Ontario Review Board
Re: Jeremy M. Montgomery
ORB File No: 5084
Hearing held on: Wednesday, October 8, 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. S. Clapp Members: Dr. H. Bloom Dr. A. Kerry Mr. P. Capelle Mr. B. Apted
Parties Appearing:
Accused: Jeremy M. Montgomery Counsel: Mr. A. Confente
The Person in charge of Hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Mr. S. Kim
REASONS FOR DISPOSITION
(Dated November 28, 2025)
Introduction
On June 23, 2008, Mr. Jeremy M. Montgomery was found not criminally responsible on account of mental disorder on a charge of assault with a weapon, contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Montgomery is currently subject to a Disposition of the Ontario Review Board (the "Board") dated October 9, 2024, detaining him at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“St. Joseph's”), with privileges up to living in the community of the catchment area of St. Joseph's in 24/7 supervised accommodation approved by the person in charge.
On October 8, 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. Mr. Montgomery was in attendance and was represented by his counsel, Mr. Confente.
Without Prejudice Position of the Parties
Ms. Barney recommended, on behalf of the hospital, continuation of the current detention disposition. That recommendation was joined by Mr. Kim, for the Attorney General, and Mr. Confente, on behalf of Mr. Montgomery. As a result of the joint position, the oral evidence focused on the events of the past clinical year and risk management issues relevant to a necessary and appropriate Disposition. However, in his closing submissions, Mr. Confente requested that sub-paragraph 4(a) of his client’s Disposition be amended to allow the use of cannabis under medical supervision.
Background
The Board admitted into evidence the Hospital Report as Exhibit 1. That document provides a great deal of information concerning Mr. Montgomery’s personal history, mental health history as well as his course in hospital and in the community, both prior to and after the index offences. As the Hospital Report was made an Exhibit, it’s unnecessary to reproduce the information contained therein in its entirety in these Reasons. Briefly:
- 2001 (age 15-16): Criminal charges as a youth, resulting in conviction for assault-related offenses
- Since becoming a Crown Ward in 2002, Mr. Montgomery has lived in various supervised residential settings, including multiple group homes and residential treatment facilities.
- Substance use since age 16.
Index Offences
The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:
“On February 4, 2008, Mr. Montgomery threw a beer bottle at a woman who was riding her bike. When she confronted him and told him the police had been called he waved a knife at her in a threatening manner. Two days later he entered a grocery store and threatened to damage the premises. He also attempted to rob a female customer of her groceries. An older gentleman advised police that earlier in the evening, he had been held up by Mr. Montgomery who had been in possession of a knife.”
Incidents during Board Supervision
Mr. Montgomery's tenure under Board jurisdiction has been marked by significant behavioral challenges. He incurred two assault charges in 2019 and 2020 when he was a patient at the Southwest Centre for Forensic Mental Health Care. Both charges were ultimately stayed.
The Hospital Report reflects recurrent instances of violent conduct and threatening behavior directed toward medical personnel, co-patients/residents and members of the public. Locked seclusion was required numerous times. Mr. Montgomery was transferred from the Waypoint Centre for Mental Health Care in April 2023. There were no incidents of violence until he stabbed a co-patient with a pen in January 2025.
Current Diagnoses
Schizoaffective Disorder (Bipolar)
Intellectual Disability (Mild)
Cannabis Use Disorder, severe, in sustained remission in a controlled environment
Stimulant (Cocaine, Crack Cocaine, Methamphetamine) Use Disorder, severe, in sustained remission in a controlled environment
Antisocial Personality Disorder
Evidence at Hearing
In addition to the documentary evidence the Board also heard from Dr. Duboff who confirmed having read and adopted the contents of the Hospital Report. Dr. Duboff has been Mr. Montgomery’s attending psychiatrist since April 10, 2025, when this patient was transferred to Waterfall 3. The clinical decision to transfer units was made after a violent attack on a co-patient in January 2025 that led to Mr. Montgomery’s seclusion on Harbour North 3. Thereafter, he was frequently locked in his room to both manage his risk and protect the safety of others. Following his transfer to Waterfall 3, Mr. Montgomery remained in locked seclusion for a couple of days and was then released to the unit population without incident to the date of this hearing.
