Re Raymond P. MacLean, 2025 CanLII 114808

Ontario Review Board

Re: Raymond P. MacLean

ORB File No: 8189

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(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: Raymond P. MacLean Counsel: Mr. J. Kopman

The person in charge of hospital: Representative: Dr. R. McMaster Attorney General of Ontario: Counsel: Mr. C. Coughlan

REASONS FOR DISPOSITION

(Dated November 5, 2025)

Reasons of the Majority

(Ms. M. Labrosse, Mr. M.D. Segal and Dr. G. Eayrs)

Introduction

1On December 1, 2022, Raymond MacLean was found not criminally responsible on account of mental disorder on two counts of uttering threats to cause death or bodily harm and one count of failing to comply with conditions of a release order, contrary to the Criminal Code of Canada.

2Mr. MacLean is currently subject to a disposition of the Ontario Review Board dated September 17, 2024, which detains him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH” or the “hospital”), with privileges up to and including to live in the community in approved accommodation by the person in charge.

3On September 22, 2025, a panel of the Ontario Review Board (the “ORB” or “the Board”) convened a hearing pursuant to s. 672.81(1) of the Criminal Code to review Mr. MacLean's last disposition. Mr. MacLean attended the hearing and was represented by his counsel, Mr. J. Kopman.

4The issues for this hearing are whether Mr. MacLean continues to meet the threshold for significant threat to the safety of the public, and if so, to determine the necessary and appropriate and least onerous and least restrictive disposition in all the circumstances.

Preliminary Positions of the Parties

5The hospital recommended that Mr. MacLean continues to pose a significant threat to the safety of the public but that a conditional discharge, with a consent to treatment provision under s. 672.55(1), is now adequate to manage the risk.

6Counsel for the Attorney General, Mr. Coughlan, indicated his support of the hospital recommendation with an added request for the existing no-contact provisions with the victim of the index offences to be added to the new disposition.

7Counsel for Mr. MacLean, Mr. Kopman, stated that his client is seeking an absolute discharge and, in the alternative, if the Board believes that he continues to pose a significant threat to the safety of the public, Mr. MacLean would not oppose the conditional discharge and would consent to treatment under s. 672.55(1) of the Criminal Code.

8For the reasons set out below, the majority of the panel finds that Mr. MacLean no longer poses a significant threat to the safety of the public and we therefore grant him an absolute discharge.

Index Offences

9The circumstances of the index offences are set out in last year’s Reasons for Disposition as follows:

“Mr. MacLean and the two complainants all used to reside in the same apartment building. In July of 2020, Mr. MacLean and the male complainant became involved in a dispute over text messages. The matter became more heated. Later that evening, Mr. MacLean struck that complainant with his pickup truck. Injuries were sustained. Mr. MacLean surrendered to police and was released on bail (charges arising from this incident were later stayed by the Crown). Mr. MacLean moved from the building, but later met the female complainant and threatened her and the original male complainant (who was not on scene). Police were called.

Mr. MacLean was co-operative in his arrest for these latter offences but described as “agitated and unstable.” He presented as disorganized and with inappropriate affect, made claims about child molesters, militias and made other comments.”

Background History

10Mr. MacLean’s personal, legal and psychiatric history is set out in detail in the Hospital Report. Briefly summarized, Mr. McLean is 33 years of age and was born in Ottawa. Mr. MacLean had a stable upbringing and completed high school. He held a variety of jobs and fathered a son, with whom he has regular access visits.

11Mr. MacLean first drank alcohol at the age of twelve. This became a problem for him, and he developed a pattern of binge drinking. His use was heaviest during adolescence and prior to the birth of his son. Mr. MacLean disclosed having had periods of heavy cannabis use and of abstinence.

