Ontario Review Board
Re: Ryan Hare
ORB File No: 8115
Hearing held on: Tuesday, March 4, 2025
Place of Hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Flanagan
Members: Dr. K. Hand Dr. A. Kerry Mr. K. McKenna Mr. A. Mete
Parties Appearing:
Accused: Ryan Hare Counsel: Mr. J. Chrolavicius
Person in charge of Hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Ms. J. McKenzie
REASONS FOR DISPOSITON
(Dated April 9, 2025)
Introduction
On June 20, 2022, Ryan Hare was found not criminally responsible on account of mental disorder (“NCR”) on a charge of aggravated assault, contrary to the Criminal Code.
Mr. Hare is currently subject to the terms and conditions of a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated March 14, 2024, detaining him at the Forensic Psychiatry Program of St. Joseph’s Healthcare Hamilton, West 5th Campus (“SJHH” or the “Hospital”) with certain privileges, including to live in the community of Southern Ontario in accommodation approved by the person in charge.
On March 4, 2025, a panel of the Board convened at the SJHH to conduct Mr. Hare’s annual review, and to make a Disposition pursuant to s. 672.81(1) of the Criminal Code.
Mr. Hare attended the hearing and was represented by his counsel, Mr. J. Chrolavicius. A Hospital Report dated February 21, 2025, was filed as Exhibit 1 at the hearing.
The issue for the hearing is whether Mr. Hare continues to pose a significant threat to the safety of the public and, if so, to determine the necessary and appropriate Disposition in all the circumstances.
Initial Position of the Parties
At the outset of the hearing, the parties were canvassed as to their recommendations to the Board.
Ms. Barney, on behalf of the Hospital, submitted that Mr. Hare represents a significant threat to the safety of the public and recommended the continuation of the existing Detention Disposition, on the same terms and conditions.
Ms. McKenzie, on behalf of the Attorney General of Ontario, supported the Hospital’s recommendation.
Mr. Chrolavicius, on behalf of Mr. Hare, recommended a Conditional Discharge Disposition and an amendment to condition 4(a) of the Disposition to allow Mr. Hare to use cannabis.
Index Offences
- The circumstances of the index offence are taken from the Hospital Report as follows:
“[DD], and Ryan HARE, age 42 are patients at the Woodstock General Hospital Mental Health Ward. On the evening of January 4, 2020, they were in a shared bedroom for the night. [GG], is another patient there in the room next to [DD] and Ryan. Dylan SHEPHERD, [REDACTED] and Albert MUKANDI, [REDACTED] were the nurses working in the unit on the evening of January 4, 2020.
On the morning of Sunday January 5, 2020, at approximately 0520 hours, [DD] woke up by Ryan beating him with his fists. David believes he was hit over 50 times. [GG] was woken up from the sound of [DD] screaming for help, so he ran down to the nurse’s station and made Dylan and Albert aware of the incident. Dylan and Albert attended the room of [DD] and Ryan and found Ryan on top of [DD] who was laying on the floor. They removed Ryan from on top of [DD] and put him in a seclusion room. They observed [DD]’s face to be cut open with blood all over it and bruising had already started to form. [DD] was complaining of breathing issues and sore ribs.
At 0630 hours PC KLEMP attended the hospital and spoke to [DD]. [DD] was clearly very sore and had a hard time speaking to PC KLEMP. At this time [DD] was satisfied with the steps taken by hospital staff that Ryan had been separated and placed into seclusion.
On Monday January 6, 2020, PC KLEMP received a voicemail from Dylan that [DD] had been transported to Victoria Hospital for life threatening injuries. At 2155 hours PC KLEMP attended Victoria Hospital and spoke with [DD] who advised him that his injured included a punctured lung, internal bleeding in his stomach, damage to his small intestine, multiple broken ribs, slight vision loss in his right eye and bruising. PC KLEMP took 7 photos of the injuries with the Sgt’s camera and obtained an audio statement from [DD]. At this time [DD] advised PC KLEMP that he would like charges laid against Ryan.
