Re: Muon Van Hoang
ORB File No: 2721
Hearing held on: Wednesday, January 22, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. M. Labrosse Members: Dr. R. Buckingham Dr. W. Loza Ms. L. Banks Mr. W. Apted
Parties Appearing:
Accused: Muon Van Hoang Counsel: Mr. T. Whillier
The person in charge of hospital: Counsel: Ms. L. Senko
Attorney General of Ontario: Counsel: Ms. D. Silver
REASONS FOR DISPOSITION
(Dated March 17, 2025)
Introduction
On June 21, 1990, Mr. Muon Van Hoang was found not guilty by reason of insanity (“NGRI”)on a charge of first-degree murder, contrary to the Criminal Code of Canada.
Mr. Hoang is currently subject to a Disposition of the Ontario Review Board dated February 2, 2024, which detains him at the General Forensic Unit of the Centre for Addiction and Mental Health, Toronto (“CAMH”), on terms and conditions including to be allowed to live in 24-hour supervised accommodation approved by the person in charge.
On January 22, 2025, the Ontario Review Board convened a hearing at CAMH to conduct the annual review of Mr. Hoang’s Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Hoang was present at the hearing and was represented by counsel, Mr. T. Whillier. A Vietnamese interpreter provided consecutive translation. A Hospital Report dated December 27, 2024, was entered as Exhibit 1 for the hearing.
The issues for this hearing are whether Mr. Hoang continues to pose a significant threat to the safety of the public and, if so, to determine the necessary and appropriate disposition bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below, the Board finds that Mr. Hoang continues to present a significant threat to the safety of the public and that the maintenance of the current Disposition, namely a detention order with permission to reside in the community in supervised accommodation approved by the person in charge, remains the necessary and appropriate, least onerous and least restrictive disposition in the circumstances.
Index Offences
- The details of the index offences are extracted from last year's Reasons for Disposition, as follows:
“On July 21, 1989, Mr. Hoang, his brother, aunt, uncle and some friends travelled by bus to Hamilton to his aunt's house. They were planning to go on to Kitchener to attend the funeral of an acquaintance, a Mr. Kong, who had been bludgeoned to death. Upon arriving in Hamilton, Mr. Hoang became frightened, but did not know what was causing his fear. While the other members of the group went on to Kitchener, Mr. Hoang and a friend remained in Hamilton and later went to visit his brother. He became more and more frightened and returned to his aunt's house. He told his friend that he felt frightened inside and was afraid that something was going to happen to his family. Mr. Hoang asked his friend to telephone his home in Ottawa because he wanted to talk to Binh, his sister, but he could not remember his home telephone number.
Mr. Hoang then set out to return to Ottawa by bus. Upon arrival in Toronto, he had to wait a long time for the bus to Ottawa. While waiting in the bus terminal in Toronto, his fear intensified. He was afraid that someone was going to kill him. The messages from the public announcement system appeared loud and confusing to him. Suddenly, Mr. Hoang heard, in his head, funeral music for Mr. Kong. Mr. Hoang felt that he was going to be killed and he had to find some way to escape. He also heard a voice through the public announcement system telling him that his family members were going to be killed and he had to save the family by killing one member instead of all family members being killed. By this time, the noises had become clear voices and he became anxious, tense, and frightened.
Mr. Hoang arrived in Ottawa very late and, while walking home, he was approached by two Caucasians who asked if he wanted to buy some cocaine. He told them he did not, but this incident further aggravated his fear as he took it as a sign that something tragic was going to happen to the family. After arriving home, he stayed in the kitchen for a while and smoked a few cigarettes. He saw a tall man outside carrying a suitcase. This man evidently gave an order to Mr. Hoang to kill. Mr. Hoang saw a red circle on the floor, an empty beer bottle, a lemon and a knife on the kitchen table. By seeing these items, he was convinced that he must sacrifice one person to save the rest of the family.
Mr. Hoang grabbed the knife and, while concealing the knife, he knocked on his mother's bedroom door. Mr. Hoang's mother reported that, when she opened the door for him, she saw a look on his face, which was very frightening and unusual. He apparently did not say anything. He then went to the room where his two sisters were sleeping. The victim was sleeping on the side closer to him. He woke her up and then stabbed her three times – in the upper rear shoulder blade, the centre of her back and through her arm. His mother's screaming woke his father who wrestled him to the floor. Mr. Hoang continued to hold the knife in his hand and was still holding it when the police arrived and arrested him.”
