Re: Michelle E. Cowan
ORB File No: 8439
Hearing held on: Tuesday, November 25, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. G. Beasley Members: Dr. T. Wilkie Dr. M. Kalia Mr. R. Bigelow Ms. B. Little
Parties Appearing:
Accused: Michelle E. Cowan Counsel: Mr. M. Schloss
The person in charge of hospital: Counsel: Ms. A. Marshall
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated December 29, 2025)
Introduction
[1]. On December 5, 2023, the accused, Michelle E. Cowan, was found not criminally responsible on account of mental disorder on a charge of aggravated assault, contrary to the Criminal Code of Canada. By reason of a Disposition of the Ontario Review Board (“ORB”) dated November 26, 2024, Ms. Cowan was ordered to be detained at the Forensic Program of the Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) with privileges up to and including residing in the community in accommodation approved by the person in charge.
[2]. On November 24, 2025, the ORB convened a hearing at Ontario Shores for the annual review of Ms. Cowan’s Disposition pursuant to s. 672.81(1) of the Criminal Code. Ms. Cowan was in attendance and represented by counsel, Mr. Schloss. Ms. Marshall appeared as counsel for the hospital and Ms. MacDonald as counsel for the Attorney General of Ontario.
Index Offence
[3]. The circumstances of the index offence are set out in the Agreed Statement of Facts found in the Hospital Report. They may be summarized as follows:
“The victim of the index offence is a 58-year-old man, H.C., who at the time of the offence resided at I[…] Avenue in F[…]. For some years prior, he had had an intimate relationship with the accused’s mother, Christine Cowan. At the time of the offence, Christine Cowan was renting a room from the victim in the Irene Avenue residence. Prior to the index offence, the victim had seen the accused three or four times. Just prior to the time of the index offence, the accused had been evicted from a women’s shelter in Cobourg and had moved in with H.C. and Christine. She had been living there for about a week prior to the assault.
In the early morning hours of April 28, 2018, according to a friend of the victim who was socializing with them that evening, the victim, and the accused got into an argument over a comment the victim made about the accused’s deceased father. The accused became angry and began to break multiple things in the house with a baseball bat and took a swing at the victim and the friend. She then hit the accused several times with her fists and the victim returned this by punching her in the side of the head. The friend was able to break them up. The victim went outside the house to the front yard to have a cigarette. The accused told the friend that she was going to go inside to apologize to the victim but instead she ran up behind the victim and stabbed him in the upper back.
All in the house, including the accused, had been drinking and used marijuana that evening.”
Current Diagnoses
[4]. The current diagnoses are taken from the Hospital Report as follows:
Psychotic Disorder due to another medical condition, with delusions (resolved).
Substance Use Disorder (stimulants) – in remission.
Criminal Record
[5]. At the time of the commission of the index offence Ms. Cowan did not have a record of criminal convictions.
Background and Personal History
[6]. Ms. Cowan’s background and personal history are comprehensively reviewed in the Hospital Report which was filed as an exhibit. For that reason, there will be no extensive reference to the details. By way of a summary, at the time of the hearing Ms. Cowan was 39 years of age. She was born in Etobicoke, Ontario and raised by her parents in Brantford and Orillia. Ms. Cowan described her relationship with her parents as great. Her father passed away in 2011, and she took the loss very hard. She had no siblings. At the age of 13 she was sexually assaulted by three men. Ms. Cowan’s only apparent misadventure as a child was to steal money from her parents which resulted in the police being called and a criminal charge which was dealt with by way of alternative measures. There was no family history of substance abuse, major mental illness, criminality, or suicide. Ms. Cowan attended secondary school and was three credits short of receiving her high school graduation diploma when she became pregnant and stopped attending school. Ms. Cowan completed a medical office administration program at Everest College which she enjoyed. Ms. Cowan has had a number of relationships which resulted in two children, a son and a daughter, both of whom reside with their father. Her employment record includes working at a coffee shop, call centres, and a doctor's office.
[7]. Information obtained from the court assessment prepared by Dr. Mark Pearce indicates that Ms. Cowan had a significant substance use history. She admitted to the problematic consumption of alcohol up to 12 beers on a daily basis. She also acknowledges abusing opioids. It was reported that Ms. Cowan had experimented with cocaine and ecstasy on one or two occasions. She had attended Alcoholics Anonymous events but did not find the meetings particularly helpful.