At 0503 hours on Tuesday January 7, 2020, PC KLEMP attended the Woodstock hospital mental health ward and issued Ryan a form 9 for Assault causing bodily harm.”
Criminal History
On September 18, 2012, Mr. Hare was convicted of careless use of a firearm, weapon, prohibited device or ammunition and received a $400 fine. On January 30, 2018, he was convicted of failing to provide a breath sample and received a $1000 fine and driving prohibition for one year.
Mr. Hare had several other criminal charges withdrawn over the years, including mischief (2007), assault causing bodily harm, possession of a weapon and uttering threats (2012), and following the index offence, theft (x3), possession of property obtained by crime (x2) and two counts of breach of undertaking (2022).
Personal Background/Psychiatric History
Mr. Hare’s personal background and psychiatric history are set out in detail in the Hospital Report filed as an exhibit at the hearing.
Briefly, Mr. Hare is a 47-year-old male born in London, Ontario. His mother had a career in nursing, while his father was a tobacco farmer. He has three older brothers. Mr. Hare was an athletic youth and involved in organized sports, including hockey. He experienced several concussions in his life both at an early age and as an adult.
Following high school. Mr. Hare received a Bachelor of Sciences Degree in Agriculture from the University of Guelph. He worked in farming “on and off” until 2018, when he lost his employment and Ontario Driver’s License for failing to provide a breath sample when required during a traffic stop.
Mr. Hare has been involved in two common law relationships. The first produced two daughters and ended in 2009. The second, lasted about 5 years and ended in 2016. Both of his daughters reside with their mother.
Mr. Hare has a longstanding history of substance use, including alcohol. Reports indicate he began using street drugs regularly in his late teens, such as cocaine and marijuana, and experienced a fentanyl overdose approximately 20 years ago.
Mr. Hare has been diagnosed with psychosis and substance-induced psychosis (attributed to significant alcohol and cannabis use) during several hospital admissions, both prior to and following the index offense. He has shown non-compliance with medication and has declined participation in substance use programming.
Between July 23 to 29, 2015, Mr. Hare had his first psychiatric admission. He was taken to Woodstock General Hospital (WGH) by police because of unusual behavior. He was acutely psychotic and eventually discharged himself against medical advice.
Between April 18 to 26, 2019, Mr. Hare was admitted to WGH due to suicidal ideation and an increase in auditory and visual hallucinations. His diagnosis included Alcohol Use Disorder and Alcohol-Induced Psychosis.
Between January 4 to 9, 2020, Mr. Hare was admitted to WGH with auditory hallucinations. He was brought in by police after he called them due to concerns for his own safety. Mr. Hare had stopped his medication and was using alcohol and cannabis regularly. He was acting in a bizarre manner and endorsed hearing voices, with a belief that people were out to get him. While he was in hospital, Mr. Hare committed the index offence, violently assaulting another patient which resulted in life threatening injuries.
Following the index offence, Mr. Hare had several hospital admissions, due to bizarre behaviour. He was paranoid, guarded, irritable/agitated, grandiose and narcissistic. This behaviour included that he was the supreme leader of Simcoe (SJHH-January 20220), showing up to people’s property demanding keys for their vehicles and having auditory hallucinations (Norfolk General Hospital-May 2020), threatening his mother with a knife (Muskoka Algonquin Healthcare-March 2021), and claiming he was a psychiatrist (Orillia Soldiers’ Memorial Hospital-March 2021).
Mr. Hare was found NCR on June 20, 2022. His initial ORB hearing was held on December 14, 2022, detaining him at SJHH. Mr. Hare is capable to consent to treatment and to manage his finances.
Current Diagnosis
- Mr. Hare is diagnosed with Schizophrenia, in partial remission and Cannabis and Alcohol Use Disorder, in remission in a controlled setting.
