Re: Gregory Cane, 2025 CanLII 33825

Ontario Review Board

Re: Gregory Cane

ORB File No: 8467

Hearing held on: Thursday, March 6, 2025

Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas

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

Before:

Alternate Chairperson: Mr. J. Weinstein Members: Dr. R.D. Chandrasena Dr. B. Sheppard Ms. K. Tomaszewski Ms. C. Plyley

Parties Appearing:

Accused: Gregory Cane Counsel: Ms. N.C. Circelli

The person in charge of hospital: Counsel: Ms. J. Zamprogna

Attorney General of Ontario: Counsel: Ms. K. Dalrymple

REASONS FOR DISPOSITION

(Dated April 14, 2025)

Introduction:

1. On December 18, 2023, Mr. Gregory Cane was found not criminally responsible on account of mental disorder, on a charge of manslaughter, contrary to the Criminal Code of Canada (“Criminal Code”).

2. Mr. Cane is subject to a Disposition of the Ontario Review Board (the “Board”), dated March 25, 2024, which orders that he be detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London (“Southwest”).

3. On March 6, 2025, the Board convened a hearing at Southwest to conduct the annual review of the current Disposition.

4. Mr. Cane was present at the hearing and was represented by his counsel, Ms. Circelli. Mr. Cane’s also attended.

5. A Hospital Report, dated January 16, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. The issue at this hearing is whether Mr. Cane is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate Disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

7. For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that Mr. Cane continues to present a significant threat to the safety of the public. The Board ordered that the necessary and appropriate Disposition in the circumstances is the continuation of the Detention Order, with the changes agreed to by all the parties, as set out in our formal Disposition.

Current Psychiatric Diagnoses:

8. Schizophrenia

Alcohol Use Disorder, in sustained remission in a controlled environment

Cannabis Use Disorder, in sustained remission in a controlled environment

Obsessive Compulsive Traits

Index Offence:

9. The circumstances giving rise to the Index Offence are extracted from last year’s Board Reasons, as follows:

“So, if I could, the accused in this case is Mr. Gregory Cane. He was 38 at the time. The victim in this case is Steven Hutchinson, who was 66 years of age at the time. They were friends at the time of this incident.

On January 31st, 2022, the victim was at home with his common law partner, Deborah McKay, at their residence 12 Springbank Drive in the City of London. Deborah left the house at 10:09 a.m. to go to the gym. The victim remained at home and began to make his breakfast.

At 10:16 a.m. a black Chevrolet Cruze, plated ARVF 114 attends 12 Springbank Drive and parks in the driveway and a lone male is seen exiting the vehicle. This vehicle is registered to the accused.

The victim and the accused get into some form of confrontation in the driveway near the rear of the house closest to the detached garage. During this altercation, the accused stabs the victim at least ten times between the chest, neck and back of the victim. Two of the stab wounds pierced the victim’s heart and another the neck of the victim. The victim collapsed in the driveway due to his injuries. A knife was left at the scene.

The accused then left the residence in his vehicle at 10:20 a.m. and the victim remained laying in the driveway suffering from his injuries until he was found at 11:40 a.m. when Deborah returned home from the gym. London Police, Paramedics and London Fire were all called to the scene to attend. The victim was transported to Victoria Hospital with life threatening injuries. At 12:18 p.m. the victim was pronounced dead by Dr. Parry,

London Police conducted a neighbourhood canvass where witnesses advised that a black car came by the house. This was confirmed by the accused’s vehicle on video, and at 10:50 p.m. Detective Constable Robertson attended the residence of the accused and conducted a door knock. Of note, the Chevrolet Cruze belonging to the accused was in the driveway. The accused answered the door and was arrested for murder. He was provided with his rights to counsel and caution which he understood. Police noted an odour of alcohol on the accused.

He was transported to London Police headquarters detention unit where he was paraded in front of Sergeant O’Brien at 11:21 p.m. The accused’s identity was confirmed via his Ministry of Transportation picture and verbally. Incident to arrest was completed on the accused and he was found to have some injuries, three cuts to the inside of his right hand.

Police the executed a search warrant at the accused’s home at 1381 Corley Drive, … in London. Items of interest were seized and swabbed including a pair of brown hiking boots which appeared to be wet or stained with blood, swabs of apparent blood from the bathroom sink and drain, seizure of a towel on the back of the bathroom door in the upstairs bathroom which appeared to have blood on it.