Medical History
[8]. Ms. Cowan's medical history is of significance to both the index offence and her current circumstances. She reported that she began to experience seizures at the age of 14. These would occur once or twice per week. Shortly after the commission of the index offence Ms. Cowan was admitted to hospital in May 2018. At that time, she was diagnosed with Anti-NMDA receptor encephalitis. Ms. Cowan had surgery to remove an ovarian mass and remained in an induced coma for some period of time. In his report of April 26, 2024, Dr. Pearce stated that Ms. Cowan was diagnosed with delirium or psychotic disorder due to the above-mentioned medical condition. Following the surgery, she has been stable without signs of psychosis, delirium, or other gross neurological disturbance for several years.
Position at the Parties
[9]. At the outset of the hearing, Ms. Marshall submitted that the recommendation of the hospital was for a continuation of the Detention Order Disposition without amendment. Ms. Marshall stated that this was not a unanimous opinion on behalf of the treatment team and the hospital. Ms. MacDonald deferred her position until the conclusion of the evidence. Mr. Schloss submitted that Ms. Cowan no longer represents a significant threat to the safety of the public and that the necessary and appropriate disposition was an Absolute Discharge.
Evidence
[10]. The evidence on behalf of the hospital was presented by Dr. Pallandi. He has been Ms. Cowan’s attending psychiatrist on the Forensic Outpatient Service (FOS) and was the co-author of the Hospital Report. Dr. Pallandi stated that there were no material updates related to risk to the Hospital Report. With respect to the diagnoses, Dr. Pallandi stated that the diagnosis of psychotic disorder was related to a tumor and was resolved a number of years ago. Ms. Cowan also has a diagnosis of substance use disorder but that is in remission. Ms. Cowan has not demonstrated any psychosis since the removal of the tumor in 2018. At the present time she is not receiving any antipsychotic medication.
[11]. Ms. Marshall asked Dr. Pallandi what factors contribute to Ms. Cowan’s risk. Dr. Pallandi stated that that is a complex answer. He stated that with reference to Dr. Pearce’s report, Ms. Cowan was found NCR as a result of the psychosis and delirium caused by her tumor. As previously mentioned, that has long since been resolved. Ms. Cowan has never demonstrated any psychosis as long as Dr. Pallandi has been her attending psychiatrist and she has never been on any antipsychotic medication. Dr. Pallandi stated that Ms. Cowan’s risk does not arise from psychosis. Dr. Pallandi stated that dealing with Ms. Cowan’s risk management plan means dealing with her substance use disorder which is set out in detail in the Hospital Report. Dr. Pallandi stated that the ongoing risk is different from the risk which was present at the time of the index offence leading to the verdict of not criminally responsible. Dr. Pallandi stated that the concern of the treatment team is Ms. Cowan’s driving. Although she is prohibited, the team found that there was some evidence that Ms. Cowan was in fact operating a motor vehicle and that the team were unable to manage this risk from a distance, given where Ms. Cowan was living. As a result, Dr. Pallandi stated the team asked for an early Board which was held in 2024. Dr. Pallandi stated that since April of 2025 there is no evidence that Ms. Cowan is operating a motor vehicle. She is engaged in the Concurrent Disorders Program, and all of her Urine Drug Screens (UDS) tests have been negative. Dr. Pallandi characterized the seven months since the ROL hearing in April as the “best stretch for her” and that her risk is now perceptively lower. Dr. Pallandi agreed with Ms. Marshall’s summary that since April of 2025, there have been no concerns of substance use and no evidence that Ms. Cowan is operating a motor vehicle.
[12]. Dr. Pallandi agreed with the timeline reviewed by Ms. Marshall commencing with the index offence in 2018. He acknowledged that following the initial ORB hearing in May of 2024, there were a number of positive UDS results for substances. Ms. Cowan had no explanation for the results and did not admit to any consumption. Ms. Cowan had a brief admission to Ontario Shores in August of 2024 on a Form 1. On January 9, 2025, Ms. Cowan was admitted to the hospital as a result of ongoing breaches of her Disposition. She remained in the hospital until May 9, 2025, when she was discharged to the community. Since that day, the treatment team have not had any concerns about Ms. Cowan.
[13]. Ms. Marshall asked Dr. Pallandi to elaborate on the difference between the treatment team's assessment of Ms. Cowan’s risk and the hospital’s assessment of risk. Dr. Pallandi said that in putting the answer in context, the treatment team believe that the Disposition in place since April of 2025 is one of the primary reasons why Ms. Cowan has been able to “turn the corner”. However, he also gave credit to Ms. Cowan having a new relationship with an individual who does not use substances and her establishment of a very prosocial lifestyle.
