Re Carrera-Ferreira, 2025 CanLII 135645

Ontario Review Board

Re: Jonathan E. Carrera-Ferreira

ORB File No: 7450

Hearing held on: Tuesday, December 2, 2025

Place of hearing: St. Joseph’s Healthcare Hamilton

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

Before:

Alternate Chairperson: Ms. L. Banks Members: Dr. M. Attia Dr. P. N. Wright Mr. E. Siebenmorgen Mr. A. Mete

Parties Appearing:

Accused: Jonathan E. Carrera-Ferreira Counsel: Mr. A. Rai

The person in charge of hospital: Representative: Ms. L. Barney

Attorney General of Ontario: Counsel: Ms. S. Wollaston

REASONS FOR DISPOSITION

(Dated December 31, 2025)

Introduction:

1. On November 8, 2018, Mr. Carrera-Ferreira was found not criminally responsible (“NCR”) on account of mental disorder on one charge of attempt murder and two charges of assault with a weapon, all contrary to the Criminal Code of Canada (the “Criminal Code”). Mr. Carrera-Ferreira is currently subject to a Disposition of the Ontario Review Board (the “Board” or “ORB”) dated December 11, 2024. This Disposition orders him detained at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton (“St. Joseph’s” or the “hospital”) but provides for a variety of discretionary privileges, including to live in the community in accommodation approved by the person in charge of the hospital.

2. On December 2, 2025, a panel of the ORB convened to conduct an annual review of Mr. Carrera-Ferreira’s Disposition pursuant to section 672.81(1) of the Criminal Code. Mr. Carrera-Ferreira attended the hearing and was represented by his counsel.

3. The issues to be considered at this hearing are whether Mr. Carrera-Ferreira remains a significant risk to public safety as now defined in s. 672.5401 of the Criminal Code and, if he is found to be a significant threat to the community, the determination of the necessary and appropriate Disposition in the circumstances bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

4. For the reasons set out below, the Board unanimously concluded that Mr. Carrera-Ferreira continues to pose a significant threat to public safety and that the necessary and appropriate Disposition is that he be discharged subject to a variety of terms and conditions as set forth at the conclusion of these Reasons.

Index Offences:

5. The circumstances of the index offences are reproduced from last year's ORB Reasons dated December 20, 2024, as follows:

"On or about May 22, 2018, Mr. Carrera-Ferreira appeared in a hospital gown at a residential address where his father and paternal grandmother lived. He was allowed to stay in a bedroom on the second floor of the residence. The next morning, he and his father consumed beer and cigarettes in the garage. He demanded a tablet of Adderall from his father and when told he had none, grabbed a drywall knife, threatened his father, and told him to go and obtain the medication. His father agreed, went to the front doorway, and yelled to his mother to run out the back door to get away from Jonathan. As his father called 911, Mr. Carrera-Ferreira attacked his grandmother on the driveway, stabbing her repeatedly. A neighbour intervened by striking Mr. Carrera-Ferreira with a rubber mallet. He responded by moving toward the male neighbour with the knife, causing the neighbour to flee into his house. Mr. Carrera-Ferreira then chased after his father and knocked him to the ground. He tried to stab his father, but his father held his wrist and prevented injury to himself.

The male neighbour reported that the accused’s father yelled to him to call police, that the man with him was armed with a knife, was his son, and had taken his phone. The neighbour told police that Jonathan let go of his grandmother when struck with a rubber mallet, but swung the knife at him in an attempt to strike him and then tried to strike his father.

When police arrived Mr. Carrera-Ferreira was on top of his father, who was holding his son’s wrist to prevent him from stabbing him. He dropped the knife when ordered by police at gunpoint and was arrested."

Personal Background:

6. Mr. Carrera-Ferreira’s personal history is set forth in great detail in the Hospital Report to the ORB dated November 11, 2025 (the “Hospital Report”) and need not be repeated here. Briefly stated, Mr. Carrera-Ferreira was 39 years old at the time of the hearing. He was born in Toronto, Ontario. His father and mother have been separated for some time. He has two younger siblings. His brother lives in Toronto, Ontario and his sister lives with their mother.

