RE: Chanh Henry Trang
ORB File No: 5879
Hearing Held On: Wednesday, September 24, 2025
Place of Hearing: Waypoint Centre for Mental Health
Pursuant To: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. T. Mann Members: Dr. K. Hand Dr. G. Kerry Ms. A. La Viola Ms. R. Chopra
Parties Appearing: Accused: Chanh Henry Trang Counsel: Ms. M. Perez Person in charge of Hospital: Representative/Counsel: Ms. T. Newman Attorney-General of Ontario: Counsel: Ms. J. Armenise
REASONS FOR DISPOSITION
(Dated November 5, 2025)
OVERVIEW
- Chanh Henry Trang was found not criminally responsible on account of mental disorder on May 20, 2011, on a charge of assault, contrary to the Criminal Code. He is currently subject to a disposition of the Ontario Review Board dated September 5, 2024, detaining him at the Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs, Penetanguishene, Ontario. The terms of his detention order include hospital and grounds privileges, beyond the secure perimeter, escorted by staff.
ISSUES
On September 24, 2025, the Board convened at Waypoint for a hearing further to s. 672.81(1) of the Criminal Code to review the disposition. The Board was asked to determine whether Mr. Trang represented a significant threat to the safety of the public at the time of the hearing, and further, what the necessary and appropriate disposition is in the circumstances according to the factors set out in s. 672.54 of the Criminal Code.
At the outset of the hearing, the Representative for the Hospital and Counsel for the Attorney General submitted that in their respective views – Mr. Trang continues to represent a significant threat to the safety of the public – both agreeing that he requires the secure setting at Waypoint, under the current disposition, with no change.
On the contrary, Counsel for Mr. Trang submitted that the Board should consider an absolute discharge, or, in the alternative, a less-secure setting would be appropriate.
FINDINGS
- After reviewing both the documentary and oral evidence, and submissions of the parties presented at the time of the hearing, the Board found that Mr. Trang represents a significant threat to the safety of the public. Accordingly, the Board determined that a detention order is required to manage the risk to the public, and for reasons that follow in more detail below, an absolute, or conditional discharge, or transfer to a less secure forensic hospital does not appropriately address Mr. Trang’s level of risk. The high secure setting at Waypoint continues to be necessary and appropriate. As a result, the Board concluded that the current disposition will continue to be in place, with no change at this time.
PERSONAL BACKGROUND
The Hospital Report dated August 26, 2025, was entered as an exhibit at the hearing. The following background information, including the events surrounding the index offence has been taken from the Hospital Report, summarized here as follows.
On May 12, 2010, a staff member at the Centre for Addiction and Mental Health was at work on the second floor of the hospital unit where Mr. Trang was an involuntary patient. She observed Mr. Trang attempting to get into the elevator, and she knew he was not allowed to leave the floor. She approached Mr. Trang and advised him that he had to go back to his confined area. Mr. Trang immediately grabbed her throat and began to squeeze. A witness quickly jumped in and subdued Mr. Trang, who was taken back to his area. The staff member was treated medically for minor injuries to her neck.
Mr. Trang is now 55 years old. He immigrated to Canada after spending his early years in Vietnam, Malaysia, and Germany. His childhood was marked by the separation of his parents and the profound impact of his mother's death due to cancer when he was 13 years old. This trauma continues to influence his delusional thoughts. Residing with his maternal grandparents in Toronto's Chinatown until age 19, Mr. Trang struggled academically but managed to graduate high school before his psychosis manifested at age 23, characterized by delusions, paranoia, agitation, aggression, and suicidal tendencies.
His work history includes working at McDonald’s, where he left due to low pay and stress, and at Simpsons as a retail clerk, from which he was fired for giving a discount to a friend. At age 25, he briefly worked as a bookkeeper at CIBC before leaving amid hallucinations, and since then, he has been unemployed.
A check of the Canadian Police Information Centre database shows that Mr. Trang has a criminal record starting in 1994 with convictions for violent and financial crimes. The record also shows a pattern of criminal offences with varying dispositions up to 2009.
Mr. Trang’s history is complicated by Neuroleptic Malignant Syndrome, which restricts treatment options, especially injectable medications, and Tardive Dystonia, causing physical impairments and increasing his fall risk. A trial with clozapine yielded positive but inconsistent results due to side effects, posing ongoing challenges in terms of finding effective pharmacological treatment for his major mental illness.
PSYCHIATRIC BACKGROUND
Mr. Trang’s current psychiatric diagnoses are Schizophrenia and Post-Traumatic Stress Disorder1. He has been found incapable of making decisions about his medical treatment, and he is also incapable of managing his finances. His sister is his substitute decision maker for his medical treatments, and the Public Guardian and Trustee has been appointed as guardian of his property. He is currently financially supported by the Ontario Disability Support Program.
Before the index offence, Mr. Trang experienced over 30 psychiatric admissions in Toronto, with mental health diagnoses ranging from schizoaffective and bipolar to schizophrenic disorders. Despite interventions involving antipsychotics and mood stabilizers, Mr. Trang exhibited minimal insight into his mental health needs and consistently resisted medication. He often refused treatment in the community, even though he was subject to various Community Treatment Orders.