[14]. In assessing the risk, the clinical team considered that there had been no evidence of psychosis for a number of years and no evidence of driving which is the primary risk concern form Ms. Cowan. Taking all that into account, the treatment team were considering recommending an Absolute Discharge for Ms. Cowan. In support of the proposed recommendation, the treatment team asked the clinical psychologist at Ontario Shores to prepare a psychological assessment and risk analysis. Dr. Pallandi referred to Ms. Slaunwhite’s report commencing on page 21 of the Hospital Report. Dr. Pallandi referred the Board to the risk assessment found on page 23 of the Hospital Report which concluded that Ms. Cowan would be considered a low risk to re-offend violently if she were awarded an Absolute Discharge. Ms. Slaunwhite referred to Ms. Cowan’s demonstrated improved mental stability with no active psychotic symptoms and negative urine drug screens. She also referenced ongoing protective factors including improved insight, a stable support network and her commitment to abstinence and personal wellness.
[15]. Dr. Pallandi testified that after the completion of the psychological assessment the treatment team then met with the Clinical Director of Ontario Shores, Dr. DeFreitas. On behalf of the hospital, Dr. DeFreitas indicated that the necessary and appropriate disposition should be a continuation of the current Detention Order. Dr. Pallandi described the discussion as “dynamic” and that ultimately it was agreed that the Hospital Report would recommend a continuation of the Detention Order. Dr. Pallandi stated that this was “not a clear-cut situation.” In his words, Dr. Pallandi stated “you have the clinical team’s view, the psychologist’s view, and the hospital’s view and not all of them accord.”
[16]. Dr. Pallandi was asked about the indication in the Hospital Report that a Conditional Discharge was not necessary and appropriate. He stated that that was an easier answer and that it was unanimous that if there was a significant risk then the Disposition should be a continuation of the Detention Order. Dr. Pallandi explained that due to the distances involved in monitoring Ms. Cowan, implementation of the Mental Health Act would be difficult and in the event of a decompensation the hospital would require the Warrant of Committal in a Detention Order to return her to the hospital. Dr. Pallandi added that he did not consider a Detention Order Disposition in the upcoming reporting year to be an obstacle to an absolute discharge at the next ORB hearing.
[17]. In response to a question from Ms. Marshall about what the treatment team would need to see in order to recommend an Absolute Discharge next year, Dr. Pallandi stated that it would simply be for Ms. Cowan to continue to do what she is doing now. Finally, Dr. Pallandi stated that since the ROL hearing in April 2025, Ms. Cowan is in a much more stable relationship, she has a stable residence, she is employed and she is abstinent from substances. He referred to these as “very, very big accomplishments and factors.” Dr. Pallandi stated that these were the determinants of why Ms. Cowan is doing so well at the present time.
[18]. In response to questions from Ms. MacDonald, Dr. Pallandi agreed that the hub of concern for the treatment team is the potential of Ms. Cowan using substances and driving a motor vehicle. Dr. Pallandi agreed that along with the term of the current Disposition which prohibits Ms. Cowan from operating a motor vehicle, her license to drive in the Province of Ontario has also been medically suspended. Dr. Pallandi said that this was done by another medical professional and agreed that the process to remove a medical suspension and obtain a driver’s licence can be lengthy. When asked about support from the treatment team if an Absolute Discharge were to be granted, Dr. Pallandi stated that there would be services available, but these have not been discussed with Ms. Cowan. Dr. Pallandi stated that Ms. Cowan would not need the services of a community psychiatrist as she has not had any mental health issues since the commission of the index offence eight years ago.