Evidence at the Hearing
The evidence was presented through the oral testimony of Dr. S. Prat, to supplement the evidence contained in the Hospital Report filed at the hearing. Dr. Prat has been Mr. Hare’s psychiatrist since May 2024.
Mr. Hare remains mentally stable and has not shown any symptoms of psychosis. Over the reporting year, all urine drug screens have been negative, he has been compliant with his medication regimen and has followed the rules of the treatment team.
Since October 2024, Mr. Hare has exercised his community privileges by spending six days a week living with his father and returning to hospital overnight between passes. His father reported no issues.
During the reporting year, Mr. Hare requested a transfer up north to be closer to his ailing mother. In December, he no longer wanted the transfer because his mother moved to Southern Ontario.
At the beginning of February 2025, Mr. Hare was discharged to live with his father, an approved person, in Teeterville, Ontario (Brantford area). Mr. Hare was knowledgeable in gardening and horticulture and would like to work with his father in this area.
Dr. Prat advised that the forensic outpatient team had many contacts with Mr. Hare’s father, who remains a good support for his son. He has a good understanding of his son’s mental health and need for treatment. Dr. Prat highlighted that Mr. Hare’s father understands the nature of his son’s illness, and that he would be able to identify signs of decompensation.
Dr. Prat advised that since Mr. Hares’ discharge to the community, he has asked to discontinue quetiapine, one of his two antipsychotic medications. The doctor advised this is concerning and speaks to his insight into the nature of his mental illness, which at present, is sub-optimal and remains limited. Mr. Hare is convinced that his symptoms will never come back but cannot provide a rationale for this statement.
Mr. Hare suffers from back pain. He was referred to a pain clinic but declined to attend. He is prescribed pain killer medication but remains convinced cannabis is the treatment for his pain. Mr. Hare has declined any substance programming and Dr. Prat believes Mr. Hare will always want to use cannabis.
Dr. Prat advised that he was against any cannabis use by Mr. Hare at this time. The doctor emphasized that cannabis would be a destabilizer. Dr. Prat highlighted that despite explaining this to him, Mr. Hare cannot appreciate the negative impact cannabis can have on his mental status. In this context, the doctor acknowledged Mr. Hare’s substance use preceding the index offence, as stated on page 3 of the Hospital Report:
“Days prior to the index offence Mr. Hare was admitted to the hospital on a Form 1 due to experiencing auditory hallucinations. He reportedly had stopped his medication approximately four months prior and he was using alcohol and cannabis regularly. Mr. Hare endorsed hearing voices and a belief that people were “out to get him”.
Dr. Prat elaborated on his concerns regarding cannabis use. In May 2024, Mr. Hare obtained two separate prescriptions for cannabis.1 Dr. Prat noted that one such prescription was for an exceedingly high dose of cannabis per day (16mg) and concentration of THC. Dr. Prat was also concerned how Mr. Hare would obtain his cannabis. In this regard, Mr. Hare informed the doctor that he could access a friend who has a license to grow cannabis. The doctor highlighted that this raised concerns about the quality and quantity of the cannabis consumed. Dr. Prat also advised that Mr. Hare’s father was against his son using cannabis.
Dr. Prat advised that Mr. Hare is currently in a transitional phase, and it is early days. When asked, the doctor stated that next year, if Mr. Hare remained stable with all other destabilizers controlled, and was adherent to his medication regimen, the cannabis issue can be revisited.
Dr. Prat advised that Mr. Hare represents a significant threat to the safety of the public. According to Dr. Prat, Mr. Hare’s risk factors included the nature of his illness, his limited insight, his recent request to discontinue one of his antipsychotic medications, the stress of his mother’s ill health, living a far distance from hospital, and his ongoing fixation on using cannabis. In this regard, Dr. Prat adopted the clinical risk assessment on pages 41-2 of the Hospital Report which stated:
“Mr. Hare continues to present with several risk factors including, the nature of his mental illness, his limited insight into it, and the fixation on using cannabis. In my clinical opinion he continues to meet the threshold for significant threat for public safety. Absent an ORB disposition, Mr. Hare will likely discontinue his medication, use cannabis with no ability to control the dose and frequency, and would become psychotic. We are at the early stage of his rehabilitation into the community.”
