Ontario Review Board
Re: Nathan Chin
ORB File No: 7357
Hearing held on: Monday, September 22, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before: Alternate Chairperson: Ms. M. Labrosse Members: Dr. B. Sheppard Dr. G. Eayrs Mr. M.D. Segal Mr. W. Apted
Parties Appearing: Accused: Nathan Chin Counsel: Mr. A. Rastgou
The person in charge of hospital: Representative: Dr. R. McMaster
Attorney General of Ontario: Counsel: Mr. C. Coughlan
REASONS FOR DECISION
(Dated November 5, 2025)
Introduction
On May 23, 2018, Mr. Nathan Chin was found not criminally responsible (“NCR”) on account of mental disorder on a charge of assault causing bodily harm, contrary to the Criminal Code of Canada.
Mr. Chin is currently subject to an Ontario Review Board Disposition dated May 30, 2025, which detains him at the General Forensic Unit of the Centre for Addiction and Mental Health, Toronto (“CAMH” or the “hospital”), subject to privileges up to and including living in the community in accommodation approved by the person in charge of the hospital.
By way of letter dated July 22, 2025, the hospital notified the Ontario Review Board (the “ORB” or “the Board”) pursuant to s. 672.56(2) of the Criminal Code, that Mr. Chin had been readmitted to hospital on July 11, 2025, thereby constituting a significant increase in the restriction of his liberty.
On September 22, 2025, a panel of the ORB convened a hearing at CAMH to conduct a restriction of liberty hearing in order to review the hospital's decision to admit Mr. Chin to hospital, where he remains to this day. Mr. Chin was present at the hearing with his counsel, Mr. A. Rastgou.
The issue for this hearing is to determine whether the hospital's decision to admit Mr. Chin to hospital represented a significant increase in the restriction of his liberty and to determine if that decision was reasonable and warranted and represented the least onerous and least restrictive course of action available to the hospital at that time. The Board is also tasked with reviewing whether that restriction remains necessary and appropriate to this date.
Initial Positions of the Parties
The parties were canvassed as to their recommendations to the Board at the outset of the hearing.
Dr. McMaster recommended that the decision to readmit Mr. Chin to hospital was and remains reasonable and warranted and represented the least onerous and least restrictive decision available to the hospital to manage the increased risk posed by Mr. Chin.
Counsel for the Attorney General, Mr. Coughlin, supported the hospital’s recommendation.
Counsel for Mr. Chin, Mr. Rastgou, recommended that the decision to readmit Mr. Chin to the hospital was not necessary and appropriate and was not the least onerous and least restrictive course of action available to the hospital.
All parties agreed that no change to the Disposition is recommended.
Decision of the Board
For the reasons set out below, the Board finds that the hospital's decision to admit Mr. Chin to hospital from his TRHP2 transitional housing in the community was reasonable and warranted given the increased risk that Mr. Chin posed to those around him at the time. Additionally, we find that the ongoing restriction remains the least onerous and least restrictive given that Mr. Chin continues to be symptomatic and has lost his transitional housing, thereby requiring new housing to be secured and approved for him prior to his discharge from the hospital.
As the only issue before the Board today is to review the restriction of liberty, there is no need to repeat the recitation of the index offences or recount the background history, all of which are addressed in detail in the recent Reasons for Disposition dated June 18, 2025, emanating from Mr. Chin’s last annual review hearing which took place on May 9, 2025.
Mr. Chin’s current diagnoses include:
- Schizophrenia, in partial remission
- Cannabis Use Disorder (moderate to severe, in remission in a controlled environment)
- Unspecified Personality Disorder Traits
Evidence at the Hearing
The hospital's evidence was presented through its reports and through the oral testimony of Dr. R. McMaster. This evidence is summarized below.
Dr. McMaster adopted the contents of the Hospital Report and highlighted that Mr. Chin had been doing quite well at his TRHP2 housing to which he had been discharged on October 30, 2023. He was engaging in some prosocial activities including athletic pursuits, church, and brief employment.
Mr. Chin was noted to be generally pleasant although occasionally irritable with staff. His insight into his mental illness continues to be limited. According to Dr. McMaster, Mr. Chin does not want to take medication. Mr. Chin's mental state tends to fluctuate and he can exhibit some disorganization, overvalued ideas, and referential beliefs.