Police also observed several cans of beer on the kitchen counter.

Police also executed a search warrant on the accused’s Chevrolet Cruze that was located in the driveway of the accused’s residence, and they located blood on the gear shift, the steering wheel and on the inside and outside of the door. There was also a piece of clear plastic on the driver’s floor covered in blood.

Swabs of several of the samples were sent to the Centre of Forensic Sciences for comparison to the victim’s DNA. The victim’s blood could not be excluded from the gear shift of the Chevrolet Cruze and to an area of the right boot seized at the accused’s residence. The accused’s DNA was also found as a contributor from the swab of the knife found at the scene.

Police interviewed multiple witnesses to determine if there was any apparent motive for the murder. Witnesses that were interviewed included the family, friends and neighbours of the victim, as well as the accused’s family, co-workers and friends. The police could not determine any credible motive for the actions of the accused. Nothing was found on the accused’s or victim’s cell phone extraction reports to suggest any pre-existing argument or tension between the two.

The accused’s family members confirmed that the accused had pre-existing mental health issues that had been generally managed and non-violent. A cell phone extraction from the accused’s cell phone revealed text messages in January 2022 from the accused complaining of vertigo and paranoia, and further indicating that he had not been taking his medication, and that he was discussing the risks of being psychotic with family.

As a result of the investigation, Mr. Cane was charged with murder contrary to s. 235(1) of the Criminal Code of Canada.”

Criminal Record, Prior Psychiatric History, Substance Use History and Personal History:

10. Mr. Cane’s criminal history, prior psychiatric history, substance use history and personal history are outlined in the Hospital Report, and they are accurately summarized in last year’s Reasons:

“Mr. Cane did not have a criminal record prior to the index offence.

Mr. Cane’s prior history is set out in extensive detail in the reports of Dr. Ramshaw, Dr. Klassen and Dr. Quinn, and will not be repeated in these Reasons. Between 2007 and 2012, Mr. Cane had a number of contacts with the Centre for Addiction and Mental Health (“CAMH”) in Toronto. He was admitted for several weeks in January 2007. Following his discharge Mr. Cane was followed in the Community Outpatient Program. The diagnosis was major depressive disorder with psychotic features. Mr. Cane had further contact with the London Health Sciences Centre (“LHSC”) starting in 2013. In early January 2014, he was admitted to the hospital under the Mental Health Act (“MHA”) for approximately three weeks. His discharge diagnosis was “psychosis not otherwise specified.” Mr. Cane’s care was then transferred to St. Joseph's Healthcare where he was again followed in the community until his last contact with the team on January 19, 2022. Mr. Cane’s last evaluation by a psychiatrist was October of 2021. The diagnosis at that time was “major depressive disorder with residual anxiety symptoms.”

As set out in the Hospital Report, Mr. Cane has a long history of substance use and abuse commencing at the age of 12. His substance of choice was alcohol and he reported having experienced “lots” of blackouts. He acknowledged that alcohol had interfered with his work. Mr. Cane also acknowledged using “lots” of cannabis commencing at age 14.

As above, Mr. Cane's personal history is set out in detail in the reports which were filed as exhibits. Mr. Cane's parents reside together. He acknowledges having a good relationship with both of them. He has two siblings, a younger and an older brother and describes a good relationship with both of them. Mr. Cane graduated from high school and attended Georgian College where he took Golf Course Management for three years. He completed that program of study and then attended the University of Toronto in General Arts but did not complete his first year. Most of Mr. Cane’s work history involves working at golf courses either in maintenance or as an assistant professional in the shop. While working together at a golf course Mr. Cane became friends with the deceased, Mr. Hutchinson. They remained in contact after Mr. Cane left the course. In 2017, Mr. Cane began working at Loblaws where he remained until his arrest. Mr. Cane has never married nor lived in a common-law relationship.”

Position of the Parties:

11. Counsel for the hospital, the Attorney General and Mr. Cane advised that this was a joint submission: all were adopting the hospital’s recommendation of a continuation of the Detention Order Disposition, with the changes recommended in the Hospital Report and set out in our formal Disposition. Changes include the privilege to enter into the community of Elgin and Middlesex Counties, indirectly supervised, as well as passes for up to 72 hours, up to six times per year, in Elgin and Middlesex Counties.