In November 2023, Mr. Trang was severely injured in a stabbing incident by a fellow patient, resulting in multiple skull fractures and a traumatic brain injury. This incident caused lasting cognitive, behavioural, and physical impairments, including a syndrome of inappropriate antidiuretic hormone, which necessitates rigorous medical management involving sodium chloride treatment, fluid restriction, and close monitoring of sodium levels to prevent life-threatening complications.
In 2024, Mr. Trang continued to display frequent aggressive and threatening behaviours, including verbal threats to staff and physical acts that required seclusion on several occasions. His behaviour often required staff interventions, especially when he was offered medication or challenged authority. His security level fluctuated as a result of these incidents, and he remains under staff escort when leaving the unit.
Of note, the Crisis Prevention Plan has been central to managing Mr. Trang’s behaviour, medication adherence, and accompanying health concerns. His hyponatremia has stabilized with consistent management, involving fluid restriction and oral sodium chloride, although he continues to believe that blood tests and treatments may harm him. Mr. Trang still requires significant staff support to ensure compliance and safety, and his behaviour remains influenced by paranoid and delusional beliefs, with ongoing risks of agitation and escalation despite ongoing interventions.
EVIDENCE AT THE HEARING
The evidence included comprehensive testimony from Dr. P. Ismail regarding the current mental health status and behaviour of Mr. Trang.
Dr. Ismail agreed with the contents and recommendations in the Hospital Report and confirmed that there have been no significant changes since then. He stated that Mr. Trang continues to pose a substantial threat, largely due to his persistent paranoia, aggression, and verbal threats, which is why discharge remains inappropriate at this time.
Mr. Trang cannot clearly recognize or articulate how his illness increases risk to others in the community and often believes that others deserve to be hurt or are planning to harm him. His psychosis includes significant grandiosity (though he is better on good days), and social withdrawal that leaves him vulnerable, especially after being assaulted last year, which is now likely related to his brain injury and hypersensitivity. His affect can quickly and unpredictably fluctuate from normal to highly aggressive, and this variability makes it extremely difficult to manage his healthcare needs, particularly since he has severe neutropenia, which complicates blood work and medication management, especially while on clozapine.
Regarding his treatment, the team agrees that effectively managing his symptoms through medication alone is highly challenging. His ongoing psychosis and behaviours such as agitation, threats, and physical assaults – necessitate a high level of security, and none of the team members believe he can be managed safely at a less restrictive level.
After further inquiries, Dr. Ismail noted that Mr. Trang’s diagnosis has been upgraded to Schizoaffective Disorder due to frequent manic episodes alongside his psychosis. His current treatment with clozapine, despite its benefits, is limited by side effects like dystonia and the difficulty in increasing the dose because of his substitute decision maker’s unwillingness to consent to adjustments.
Dr. Ismail emphasized the importance of achieving greater stability – reducing delusions and mood symptoms – to consider any transition to a less secure placement, but this requires his sister’s cooperation. Mr. Trang’s sister remains hesitant to consent to medication changes or additional mood stabilizers, and although the team hopes to gain her approval for these, her cautious stance limits options such as ECT. As such, the current level of security remains necessary given his history of violence, vulnerability due to brain injury, and the need for continuous staff supervision to prevent escalation and manage his complex medical and mental health needs.
Evidence by Mr. Trang
Mr. Trang addressed the Board, asserting that most of his medication is ineffective, claiming he is not mentally ill or schizophrenic.
Mr. Trang stated that he was wrongly charged with crimes he did not commit and criticizes law enforcement and the justice system, attributing his incarceration to corruption and bad karma. He expressed that his suffering is the result of evil, which he blames on corrupt authorities, believing that only half of the world was created by God. He stated that his medications are ineffective because he views his issues are all ‘in the mind and not real,’ suggesting that understanding this alleviates much of his suffering, referencing Tibetan Buddhism. He also described seeing and sleeping with images of people and believing they are evil, claiming that these are related to a harmful “evil eye.” He asked for some form of protection or relief, indicating a belief that his perceptions and delusions are real and rooted in his spiritual beliefs, which significantly influence his mental state and perspective.
SUBMISSIONS
After hearing the evidence, the parties' closing submissions reflected their initial positions. The Hospital submitted that the evidence continues to demonstrate that Mr. Trang is a significant threat to public safety, with active symptoms and no insight. Despite efforts for compliance, Mr. Trang demonstrates thoughts of harming others and has been subject to seclusion on 25 occasions. It is necessary for him to remain stabilized before considering any transfer, as he cannot be managed in a less secure setting at this time. The Hospital also noted that a Rule 13 notice2 had not been filed.
Counsel for the Attorney General joined the Hospital and adopted her submissions, emphasizing that if Mr. Trang were placed in a less secure setting, it would be more difficult to manage him. She stated that it is premature to conclude he can be safely managed at a lesser security level, citing his lack of insight and ongoing risks.
Counsel for Mr. Trang, on the other hand, advocated for either and absolute discharge or a transfer to a less secure setting. Noting that Mr. Trang feels he is ready to move on from Waypoint, having been there many years – advocating for the least onerous and least restrictive options.