Mr. Montgomery has an extensive ORB history and multiple diagnoses over the years. As indicated at page 123 of the Hospital Report, more in depth cognitive testing was completed this year in order to try to understand Mr. Montgomery’s strengths, difficulties, and risk factors. The results of the intellectual assessment (WAIS-IV) concluded that he has impaired intellectual abilities (<1st percentile). The Adaptive Behaviour Assessment System (ABAS-II) supported “global impairment (Extremely Low)” across all domains. These results helped the treatment team develop a behaviour plan for Mr. Montgomery. He is working very closely with the behaviour technologist on many aspects of his care.
Mr. Montgomery is generally adherent in taking his psychiatric medications. He is treatment incapable with his mother serving as his substitute decision maker. Clozapine is the mainstay of his psychotropic treatment regime and remains at a therapeutic level. Mr. Montgomery has given no indication that he would remain medication compliant on his own accord. He would decompensate and his risk would elevate within days of falling away from clozapine. Mr. Montgomery is not symptom free at this juncture. A few days prior to this hearing he related auditory hallucinations and ideas regarding race but did not vocalize any intention to harm others.
Although Mr. Montgomery engages in programming, he continues to believe that others do not like him and he therefore needs to focus on developing social skills. At present, he simply enjoys being in a room where he does not feel excluded.
Mr. Montgomery has been gradually augmenting his privileges. He is currently accorded indirect level 3 privileges within the hospital and level 4 accompanied privileges outside of the hospital.
Dr. Duboff advised that the treatment team may have to advocate to obtain DSO funding for Mr. Montgomery as there is no information that he was tested for intellectual deficits prior to the age of 18. If DSO funding is approved, then efforts to obtain a Bartimaeus worker for Mr. Montgomery may be initiated. It was noted that Mr. Montgomery has been meeting with a Peer Support Worker at the hospital since October 2024.
Mr. Montgomery will require 24/7 supervision to be placed in the community and is already on several waitlists notwithstanding that he is currently inappropriate for community housing. Placement within Indwell 24/7 housing waitlists (Wentworth Program) is not dependent on DSO funding which has its own waitlists.
Mr. Montgomery has relapsed to cannabis use throughout his tenure under the ORB. Most recently, there was a presumptive positive test result in November 2024. Mr. Montgomery continues to speak fondly to staff about recreational drugs that he finds “fun” and would want to use again. Dr. Duboff does not recommend the administration of cannabis for pain management or for any other reason as this would be destabilizing for Mr. Montgomery. Dr. Duboff noted that Mr. Montgomery is working with a physiotherapist regarding his knee pain.
Mr. Confente inquired if Mr. Montgomery's mother or aunt have shown an interest in coming forward to become an approved person. Dr. Duboff responded that he had not directly asked this question of Mr. Montgomery's mother who resides in the Windsor area. Dr. Duboff noted that Mr. Montgomery's mother has not visited him over the past year.
Dr. Duboff was asked about Mr. Montgomery’s inappropriate sexual behaviours. Dr. Duboff stated that Mr. Montgomery has never been diagnosed with paraphilia, and he believes his behaviours are more the result of active symptoms and a lack of understanding of relationships and social norms. Mr. Montgomery now has access to paper and video pornography that he can use in his room. By history there has been a lack of understanding as to how to address his sexual behaviors and the issue of consent.
Mr. Montgomery was called to testify by Mr. Confente. He stated that no one other than Dr. Duboff cares whether he smokes weed. Mr. Montgomery advised that he broke his leg five times and now must walk slowly so it will not break again and needs weed for pain control. He stopped physiotherapy a week ago because it exhausted him. He had been doing exercises provided for a few months. Mr. Montgomery emphasized that he is in hospital for breach of probation rather than for an assault and that he has a “white mother”.