7. Mr. Carrera-Ferreira dropped out of school in Grade 10 as a result of difficulties with his concentration and Attention Deficit Disorder. Thereafter, he worked as a janitor for approximately one year. Since that time, his mother reported that he has been back and forth between social assistance and odd jobs. His last employment was in September 2017, when he obtained work again as a janitor in a high school.

8. Shortly after Mr. Carrera-Ferreira dropped out of school, he began a relationship with a female, who moved into the family home for a period of time.

9. At age 16, Mr. Carrera-Ferreira and his partner got their own place. This relationship lasted 7 years and then the couple separated. Mr. Carrera-Ferreira has two teenage daughters from this relationship, both of whom lived in Newmarket with their mother. As described below, he has more recently reconnected with his daughters, although relational challenges remain.

10. At the time of the index offences, Mr. Carrera-Ferreira had been staying at his grandmother’s home with her and his father for approximately one week. Prior to that, he had been living with his mother for approximately a year and a half.

11. The full extent of Mr. Carrera-Ferreira’s substance use history is not clear; however, in previous hospitalizations, Mr. Carrera-Ferreira has self-reported marijuana and crystal methamphetamine use, the quantity and frequency of which are unknown.

Psychiatric History:

12. Mr. Carrera-Ferreira’s first contact with mental health services appears to have occurred in December 2012 when he was brought to the ER at York Central Hospital by police after he had incurred charges relating to “smashing his father’s television”. He appeared to be seeking stimulant medication.

13. A few weeks later, he attended at the ER at Humber River Hospital in Toronto advising that he had overdosed on 30 Advil tablets. He initially denied alcohol or other substance use but later admitted to using marijuana. Urine toxicology tests revealed the presence of MDMA although this could have been secondary to his use of Adderall. THC was also detected.

14. Mr. Carrera-Ferreira had additional hospital mental health contacts and/or hospital admissions in 2013, 2016, and 2018, all of which are detailed in the Hospital Report. Briefly, in 2013, he was referred for an outpatient psychiatry assessment at Mackenzie Health in Richmond Hill to rule out Bipolar Disorder. He was prescribed Adderall and was referred for follow-up.

15. In 2016, he was brought to Brampton Civic Hospital by police and admitted for approximately two weeks following an incident of aggression in his family’s home where he had threatened to kill his mother and his sister. He reported auditory hallucinations and disturbed sleep and was prescribed an antipsychotic medication and admitted on a Form 1. His diagnosis on discharge was Schizophrenia.

16. In April 2018, Mr. Carrera-Ferreira was admitted overnight to Mackenzie Health following a reported overdose of Adderall, Trazodone and Venlafaxine. He also reported using crystal methamphetamine. He advised he had become noncompliant with prescribed antipsychotic medication and was vague about his ongoing treatment.

Current Diagnoses:

17. Mr. Carrera-Ferreira’s current diagnoses are:

Schizophrenia;

Stimulant Use Disorder, in remission;

Alcohol Use Disorder, in remission;

Attention Deficit Hyperactivity Disorder; and

Major Depressive Disorder.

Criminal History:

18. In 2014, before the index offences, Mr. Carrera-Ferreira was charged and convicted for assaulting his mother. He received a three-month conditional sentence with probation for one year and a discretionary weapons prohibition for five years. It is also reported in the Hospital Report that he threatened to kill his mother in 2016 and had a physical altercation with his brother in 2018.

Positions of the Parties:

19. At the outset of the hearing, the parties were canvassed as to their recommendations to the Board. Counsel for the hospital indicated that the recommendation was for a continuation of his existing Detention Order on the same terms and conditions.

20. Counsel for the Crown indicated support for the hospital’s recommendation.

21. Counsel for Mr. Carrera-Ferreira indicated that his client was requesting that the Board grant him a Conditional Discharge on the following terms:

• he reside at 195 Ferguson Ave. N, Hamilton, Ontario;
• he report to the person in charge of St. Joseph's (“PIC”) or his or her designate, not less than once per week, or as required;
• he abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant;
• he submit samples of his urine and/or breath to the PIC, or his or her designate, for the purpose of analyzing whether he has ingested alcohol, drugs or any other intoxicant;
• he refrain from having in his possession any weapon;
• he refrain from contact or communication, direct or indirect, with Ms. Leon Lukiyanets;
• on his consent, agree to take treatment/medication as prescribed by the PIC, or his or her designate, in accordance with s.672.55(1) of the Criminal Code; and
• upon notice by the PIC or his/her designate, he shall immediately submit to attendance at the hospital for psychiatric assessment and readmission (referred to as a “Young condition”).