Psychiatric History

12Mr. MacLean’s psychiatric history dates from June of 2020 when he sought help from a hospital emergency department due to feelings of paranoia. A brother apparently suffered from schizophrenia and this affected Mr. MacLean’s perception of what might be happening to him. He had been self-isolating since March 2020, and he endorsed hearing voices. He was apparently assessed and then released with a discharge diagnosis of paranoia. Within a week, Mr. MacLean was again assessed by a psychiatrist. He presented as paranoid. His thought form was over-inclusive. He believed that conspiracies existed. He had poor insight and was not responsive to reality testing. He denied hallucinatory experiences but reported experiencing panic symptoms when walking his dog or driving. He smoked cannabis nightly. Some residual delusions were present, but these were not strong at the time. His diagnosis remained one of paranoia. Psychosocial treatments were recommended.

13Mr. MacLean’s counsel arranged for a psychological assessment to be conducted in September of 2020. The psychologist concluded that no signs of psychopathy or sociopathy were present. Mr. MacLean was found not to have an anger disorder and was deemed not to pose a risk to himself or others. However, within a month, Mr. MacLean was taken to a hospital emergency department by his brother due to possibly delusional beliefs about being molested as a child. He was behaving bizarrely and was “very loud and escalating.” He was experiencing “some hallucinations.” Ultimately, he was diagnosed with PTSD and discharged.

14Shortly thereafter, Mr. MacLean was visited at his home by a mobile crisis intervention team because he had been behaving aggressively. The next day, he was admitted to hospital via a Form 2 application to a Justice of the Peace. He had been abusing cannabis, and expressed delusional beliefs about paedophile rings, being surveyed, and a long personal history of sexual abuse. On discharge, he remained delusional.

15Mr. MacLean continued to suffer delusions of a similar nature well into 2021 and at the time was likely abusing cannabis. In February, he was involuntarily admitted to hospital, expressing delusions with disordered thoughts. He admitted to being non- compliant with prescribed medication for the preceding two weeks. He was also seen a number of times at CAMH, and he continued to express delusional thoughts.

16Mr. MacLean had no further hospitalizations or mental health decompensations subsequent to being seen by Dr. Pearce in August 2022. He was by and large compliant with antipsychotic medication. In January of 2023, interviews demonstrated a greater insight into his illness, the need for medication and the deleterious effects of substances.

17Mr. MacLean's current diagnoses include schizophrenia and cannabis use disorder.

Evidence at the Hearing

18The hospital's evidence was presented through its report dated August 15, 2025, entered as Exhibit 1 for the hearing and through the oral testimony of Dr. A. Igoumenou. This evidence is summarized below.

19Dr. Igoumenou adopted the contents of the Hospital Report and confirmed that she has been Mr. MacLean’s outpatient psychiatrist since January 2025.

20Mr. MacLean has maintained a stable mental status and his illness is well controlled on his current medication. Over the course of the past year, Mr. MacLean has remained an outpatient of the hospital and has not required any readmissions.

21Mr. MacLean has faced a number of stressors over the course of the past year which he has managed successfully. Firstly, with respect to financial issues, Mr. MacLean had significant consumer debt, in the range of about $68,000, which was causing him much stress. With the assistance of the treatment team, Mr. MacLean was able to obtain legal and expert advice and ultimately entered into a consumer proposal to relieve some of that financial stress. Dr. Igoumenou believes that his overall debt load was reduced by approximately 30 percent and that he is required to make regular payments on the outstanding debt.

22Mr. MacLean continues to work as a bricklayer; however, he has shifted to self-employment and is now operating his own business with staff and subcontractors. According to Dr. Igoumenou, he is quite motivated to operate a successful business. Mr. MacLean has mentioned that he is not certain as to how things will work out in the off-season as the work that he does is highly seasonal in nature and he is concerned about financial insecurity.

23Mr. MacLean was married in October 2023. He and his wife are attempting to start a family. They have undergone a fertility assessment due to the fact that those efforts have not yet resulted in a pregnancy. According to Dr. Igoumenou, Mr. MacLean and his spouse are on a long wait list for a fertility clinic and this has been an additional stressor in Mr. MacLean's life.