ANALYSIS AND CONCLUSION
(a) Significant Threat
The Board must first determine whether Mr. Trang continues to pose a significant threat to the safety of the public as defined in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. Based on the totality of the evidence, including the testimony of Dr. Ismail, recent clinical findings, and the actuarial risk assessment results, the Board concludes that Mr. Trang continues to meet the legal threshold for a finding of ‘significant threat’.
Dr. Ismail's testimony was particularly compelling. He articulated in detail the ongoing presence of Mr. Trang's active psychotic symptoms, which include prominent grandiose and paranoid delusions, pressured and disorganized speech, and a persistent lack of impulse control. Dr. Ismail provided concrete examples of how these symptoms manifest in Mr. Trang's daily life, including his firmly held beliefs that he possesses special powers, that staff members are malevolent, and that his medications are intended to harm him. These delusions not only impair his judgement and decision-making abilities but also contribute to his volatility and potential for aggressive behaviour.
Further supporting this conclusion is Mr. Trang's prolonged history of treatment resistance, his persistent symptoms, and his demonstrated propensity for violent behaviour. We also note the limited effectiveness of pharmacological treatments in controlling his symptoms, and the significant challenges in ensuring his compliance with medication regimens.
The actuarial risk assessments provide additional objective evidence of Mr. Trang's ongoing risk. His VRAG score places him in the 5th risk category for violent recidivism, indicating a substantial likelihood of future violence. The HCR-20 assessment identifies numerous historical and clinical risk factors that contribute to his overall risk profile, including a significant history of violence, other antisocial behaviour, unstable relationships, and the presence of a major mental disorder. The presence of these factors, combined with his current symptoms and behaviours, paints a concerning picture of an individual who continues to pose a significant risk to the safety of others.
Mr. Trang’s own statements to the Board, during which he denied his mental illness, the validity of the charges against him, and the need for treatment, further highlight his lack of insight and his resistance to accepting responsibility for his actions. The content of his statements, including his grandiose claims and paranoid beliefs, demonstrates that his delusional thinking remains pervasive and that he continues to lack a realistic understanding of his own condition. The frequency and intensity of threats made by Mr. Trang, alongside the documented instances of physical aggression, underscore the continuing immediacy and seriousness of the risk he poses.
(b) Necessary and Appropriate
The Board must next determine the disposition that is necessary and appropriate in the circumstances. The disposition must embrace the principle of ‘least onerous and least restrictive’ with due consideration given to Mr. Trang’s liberty interests, which must also be consistently weighed together with concerns about public safety, his mental condition, and his reintegration into society, as required by s. 672.54 of the Criminal Code.
The Board has carefully considered the possibility of an absolute discharge. However, it would be entirely inappropriate given the significant and ongoing risk he poses to the public. An absolute discharge would remove all restrictions on Mr. Trang's liberty and would terminate the Board's jurisdiction over his case. Given his lack of insight into his mental illness, his resistance to treatment, and his history of violence, the Board is not satisfied that Mr. Trang would adhere to any treatment plan, or, more importantly, refrain from engaging in harmful behaviour if he were to be released without supervision. Such a disposition would create an unacceptable risk to the public and would be inconsistent with the Board's mandate to protect public safety. Therefore, an absolute discharge is not a viable option at this time.
Managing Mr. Trang's medical needs is also relevant, given the specialized support he requires. Mr. Trang’s symptoms are not sufficiently controlled, and he requires a level of supervision and support that simply cannot be provided in a less secure setting. Considering public safety as paramount, and the specialized level of care he requires, the current setting is considered necessary and appropriate at this time. For the same reasons, a conditional discharge would not adequately mitigate the risk to public safety.
The Board acknowledges Counsel for Mr. Trang’s submission, in the alternative, that Mr. Trang should be transferred to a less secure facility. However, the evidence before the Board does not support such a transfer. The Board acknowledges the restrictions on Mr. Trang's liberty that result from a detention order but finds that these restrictions are justified by the serious and ongoing risks he presents to public safety.
Given the concerns outlined above, it is our view that the current plan emphasizes the importance of ongoing efforts to engage Mr. Trang in meaningful treatment and rehabilitation. The Board encourages the treatment team and supports the need for ongoing communication and collaboration with Mr. Trang's substitute decision maker to ensure that his treatment plan is aligned with the best treatment options available. In conclusion, Mr. Trang’s continued detention in the high secure provincial forensic program, with the necessary structure and support, is the most appropriate way to manage the risk effectively. As a result, the current disposition will remain in place, with no change at this time.
DATED this 5th day of November 2025, at the City of Toronto, in the Toronto Region.
Ms. A. La Viola Legal Member
Office of the Registrar Ontario Review Board
Footnotes
- The diagnosis of Post Traumatic Disorder was changed at the hearing to Schizoaffective Disorder.
- Ontario Review Board Rules of Procedures, Schedule A, Rule 13 – transfer requests from one hospital to another requires no less than four weeks’ notice prior to the annual hearing be given to all parties, including the prospective receiving hospital, if one is identified.