Re: Brandon J. Stewart, 2025 CanLII 135653

Re: Brandon J. Stewart

ORB File No: 7940

Hearing held on: Thursday, December 4, 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: Brandon J. Stewart Counsel: Ms. M. Addie

The Person in Charge of Hospital: Counsel: Mr. S. O’Brien

Attorney General of Ontario: Counsel: Ms. J. McKenzie

REASONS FOR DISPOSITION

(Dated December 31, 2025)

Introduction:

1On August 19, 2021, Mr. Brandon Stewart was found not criminally responsible by reason of mental disorder (“NCR”) on charges of attempted murder and assault with a weapon. He is presently subject to a Disposition dated December 13, 2024, that orders his detention at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton (“St. Joseph’s” or the “hospital”) with a variety of terms and conditions, including discretionary privileges, the most liberal of which allows him to reside in the community within the catchment area of the hospital, in accommodation approved by the person in charge.

2On December 4, 2025, the Ontario Review Board (“ORB” or the “Board”) convened a hearing to review the Disposition as required by s. 672.81(1) of the Criminal Code. Mr. Stewart was present at the hearing and was represented by his counsel, Ms. Addie.

3The issues to be considered at this hearing are whether Mr. Stewart 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.

4For the reasons set out below, the Board unanimously concluded that Mr. Stewart continues to pose a significant threat to public safety and that the necessary and appropriate Disposition was his existing Detention Order Disposition.

Initial Positions of the Parties:

5At the outset of the hearing, all parties were canvassed as to their initial recommendations to the Board. Counsel for the hospital recommended that there be a continuation of the existing Disposition.

6Counsel for the Attorney General supported the hospital’s recommendation.

7Counsel for Mr. Stewart also supported the hospital’s Disposition recommendation and conceded the issue of significant threat.

8All parties maintained their joint recommendation in closing submissions.

Index Offences:

9The details of the index offences are set out in detail in the Hospital Report to the ORB dated November 17, 2025 (the “Hospital Report”) which was entered as an Exhibit at the hearing. We include a description of the index offences from last year’s Reasons for Disposition dated December 20, 2024, as follows:

“The index offences occurred on May 18, 2018. Mr. Stewart was unemployed, homeless, and living alone in a tent in the Fort Erie area. On May 18, 2018, he called Emergency Medical Services, and advised that he had been living in the bush and was suffering from nausea, tick bites, and had been experiencing hallucinations. On route to the hospital, Mr. Stewart advised the paramedics that he had a knife. He was told to keep the knife in a bag that he was carrying. Mr. Stewart arrived at the hospital at 5:41 p.m. At the hospital, the paramedics alerted the nursing staff to Mr. Stewart’s possession of a knife and offered to take custody of it. The nursing staff declined the offer and said they would take care of it. Mr. Stewart was described by the nurse as calm and polite. Mr. Stewart was taken to a treatment room, but soon after was observed to be pacing in the hallway.

At approximately 6:00 p.m. the victim P.A. arrived at the hospital with a broken wrist and other injuries suffered in a fall. He was placed on a stretcher and taken to a critical care room. At approximately 7:55 p.m. Mr. Stewart entered P.A.’s room and moved toward P.A. very quickly. Mr. Stewart straddled P.A. and began to stab him with what appeared to the nurse to be a hunting knife. The nurse estimated that Mr. Stewart stabbed him 3 times. P. A. fought with Mr. Stewart, and indicated that Mr. Stewart was yelling at him during the stabbing that he should die and was hurting kids.

Police were on scene and shot Mr. Stewart, who later received treatment to remove the bullet from his abdomen. P. A. was treated for a punctured lung suffered in this assault. Mr. Stewart and P.A. were strangers to each other. Mr. Stewart told the paramedics after the assault that the guy was bragging about killing puppies. He hated the guy for saying this so he took out his knife and stabbed him.”

10In addition to the foregoing summary, it should be pointed out that the second index offence, assault with a weapon, occurred when Mr. Stewart ran at a responding police officer, while brandishing the knife, after ignoring several commands to drop the knife. The officer shot Mr. Stewart in the abdomen, as noted above.

Background and History:

11The Board received the Hospital Report which was entered as an exhibit at the hearing. This report contains considerable information regarding Mr. Stewart’s personal background, criminal history, and his psychiatric history which need not be repeated here; however, we highlight the following relevant information below.

12Mr. Stewart is presently 37 years of age. He grew up in the Niagara Region of Ontario with his mother, stepfather, and two brothers. One brother died in a motorcycle accident in June 2018 and his mother died in May 2024 from cancer.

13Mr. Stewart exhibited problematic behaviour at a young age, began consuming alcohol at the age of twelve, and experimented with illicit substances when he was fourteen.

