Ontario Review Board
Re: Brett Smith
ORB File No: 7855
Hearing held on: Tuesday, March 25, 2025
Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M.D. Segal Members: Dr. B. Sheppard Dr. G. Stones Mr. K. McKenna Mr. A. Mete
Parties Appearing:
Accused: Brett Smith Counsel: Mr. R. Brooks
The person in charge of hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Mr. I. Shaikh
REASONS FOR DISPOSITION
(Dated April 28, 2025)
Introduction
Brett Smith, age 46, was found not criminally responsible on account of mental disorder on a charge of second-degree murder, contrary to the Criminal Code, on February 24, 2021.
On March 25, 2025, Mr. Smith appeared for his annual review from St. Joseph's Healthcare Hamilton (the “hospital”) before the Ontario Review Board (the “Board”). He is currently subject to a Detention Order with privileges up to living in the community of Hamilton in approved accommodation.
The panel had before it as Exhibit 1 a Hospital Report dated March 10, 2025. It also had before it the most recent Disposition, most recent Reasons for Disposition, and a Victim Impact Statement.
In preliminary positions, all parties advanced the continuation of the current Disposition with one change to allow for travel passes up to seven days, indirectly supervised, within the Province of Ontario. Following the hearing, the panel agreed with the joint submission.
Index Offence
- The circumstances of the index offences are taken from last year’s Reasons for Disposition, as follows:
“On August 25, 2019, police received a telephone call from the Accused's mother in which she stated that she and her husband, that is the Accused's father, had returned to their apartment home and found the Accused lying on his bed. Shortly afterwards she heard a disturbance and her husband yelling for her to call 911. When she came to her husband's aid, she saw the Accused with a knife in his hand and her husband bleeding. She then phoned 911 and ran out of the apartment and informed the 911 operator that the Accused had a knife and a crossbow and that he had stabbed her husband. The police arrived and took control of the Accused without incident, arresting him on the charge of assault with a weapon. This charge was upgraded to murder following information received that the victim had been pronounced dead.”
Background
The Hospital Report contains information about Mr. Smith’s background and psychiatric history and need not be reviewed here beyond the following highlights. Mr. Smith is a 46-year-old man who was born and raised in Mississauga, Ontario. He had a stable childhood. After graduating from high school, Mr. Smith struggled to maintain employment. He resided with his parents for the most part. He moved into an independent apartment for a period of seven months but had to return to his parents’ home when his mental health deteriorated.
According to the Hospital Report, in 2015 Mr. Smith was admitted to hospital with “symptoms indicative of psychosis” and was started on medication with good effect. He was discharged with a diagnosis of schizoaffective disorder. Unfortunately, he discontinued psychiatric follow up and became non-compliant with his medication. He began to rely on alcohol and cannabis to try to drown out distressing auditory hallucinations and to manage his symptoms.
Since his finding of NCR, Mr. Smith has been compliant with treatment. He has been polite and cooperative with staff and there have been no notable incidents.
Diagnoses
- Mr. Smith’s current diagnoses are:
Schizoaffective Disorder – Depressive Type
Cannabis Use Disorder - in remission in a controlled environment
Alcohol Use Disorder - in remission in a controlled environment
Evidence at Hearing
Dr. S. Baldeo, the patient’s psychiatrist, testified. It has been another positive year. Liberal passes have been used appropriately. Mr. Smith often goes into the community for up to six hours. There have been no major incidents. Mr. Smith is adherent to treatment and medication. He takes two antipsychotics which are long acting, and an antidepressant.
There have been no symptoms of psychosis or depression this past year. Mr. Smith’s mental health has been stable. Mr. Smith denies cravings for substances, an important feature given his history. Mr. Smith has received substantive treatment. He has participated in CBT for psychosis and DBT. He is now in a new group focusing on healing and forgiveness that is directed at individuals who have committed violent index offences. He is doing well in the new group.
Mr. Smith is on a waitlist for community living. If an opening appeared, he would be ready for discharge.
A Detention Order assists in smoothing the transition to community living.
In the upcoming year, the hospital will continue to encourage vocational activity, as it has for some years. Mr. Smith has grade 12. The hospital is of the view and has told Mr. Smith that a job may assist in expediting housing availability. Mr. Smith has a great amount of unstructured time at present.
He is at low risk for violence under a Detention Order.
The index offence was preceded by non-adherence to medication and significant substance abuse, both alcohol and non-prescription drugs.
The hospital continues to require a Detention Order to quickly bring Mr. Smith into hospital if he starts to decompensate. That may be prompted by stressors, non-adherence to medication, and/or a substance relapse.
Mr. Smith has some insight, but more work needs to be done in that regard.
When Mr. Smith was admitted to hospital, he was disorganized and very unkempt but has taken direction and those areas are improving.
While he may not require 24-hour supervised housing, he will need supportive housing to assist with medication administration.
The purpose of the requested travel passes is to allow for hospital-sponsored outings.
Analysis
The Board was presented with a joint submission. The submission is sensible. Mr. Smith has enjoyed a good year. The index offences were extremely serious. The hospital is employing a cautious approach in readying Mr. Smith for a possible transition into community living. There remain concerns that prompt the hospital to wish to have the ability to quickly hospitalize in the event of deterioration. Ongoing concerns relate to non-adherence to medication and treatment, substance relapse and stressors. Mr. Smith’s illness is serious - schizoaffective disorder - depressive type with cannabis use disorder and alcohol use disorder, both in remission in a controlled environment.
The purpose of adding passes is to facilitate activities under the Forensic Program, a laudable goal. Continuing to encourage Mr. Smith to take employment, even part-time employment, is desirable. It will address the free time Mr. Smith has, enhance protective measures, and potentially assist with community placement. We wish Mr. Smith well.
DATED this 28th day of April 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
Office of the Registrar Ontario Review Board