Counsel advised that he was not arguing the issue of significant threat at this hearing.

22. At the conclusion of the hospital’s evidence, all parties maintained their respective positions in closing submissions.

Evidence at the Hearing:

23. Dr. K. Shariati, Mr. Carrera-Ferreira’s out-patient forensic psychiatrist since February 2024, testified at the hearing in order to supplement the documentary evidence provided to the Board. The doctor endorsed the contents of the Hospital Report including the Psychological Risk Assessment contained therein.

24. Dr. Shariati advised that Mr. Carrera-Ferreira continues to be assessed as capable to consent to psychiatric treatment and he is treated with daily oral doses of Olanzapine, Trazadone, and Venlaxafine. He also receives a long-acting injection (“LAI”) of the antipsychotic medication, Paliperidone Palmitate, every 28 days. He receives his oral medications in a blister pack and it is checked on a random basis at least monthly by his Forensic Outpatient (“FOP”) team. He has been self-administering his oral medications since October 2024 and to date, there have been no concerns regarding consistent adherence.

25. The Hospital Report indicates that “Mr. Carrera-Ferreira’s mental status has remained stable this year. He is typically calm and cooperative. His thought process is linear and logical with speech of normal rhythm, rate and volume. He consistently denies experiencing any auditory or visual hallucinations, along with denying any thoughts of suicidal or homicidal ideation. Mr. Carrera-Ferreira typically expresses his mood to be good, with congruent affect.” Mr. Carrera-Ferreira has not endorsed any auditory or visual hallucinations since 2020 and the doctor advised that the positive symptoms of his illness (i.e., hallucinations, delusions and disorganization of speech and thought) of his illness appear to be well-managed and in remission. Dr. Shariati advised that the negative symptoms of Mr. Carrera-Ferreira’s illness, being, amotivation and paucity of speech, continue to persist.

26. A brief review of Mr. Carrera-Ferreira’s history as set forth in the Hospital Report indicates that on April 26, 2021, Mr. Carrera-Ferreira was discharged from the hospital to reside with his mother, stepfather, brother, sister and two nephews at his family home in Fergus, Ontario. On March 21, 2022, Mr. Carrera-Ferreira was admitted to the hospital after consuming two twenty-six-ounce bottles of vodka at his mother’s home. His mother contacted the outpatient team as she was extremely concerned given her son’s level of intoxication and the presence of young children in the home. He was admitted to Groves Memorial Hospital in Fergus on a Form 1 under the Mental Health Act (“MHA”) and was transferred to St. Joseph’s hospital on March 22, 2022. Since this incident, his mother was unwilling to have him return to live in the family home for some time.

27. On August 25, 2023, Mr. Carrera-Ferreira was discharged from the hospital to Emmaus Place in the Transitional Rehabilitation Housing Program (“TRHP”). This residence is a 24-7 supervised setting that provides medication administration. The housing is transitional in nature and the TRHP aims to transition patients towards independent living within two years.

28. In July 2025, Mr. Carrera-Ferreira moved to an independent apartment building within the HOMES program. His new apartment is part of the Forensic Supported Housing Program (“FSHP”) which is subsidized through Good Shepherd. He has transitioned to his new home well, without incident.

29. As part of the FSHP, Mr. Carrera- Ferreira meets with Team 5 (mobile housing support workers with addictions education, through Good Shepherd) twice per week. He is also followed in the community by the Forensic Outpatient (“FOP”) team of the hospital. He currently he meets with his FOP case manager worker weekly. There have been no concerns with his reporting.

30. Mr. Carrera-Ferreira reports no cravings to use alcohol or other substances. He has not engaged in any substance use over the past reporting year. This was verified by random urine drug screens.