24In the opinion of Dr. Igoumenou, stress has played a major role in the decompensation of Mr. MacLean's mental illness in the past. Mr. MacLean has historically resorted to using cannabis as a coping strategy, and this too has impacted his mental illness. The treatment team believes that it is essential to the management of risk that Mr. MacLean be assisted in developing other coping strategies that do not involve the use of substances that can accelerate the decompensation of his schizophrenia.

25Dr. Igoumenou believes that it would be premature for Mr. MacLean to have an absolute discharge as he is still in the process of developing strategies to manage stress and also to maintain his abstinence from substance use. Though Mr. MacLean has not used cannabis in approximately 12 months, he has shared with Dr. Igoumenou that he still has cravings for alcohol and has also acknowledged he does not know if he would be able to control himself to maintain moderate use. Dr. Igoumenou believes that it is important to solidify the safeguards that are in place to help Mr. MacLean manage his stress and not lose control by using substances.

26The treatment team would also like to see Mr. MacLean engage in trauma-informed therapy in order to deal with his early life trauma. According to Dr. Igoumenou, that type of therapy is quite heavy and could be started within the forensic psychologist but would no longer be available once Mr. MacLean receives an absolute discharge.

27Dr. Igoumenou believes that a conditional discharge would be adequate to manage the risk at this time. It continues to be protective for Mr. MacLean to be under an ORB disposition including the requirement to report and to submit to urine drug screens.

28Dr. Igoumenou confirmed that Mr. MacLean is capable of consenting to treatment and that he is willing to continue to take treatment, namely his long-acting injectable antipsychotic (Abilify 300 mgs/every 4 weeks). He is not experiencing any side effects from that medication.

29In response to questions posed to her by counsel for the Attorney General, Mr. Coughlin, Dr. Igoumenou acknowledged that Mr. MacLean has described himself as impulsive, and that he needs to be tested with a conditional discharge to see if he is capable of maintaining abstinence and sobriety without the external constraints of a disposition. Mr. MacLean told her that when he traveled to Indonesia with his wife last year, he was able to resist consuming alcohol in the plane while everyone was enjoying alcohol around them.

30Responding to questions posed to her by counsel for Mr. MacLean, Mr. Kopman, Dr. Igoumenou testified as follows:

a) Mr. MacLean's financial issues have existed for some time, and he has been able to work through this by doing a consumer proposal which he sought of his own accord. The hospital did provide some guidance and monitoring of the situation while he was going through that. Despite this stress, Mr. MacLean did not relapse and remained stable through this period.

b) Mr. MacLean started his own business and despite the stress of doing so, he did not experience any decompensation. He has also dealt with the stress of having to consult with fertility experts about plans to start a family. Dr. Igoumenou agreed that Mr. MacLean deserves credit for dealing with these things, however, he has had benefitted from the ongoing support of the treatment team. He reports every two weeks, as well as having the external controls of his disposition.

c) Dr. Igoumenou testified that Mr. MacLean said that he would like to be able to drink alcohol once he is no longer required to abstain but is fearful that his impulsivity will make it impossible for him to use moderately. Despite the fact that his wife does not consume alcohol, Dr. Igoumenou does not think that he can abstain without his ORB disposition.

d) If Mr. MacLean was granted an absolute discharge, he would no longer have the support of the hospital. According to Dr. Igoumenou, Mr. McLane had mentioned some time ago that he wanted an absolute discharge for his wife to be able to obtain Canadian citizenship. There have been no discussions since about an absolute discharge nor any discussion about obtaining psychiatric follow-up in the community.

e) When asked what evidence suggests that Mr. MacLean would disengage from psychiatric care if he were not under an ORB disposition, Dr. Igoumenou referred to the history of noncompliance with treatment and substance use when experiencing stressors, all of which occurred prior to 2021.

f) If the Board orders an absolute discharge, the treatment team would have a discharge meeting with Mr. MacLean and make a referral for psychiatric hand over to a community psychiatrist. Dr. Igoumenou’s concern is what will happen after the absolute discharge.