14As noted, Mr. Stewart began to abuse alcohol and illicit substances at an early age. Health records indicate he has reported being a heavy user of MDMA from the age of fifteen to nineteen, ingesting the substance orally approximately five times a week. He started misusing opiates around 2012 and has reported taking between two and twenty Percocet tablets per day. He has also reported sniffing or orally consuming OxyContin, up to 120 milligrams per day, which progressed to using approximately one gram of heroin per day.

15He reported the last time he used heroin was in 2014. He has also stated he started using crystal methamphetamine around 2014 but has only used it five or six times in his life. However, health records reveal that in December 2017 he endorsed using crystal methamphetamine for three consecutive days prior to being admitted to hospital for psychosis. His urine drug screen following admission at that time was positive for amphetamine, cocaine, MDMA, and Oxycodone. He has also been prescribed Concerta for attention deficit hyperactivity disorder and on a number of his admissions to psychiatric facilities he has reported abusing Concerta by nasal inhalation.

16As a consequence of substance use, his problematic behaviour at home and at school became more severe, and as a teenager, he was involved regularly with the criminal justice system. He recalled being in and out of group homes for young offenders, youth detention centres, and adult detention in the Niagara Region. According to Mr. Stewart, he moved to Ottawa in mid-2010 to attend a residential addictions programme which he did not complete.

17Mr. Stewart stopped attending school in grade nine but stated he obtained his grade ten equivalency while incarcerated.

18Mr. Stewart’s employment has been varied and short-term. Health records indicate that Mr. Stewart has reported losing employment due to absenteeism and tardiness for most of his employment history. His longest period of employment was for eight months as a machine operator when he was 21 years of age.

19He has not been involved in any long-term relationships and has no children.

Criminal History:

20Mr. Stewart’s lengthy criminal record began in 2002 and includes Youth Justice Court convictions for failing to comply with court orders, dangerous operation of a motor vehicle, impaired driving, possession of a narcotic, and possession of property obtained by crime. In addition, he incurred adult convictions between 2007 and 2017 for, among other offences, theft under $5,000, break and enter, uttering threats, assault, aggravated assault, and possession of a prohibited or restricted weapon. The aggravated assault conviction in in 2011 resulted in a sentence of 18 months’ imprisonment. His last conviction prior to the index offences was in 2017 for possession of a prohibited or restricted weapon.

Psychiatric History:

21Mr. Stewart’s psychiatric history began in February 2006 when he was assessed by a community psychiatrist while living in a group home for young offenders. In 2012, he was treated at the St. Lawrence Valley Correctional Treatment Centre while serving a sentence for aggravated assault, failure to comply with undertaking, assault, theft under $5,000, and unlawful possession of a Schedule II substance. He exhibited negative symptoms of schizophrenia and reported auditory hallucinations.

22Prior to the index offences, Mr. Stewart had been admitted to the hospital on five occasions for psychiatric care, as follows:

(i) July 2015-overdose of methylphenidate, and experiencing auditory hallucinations and homicidal ideations;

(ii) August 2015-mother called police as Mr. Stewart was talking to imaginary people, exhibiting bizarre behaviour, and experiencing auditory hallucinations;

(iii) August 2015-physically assaulted mother’s boyfriend;

(iv) December 2015-Mr. Stewart called police to report that someone was in his apartment stealing property and that he was being blamed for murder. His urine drug screen tested positive for MDMA, methamphetamines, benzodiazepines, and amphetamines. He also advised that he had used crystal methamphetamine a few days prior; and

(v) December 2017-Mr. Stewart stopped a police car and stated he had a knife and wanted to harm himself and others. He advised that he had been sleeping on the street and used crystal methamphetamine and cocaine.

Current Diagnoses:

23Mr. Stewart is currently diagnosed with:

Schizophrenia;

Stimulant (Methamphetamine and Methylphenidate) Use Disorder;

Antisocial Personality Disorder; and

Attention Deficit Disorder.

Evidence at the Hearing:

24Dr. Y. Alatishe, the most responsible psychiatrist involved in Mr. Stewart’s care since February 2024, testified on behalf of the hospital at the hearing. He advised that he had read the Hospital Report and adopted its contents.

25Over the year in review Mr. Stewart has remained an inpatient on Orchard 3 unit. He has recently been accepted to supportive housing at Emmaus Place and has been preparing for this transition. Housing at Emmaus Place is under the Transitional Housing and Rehabilitation Program (“THRP”) which is a joint initiative between the Forensic Psychiatry Program and the Good Shepherd of Hamilton. Mr. Stewart will be living in a subsidized independent full-size apartment, with the support of the 24-hour staff who are available for medication administration, support, problem solving and teaching of practical living skills.