31. Mr. Carrera-Ferreira has not engaged in any threatening or aggressive behaviours since his return to the community in 2023. He has not required any readmissions to the hospital over the reporting period.

32. In terms of insight, Mr. Carrera-Ferreira has demonstrated fair insight into his psychiatric illness. He states that he understands that he suffers from Schizophrenia and that his medication has helped him. He expresses a commitment to adhering to psychiatric medication as prescribed.

33. Mr. Carrera-Ferreira expresses superficial insight with regard to the likely negative impact of substance use on his mental state and his risk of relapse of his mental illness. Although Mr. Carrera-Ferreira is able to acknowledge the risks associated with cannabis and psychosis, Dr. Shariati confirmed that Mr. Carrera-Ferreira generally does not believe that these risks apply to him personally. Notwithstanding, he has engaged with Team 5 for relapse prevention on a weekly basis. With considerable encouragement and prompting, Mr. Carrera-Ferreira has agreed to attend additional relapse prevention programming but, in the treatment team’s assessment, it appears that Mr. Carrera-Ferreira’s motivation to do so is externally driven.

34. In terms of his use of privileges, Mr. Carrera-Ferreira has a standing pass for 72 hours, indirectly supervised, twice per month to his mother’s home in Fergus, Ontario. He also enjoyed numerous passes over the summer to his sister’s trailer in Port Elgin, Ontario.

35. In February 2025, while exercising a 72-hour pass to his mother’s home, he was unable to return home on time due to severe weather. Mr. Carrera-Ferreira, without the prior approval of the hospital, extended his pass by two days. Expectations for future pass use was discussed with him, including his responsibility to be aware of impediments to his returning to his community residence when expected. There have been no further incidents of concern. Dr. Shariati stated that Mr. Carrera-Ferreira’s behaviour on this occasion signals to the team that he undervalues the importance of the reporting requirements of his Disposition and, at times, the expectations of the team.

36. Mr. Carrera-Ferreira continues to be well supported by his family and he is in regular contact with his mother, father and sister’s family. Unfortunately, his relationships with his two daughters (ages 17 and 20) have been tumultuous over the past year. He does not currently have contact with his older daughter, who had a baby with her partner in February 2025. At times, he has had contact with his younger daughter and she has come to spend time at his apartment. To improve his relationships with his daughters, Mr. Carrera-Ferreira has expressed an interest in engaging in individualized psychotherapy sessions. He was offered sessions in the summer of 2025 but declined. More recently, in October 2025, he indicated a willingness to engage and he has been re-referred to a clinician in the FOP for 1:1 psychotherapy.

37. Between March 31 and June 12, 2025, Mr. Carrera-Ferreira attended the forensic Cognitive Behavioural Therapy for psychosis group program. Dr. Shariati stated that the group facilitator expressed concerns about his participation in this group and his ability to retain information delivered and, for that reason, did not think he would benefit from further programming of this nature.

38. Mr. Carrera-Ferreira continues to express his interest in seeking employment in the community and accepts assistance from his caseworker. The Hospital Report indicates that, to date “…he has had difficulty following through multi-step tasks. The pattern is consistent with executive-function challenges and stress-related avoidance.”

39. The Hospital Report indicates that in 2024, Dr. P. Sheridan conducted a risk assessment for Mr. Carrera-Ferreira that concluded that his risk for violent recidivism was estimated to be in the low range under a Detention Order and a higher classification was anticipated if he were to have less oversight. The team considers that risk assessment to remain valid. In response to a question posed by a panel member, Dr. Shariati testified that he thought that Mr. Carrera-Ferreira’s risk for violent recidivism would continue to be in the low range under a Conditional Discharge Disposition provided he was managed with the same level of external supervision.