[19]. In response to questions from Mr. Schloss, Dr. Pallandi confirmed that Ms. Cowan's original psychotic symptoms were caused by her suffering from encephalitis. That illness was corrected by surgery and there is a low likelihood of it reoccurring. Dr. Pallandi stated it is a rare illness and quite unlikely to affect Ms. Cowan in the future. Dr. Pallandi agreed that it was his understanding that Ms. Cowan’s driver’s licence had been suspended because of the seizures she was suffering as a result of her medical condition. Again, the seizures are unlikely to reoccur. Dr. Pallandi confirmed that the risk assessment found in the Hospital Report had been completed by a psychometrist at Ontario Shores. The psychometrist, Ms. Slaunwhite, had no prior knowledge of Ms. Cowan before completing the assessment. Dr. Pallandi agreed that the conclusion reached by the treatment team was that Ms. Cowan was a low risk on an Absolute Discharge and in fact Ms. Cowan had been told that the recommendation would be for an Absolute Discharge. The change in the recommendation in the Hospital Report was late in coming as a result of the delay in completing the risk assessment and having the opportunity for the team to meet with the hospital. Dr. Pallandi agreed with Mr. Schloss that Ms. Cowan notified the treatment team immediately of an incident which occurred at the concert in London. Dr. Pallandi also stated it was his understanding that the outstanding charges from 2023 mentioned in the Hospital Report have since been resolved without criminal convictions. Finally, Dr. Pallandi agreed that Ms. Cowan had not had any positive tests for substances since February of 2025. There were no positive tests while Ms. Cowan was admitted to the hospital even though there are substances available. Dr. Pallandi agreed that there had been an increase in Ms. Cowan’s insight.
[20]. In response to questions from the Board, Dr. Pallandi stated that in the event of an Absolute Discharge, Ms. Cowan’s community support would come from her immediate family and her partner. Ms. Cowan would also likely still receive support from the Concurrent Disorders team and she has a neurologist in the community for medical issues. In the event that the disposition was a Detention Order, Dr. Pallandi did not feel it was necessary to specify any geographic area. Dr. Pallandi stated that while there was an air of reality to a Conditional Discharge given Ms. Cowan’s progression, it would not assist the treatment team in the event that Ms. Cowan’s risk to the safety of the public increased.
[21]. Dr. Pallandi confirmed that he agreed with Dr. Pearce’s diagnosis that Ms. Cowan suffered from a psychotic disorder secondary to a medical condition which has now been resolved by surgery. When asked about the reference to a “challenging admission” found on page 18 of the Hospital Report, Dr. Pallandi stated that Ms. Cowan does not like being in the hospital and did not believe that she had done anything to justify admission. Dr. Pallandi was asked about the stability in the community Ms. Cowan has demonstrated since the early Board hearing in April. Dr. Pallandi stated that as he had testified earlier, he attributes some of this result to the imposition of a Detention Order Disposition at the early Board hearing. He candidly acknowledged that he did not believe or predict that Ms. Cowan would “get this well this fast.” Dr. Pallandi stated that Ms. Cowan made changes in her life which propelled her progress. This included a new prosocial partner, a new residence and of importance, full-time employment. Dr. Pallandi stated that Ms. Cowan values the opportunity she has to work. It is also significant that Ms. Cowan has avoided the use of substances since her discharge from the hospital. When asked if it seems that Ms. Cowan has learned from being placed on a Detention Order, Dr. Pallandi agreed stating that she does not like being in the hospital.
[22]. Dr. Pallandi was asked whether or not the imposition of a Conditional Discharge with less control over Ms. Cowan might be informative as to the contextual impact of the Detention Order on her stability for the past seven months. Dr. Pallandi agreed that it would give more information but that his logic was to maintain Ms. Cowan on her current positive trajectory on the Detention Order and then move to the Absolute Discharge. He stated that in the event of a significant relapse by Ms. Cowan on a Conditional Discharge the team would have difficulty in returning her to the hospital. Dr. Pallandi was asked about the second re-offence scenario set out on page 23 of the Hospital Report. This scenario centred on Ms. Cowan experiencing increasing psychosocial stressors related to interpersonal conflict, financial strain, or employment difficulties, causing her to significantly relapse into substance use. Dr. Pallandi stated that in his opinion Ms. Cowan has managed her own risk in these factors. Dr. Pallandi stated that given the totality of Ms. Cowan’s history, in his opinion if she is going to decompensate as a result of the use of substances it does not matter if she is on a Conditional Discharge or a Detention Order. He stated that if Ms. Cowan were capable of complying with the terms of a Disposition of a Detention Order for another year, which would be “instructive.”
[23]. Dr. Pallandi was asked if the Mental Health Act would be of any assistance to the treatment team in the event that a Conditional Discharge Disposition was the result of the hearing. He stated that that would only be the case if Ms. Cowan developed some form of psychotic disorder or mental illness and he believed that this would be an unlikely scenario.
[24]. In re-examination by Ms. MacDonald, Dr. Pallandi agreed that it would no longer be necessary to approve Ms. Cowan’s accommodation in the community given her current living circumstance. He also agreed that reducing the reporting condition to once every four weeks would be appropriate.
