Re Natasha E. Allain, 2025 CanLII 129573

Ontario Review Board

Re: Natasha E. Allain

ORB File No: 7347

Hearing held on: Tuesday, November 25, 2025

Place of Hearing: Royal Ottawa Mental Health Centre

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

Before:

Alternate Chairperson: Mr. J. Weinstein

Members: Dr. R. Kunjukrishnan

Dr. W. Loza

Ms. L. Banks

Mr. A. Bouvier

Parties Appearing:

Accused: Natasha E. Allain

Counsel: Ms. M. Munsterman

The person in charge of hospital: Representative: Dr. M. Strike

Attorney-General of Ontario: Counsel: Ms. M. Dufort

REASONS FOR DISPOSITION

(Dated December 9, 2025)

Introduction

1. On April 10, 2018, Ms. Natasha E. Allain, was found not criminally responsible on account of mental disorder, on two charges of assault, both contrary to the Criminal Code of Canada (“Criminal Code”).

2. Ms. Allain is subject to a Disposition of the Ontario Review Board (the “Board”), dated December 2, 2024, which orders that she be conditionally discharged from the Royal Ottawa Mental Health Care, Ottawa (“Royal Ottawa”) on certain terms, including: she must report to the Royal Ottawa not less than once every week; she must abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant; and she must submit samples of urine and/or breath.

3. On November 25, 2025, the Board convened a hearing at the Royal Ottawa to conduct the annual review of the current Disposition.

4. Ms. Allain was present at the hearing and was represented by her counsel, Ms. M. Munsterman.

5. A Hospital Report, dated October 26, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. The issues at this hearing were whether Ms. Allain is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code, and, if so, what is the necessary and appropriate Disposition in the circumstances, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

7. For the reasons set out below and based on the expert evidence and opinions before us, the Board concluded that Ms. Allain continues to represent a significant threat to the safety of the public. The Board found that the necessary and appropriate Disposition in the circumstances is the continuation of her current Conditional Discharge with the following changes:

(a) A reduction in the frequency of her reporting requirement to not less than once per month;

(b) Removal of the requirement that she abstains absolutely from the non-medical use of alcohol or drugs or any other intoxicant; and

(c) The addition of a consent to a treatment clause, pursuant to s. 672.55(1) of the Criminal Code.

Current Psychiatric Diagnoses

• Schizophrenia, multiple episodes, in partial remission

• Stimulant use disorder (amphetamine and cocaine types)

• Cannabis Use Disorder

Position of the Parties

8. Dr. Strike, as representative of the hospital, and as the most responsible physician, recommended continuation of the existing Conditional Discharge Disposition, with the following changes:

(a) A reduction in the frequency of her reporting requirement to not less than once every three months;

(b) Removal of the requirement that she abstains absolutely from the non-medical use of alcohol or drugs or any other intoxicant; and.

(c) The addition of a consent to a treatment clause, pursuant to s. 672.55(1) of the Criminal Code.

9. Counsel for the Attorney-General agreed with the second and third recommendations, but she requested a reporting requirement of not less than once every two weeks or once every three weeks.

10. Counsel for Ms. Allain advised as follows:

(i) She agreed with the hospital’s recommendations.

(ii) Her client agreed to the inclusion of a consent to treatment clause pursuant to s. 672.55(1) of the Criminal Code.

(iii) She has discussed with her client the consequences of a breach of the consent to treatment clause, and her client understood the impact of having such a clause added to her current Disposition.

(iv) For the purposes of this hearing, significant threat was not in dispute.

Index Offences

11. The circumstances giving rise to the Index Offences are extracted from last year’s Board’s Reasons, as follows:

“As per the case file synopsis, on July 10, 2017, Ms. Tina Stratton was outside of her residence in her wheelchair watching her grandchildren play. Ms. Allain approached Ms. Stratton, yelling, and kicked Ms. Stratton in the face. Ms. Stratton's neighbour Maureen O'Brien approached Ms. Allain to inquire why she assaulted Ms. Stratton, at which time Ms. Allain yelled at Ms. O'Brien and punched her twice in the head.”