Background History
Mr. Hoang’s personal, legal and psychiatric history are set out in detail in the Hospital Report. Briefly summarized, Mr. Hoang is currently 60 years of age and was born in Vietnam. He was 19 years of age when he left Vietnam with his family. The family initially settled in Quebec City and then moved to Ottawa in 1989. Mr. Hoang’s parents were unable to find employment and relied on welfare assistance.
Mr. Hoang went to school in Vietnam for a year though he did not like school and did not finish grade 1. He never returned to school. With respect to employment history, he reported that he had worked as a dishwasher and also worked in a factory for seven months. Mr. Hoang is currently supported by ODSP, and his finances are managed by the Public Guardian and Trustee.
Mr. Hoang has no formal psychiatric history prior to the index offences. There is no reported family history of psychiatric illness. He committed the index offence in 1989 at the age of 25.
With respect to his criminal history, Mr. Hoang has no charges or convictions prior to the index offences but following the NGRI finding for the first-degree murder of his sister, Mr. Hoang was charged with possession of a scheduled substance which resulted in a stay of proceedings in 1997 and in 2012 he was charged and convicted of assault with a weapon for which he received a four-month term of incarceration, making him a dual status offender at the time. The assault related to an incident when Mr. Hoang stabbed a co-patient at a 24/7 supervised home in the community.
Mr. Hoang’s current diagnosis is treatment-resistant schizophrenia.
Evidence at the Hearing
The hospital's evidence was presented through its report and through the oral testimony of Dr. D. Jaiswal. This evidence is summarized as follows.
Dr. Jaiswal adopted the contents of the hospital report and stated that throughout the past reporting year Mr. Hoang has continued to reside on the Forensic General Unit B of the hospital.
Despite experiencing residual non-commanding auditory hallucinations, his mental status has remained largely unchanged. As stated in the Hospital Report, Mr. Hoang continues to participate in recreational programming offered by the hospital and on his unit. He has also attended community walks with his DSO Passport worker and occasionally with the Reena housing program worker where he has been accepted for discharge to the community. Dr. Jaiswal confirmed that the hospital is still waiting for Reena House to provide a date when they can start the transition of Mr. Hoang to that facility. This residence is located in North York.
Mr. Hoang remains incapable with respect to treatment and his substitute decision maker (SDM) is his sister. When his sister is unavailable, his niece has also provided substitute consent. The Hospital Report sets out that in February of 2024, Mr. Hoang refused to take his clozapine, and the clinical team felt that the stressors associated with undergoing a risk assessment organized by the Reena housing program was a possible precipitant of the medication refusal. It is around this time, and again in May of 2024, that Mr. Hoang had introductory meetings with staff members from the Reena housing program.
In March of 2024, with the consent of the SDM, Mr. Hoang began treatment with the long-acting injectable antipsychotic medication aripiprazole which he receives regularly along with the continuation of oral antipsychotic medication clozapine which he has accepted without any refusal since May 2024. Mr. Hoang is reportedly less drowsy and now complains less frequently of headaches.
In response to questions posed to him by counsel for the Attorney General, Ms. Silver, Dr. Jaiswal acknowledged that Mr. Hoang has been reluctant to leave the hospital, and that the hospital plans to address this with a very gradual transition to community living. Mr. Hoang will be gradually exposed to the housing facility, with the goal of increasing his level of comfort with the program. Dr. Jaiswal also confirmed that Mr. Hoang was experiencing somatic symptoms which increased in intensity around the time where he was introduced to the staff at Reena. If for some reason Reena housing does not work out, the hospital will consider another long-term care residence. The focus will be on ensuring a successful discharge to Reena over the course of the next year. Dr. Jaiswal believes that that facility will be a good fit for Mr. Hoang's needs but his ability to fit in with staff and the house population remains to be seen. To this end, the hospital will ensure a very gradual transition.
In response to questions posed to him by counsel for Mr. Hoang, Mr. Whillier, Dr. Jaiswal confirmed that Mr. Hoang is utilizing his level 4 privileges three times per week. At times, Mr. Hoang has not been willing to use his indirectly supervised passes, and the treatment team has been trying to encourage him to do so. Dr. Jaiswal also confirmed that the DSO Passport worker will still be in place if and when the move to Reena occurs.
Dr. Jaiswal was asked whether he had used an interpreter to explore why Mr. Hoang had refused medications earlier this year to which he responded that it was not necessary as Mr. Hoang speaks both Cantonese and French and there are staff at in the hospital that are able to communicate with him in those languages.