31Responding to questions posed to her by members of the panel, Dr. Igoumenou testified as follows:

a) She believes that Mr. MacLean would eventually be noncompliant if he was granted an absolute discharge but not necessarily right away. As Mr. MacLean is on a long-acting injectable, it would likely take four to six weeks for him to start experiencing symptoms if he was to discontinue the medication.

b) The Hospital Report references a history of rapid decompensation. Based on his history and previous admissions to hospital, it would be difficult to admit Mr. MacLean under the provisions of the Mental Health Act.

c) The hospital continues to recommend reporting at a frequency of not less than once every two weeks, though Dr. Igoumenou is contemplating one in-person meeting and one virtual meeting to accommodate Mr. MacLean's work obligations.

d) With respect to insight, Dr. Igoumenou believes that Mr. MacLean has insight into his major mental illness and its symptoms as well as the importance of continuing to take treatment. She believes that his insight is partial in relation to the fact that drugs can lead to decompensation and ultimately, violent behaviour.

e) Mr. MacLean did complete a Narcotics Anonymous course as well as receiving addictions counseling from the treatment team with a focus on cannabis use. It would be likely that the hospital would focus on a harm minimization approach with respect to alcohol consumption given that Mr. MacLean has expressed wanting to drink socially.

f) Mr. MacLean is currently working long weeks as well as some weekends and according to Dr. Igoumenou, he is very conscientious in his work.

g) Though the treatment team has met with Mr. MacLean's wife on several occasions, Dr. Igoumenou does not know what her views are regarding cannabis consumption and substance use in general.

h) Regarding the victims of the index offences, Dr. Igoumenou stated that Mr. MacLean has reported concerns about running into the victims given that he travels to Scarborough to see his son regularly.

i) According to Dr. Igoumenou, Mr. MacLean is paying child support for his son at this time, and she believed it was in the range of approximately $400.00 a month.

j) In the opinion of Dr. Igoumenou, Mr. MacLean still meets the threshold of significant threat as there remains a likelihood that he would commit a serious criminal offence if not treated and using substances leading to the decompensation of his illness. Dr. Igoumenou acknowledged that though she believes that Mr. MacLean does not have full insight into the role that substances played in precipitating violence, he has stated that he appreciates that cannabis played a role in the symptoms that he was experiencing at the time of the index offences.

k) Mr. MacLean recognizes the symptoms of schizophrenia and has stated that he understands that medications help to make them go away.

l) Dr. Igoumenou confirmed that Mr. MacLean's ex-spouse, who is the mother of his son, had previously been requesting confirmation of when Mr. MacLean would receive his LAI injection, but that this is no longer happening. Mr. MacLean has provided consent to the treatment team to disclose information to the mother of his son.

m) Dr. Igoumenou has given thought to removing the prohibition on the consumption of alcohol and cannabis in order to test Mr. MacLean's ability to abstain, however, they have opted to retain those conditions given his own concerns about losing control if he consumes alcohol. Dr. Igoumenou, nevertheless, acknowledged that it is probably not necessary for the disposition to contain a prohibition on cannabis use, given that Mr. MacLean has indicated that he has no intention of using it and that he has successfully abstained for some time.

32No other evidence was presented.

Submissions of the Parties

33The hospital maintains its recommendation that Mr. MacLean continues to pose a significant threat to the safety of the public and that a conditional discharge, with a consent to treatment provision, would be the least onerous and least restrictive disposition at this time. Despite Mr. MacLean's significant progress in the past few years, it has been under the significant oversight of his treatment team and with the external motivation of his disposition. A conditional discharge recognizes the progress that has been made but it also takes into account the need to manage the risk associated with the ongoing stressors in Mr. MacLean's life. The hospital maintains that if Mr. MacLean was not under a Board Disposition, the effect of these stressors in his life would eventually lead to relapse and decompensation of his illness.

34Counsel for the Attorney General, Mr. Coughlin, indicated his support of the hospital position and adopts the submissions of the hospital and stresses the history of lack of illness management, pointing to the fact that support and supervision is still needed to manage the risk.