Background History

12. Ms. Allain’s background history and psychiatric history are outlined in the Hospital Report, and they are accurately summarized in last year’s Reasons:

“Ms. Allain is reported to have had a chaotic and stressful childhood. She has brothers who share the same mother but have different fathers. Ms. Allain was primarily raised by her mother. The family often moved requiring her to change schools multiple times. She lived with her mother until she was apprehended by CAS and placed in care, first in a group home and then with her grandmother. According to reports, Ms. Allain was physically and emotionally abused by her mother who was also abusing various substances. It was reported that Ms. Allain was neglected and provided with substances by her mother. School was difficult for her and according to reports she was held back in Grade 2 and at the time diagnosed with dyslexia.

Ms. Allain started using substances at age 14 and was unable to attend school past Grade 10 due to the increase in her use. Her substance abuse consisted mostly of snorting speed as well as using marijuana and cocaine. Ms. Allain had therapeutic abortions at age 14 and 18.

Ms. Allain’s first psychiatric admission appears to have taken place in 2011, with multiple admissions following, up to 2018.

Ms. Allain has a criminal record that includes convictions in 2015 for possession of cocaine for the purpose of trafficking, fail to comply with recognizance, 2018 with failing to comply with an undertaking and possession of a Schedule 1 substance.

Ms. Allain was followed by an ACT Team from 2014 until the time of the index offence at which time she was living in the community. Ms. Allain was first admitted to the Royal Ottawa Mental Health Centre (ROMHC) on an assessment order in February 2018. She was returned to hospital following her NCR finding, on April 4, 2018. She initially did well on the Forensic Rehabilitation Unit (FRU) but there were concerns in January 2019, that she may not have been taking her Clozapine medication. She had a seizure in January 2019 and blamed her seizures on the medication. Clozapine was discontinued, following which her mental state deteriorated. Clozapine was restarted at the end of February 2019. Ms. Allain’s condition improved.

On August 4, 2020, Ms. Allain was discharged to Wymering Manor where she remained stable until November 2020, when she started presenting problems at the Home. She almost got into a physical fight in the store when she got upset after someone bumped into her and she dropped the racks onto the floor. There was also a concern that Ms. Allain was quite vulnerable in the community potentially being at risk of an unwanted pregnancy or a sexually transmitted infection.

On April 7, 2021, Ms. Allain eloped with a male. She contacted a member of the treatment team indicating she did not know where she was. She returned to the home the following night having missed two days of medication and tested positive for methamphetamines.

In July 2021, the Group Home had concerns about Ms. Allain’s behaviours, including entering a co-resident’s room and stealing a bank card. She also left the home without informing staff where she was going and indicated that “she was an adult and that she could do what she wanted.” The Group Home was willing to continue Ms. Allain’s residence, with increased assistance and contact of the treatment team. She presented with increasingly problematic behaviour. Some of these behaviours caused issues with other residents who were unable to use the bathroom and, as well, she would stay overnight at her boyfriend’s place and refuse her medication.

As a result of these increasing concerns, Ms. Allain was readmitted to the Forensic Assessment Unit (FAU) on September 21, 2021. She had tested positive for amphetamine and methamphetamine. Ms. Allain refused to give permission for the treatment team to contact her boyfriend, Matt, but only agreed when it was emphasized to her that that would be expected prior to her being discharged.”

Criminal History

13. Ms. Allain’s criminal history is set out in the Hospital Report as follows:

• “June 28, 2011: charged with fail to leave premises when directed

• June 1, 2015: conviction for possession of a schedule 1 substance for the purpose of trafficking cocaine (adult)

• December 14, 2015: conviction for fail to comply with recognizance. Conditional sentence order, 30 days condition sentence (1st 20 days house arrest)/probation x 12 months

• February 28, 2018: charged with fail to comply with undertaking given by officer and possession of a schedule 1 substance.”