[25]. Mr. Schloss asked about the second re-offence scenario. He asked Dr. Pallandi what the risk would be were that scenario to occur. Dr. Pallandi stated that he could only point to the incident involving the taxi driver arising from the consequence of Ms. Cowan consuming alcohol. He agreed that this was apparently relatively minor and did not result in any serious physical or psychological harm to anyone. Dr. Pallandi agreed that there had been no criminal conduct since the index offence in 2018.
[26]. Neither Ms. MacDonald nor Mr. Schloss called evidence at the hearing.
Submissions
[27]. Ms. MacDonald went first with her submissions on behalf of the Attorney General. She acknowledged at the outset that this was “close to the line” but submitted that the evidence of Dr. Pallandi and the Hospital Report supported a finding that Ms. Cowan continued to represent a significant threat to the safety of the public. Ms. MacDonald submitted that the necessary and appropriate disposition was a continuation of the Detention Order but with the removal of the necessity of residing in approved accommodation and reducing the reporting condition to once every four weeks.
[28]. Ms. Marshall submitted that there is evidence that Ms. Cowan continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current Detention Order. Ms. Marshall stated that if Ms. Cowan continues to display the same stability as she has for the past seven months then over the course of the next reporting year, then the hospital would be in a position to recommend an Absolute Discharge at the next ORB hearing.
[29]. Mr. Schloss submitted that Ms. Cowan no longer represents a significant threat to the safety of the public and therefore should receive an Absolute Discharge. Mr. Schloss submitted that Ms. Cowan has been abstinent from substances, has secured full-time employment, has a more stable residence and is in a positive prosocial relationship. He stated that the circumstances surrounding the original index offence of serious violence are unlikely to occur again as it was a result of a medical condition which has been resolved. Mr. Schloss submitted that there is no evidence that serious physical or psychological harm is likely to result from the possible consumption of substances. The evidence with respect to Ms. Cowan driving does not rise to the level of a likely risk of serious harm.
Analysis and Disposition
[30]. The threshold issue for the panel to determine is whether or not Ms. Cowan continues to represent a significant threat to the safety of the public. The “significant threat” standard is an onerous one. There must be both a likelihood of a risk materializing and the likelihood that serious harm will occur. An accused is not to be detained based on mere speculation; the Board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the accused to deny them an absolute discharge. As set out in Winko (1999] 1999 CanLII 694 (SCC), 2 S.C.R. 625) the threat must be:
(1) More than speculative in nature and must be supported by the evidence;
(2) Significant in the sense of there being a real risk of physical or psychological harm to individuals in the community and in the sense that this potential harm must be serious; and
(3) The conduct creating the harm must be criminal in nature.
As stated by McLachlin, J. (as she then was) at para. 69
“it is for the court or Review Board, acting in an inquisitorial capacity, to investigate the situation prevailing at the time of the hearing and determine whether the accused poses a significant threat to the safety of the public. If the record does not permit it to conclude that the person constitutes such a threat, the court or Review Board is obliged to make an order for unconditional discharge.”
[31]. The Ontario Court of Appeal re-emphasized the onerous test in Re: Gibson 2022 ONCA 527, per Lauwers J.A. at para. 9:
Huscroft J.A. said in Carrick (Re), 2015 ONCA 866, 128 O.R. (3d) 209, at para. 17, that “the ‘significant threat’ standard is an onerous one”. He added that “[t]he board must be satisfied as to both the existence and gravity of the risk of physical or psychological harm posed by the appellant in order to deny him an absolute discharge.” Mere speculation is insufficient. See also, Sim (Re), 2020 ONCA 563, at paras. 63-65, per Strathy C.J.O., Marmolejo (Re), 2021 ONCA 130, 155 O.R. (3d) 185, per Tulloch J.A., at paras. 33-37.