35Counsel for Mr. MacLean, Mr. Kopman, reiterated his client’s request for an absolute discharge citing that Mr. MacLean has managed quite well despite a number of potential stressors in his life and that he has continued to manage those stressors on an ongoing basis, without relapse. With respect to the issue of significant threat to the safety of the public, the hospital’s position hinges on evidence that is mostly historical in nature. The risk assessment demonstrates the progress achieved by Mr. MacLean and the evidence highlights how motivated Mr. MacLean is by wanting to succeed with his family and his business and that he has developed insight into the importance of remaining adherent to medication.

Analysis and Conclusion

36Having considered all of the evidence presented at the hearing, and the submissions of the parties, the majority of the panel finds that Mr. MacLean no longer poses a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code and as further defined in R. v. Winko, (Forensic Psychiatric Services) 1999 CanLII 694 (SCC), [1999], 2 S.C.R. 625.

37According to R. v. Winko, a ‘significant threat to the safety of the public’ means a real risk of physical or psychological harm to members of the public that is serious in the sense of going beyond the merely trivial or annoying. The conduct giving rise to the harm must be criminal in nature. There must be a positive finding by the Board of a significant risk to the safety of the public to engage the provisions of the Criminal Code and to support restrictions on an NCR accused’s liberty. Uncertainty does not suffice. If the Board cannot resolve the question of whether or not the NCR accused constitutes a significant threat to public safety, it must grant the accused an Absolute Discharge.

38In Winko, the Supreme Court also outlined that in coming to a conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence including the circumstances of the original offence, the past and expected course of the accused's treatment, the present state of the NCR accused's medical condition and the NCR accused's own plans for the future, the support services existing for the NCR accused in the community and the recommendations provided by experts who have examined the NCR accused.

39Upon first becoming unwell with psychotic symptoms about five and a half years ago, Mr. MacLean presented voluntarily to an emergency department in June 2020. In spite of some subsequent difficulty establishing the diagnosis and ensuring engagement with treatment, he was actually found to have achieved mental stability and sound insight into his illness, and to be engaging well with treatment by the time of his NCR finding in December 2022.

40Mr. MacLean has been residing in the community for his entire ORB tenure and has been functioning at a high level with minimal therapeutic supports. There has been sufficient time to assess 1) ability to abstain from the significant intoxicant in this case, cannabis; 2) to be confident that his medication is sufficient to sustain mental stability; and 3) that he has sufficient ability to tolerate stressors without the support of an ORB disposition.

41The evidence before us outlines the sustained progress that Mr. MacLean has continued to make over the years since coming under the jurisdiction of the ORB. Mr. MacLean has not engaged in any violence or assaultive behaviour. He attends his appointments with the FOPS team and is compliant with treatment, namely his LAI antipsychotic Abilify, which he takes without issue. Mr. MacLean demonstrates insight into the fact that he needs to continue to take treatment for his major mental illness.

42Mr. MacLean is diagnosed with a Cannabis Use Disorder which is in remission. He completed substance use programming and his UDS results have all returned negative for substances in the last year. Cannabis use was a factor at the time of the index offences. The evidence of the hospital is that Mr. MacLean demonstrates insight into the role of psychosis and substance use at the time of the index offences. He has expressed no desire to return to using cannabis, though he would like to be able to consume alcohol socially, though is concerned with his ability to use it moderately. Alcohol was not involved at the time of the index offences.

43Mr. MacLean is an active participant in pro-social endeavors including full-time employment. He is a bricklayer who has transitioned to self-employment and now operates his own business with staff and sub-contractors. He is described as hard-working and ambitious.

44Mr. MacLean has been married since 2023, and he and his wife are attempting to start a family, though they have not been successful to date. They have applied to a fertility clinic to obtain assistance.

45Mr. MacLean has complied with all of the terms in his ORB Disposition. These are all indicators of his positive trajectory in terms of full community re-integration. Though he has benefitted from the support provided to him by his forensic treatment team, he has assumed responsibility for his life and the management of his illness, and the evidence suggests that this will continue absent an ORB Disposition.