Course since Last Disposition

14. Ms. Allain's course since her last disposition is as set out in the Hospital Report. The following extracted paragraphs are relevant to this hearing.

“Ms. Allain remained living at the Baycrest female-only 24-hour supported residence over the past year. She did not have any psychiatric admissions. She did not have any involvement with police.

Her schizophrenia remained rather stable over the past year. She continued to have a treatment-resistant form of this severe mental illness, with prominent negative and cognitive symptoms of schizophrenia and brief periods of attenuated positive symptoms. She was sensitive to the effects of substances or a single dose of missed medication, where she abruptly developed auditory hallucinations, paranoid thinking and fear that she would be kidnapped, in response to these destabilizers. This occurred about three to four times over the year. These symptoms resolved within one to two days, when she resumed her medication or stopped using substances. Each time, she reached out promptly to her mother and team members to report these symptoms while they were occurring. On two such occasions – in mid July and late October, 2025 – Ms. Allain asked to be admitted to hospital to manage safety concerns related to her residence.

Ms. Allain had a fairly successful period with management of her substance use disorder, until September 2025.

On March 31, 2025, she smoked unknown substances with a male peer and subsequently tested positive, transiently, for methamphetamine, cocaine and fentanyl.

We were very pleased that Ms. Allain was accepted to the Pinecrest Queensway Assertive Community Treatment (ACT) Team late last year.

Ms. Allain agreed to accept services after she explained that several ACTT clients transition from supervised to semi-independent or independent housing successfully, via support from an ACT team. She met with ACTT staff throughout October, and began building rapport.

Ms. Allain expressed an interest in attending cooking group offered at the hospital in the morning to increase her independent living skills. However, Ms. Allain’s challenges waking up in the morning and inconsistent group attendance/engagement were a barrier to moving forward with this referral.

She currently resides at Baycrest group home and expressed dissatisfaction with her current living environment, describing a general feeling of not fitting in and a lack of personal independence.

At present, the client continues to reside at Baycrest group home and remains fixated on obtaining more independent housing. While her motivation for increased autonomy is evident, her readiness for a low-support environment remains limited due to inconsistent follow-through on skill development, medication adherence, and engagement with supports.”

Evidence at the Hearing

15. The Board had available to it the evidence and documents forming the Record, the Exhibits, and the oral evidence from Dr. Strike. Dr. Strike co-authored the Hospital Report. She testified as follows:

a) Ms. Allain continues to reside at the Baycrest residence, which is 24-7 supportive accommodations.

b) The Pinecrest ACTT provides Ms. Allain ongoing assistance with daily functioning, transportation and medical adherence.

c) Ms. Allain plans to visit her mother, who lives in New Brunswick, for a month. Her mother and family are a very strong support for Ms. Allain; however, Ms. Allain has refused to consent to the treatment team informing her mother of her recent use of substances.

d) Ms. Allain admitted to the treatment team that she has been using crystal methamphetamines at least once per week. There have been positive toxicology screens for methamphetamines on multiple occasions, including July 18, September 25, October 8 and October 23.

e) Ms. Allain has missed several urine drug screens since September.

f) Ms. Allain has a history of very poor medication adherence. In particular, she has missed eight of her doses in recent weeks, including 4 doses of Clozapine.

g) The treatment team is concerned that Ms. Allain is often late for her Clozapine blood work. Failure to obtain blood work when due puts her at risk of having to discontinue her Clozapine treatment.

h) Historically, non-adherence to her medications has caused Ms. Allain to hear voices and experience fear of being kidnapped. These are the same symptoms that occurred at the time of the Index Offences. When Ms. Allain has missed even one dose of her antipsychotics in the past, it has led to acute psychotic symptoms. Notwithstanding lapses in consistent medication over this past year, Ms. A has not engaged in any physically aggressive behaviour.