12. For the purposes of this hearing, counsel for Mr. Cane advised that significant threat was not in dispute.

Course Since Last Disposition:

13. Mr. Cane’s course since his last Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:

“Mr. Cane was transferred from the Assessment Unit A3 to the Treatment Unit North A2 on March 27, 2024, and his care was subsequently transferred to Dr. Naghmeh Mokhber. Although he continues to reside on the Treatment Unit A2, his care was transferred to Dr. Ashley Malka on December 6, 2024, as she is the new attending physician for the unit.

Since Mr. Cane’s last ORB hearing, he continued to experience residual symptoms of his illness such as paranoia, auditory hallucinations, delusions, anxiety, and obsessive thinking.

Mr. Cane has been actively working to expand his coping strategies through participation in various psycho-therapeutic group programs including Dialectical Behavioural Therapy (DBT), Distress Tolerance, and Cognitive Behavioural Therapy for psychosis (CBTp).

Mr. Cane also started to attend the Concurrent Disorders group.

On October 20, 2024, Mr. Cane went on a pass to his parents' home.

Mr. Cane also visited his parent’s home on December 20, 2024. Both passes were reported to have gone well.”

Evidence at the Hearing:

14. The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Malka. Dr. Malka co-authored the Hospital Report, and she testified as follows:

a) She has been Mr. Cane’s attending psychiatrist since December 9, 2024, and she adopts the contents of the Hospital Report.

b) As a result of recent changes to Mr. Cane’s medication regimen, the treatment team has seen improvement in his anxiety level.

c) Mr. Cane has also become more forthcoming with the treatment team with respect to his symptoms, and he has been able to question the validity of some of his delusions, on a regular basis.

d) As set out on page 1 of the Hospital Report, he does suffer from obsessive compulsive traits. They are noticing on the unit that Mr. Cane does adhere to very strict routines, such as drinking coffee at the exact same time and weighing himself daily. Mr. Cane engaged in similar obsessive-compulsive behaviour leading up to the Index Offence.

e) Mr. Cane’s insight into his diagnosis and his symptoms is developing.

f) The treatment team has seen an improvement in Mr. Cane, in response to a change to his antidepressant medication, which is used to treat his OCD.

g) Mr. Cane has been accepting the treatment team’s recommendations for changes in his medication regimen; however, he is resisting their attempts to trial him on clozapine at this time.

h) Mr. Cane has participated in recommended therapies, such as DBT and CBT for psychosis, which have been very helpful. He has also been engaged in the Concurrent Disorders program.

i) Since the time of the Index Offence, Mr. Cane has not used any substances.

j) Cannabis does exacerbate Mr. Cane’s psychosis and paranoia, as does alcohol.

k) Mr. Cane’s insight into his need to abstain from substances could be described as “developing.” It is positive that he has participated in the Concurrent Disorders group, which deals with substance abuse issues.

l) She adopts the treatment team’s findings of Mr. Cane being a significant threat, for the reasons set out on pages 39 and 40 of the Hospital Report.

m) Mr. Cane is currently using Level 5 privileges: full access to the hospital and grounds, three times a day, indirectly supervised.

n) Mr. Cane has used his approved passes, and they have gone very well. His parents are approved persons and are a very good support. Mr. Cane also receives strong support from his brothers, with whom he stays in contact.

o) Passes are being recommended as additions to Mr. Cane’s current Disposition in anticipation of his transfer to the rehabilitation unit from the treatment unit. When the time arises, these passes, including indirectly supervised passes into Elgin and Middlesex Counties, will allow the treatment team to assess how Mr. Cane handles his transition into the community. They will evaluate whether he can handle the stress of being in the community and remain abstinent from substances.

p) Going forward, the treatment team hopes that Mr. Cane will engage in therapies to target his OCD symptoms.

q) She would describe Mr. Cane as being very polite and kind to other patients on the unit. He has increased his insight into his illness, and he is more forthcoming, and less guarded, with the staff, all of which is very positive.

r) The following paragraph from last year’s Reasons for Disposition is still true today:

“The parties also jointly submitted that the necessary and appropriate Disposition was a Detention Order with conditions. There would be no “air of reality” to considering a Conditional Discharge for Mr. Cane at this time. He has only very recently come into the care of the hospital and his treatment is in the very early stages of development. Although he has the support of his family, Mr. Cane has little else by the way of community support. He would have no place to reside if discharged into the community at this time. Once again, the Board has no hesitation in accepting the joint submission of the parties.”