The hospital believes that Mr. Chin has issues with medication adherence. His clozapine levels also confirm this. When confronted with this, Mr. Chin claims that he was compliant, other than missing the occasional dose. This coincides with some observed decompensation of his mental state including irritability, paranoia and increased reactivity to stressors.
According to Dr. McMaster, residence staff were frightened by some of Mr. Chin’s threatening behaviours. In view of Mr. Chin's history of acting out violently towards mental health staff and psychiatric supports, it was felt that this had to be addressed by way of an admission to hospital to avoid any incidents of violence.
On January 11, 2025, Mr. Chin was brought to hospital by police. A “code white” was called on the following day, when he tried to open the door with what appeared to be a staff key. He refused to return the card stating that he worked there while smiling inappropriately. He started to bang the exit door after which he was offered PRN medication which he knocked out of a nurse’s medication cup and stared intently at that person. He required mechanical restraints and was given medication. Dr. McMaster confirmed that Mr. Chin’s clozapine levels as tested in June of 2025, were found to be sub-therapeutic and raising concerns that he was not taking his medication.
Mr. Chin is currently doing well on the hospital unit (LGUA). He is engaging in programming including Dialectical Behavioural Therapy (“DBT”), is active on the unit and works on the unit canteen. According to Dr. McMaster, Mr. Chin is progressing up the privilege ladder and has just today been approved for level 2 privileges which are escorted hospital grounds privileges.
Mr. Chin has lost his TRHP2 transitional housing. This decision was made shortly after his admission to hospital. Dr. McMaster explained that the TRHP2 housing is transitional housing to prepare patients for independent living. In retrospect, it appears that this may not have been the right setting for Mr. Chin who has issues with compliance to treatment and as a result could not be moved on through the program to live independently. The hospital is looking for more permanent housing which will necessarily include medication supervision. The treatment team is working on applications for new housing.
In response to questions posed to him by counsel for Mr. Chin, Ms. Rastgou, Dr. McMaster responded as follows:
a. Dr. Van is now Mr. Chin’s most responsible physician.
b. Mr. Chin is motivated to get back to the workforce and once he is at the requisite privilege level, he would be able to seek employment even while he remains in hospital awaiting discharge to a new residence.
c. Dr. McMaster confirmed that there have been no critical incidents and no direct threats against anyone since soon after Mr. Chin has been admitted to hospital.
d. Mr. Chin is asking to work with more diverse staff, and the treatment team is aware that he feels that he is being discriminated against because of his ethnicity. The team wants to validate this and is doing what is possible in the circumstances, but it is also believed that these are residual symptoms of Mr. Chin’s illness.
e. Mr. Chin lost his housing very quickly after admission but it had been obvious to the TRHP2 staff that they could not move him forward because of his lack of insight. Dr. McMaster characterized the incident as “a near miss” given the increased threatening conduct by Mr. Chin against staff members.
f. Dr. McMaster acknowledged that the admission has disrupted Mr. Chin’s progress as he was enjoying a variety of activities in the community including going to church; however, that disruption has also been triggered by noncompliance with treatment.
g. Dr. McMaster believes that Mr. Chin is currently optimally treated on clozapine which he takes for treatment-resistant schizophrenia.
h. Finally, Dr. McMaster confirmed that Mr. Chin could be discharged possibly within a few months should the team be able to secure appropriate accommodation for him. He is on waitlists, and his treatment team are well aware of his needs.
- In response to questions posed to him by members of the panel, Dr. McMaster responded as follows:
a) Mr. Chin was being tested monthly for his clozapine blood levels, and the sub-therapeutic levels corresponded to his deteriorating mental state in June of 2025.
b) When he was discharged to the TRHP2 transitional housing, Mr. Chin was initially observed taking his medication but over time was expected to gradually take his medication independently. Dr. McMaster stated that taking medication on a daily basis can be onerous and that errors can happen but that the team has now come to the conclusion that it is not realistic for him to take treatment independently. At this time the treatment team is looking for accommodation with medication supervision, but should Mr. Chin’s insight improve over time, that could change.
c) Dr. McMaster stated that he was unsure whether Mr. Chin was intentionally trying to mislead the staff about taking his medication. He also stated that TRHP2 housing has 24-hour staff on site but that residents are able to leave regularly during the day. The hospital would be looking for equivalent-type accommodation with medication oversight.
d) Mr. Chin is keen to get back into the workforce and is already working within the hospital running the canteen. Dr. McMaster added that when Mr. Chin is well, he is a very prosocial individual, and that the hospital is supporting that he can resume those activities as he gets better.