i) Ms. Allain’s goal is to live independently, but the treatment team considers this goal currently unrealistic.

j) Ms. Allain sometimes has difficulty returning to her residence by her 9:30 p.m. curfew. Baycrest will not dispense medications after curfew, so being late causes Ms. Allain to miss her oral medications. The treatment team is working with Baycrest on accommodations with respect to the evening medication administration, so that Ms. Allain would be able to obtain her medications, even if she were late.

k) Ms. Allain’s substance use, and poor medication adherence are major destabilizers, requiring intensive ACTT support and ongoing monitoring.

16. In response to questions from counsel for the Attorney-General, Dr. Strike testified:

a) Ms. Allain’s mother is supportive, she understands her daughter’s diagnosis, and she will ensure that her home is substance-free during Ms. Allain’s visits. Ms. Allain has not disclosed her recent/on-going substance use to her mother, despite encouragement from the team. Dr. S testified that Ms. Allain’s mother is very insightful and is well aware of her daughter’s long-term drug use and even indicated that she suspected that she had been using drugs. The doctor noted that Ms. Allain’s mother had visited Ms. Allain a few times over the past year.

b) Ms. Allain often only admits to using substances after being confronted with toxicology results.

c) Ms. Allain buys her drugs from shelters, a behaviour that exposes her to serious risk. She has stated that she visits the shelters and takes substances when she is bored or lonely. This behaviour is one of the reasons that the team is trying to engage her in more programs, both with the ACT Team and in hospital.

d) Ms. Allain is starting to engage and build a rapport with the new ACT Team, and this is promising. The treatment team’s goal in reducing reporting requirements is to encourage Ms. Allain to become more self-reliant and to assess how she preforms with the recommended loosening of her conditional discharge while she is still under the authority of the Ontario Review Board.

e) As set out in the Hospital Report, it has been very positive that Ms. Allain did voluntarily request to be admitted to the hospital when she was experiencing psychotic episodes.

f) She agreed that the police did have to get involved in July of this year and bring Ms. Allain into hospital.

17. In response to questions from counsel for Ms. Allain, Dr. Strike testified:

a) Ms. Allain was doing relatively well until July 2025, when positive drug screens began appearing.

b) Two factors may have contributed to her return to substances: staff changes in Ms. Allain’s treatment team and the introduction to a new ACT Team. Ms. Allain is sensitive to stress, and adding new ACT Team members may have caused her some anxiety. Ms. Allain is now beginning to engage positively with the ACT Team. There have been no aggressive behaviours or violent ideation since Ms. Allain’s Index Offences.

c) Ms. Allain’s psychotic themes, fears and feelings of victimization are related to her past trauma and exploitation.

d) The treatment team has recommended that she be transitioned to a LAI to address concerns about Ms. A’s intermittent med non-adherence, but she does not consent

e) Ms. Allain responds better to supportive, non-authoritarian, approaches rather that strict rules or threats.

18. In response to questions from the panel, Dr. Strike testified:

a) Ms. Allain’s mother is quite supportive and has good insight into her daughter’s illness. She will ensure that her home is substance-free during Ms. Allain’s visit.

b) Recent drug screens, from September to November, were missed or tested positive for methamphetamines, and occasionally alcohol.

c) There have been no acts of violence in the last year because of the heavy support and supervision provided by the treatment team. The concern when Ms. Allain decompensates is not that she acts out violently immediately; rather, her psychotic symptoms increase, including paranoia and fear of being kidnapped. It is these paranoid beliefs that cause her to act out in a similar way to the index offences.

d) A combination of medication non-adherence and substance abuse would be clear destabilizers for Ms. Allian.

e) Ms. Allain has engaged in individual addiction counselling, as well as Concurrent Disorders Groups. She continues to receive addiction counselling from both the treatment team and ACTT. She is in contact with both more than once per week.