[32]. The Board takes note of the somewhat unique circumstances which brought Ms. Cowan under the jurisdiction of the ORB on December 5, 2023. As set out above in Ms. Cowan’s background, for a number of years prior to the date of the index offence in 2018, she had suffered from regular seizures. These commenced in 2013 or 2014 and were described as tonic-clonic in nature. After seeing a neurologist in Barrie, Ms. Cowan was treated with an anti-epileptic medication when the seizures started to get worse. She was ultimately diagnosed as having epilepsy, although the doctor could not determine the underlying cause of the seizures. In June 2017, Ms. Cowan was involved in a motor vehicle accident when the vehicle her mother was driving went into a ditch. Ms. Cowan was not wearing her seat belt properly and was taken to hospital after the accident. She was unsure if she lost consciousness. As set out in Dr. Pearce’s report of April 26, 2024, Ms. Cowan was ultimately diagnosed with a delirium or psychotic disorder due to a medical condition, secondary to NMDA receptor encephalitis which was active at the time of the index offence. Following the commission of the index offence, Ms. Cowan was hospitalized and had surgery to remove an ovarian mass. Since that surgery, Ms. Cowan has not had any signs of psychosis, delirium, or other gross neurological disturbance. The Board accepts the unchallenged evidence from the Hospital Report, the excerpts of the report of Dr. Pearce, and the viva voce evidence of Dr. Pallandi that the criminal conduct resulting in the commission of the index offence on April 28, 2018, was a result of a psychosis precipitated by a medical condition. That medical condition has now been resolved.
[33]. As set out in the Hospital Report and the excerpts of Dr. Pearce’s report, Ms. Cowan had a significant substance abuse problem commencing in her early teenage years. Her primary substance of choice was alcohol although there was also abuse of other substances including cannabis and opioids. The hospital diagnosis characterizes the substance use disorder as being in remission.
[34]. The Board was not presented with a joint submission with respect to significant risk. Ms. Marshall candidly acknowledged in her opening submissions that although the recommendation of the Hospital Report was for a continuation of the current Detention Order, the hospital administration and the treatment team were not necessarily ad idem. Ms. MacDonald submitted that the necessary and appropriate disposition was a Detention Order but with changes to the residence and reporting clauses. Mr. Schloss submitted that there was an absence of evidence upon which a finding of significant threat could be made and therefore Ms. Cowan was entitled to an Absolute Discharge.
[35]. In his evidence Dr. Pallandi referenced the overall stability which Ms. Cowan has demonstrated since the early Board hearing in April 2025. He testified that the stability Ms. Cowan has demonstrated in the community has been a result of the changes she has made in her lifestyle, employment, residential accommodation and having a new prosocial partner. He stated that this has “propelled her progress.” Dr. Pallandi was candid in testifying that he did not predict or expect that Ms. Cowan would “get well this fast.” Dr. Pallandi articulated the reasons why the initial recommendation of the treatment team was for an Absolute Discharge. It included the Risk Assessment conducted by the psychometrist at Ontario Shores which concluded that Ms. Cowan was a low risk to re-offend violently on an Absolute Discharge. After the treatment team met with Dr. DeFreitas, who represented the hospital, the recommendation was changed to a continuation of the current Detention Order Disposition.
[36]. The Board has carefully considered all of the evidence available at the hearing, including the Hospital Report, the excerpts of evidence from a Dr. Pearce’s Report, and the viva voce evidence of Dr. Pallandi. As set out above, a finding of significant threat cannot be based on speculation but must be fully supported by the evidence. In addition, a significant threat must be a threat of serious physical or psychological harm resulting from criminal conduct. The Hospital Report sets out on page 23 the primary re-offense scenario for future violence. As indicated in the report, according to the HCR-20^V3^ a re-offence scenario “is not a prediction about what will happen; rather it is projection about what could happen”. The report then sets out “two possible but unlikely re-offence scenarios, given an Absolute Discharge from the ORB.” The first re-offence scenario involves the potential relapse of anti-NMDA receptor encephalitis which caused the psychosis resulting in the index offence. The report states that the likelihood of this potential scenario is considered low. The second re-offence scenario involves Ms. Cowan experiencing increasing psychosocial stressors related to interpersonal conflict, financial strain, or employment difficulties, causing her to significantly relapse into substance use. The report once again concludes that the likelihood of serious physical violence in this scenario is considered low.
[37]. The Board is unanimous in agreeing with the submissions of Mr. Schloss, on behalf of Ms. Cowan. Although the evidence of Ms. Cowan’s significant improvement is almost entirely on the basis of her lifestyle since discharge from Ontario Shores in May 2025, it represents a significant improvement in her stability. There is no evidence of criminal conduct since the index offence in 2018. There is an absence of evidence of behaviour which is likely to result in serious physical or psychological harm. Given these findings, the necessary and appropriate Disposition is an Absolute Discharge.
DATED this 29th day of December 2025, at the City of Toronto, in the Region of Toronto.
Mr. G. Beasley Alternate Chairperson
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Office of the Registrar Ontario Review Board