40. Dr. Shariati advised that Mr. Carrera-Ferreira continues to represent a significant threat to public safety. In addition to the risk factors outlined in the Hospital Report being his diagnosis of Schizophrenia, his history of substance use disorder, and his unstructured time in the community, Dr. Shariati noted that Mr. Carrera-Ferreira continues to express limited appreciation of the severity of the index offences and the magnitude of the risk he poses when he is unwell. Further, absent an ORB Disposition, the doctor opined that Mr. Carrera-Ferreira will continue to require professional supports, which over time, he would be likely to fall away from. In that context, considering all of his risk factors, the doctor endorsed the conclusion that Mr. Carrera-Ferreira would be likely, over time, to become medication non-adherent and/or relapse into substance use, either of which possibilities would elevate his risk of engaging in aggressive criminal behaviours.

41. Dr. Shariati commented that safe management of Mr. Carrera-Ferreira’s risk continues to require a Detention Order Disposition. He stated that although his community housing is stable and approved, a Detention Order allows the team to have continued oversight regarding his residence in the community to ensure that it continues to provide him with the requisite degree of support, supervision, and monitoring. The doctor commented that of greater importance in the circumstances of this case, is that a Detention Order is required in case it becomes necessary to effect Mr. Carrera-Ferreira’s prompt admission to the hospital should he experience any decompensation in his mental status while living in the community (whether as a result of medication non-compliance, relapse to alcohol or illicit substance consumption, his experience of stressors, or for any other reason). The doctor stated that if Mr. Carrera-Ferreira were managed under a Conditional Discharge, the treatment team would have to wait until he became decompensated to a degree that he would satisfy criteria of the Mental Health Act for an involuntary admission. As stated, under a Detention Order, his risk could be managed proactively thereby reducing the likelihood of risk to others.

42. In addition, Dr. Shariati stated that a Detention Order allows for a prolonged admission of a patient whether or not the patient continues to satisfy criteria for an involuntary admission under the Mental Health Act, while the Conditional Discharge does not. The Conditional Discharge does not. The doctor elaborated by stating that even with the inclusion of a Young condition that extended to include Mr. Carrera-Ferreira’s hospital admission, it would still be necessary that he voluntarily consent to a hospital admission, or, alternatively, that he continue to satisfy criteria for an involuntary admission under the Mental Health Act. The doctor stated that the inclusion of the Young condition is realistically only a mechanism to bring a patient to the hospital for psychiatric assessment but it does not guarantee that patient’s admission. For these reasons, the doctor stated that it continues to be necessary and appropriate for the safe management of Mr. Carrera-Ferreira’s risk, that he be subject to a Detention Order Disposition.

43. Dr. Shariati was asked whether Mr. Carrera-Ferreira would be like to comply with a Young condition requiring that he attend at the hospital for psychiatric assessment. The doctor stated that Mr. Carrera-Ferreira’s cooperation would be contingent, to a large extent, on his mental state at the relevant time, and specifically, whether or not he was floridly psychotic. The doctor speculated that if Mr. Carrera-Ferreira was profoundly unwell then, despite his positive therapeutic relationship that he has with the treatment team members, he would be unlikely to cooperate with a voluntary return to the hospital, whether or not his Disposition, mandated same.

44. In response to a question posed by a panel member, Dr. Shariati acknowledged that if Mr. Carrera-Ferreira was under a Conditional Discharge and he did not satisfy criteria under the Mental Health Act to allow for a prolonged admission and he would not consent to a voluntary admission, then, at that juncture, the hospital could request that the ORB conduct an early review of his Disposition, at which time the hospital would be likely to request that he be managed under a Detention Order. Dr. Shariati stated that convening an early ORB hearing typically takes some time and, in his assessment, it might not allow for the type of rapid intervention that the hospital would require to safely manage Mr. Carrera-Ferreira’s risk to public safety.

45. In response to a question posed by Mr. Rai, Dr. Shariati acknowledged that if there is a breach of any condition under a Conditional Discharge Disposition, police can be notified and a mechanism exists to have the police return a patient to the hospital; however, the doctor stated that often police do not act upon such breaches and do not promptly return the patient to the hospital.