f) The plan is to engage Ms. Allain in groups and programs that will allow her to build her resume, to eventually put her in a position to obtain employment.

g) It is important to maintain a requirement in the current Disposition that Ms. Allain submit to urine drug screens; if Ms. Allain’s mental state decompensates, these screens would help the treatment term determine if it is a result of stress, medication non-adherence or substance abuse.

h) Regarding the potential for Ms. Allain to access illicit substances when visiting her mother, she commented that her mother’s residence is in a small community an hour outside of Fredericton and Ms. Allain will be in the company of family members fairly consistently. She also noted that Ms. Allain has the ability to abstain from substance use for extended periods of time.

i) There are no concerns that Ms. Allain would move from her current residence; she would have difficulty, both financially and logistically, to find other accommodation.

j) It was not speculative that Ms. Allain would engage in conduct that was serious and criminal in nature if she were granted an Absolute Discharge.

19. No other evidence was called.

Analysis and Conclusion

20. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission that Ms. Allain remains a significant threat to the safety of the public.

21. In Winko, the Supreme Court outlined that, in coming to the 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; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Strike, in addition to the documentary evidence before us.

22. Ms. Allain has ongoing challenges with poor insight, instability and response to treatment or supervision.

23. Ms. Allain has a treatment-refractory form of schizophrenia. She has a very recent history of chronic medication non-adherence and substance use, particularly stimulants, which have caused an increase in her psychotic symptoms, including paranoia. Ms. Allain’s reoffence scenario continues to be assaultive behaviour driven by delusional thinking. Such thinking could emerge in response to severe stress, missed medication doses and increased substance use, as has emerged in the current reporting year.

24. The Board is prepared to delete the clause requiring Ms. Allain to abstain absolutely from the non-medical use of alcohol or drugs or other intoxicants, while she is still under the auspices of the Board. Ms. Allain is on a path towards an Absolute Discharge, and this is hopefully a step forward. The Board is cognizant of the fact that the expert evidence before us indicates that Ms. Allain is more receptive to work cooperatively with the treatment team when less external controls are placed on her. The treatment team would like to assess her commitment to abstinence when she has greater liberties and not simply mandated to refrain from substance use.

25. The Board agrees that it is important to maintain the clause in her current Disposition requiring her to submit samples of her urine and breath; the treatment team can use the results to ascertain whether any future decompensation is the result of Ms. Allain using substances or of other factors, such as stress or medication non-adherence.

26. The only remaining issue before the Board is Ms. Allain’s reporting requirements. We agree with the Crown’s submissions that a three-month reporting period would not be consistent with the medically necessary treatment, both to maintain Ms. Allain’s physical health and to manage her risk to public safety; treatment with clozapine requires monthly blood work.

27. The Board understands that it has an obligation to craft a Disposition that is necessary and appropriate, as well as being the least onerous, and least restrictive, option. Reporting monthly will not interfere with Ms. Allain’s rehabilitative goals, nor limit her ability to partake in programs and build a resume. Furthermore, the reporting does not have to be in person, which limits the impact even more. A monthly reporting requirement would coincide with her monthly clozapine test and required blood work. Missing doses for more than a brief period (typically more than 48-72 hours) requires one to restart the medication at a lower, sub-optimal dose. This provision allows the hospital to bring Ms. Allian back to hospital in a timely manner. The Board also acknowledges that public safety is the paramount obligation, and a one-month reporting requirement satisfies this requirement.

28. In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Ms. Allain, her reintegration into society and her other needs, the necessary and appropriate Disposition is a continuation of the Conditional Discharge, with the changes set out in our formal Disposition.

DATED this 9th day of December 2025, at the City of Toronto, in the Toronto Region.

Mr. J. Weinstein

Alternate Chairperson

___________________

Office of the Registrar

Ontario Review Board