26Once in the community, Mr. Stewart will be followed by the hospital’s Forensic Outpatient Program (“FOP”) team and the THRP team. Mr. Stewart has engaged appropriately in the transition process to date with these two teams and it is expected that he will be discharged to Emmaus Place by December 15, 2025. To date, he has exercised several 72-hour leaves of absences (“LOA”) to Emmaus Place and all passes have been used appropriately. Mr. Stewart is setting up his residence and is looking forward to the transition. Dr. Alatishe stated that on December 8, 2025, Mr. Stewart will be granted a 7-day LOA to this residence and, if all goes well, it is anticipated that he will be formally discharged to this residence on December 15, 2025.

27The doctor advised that Mr. Stewart is capable to consent to his psychiatric treatment and he receives a long-acting injection (“LAI”) of the antipsychotic medication, Paliperidone Palmitate. He also receives oral stimulant, anxiolytic, and antidepressant medications. He is compliant with his treatment and has remained psychiatrically stable. His thought process is organized and he denies experiencing any homicidal or suicidal ideation, or perceptual disturbances. He has not been observed reacting to unseen stimuli. At times, Mr. Stewart displays irritability and guarded behaviours when questioned about his mental status.

28Mr. Stewart is described as remaining pleasant and polite, displaying good judgment, and adhering to the rules of the unit. He has used privilege levels (up to level 4 indirectly supervised into the community) appropriately, with no concerns arising and has successfully participated in community outings. He has always returned from passes at the appropriate time and has also been consistent with calling the unit if he needs to make changes to his itinerary when off the unit and in the community. In addition to attending his college program (described below), Mr. Stewart spends his free time independently visiting family, shopping and going for hikes in local parks and conservation areas.

29The Hospital Report highlights two isolated incidents of concern over the past reporting year. In July 2025, he presented with irritability and made threatening comments related to people touching his laundry. Later, in September 2025, Mr. Stewart expressed concerns to his psychiatrist that individuals on hospital grounds were connected to his past, potentially reflecting low-level suspiciousness. Both incidents were managed without escalation.

30The Hospital Report indicates that “Overall, Mr. Stewart’s stability reflects a combination of medication adherence, abstinence from substances, predictable routines, and the external structure and supervision inherent to the forensic inpatient setting. Despite improvements, he continues to exhibit residual vulnerabilities, including baseline suspiciousness and low frustration tolerance, which remain relevant to risk assessment.”

31Mr. Stewart has been attending a full-time post-secondary automotive course at Mohawk College. He is currently enrolled in his third semester of the course and is receiving good grades.

32Regular urine drug screens have been negative for the presence of substances of abuse but several samples have shown low creatinine levels suggestive of possible dilution; however, no evidence supports active substance use. Dr. Alatishe commented that urine tampering was considered but it was noted that Mr. Stewart did not present with corresponding behavioural changes. Dr. Alatishe further noted that Mr. Stewart consumes a great deal of fluids and that low creatinine levels would be consistent with this level of consumption. Mr. Stewart continues to be closely monitored in this regard.

33Mr. Stewart expresses fair insight into his illness and has remained adherent to his medication regimen. His insight into his substance use disorders is described as partial; however, the doctor was clear that Mr. Stewart is able to articulate that he understands there is a direct link between his use of substances and his risk of harm to others. He has denied experiencing any cravings for substances.

34Mr. Stewart’s social network is limited and he does not have an Approved Person. However, he has support from his brother Dylan and he frequently goes to his brother’s home to visit. His professional support system is limited to that provided by the Forensic Psychiatry Program.

35In terms of the expectations of the treatment team for the year ahead for Mr. Stewart, Dr. Alatishe identified the following:

• ongoing psychiatric stability;

• medication adherence;

• continued abstinence from alcohol and substance use;

• engagement in programming or counselling to address relapse prevention;

• stability in his housing at Emmaus Place and adherence to the residence’s rules;

• continued engagement in his educational studies;

• appropriate engagement with his FOP team members; and

• ongoing psychiatric stability.

36The Clinical Risk Summary in the Hospital Report notes that Mr. Stewart has demonstrated good success within the hospital environment; however, it notes that his “…stability is closely tied to the hospital’s structured environment.” Dr. Alatishe stated that he will be closely monitored and supported as he transitions to community living.

37The Hospital Report also indicates that although Mr. Stewart’s insight into his diagnosis of schizophrenia is fair, his insight into his substance use disorder and antisocial personality disorder appears less developed.