Although Mr. Hare’s father would contact the treatment team if there were indications of decompensation, Dr. Prat emphasized that decompensation could occur rapidly, potentially resulting in significant aggression, as observed in the index offence.
Dr. Prat did not support a Conditional Discharge Disposition. Mr. Hare only recently moved into the community and is still in a transitional period. If Mr. Hare developed psychotic symptoms, he would not appreciate the need for support or treatment and there would be the potential for violent behaviour, like in the index offence. The doctor highlighted Mr. Hare’s very serious and explosive index offence that took place quickly in hospital with staff in the vicinity. In this regard, the hospital needs the ability to return Mr. Hare quickly and given Dr. Prat sees Mr. Hare monthly, the criteria under the MHA would not be sufficient to manage the escalating risk. The doctor highlighted that Mr. Hare resides alone with his father, who is not as strong as his son. Dr. Prat emphasized that a Detention Order is required to ensure Mr. Hare’s mental stability and community safety.
No other evidence was presented at the hearing.
Final Submission of the Parties
Ms. Barney, on behalf of the Hospital, maintained her initial position. She submitted that Mr. Hare was recently discharged in the last month. He lives with his father and engages in activities around the home without a lot of other structure. She submitted that the hospital needs the ability to readmit Mr. Hare rapidly in the event of decompensation in his mental state or relapse into substance use. Ms. Barney submitted that because Dr. Prat sees Mr. Hare monthly, it would be difficult to meet the criteria for an admission under the parameters of the MHA. She further submitted that Mr. Hare’s history of alcohol and cannabis use were a factor when he became unwell, including at the time of the index offence. She highlighted that any cannabis use by Mr. Hare should not be considered an acceptable risk. In this regard, Ms. Barney submitted that the current clause 4(a) of the Mr. Hare’s Disposition be amended to read “abstain absolutely from alcohol and drugs, including cannabis”. This would make it abundantly clear that all cannabis use, including by prescription, was prohibited.
Ms. McKenzie, on behalf of the Attorney General of Ontario, submitted that the index offence was extremely violent occurring within a hospital setting with staff around. Mr. Hare’s discharge to his father’s residence is recent, somewhat isolated and a distance away from the hospital. She submitted there are potential stressors on the horizon, including the caregiving to his mother. Ms. McKenzie submitted that it is clear on the evidence that the MHA would be insufficient to manage the risk in the event of a rapid decompensation. Mr. Hare’s history suggests that cannabis and other substances represent a specific risk to his mental health and mental stability. Further, Mr. Hare has limited insight into his mental disorder and the potential effects of cannabis on his mental disorder. Mr. Hare’s recent request to discontinue his quetiapine antipsychotic medication is concerning. Ms. McKenzie submitted that a Detention Order, including an absolute prohibition against cannabis use, was both warranted and most appropriate at this juncture.
Mr. Chrolavicius, on behalf of Mr. Hare, submitted that Mr. Hare has no criminal record. At the time of the index offence, Mr. Hare was having a lot of difficulty and has since done extremely well with treatment. He has now been discharged to live in the community and has good family support. He submitted that Mr. Hare is asking to use cannabis recreationally to assist with his physical pain. Mr. Chrolavicius submitted that this should be permitted based on Mr. Hare’s supports in the community and the fact that his cannabis use can be appropriately moderated by the hospital, under a Board Disposition.
Mr. Chrolavicius submitted that a Conditional Discharge Disposition is an appropriate Disposition at this juncture. Mr. Hare could be brought back to hospital under the MHA should the need arise. In summary, Mr. Hare’s situation is now much different than at the time of the index offence. He is doing well and should be permitted, as is his wish, to use some cannabis while he continues to live in the community.