15. In response to questions from counsel for Mr. Cane, Dr. Malka testified:

a) To Mr. Cane’s credit, he was able to resist a craving for alcohol while he was at his home; he continued to abstain, and he shared his thoughts with the treatment team. All of Mr. Cane’s passes with his parents, whether in the community or at their residence, have gone well.

b) Mr. Cane continues to suffer from positive symptoms of his major mental illness.

c) There have been no reported incidents of aggression or violence, towards co-patients or staff, during this reporting period.

16. In response to questions from the panel, Dr. Malka testified:

a) Before the treatment team could recommend that Mr. Cane be transferred from the treatment unit to the rehabilitation unit, they would need to see further improvement in the positive symptoms of his major mental illness, as well as increased willingness to disclose his symptoms and thoughts to them.

17. No other evidence was called.

Analysis and Conclusions:

18. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: Mr. Cane remains a significant threat to the safety of the public.

19. In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Malka, in addition to the documentary evidence before us.

20. Mr. Cane is still suffering from positive symptoms of his major mental illness, and his insight across all domains is still developing.

21. In particular, the Board relies on the Re-Offence Scenario and the Overall Clinical Assessment of Risk, set out in the Hospital Report:

“Re-Offence Scenario:

Absent forensic supervision and support and the highly structured environment of the hospital, Mr. Cane would experience significant stress, which he would likely use substances to cope with. It is not clear where he would live at this juncture, further compounding his stress. He already experiences symptoms, including referential and persecutory delusions, similar to what he described experiencing at the time of the index offence. Stress and substance use would lead to a further exacerbation of symptoms, given his already compromised mental state. He would be at significant risk for responding to his symptoms with violence, as in the index offence.

Overall Clinical Assessment of Risk

It is the opinion of the treatment team that Mr. Cane continues to pose a risk of serious physical or psychological harm to members of the public. The following evidence supports this opinion:

1. Mr. Cane has been diagnosed with a major mental illness, namely schizophrenia. He continues to experience residual symptoms including auditory hallucinations and referential and persecutory delusions, which were present at the time of the index offence and lead to catastrophic violence. These symptoms are connected to his ongoing violence risk;

2. Mr. Cane has demonstrated affective and behavioural instability, specifically ongoing anxiety and restlessness which has required the use of PRN medication and staff reassurance and support;

3. Mr. Cane’s insight into his illness, need for treatment, and risk for violence remains underdeveloped. He remains guarded at times when discussing his symptoms and the treatment team continues to believe that he engages in positive impression management;

4. Mr. Cane has a history of non-adherence to treatment recommendations and has been mostly resistant to medication changes this review year. His medications are not yet optimized;

5. Mr. Cane has a history of substance use and has not completed any treatment programs. He is in the early stages of the Concurrent Disorders group and has not been tested with less supervision;

6. Although Mr. Cane’s ability to cope with stress has improved, he continues to rely on staff support and reassurance. It is unknown how he will manage with less supervision and more access to substances. Historically, he coped with stress by using substances;

7. Although Mr. Cane has good support from his family, historically they have been unable to manage his illness and have not been able to mitigate his level of risk; and

8. Mr. Cane has minimal professional support. He has been connected to community based mental health teams in the past but was not forthcoming with the symptoms that he experienced.”

9. The treatment team is recommending the addition of short-duration overnight passes with Mr. Cane’s parents, who are approved persons; as his parents have advised that they would be comfortable with such passes. The passes would help with his reintegration and other needs.

10. In light of the Board finding of significant threat, it is charged with shaping a Disposition for the coming year. The Board relies on paragraph 22 from last year’s Reasons, as well as the following paragraph from the Hospital Report:

“Mr. Cane continues to require a detention disposition to provide him with the supervision, monitoring and support that is necessary. A conditional discharge was considered unrealistic as he continues to be impacted by symptoms similar to those at the time of the index offence, which lead to catastrophic violence. His insight into his illness, need for treatment and risk for violence remains underdeveloped. He has been largely resistant to medication changes this review year and his medications are not yet optimized. The Mental Health Act would not be sufficient to promote public safety because it is reactive, rather than preventive.”

24. In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Cane, his reintegration into society and his other needs, the necessary and appropriate Disposition is a Detention Order, upon the terms set out in our formal Disposition.

DATED this 14^th day of April 2025, at the City of Toronto, in the Region of Toronto.

Mr. J. Weinstein

Alternate Chairperson

Office of the Registrar

Ontario Review Board