46. When responding to a series of questions posed by panel members, Dr. Shariati advised as follows:

• whether governed by a Detention Order or a Conditional Discharge Disposition, Mr. Carrera-Ferreira will be managed with the same level of structure, monitoring and external supervision by the FOP and the Team 5 teams;
• there have been no supervision failures over the year in review and Mr. Carrera-Ferreira has consistently maintained all appointments, both at the FOP clinic and/or his residence, as required;
• Mr. Carrera-Ferreira has remained fully abstinent of alcohol, drugs and other intoxicants while residing in the community (as confirmed by negative UDS), despite having extensive exposure to same;
• Mr. Carrera-Ferreira does not present with any positive symptoms of his illness and has remained medication compliant over the year in review; and
• Mr. Carrera-Ferreira continues to present with a superficial level of insight into his illness, its symptoms, his risk of relapsing to substance use, and the index offences.

47. Dr. Shariati stated that overall, Mr. Carrera-Ferreira has had a relatively good year in review. He has attended all of his scheduled appointments and maintained medication compliance and remained abstinent. He transitioned well to independent housing and agrees to follow-up with Good Shepherd team 5. He continues to look for employment opportunities. In response to the ongoing encouragement of the treatment team, Mr. Carrera-Ferreira has been engaged in the hospital’s Dual Recovery Anonymous relapse prevention programming on a weekly basis for the past few months. The doctor opined that Mr. Carrera-Ferreira’s engagement in this programming was likely motivated by the treatment team disclosure that they would not be recommending a Conditional or Absolute Discharge at this hearing.

48. No further evidence was called by the parties.

Analysis and Conclusions:

49. The Board has no difficulty in finding that Mr. Carrera-Ferreira continues to pose a significant threat to the safety of the public. The Board relies upon the expert medical opinion of Dr. Shariati that significant threat exists. While this issue was not contested at the hearing, Mr. Carrera-Ferreira’s risk flows from his diagnosis of Schizophrenia which is compounded by his diagnoses of substance use disorders. Further, Mr. Carrera-Ferreira has a history of aggression against family members that precedes the index offences. He physically assaulted his mother in 2014, threatened to kill his mother in 2016, and had a physical altercation with his brother in 2018. The index offence was a violent and unprovoked assault with a weapon against his grandmother and his father, the results of which could have been lethal. Historically, his violence and aggressive behaviours have been driven by his experience of auditory hallucinations and paranoid delusions, as well as by substance use.

50. Mr. Carrera-Ferreira also has a history of medication non-compliance and the expert evidence presented indicates that absent a Disposition of the ORB, over time, he would be likely to become non-compliant with medication, and/or relapse to substance use, and become physically aggressive.

51. According to the expert evidence, Mr. Carrera-Ferreira has partial insight into the nature of his mental illness and his need for medications. His insight is more limited with respect to his understanding of his violence risk and the contribution of substance use to his index offence.

52. In light of our independent finding of significant threat, we must shape a Disposition that is necessary and appropriate, as well as least onerous and least restrictive in the circumstances, for the coming year. In doing so, we are mindful of the significant progress Mr. Carrera-Ferreira has made over the past several years. He has successfully resided in the community since August 2023 and, in July 2025, he transitioned to independent housing, without issue. Since coming under the jurisdiction of the ORB in 2018, Mr. Carrera-Ferreira has not engaged in any violence or aggression. Further, he has remained medication compliant and the symptoms of his illness are now well-managed. Since July 2022, Mr. Carrera-Ferreira has remained abstinent of substance use despite having considerable access to same. Mr. Carrera-Ferreira has not required hospital readmission since his most recent discharge to the community in August 2023.

53. The expert evidence of Dr. Shariati indicates that although Mr. Carrera-Ferreira has done well over the past several years, the hospital requires the authority of a Detention Order for several risk management reasons. In particular, it would allow the hospital to intervene proactively and immediately return Mr. Carrera-Ferreira to hospital for a prolonged readmission without having to meet Mental Health Act criteria for an involuntary admission. The doctor asserted that if Mr. Carrera-Ferreira were to become non-compliant with his prescribed medications, his mental health would be likely to deteriorate relatively quickly. The doctor commented that should Mr. Carrera-Ferreira relapse to substance use, he would be likely to suffer an even more rapid decompensation in his mental health.