Analysis and Conclusion
The threshold issue for the Board to determine is whether Mr. Hare continues to represent a significant threat to the safety of the public. Based on the testimony of Dr. Prat and the evidence contained in the Hospital Report, filed as an exhibit, this Board finds Mr. Hare is a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code.
Mr. Hare is diagnosed with a major mental disorder and Cannabis and Alcohol Use Disorder, which is in remission in a controlled setting. He has a history of psychosis and substance induced psychosis and non-adherence to treatment. Notably, Mr. Hare’s explosive and very violent index offence took place in the controlled setting of a hospital.
Mr. Hare’s discharge is quite recent and early days. His ongoing risk factors include his major mental disorder and limited insight into this illness, stressors of community living, including the potential need to care for his mother, his ongoing desire to use cannabis and his recent request to discontinue his quetiapine antipsychotic medication. In this regard, it is important the hospital proceed in a careful and cautious manner to manage Mr. Hare’s significant risk. As stated in the Hospital Report, absent a Board Disposition, Mr. Hare will likely discontinue his medication, use cannabis with no ability to control the dose and frequency, and become psychotic leading to potential violence in the community.
Having found Mr. Hare represents a significant threat to the safety of the public, this Board finds that a Conditional Discharge Disposition is inappropriate and premature at this juncture to manage this risk. As stated by Dr. Prat, whose evidence we accept, exacerbation of Mr. Hare’s symptoms, in the event of a decompensation in his mental state or relapse into substance use, could occur quite quickly leading to significant aggression, as it did in the index offence. Although symptoms may be recognized by his father, given Mr. Harte’s potential explosive behaviour, the hospital needs the ability to readmit Mr. Hare rapidly under a Detention Disposition. In this regard, the specific parameters of the MHA would not suffice to manage the risk, particularly given Dr. Prat sees Mr. Hare only monthly.
Mr. Hare is determined to use cannabis recreationally to treat his back pain and has refused to attend a pain clinic. This Board notes that in the days leading up to the index offence, Mr. Hare, who had been off his medication for some time, was regularly using alcohol and cannabis. This Board does not support Mr. Hare using cannabis. The evidence of Dr. Prat, which we accept, is that cannabis can have a destabilizing and negative effect on Mr. Hare’s mental state with the potential of leading to violence. Mr. Hare does not seem to fully appreciate the potential negative impact cannabis can have on his mental state and the risk such use poses to the community. In this regard, Mr. Hare’s previous prescription for an exceedingly high amount of cannabis per day (16g) and high concentration of THC, and his intention to purchase cannabis from a friend with a growing license, raises concerns about the quality and quantity of cannabis he would consume. Notably, Mr. Hare’s father, with whom he currently resides, is against his son using cannabis.
It may be that over the next year, should Mr. Hare remain consistently mentally stable, adhere fully to his medication regime, improve his insight into substance use, and continue to engage with his forensic outpatient team, the cannabis issue may be revisited.
On a positive note, over the reporting year, Mr. Hare has had no inappropriate or untoward behaviour either in hospital or while out in the community. He has exercised his privileges appropriately, been adherent to his medication regimen, all urine drug screens have been negative, and he follows the rules of his treatment team. Mr. Hare also enjoys the support of his family, particularly his father with whom he resides.
For all these reasons, the Board finds that the necessary and appropriate Disposition in the circumstances is a continuation of the current Detention Disposition with an amendment to clause 4(a) to read “abstain absolutely from the use of alcohol and cannabis or any illicit substances”. This Board wishes Mr. Hare well as he moves forward on a positive trajectory.
In reaching our decision, the Board has considered the safety of the public, Mr. Hare’s mental condition, his reintegration into society, and his other needs.
DATED this 9th day of April 2025, at the City of Toronto, in the Toronto Region.
Mr. C. Flanagan
Legal Member
Office of the Registrar
Ontario Review Board