46Because an absolute discharge was not being contemplated by the hospital, there has been no steps taken towards setting Mr. MacLean up with community mental health care. Though it would have been preferable for this to be in place in advance, we do not find that the absence of confirmed community mental health services for Mr. MacLean at this time is sufficient to tip the scales in favour of a finding of ongoing significant threat to public safety. Dr. Igoumenou confirmed that Mr. MacLean would be referred to community mental health services if he is granted an absolute discharge. It would be expected that Dr. Igoumenou and the FOPS team would continue to bridge care while Mr. MacLean is being transitioned to a civil treatment team.

47In summary, we are not persuaded that risk to public safety posed by Mr. MacLean continues to meet the threshold of significant threat to the safety of the public.

48In view of the finding that Mr. MacLean no longer meets the threshold of significant threat to the safety of the public, we therefore grant Mr. MacLean an absolute discharge and wish him all the best in the future.

Reasons of the Minority

(Dr. B. Sheppard and Mr. W. Apted)

49The minority believes that Mr. MacLean remains a significant threat to public safety. We would impose a Conditional Discharge disposition, as recommended by the hospital.

50Mr. MacLean suffers from Schizophrenia, and from a co-morbid Cannabis Use Disorder. He committed the index offences in March 2021, following a protracted period of psychiatric instability, over the course of which his behaviour was characterized, at times, as aggressive, threatening, and violent. Although he saw a number of psychiatrists and was admitted to hospitals on occasion, he lacked insight, used cannabis regularly, and remained unwell. He committed the index offences, and indulged in other threatening conduct, while under the influence of persecutory delusions.

51It is clear that Mr. MacLean has done well in recent years. Over the past reporting period he has been living independently in the community, supporting himself through full-time employment, and he has remained adherent to his psychiatric medications and abstinent from substances. He is fully engaged with his FOPS team, which provides him with psychiatric follow-up, case management, and opportunities to participate in a number of therapeutic programs targeting substance use, stress management, illness management and recovery. He receives a considerable amount of support from his outpatient team.

52The concern of the minority with respect to future risk is that, given that Mr. MacLean has a number of historical risk factors including long-term psychiatric illness, substance use, deficient insight, and violence when unwell, ongoing maintenance of clinical stability will require future psychiatric follow-up, and the provision of necessary mental health supports and services for Mr. MacLean moving forward. Mr. MacLean is presently receiving these necessary services and supports through the FOPS team. He is doing well.

53There is, however, no plan in place for continued psychiatric follow-up, and related mental health supports, in the event of an Absolute Discharge. Even if a community support plan were put in place, and the hospital was able to offer bridging services in the interim, the minority is of the view that there is a real risk that, absent the external structure of an ORB disposition, Mr. MacLean’s current level of insight, described by his treating psychiatrist as “fair”, will be insufficient to ensure that he remains engaged with mental health services. Disengagement would likely lead to eventual clinical deterioration through medication non-adherence, poor stress management, substance use, or a combination of these. A relapse into active psychosis would likely lead to the re-emergence of aggressive behaviour, as seen prior to, and at the time of, the index offences. Public safety would be at risk.

54The minority would recommend a Conditional Discharge disposition so that Mr. MacLean can remain engaged with the FOPS team, hopefully pending the development of a plan to gradually transition his care to suitable non-forensic service providers in the community. There will thus be greater confidence that the relevant risk factors would be successfully managed in the event of a future Absolute Discharge.

55The minority would remove the proposed clauses in a Conditional Discharge requiring Mr. MacLean to abstain absolutely from substances, and to take medication in accordance with Section 672.55(1) of the Criminal Code. The evidence at the hearing leads to the conclusion that these clauses are no longer necessary. We would, however, continue to require Mr. MacLean to submit samples of his urine to the person-in-charge or designate, to monitor the extent of his substance use, if any.