54. When asked why he thought Mr. Carrera-Ferreira would be likely to relapse to substances or become medication non-adherent, the doctor stated that Mr. Carrera-Ferreira’s continued success in these specific domains was predicated upon his intensive external supports. The panel notes that these critical intensive supports (i.e., his residence’s Team 5 team as well as the FOP team) will continue to be available to Mr. Carrera-Ferreira even in the context of the Board granting him a Conditional Discharge. Indeed, his engagement with Team 5 is a requirement for remaining with the Good Shepherd housing program.

55. Further, we note that the inclusion of a residency clause at his existing community residence will ensure continuity in his current, stable housing.

56. Mr. Carrera-Ferreira’s counsel recommended a Conditional Discharge Disposition that would include a s.672.55 consent to treatment condition which would considerably mitigate Mr. Carrera-Ferreira’s risk of medication non-adherence. Further, Mr. Rai indicated that his client consented to the inclusion of a Young condition to further mitigate his risk by requiring that Mr. Carrera-Ferreira attend at the hospital for psychiatric assessment and admission (should he not cooperate with a request that he voluntarily agree to readmission). In this panel’s assessment, the inclusion of a residency clause, a consent to treatment condition, and a Young condition, collectively serve to mitigate Mr. Carrera-Ferreira’s risk to public safety.

57. In our assessment, there is no question that the authority of a Detention Order allows the hospital to intervene at an early stage to force an NCR patient to return to hospital for an indeterminate readmission (without the need to satisfy criteria under the Mental Health Act, or otherwise). However, the ease and convenience of a Detention Order in mandating a prolonged hospital readmission (as opposed to under a Conditional Discharge) should not be the driving factor when considering the least onerous and least restrictive Disposition that safeguards the paramount interest of public safety. The liberty interests of the NCR patient and the goal of that patient’s community reintegration must also be considered.

58. As articulated in Ramos (Re), 2025 ONCA 820, “…s. 672.93(2) [of the Criminal Code] empowers courts to order re-confinement in hospital following a breach of conditional discharge: at paras. 26, 32. This interpretation, later echoed in R. v. Conception, 2014 SCC 60, [2014] 3 S.C.R. 82, at para. 97 & fn. 23, ensures that compulsory readmission is available but subject to judicial authorization, thereby safeguarding liberty while maintaining accountability.”

59. Dr. Shariati stated that the severity of the index offences must be kept in mind when making our Disposition. This panel is well aware of Mr. Carrera-Ferreira’s history of violence up to the time of the index offences; however, we are also cognizant of the fact that since that time, he has not engaged in further violence. Further, we are cognizant that Mr. Carrera-Ferreira has maintained psychiatric stability with sustained medication adherence, has remained abstinent of substances over the past three years, has engaged appropriately with the FOP and Team 5, and has not required hospital readmission over the past two years. His sustained progress under the ORB over the past several years leads us to the conclusion that Mr. Carrera-Ferreira can now be safely managed under a more liberal Conditional Discharge Disposition on the following terms and conditions below (all as set forth in his formal Disposition):

• he reside at 195 Ferguson Ave. N, Hamilton, Ontario;
• he report to the person in charge of St. Joseph's (“PIC”) or his or her designate, not less than once per week, or as required;
• he abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant;
• he submit samples of his urine and/or breath to the PIC, or his or her designate, for the purpose of analyzing whether he has ingested alcohol, drugs or any other intoxicant;
• he refrain from having in his possession any weapon;
• he refrain from contact or communication, direct or indirect, with Ms. Leon Lukiyanets;
• on his consent, agree to take treatment/medication as prescribed by the PIC, or his or her designate, in accordance with s.672.55(1) of the Criminal Code;
• he advise the PIC, or his or her designate, in advance, of any absence from his residence of 24 hours or more;
• upon notice by the PIC or his/her designate, he shall immediately submit to attendance at the hospital for psychiatric assessment;
• upon notice, he attend before the ORB as required; and
• he shall keep the peace and be of good behaviour.

60. In making this Disposition, the Board has taken into consideration Mr. Carrera-Ferreira’s mental status, his reintegration into society, his other needs, and the paramount need, of the safety of the public.

Dated this 31^st^ day of December 2025, at the City of Toronto, in the Toronto Region.

Ms. L. Banks Alternate Chairperson

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Office of the Registrar Ontario Review Board