as required, and not less than twice per month;

(c) abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant;

(d) submit samples of their urine and/or breath to the person in charge of St. Joseph's Healthcare Hamilton, West 5th Campus, or their designate for the purpose of analyzing whether the accused has ingested alcohol, drugs or any other intoxicant;

(e) refrain from having in their possession any firearm, ammunition or other offensive weapon, or being in the company of any person possessing a firearm other than a peace officer;

(f) refrain from contact or communication, direct or indirect, with Eimy Novoa-Urrego and Alham Khamo;

(g) not attend within 500 metres of Maple Leaf Foods, 440 Glover Road. Hamilton, Ontario; and

(h) participate in a program of rehabilitation created by the person in charge of the St. Joseph's Healthcare Hamilton, West 5th Campus or their designate;

(i) on their consent, take such treatment/medication as prescribed by the person in charge of St. Joseph's Healthcare Hamilton, West 5th Campus or their designate, pursuant to s.672.55 of the Criminal Code;

(j) advise the person in charge of St. Joseph's Healthcare Hamilton, West 5th Campus or their designate, in advance, of any absence from their residence of 24 hours or more;

(k) notify, in writing, the person in charge of St. Joseph's Healthcare Hamilton, West 5th Campus or their designate and the Ontario Review Board 24 hours in advance of any change of existing address or telephone number;

(l) upon request of St. Joseph’s Healthcare Hamilton, West 5th Campus, will attend for psychiatric assessment;

(m) upon notice, attend before the Ontario Review Board as required; and

(n) keep the peace and be of good behavior.

42. In consideration of all the evidence, the submissions of the parties, and the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. McLean, his reintegration into society and his other needs, the Panel finds that a Conditional Discharge with appropriate terms and conditions is the necessary and appropriate Disposition.

DATED this 20^th^ day of October 2025, at the City of Toronto, in the Toronto Region.

Mr. D. D’Intino Legal Member

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Office of the Registrar Ontario Review Board