Mr. Hoang's complaints of pain have been recurring. Dr. Jaiswal thinks that they are primarily somatic symptoms that come out in moments of stress. Dr. Jaiswal confirmed that Reena is a 24-hour supervised residence.
In response to questions posed to him by members of the panel, Dr. Jaiswal responded as follows:
He was not able to confirm how and why Mr. Hoang had been accepted for DSO housing and Passport funding when the Hospital Report does not indicate a diagnosis of developmental delays or neurocognitive degeneration. Dr. Jaiswal admitted that this predates his involvement and that he will attempt to clarify on what basis Mr. Hoang had been accepted by DSO. The Hospital Report does set out a psychological assessment in January 2017 which identifies some cognitive deficits but contains no summary opinion.
Dr. Jaiswal acknowledged that Mr. Hoang was last discharged to the community in 2011 to a 24-hour supervised group home and he stabbed a co-patient one year after that discharge for which he was found criminally responsible. Dr. Jaiswal stated that there are ongoing concerns even though this happened 13 years ago and that is why they will gradually introduce Mr. Hoang to his new residence and make sure that they adequately support him and address any factors of discontent that may arise while he is at that facility. Dr. Jaiswal added that it is important for Reena housing staff members to have familiarity with Mr. Hoang prior to the transition and that any needed risk mitigating factors will be considered at that time. The hospital is attempting to continue to build rapport between Mr. Hoang and the residents to ensure a successful transition. Dr. Jaiswal believes that the level of risk will become clearer as they start facilitating passes to the residence and assess Mr. Hoang's behavioural response which may require risk mitigating strategies where necessary.
Dr. Jaiswal was asked about the Reena housing population which consists of many young adults with cognitive impairments who can be a vulnerable population. Dr. Jaiswal confirmed that he is not aware that there are any forensic specialists on site, but that the Forensic Outpatient Services of the hospital will be very involved and will be there to address any forensic needs and assume a proactive approach to risk mitigation.
Dr. Jaiswal believes that Mr. Hoang will have a private room with staff on site although he was not certain whether the staff is on the same floor or within the unit where Mr. Hoang will be housed. Dr. Jaiswal believes that it is a high ratio of staff-to-residents in that facility.
Dr. Jaiswal confirmed that there has been full disclosure of Mr. Hoang’s history to Reena, and that as part of the intake assessment, the Hospital Report was reviewed with the residence staff.
No other evidence was presented.
Submissions of the Parties
- The Board was presented with a joint submission of all parties that Mr. Hoang continues to pose a significant threat to the safety of the public and that the maintenance of the current Disposition, namely a detention order with permission to live in the community in supervised accommodation, remains the necessary and appropriate disposition.
Analysis and Conclusion
Having considered all of the evidence tendered at the hearing, and the joint submission of the parties, the Board does find that Mr. Hoang continues to pose a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code of Canada and as further defined by the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
Mr. Hoang is diagnosed with treatment-resistant schizophrenia, from which he has suffered since the late 1980s. His index offence was severe. He killed his sister with a knife in the context of a serious psychotic decompensation.
Mr. Hoang has been residing in hospital almost continuously since 1999. He experiences some residual symptoms despite ongoing treatment with clozapine and a long-acting injectable antipsychotic.
The hospital is working on a discharge plan which involves a very gradual transition to a DSO high-support Reena housing program residence. Though some of the panel members expressed some concern with the suitability of Reena, which typically houses individuals with intellectual and cognitive disabilities, Dr. Jaiswal states that the hospital is focused on risk mitigation strategies, including a very gradual transition of Mr. Hoang to the Reena program.
It is clear that Mr. Hoang requires significant supports, and it will be important for the Forensic Outpatient Services to be very involved given the possibility that there are no forensic specialists in that residence. Should the mitigation strategies not be adequate, the hospital may have to pull back and look at other options. The primary consideration of public safety must remain at the forefront of this plan.
The Panel also recommends that the hospital should clarify how Mr. Hoang received DSO Passport funding and acceptance into a DSO residence, given absence of diagnosis and information on any psychological assessment and level of functioning.
Having considered the four factors set out in s. 672.54 of the Criminal Code, namely the protection of the public which is the paramount consideration, the mental condition of the accused, his reintegration into society and his other needs, the Board finds that the current detention order, on the same terms and conditions, remains the necessary and appropriate, least onerous and least restrictive Disposition in all of the circumstances.
DATED this 17^th^ day of March, 2025, at the City of Toronto, in the Region of Toronto.
Ms. M. Labrosse Alternate Chairperson
__________________ Office of the Registrar Ontario Review Board