e) Dr. McMaster believes that had Mr. Chin not been admitted to hospital, the situation could very well have led to an assault against staff based on his presentation and his history of assaulting staff and a psychiatrist. The team felt that it was better to admit him before something of that nature happened.
f) Dr. McMaster does not believe that the admission was pre-emptive in nature and rather that it was a response to the actual risk that was increasing at the time such that the hospital could not wait for something to happen.
g) Dr. McMaster confirmed that on his current General Unit, Mr. Chin can receive up to level 9 privileges which include indirectly supervised community passes as well as overnight passes. Mr. Chin’s privilege levels are being reviewed regularly, and he is currently on a good trajectory to continue climbing the pass ladder.
In a question arising from questions posed by the panel members, by Mr. Rastgou, Dr. McMaster confirmed that employment can be accessed while Mr. Chin remains at CAMH provided that he is at the sufficient pass level.
No other evidence was presented.
Submissions of the Parties
The parties confirmed their initial recommendations to the Board; namely, the hospital submits that the decision to admit Mr. Chin was necessary and appropriate in the circumstances and continues to be the least onerous and lease restrictive decision to manage the risk caused by Mr. Chin’s mental decompensation, and the fact that he currently has no identified community living and that the hospital must find new accommodation for him. The hospital recommends no change to the Disposition.
Counsel for the Attorney General, Coughlan, maintained that he supports the hospital recommendation.
Counsel for Mr. Chin, Mr. Rastgou, confirmed that on behalf of Mr. Chin, he is taking the position that the admission to hospital was not warranted, that Mr. Chin was not aggressive, made no direct threats, and that he lost his transitional housing so very quickly after the admission. Mr. Rastgou added that the hospital needs to address the discrimination issue and that ultimately the decision to admit Mr. Chin to hospital was not warranted at that time nor is it warranted today. Mr. Chin has greatly improved, is compliant with treatment and there have been no major incidents since shortly after his admission to hospital. The hospital must take a more active role in finding the necessary housing to enable Mr. Chin to be discharged.
Analysis and Conclusion
Regarding the law applicable to restriction of liberty hearings, the analytical framework established by Campbell (Re), 2018 ONCA 140, requires the Board to consider the liberty norm and the liberty status of an accused on a restriction. The liberty norm and liberty status for each restriction must be examined to determine the significance of the increase (if any) on the restriction of an accused’s liberty caused by the restriction. In determining the liberty norm of an accused at the outset of each period of restriction, the Board must “take a contextual approach – one that considers the individual’s pattern of liberty in the recent past.” ((Re) Campbell, para. 66). The liberty she/he was actually experiencing (rather than what she/he was entitled to) at the time of the increase is what the Board is to consider, and that “liberty must be of sufficient duration to have become, objectively speaking, the NCR accused’s norm” ((Re) Campbell, para 65).
Having considered all of the evidence tendered at the hearing, and the submissions of the parties, the Board finds that the hospital’s decision to significantly increase the restriction of Mr. Chin by admitting him to hospital following his threatening behaviour towards staff in light of his history of acting out violently against staff, was reasonable and warranted and represented the least onerous and least restrictive course of action available to the hospital to manage the heightened risk to others. The hospital also had evidence that Mr. Chin’s clozapine levels were sub-therapeutic, confirming suspected non-compliance with treatment.
The hospital submission presented to this Panel is appropriate on the evidence on each of the issues set out for consideration in Campbell. The necessity of the restriction arose from the decompensation of Mr. Chin’s mental condition, the threats to staff and non-compliance with treatment. There was, accordingly, a significant restriction of his liberty that was undertaken out of necessity, having regard to both the hospital’s obligation to ensure the safety of the public (as the primary objective) and its duty to ensure that Mr. Chin’s mental health and other needs are being met.
Mr. Chin is doing well in hospital despite some ongoing symptoms. He is progressing up the privilege ladder and is participating in programing. The hospital must remain mindful of the need to maximize privileges as appropriate to manage risk. As a result of the loss of Mr. Chin’s transitional housing, the situation requires new applications to be expedited to facilitate discharge as soon as possible.
The Board is hopeful that Mr. Chin will continue to progress and that all efforts are being deployed to secure new accommodation for him in the community.
DATED this 5th day of November, 2025, at the City of Toronto, in the Region of Toronto.
Ms. M. Labrosse Alternate Chairperson
__________________ Office of the Registrar Ontario Review Board