38The Risk Assessment Summary indicates that:

“Despite these gains, Mr. Stewart’s enduring diagnoses- schizophrenia, stimulant use disorder, antisocial personality disorder, and attention deficit disorder—remain firmly established. His historical and current dynamic risk factors include a chronic vulnerability to psychotic relapse, residual suspiciousness, low frustration tolerance, and the risk of substance use should external constraints weaken. Static risk factors include his severe index offence involving near-fatal violence, an extensive criminal history beginning in adolescence, longstanding antisocial traits, and documented violent behaviour directly linked to psychosis and stimulant misuse.

Given this constellation, Mr. Stewart continues to pose a significant threat to the safety of the public. His current stability is contingent upon the therapeutic structure, supervision, external controls, and consistent medication adherence inherent to the inpatient forensic setting. When these supports are reduced—as his history repeatedly demonstrates—he is at risk of rapid destabilization, impaired insight, perceptual disturbances, and violent behaviour.”

39Dr. Alatishe testified that absent the oversight and the interventions of the forensic system, Mr. Stewart would be likely to experience difficulty coping with stressors and, in combination with his antisocial personality disorder, would become impulsive and impaired in his judgment and decision making, likely resulting in him becoming noncompliant with medication and relapsing into substance use. His psychotic symptoms would then return, and he would be at high risk of engaging in violent behaviour. The doctor endorsed the finding that Mr. Stewart continues to represent a significant threat to the safety of the public but stated that he can be safely managed under the terms of his existing Detention Order Disposition which contains a community living privilege.

40Overall, the doctor testified that it has been a positive year in review for Mr. Stewart. He remains medication compliant and has not engaged in substance use. There have been no incidents of aggression over the year in review and Mr. Stewart has remained involved in educational pursuits at Mohawk College. He has managed all LOAs to Emmaus Place successfully and it is expected that he will be formally discharged to this residence in the very near future.

41No evidence was adduced by counsel for the Attorney General or Mr. Stewart.

Analysis and Conclusions:

42Having reviewed all of the evidence and heard the submissions of the parties’ respective counsel, the panel finds that Mr. Stewart remains a significant threat to the safety of the public. The index offences were severe, unprovoked and unpredictable. It occurred in the context of untreated psychosis, paranoia, and long-standing stimulant misuse. Complicating Mr. Stewart’s risk profile is the fact that he has an extensive criminal record which includes offences of violence, and in particular, a conviction for aggravated assault for which he was imprisoned for 18 months. He has a longstanding history of substance misuse and past noncompliance with prescribed medications, and failing to engage in the treatment arranged for him in the community.

43Dr. Alatishe endorsed the findings in the Hospital Report indicating that absent oversight and intervention, Mr. Stewart would be likely to become challenged by stressors, temptations, and influences, which in concert with his antisocial personality disorder would likely lead to problems with impulse control, judgment, and a high likelihood, over time, of medication noncompliance and substance abuse. In that context, Mr. Stewart is likely to experience a relapse of frank psychiatric symptoms, potentiated by the effects of drugs and alcohol, resulting in paranoia and perceptual disturbances. We highlight that the commission of the index offences occurred without provocation or any warning, and while Mr. Stewart was in a delusional state.

44Having reached a finding of significant threat, we must craft a Disposition which is necessary and appropriate in the circumstances, having regard to the four factors set out in s. 672.54 of the Criminal Code, the protection of the public being paramount.

45The evidence before us establishes that Mr. Stewart has demonstrated stability over the past reporting period. He has been medication adherent, psychiatrically stable and has not engaged in any significant incidents of physical violence. He has been well engaged in his education and has used his privileges appropriately. He has remained abstinent of substances of abuse. He should be congratulated for all of his successes.

46He is on the cusp of being discharged to community housing at Emmaus Place and this is a very significant step in his process of community reintegration. At this pivotal juncture, we find that his existing Detention Order remains necessary and appropriate as well as the least restrictive and least onerous Disposition. In the Board’s assessment, a Detention Order provides two critical risk management tools. First, the Detention Order allows the hospital oversight with regard to Mr. Stewart’s residence in the community to ensure that it offers him an appropriate level of support, monitoring and supervision to safely manage his risk. In addition, the evidence presented indicates that the hospital requires the authority of a Detention Order to intervene at an early juncture to readmit Mr. Stewart to the hospital should he suffer a decompensation in his mental status when he is residing in the community. The documentary evidence indicates that Mr. Stewart may not meet criteria for an involuntary admission under the Mental Health Act in the context of the early stages of a mental status deterioration. For all of these reasons, Mr. Stewart’s existing Disposition remains the necessary and appropriate one to safely manage his risk to the safety of the public.

47In arriving at its Decision and Disposition, the panel has taken into account the mandatory requirements of Section 672.54 of the Criminal Code and Section 672.5401 of the Criminal Code, namely, the paramount need to protect the public from dangerous persons, the mental condition of Mr. Stewart, his reintegration into society and his other needs.