Closing Submissions
Ms. Barney submitted that since his transfer to Waterfall 3, Mr. Montgomery has done quite well in working with Dr. Duboff and a behavioural therapist. He has been more physically active. He has a knee brace and has lost some weight which may assist with his knee pain. An updated psychological assessment and application for DSO will be worked on in the coming year. It is hoped that Mr. Montgomery will continue to work on targets set for him. Ms. Barney’s submissions were supported by Mr. Kim. Mr. Confente requested that sub-paragraph 4(a) of his client’s Disposition be amended to allow the use of cannabis under medical supervision.
Analysis and Decision
(a) Significant Threat
Ongoing 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.
In determining whether Mr. Montgomery continues to represent 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.
The Board unanimously finds that Mr. Montgomery continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Duboff that Mr. Montgomery continues to pose a significant threat. In arriving at its independent finding the Board also relies on the Hospital Report and the current Clinical Risk Summary contained therein at pages 124-125. The portion that addresses Mr. Montgomery’s risk profile is reproduced below:
Mr. Montgomery’s risk for violent offending continues to be impacted by the nature of his psychotic illness, comorbid substance use disorder, and intellectual disability. Absent significant supervision from a Forensic Psychiatric Team ordered by the Review Board, Mr. Montgomery will likely stop his medications and/or relapse in substance use, as has been the case in the past, which would likely lead to rapid decompensation in his mental status and significantly increase his risk to reoffend in the same manner seen at the time of the index offence.
Given the foregoing the Board accepts that absent an ORB Disposition, Mr. Montgomery would likely become non-compliant with prescribed medications which would lead to decompensation, use of substances and the re-emergence of behaviours similar to those seen at the time of the index offences. It was also noted that Mr. Montgomery’s mental state is described as “incredibly fragile”, and he has engaged in significant violence while subject to the close monitoring and supervision of the Board. We are satisfied that absent an ORB Disposition, it is likely that Mr. Montgomery will cause serious physical or psychological harm to members of the public and such conduct will likely be criminal in nature.
(b) Disposition
Flowing from the Board’s finding that Mr. Montgomery continues to pose a significant threat to the safety of the public it must shape a Disposition for the year ahead. Its paramount consideration in doing so must be the safety of the public while also considering Mr. Montgomery’s needs pursuant to s. 672.54 of the Criminal Code.
The necessary and appropriate disposition for Mr. Montgomery provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.
Mr. Montgomery presents with complex psychiatric, cognitive, and behavioral needs requiring ongoing structured care, treatment, and supervision. His history under the Board’s jurisdiction reflects persistent challenges with managing his risk of violence. The constellation of severe mental illness, intellectual disability, historical substance abuse, and entrenched behavioral difficulties necessitates careful oversight. These factors support the duplication of his current Detention Disposition for 2025/2026 to address the significant threat he continues to pose to public safety.
In considering Mr. Montgomery’s needs, the Board was attentive to his potential eligibility for Developmental Services Ontario (DSO) funding. Mr. Montgomery’s intellectual abilities were assessed at the <1st percentile and Intellectual Disability (Mild) is one of his six current psychiatric diagnosis. While DSO funding applications are ordinarily submitted for individuals in their teenage years with a diagnosis of developmental disability this should not dissuade the hospital from putting forward a fully supported application for this now 29-year-old gentleman. Towards that objective, requisitioning Mr. Montgomery’s school records could substantiate the presence of developmental disability from an early age. As noted by Dr. Duboff additional DSO funding would be directed towards engaging a Bartimaeus worker to interact with Mr. Montgomery thereby alleviating his feelings of social isolation. DSO funding may also assist with finding suitable housing for Mr. Montgomery going forward.
The panel did not accept that removing the cannabis prohibition from Mr. Montgomery’s Disposition was necessary or appropriate. The panel accepted Dr. Duboff’s evidence that Montgomery’s risk factors “exponentially increase” with substance use.
Conclusion
Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Montgomery poses to the safety of the public while still meeting his needs, remains a Detention Disposition without changes.
In making this Disposition, the Board carefully considered the positions and submissions of the parties and the evidence of Dr. Duboff and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Montgomery’s mental condition, his reintegration into society and other needs.
DATED this 28th day of November 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Capelle
Legal Member
Office of the Registrar
Ontario Review Board