Ontario Review Board
Re: Minh Tran
ORB File No: 7746
Hearing held on: Thursday, April 3, 2025
Place of hearing: Waypoint Centre for Mental Health Care 500 Church Street, Penetanguishene
Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code
Before: Alternate Chairperson: Mr. M. D. Segal Members: Dr. K. Hand Dr. G. Kerry Ms. M. Chamberlain Mr. J. Cyr
Parties Appearing: Accused: Minh Tran Counsel: Ms. C. E. Currie
The person in charge of hospital: Counsel: Mr. J. Thomson
Attorney General of Ontario: Counsel: Ms. J. Armenise
REASONS FOR DECISION AND DISPOSITION
(Dated May 7, 2025)
On June 23, 2020, Minh Tran was found not criminally responsible on account of mental disorder on charges of attempted murder, aggravated assault, assault with a weapon, possession of weapon for dangerous purpose, and failure to comply with probation order (x2), all contrary to the Criminal Code of Canada (the "Criminal Code").
Mr. Tran is subject to a Decision and Disposition of the Ontario Review Board (the "Board") dated April 17, 2024, which orders that he be detained at the Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Programs, Penetanguishene ("Waypoint" or the "Hospital"), with hospital grounds privileges, beyond the secure perimeter, escorted by staff.
On Thursday, April 3, 2025, the Ontario Review Board convened a hearing at Waypoint pursuant to ss. 672.81(1) and 672.81(2.1) of the Criminal Code. Mr. Tran was in attendance and was represented by his counsel, Ms. Currie.
Position of the Parties
Mr. Thomson, on behalf of the Hospital, submitted that the restriction of liberty was the least onerous and least restrictive manner to deal with Mr. Tran's behaviours. The Hospital also took the position that Mr. Tran remained a significant threat to the safety of the public and recommended that the Board make no change to his current Disposition. This position was supported by Ms. Armenise, on behalf of the Attorney General.
Ms. Currie agreed that the seclusion was warranted. Her client was not arguing the issue of significant threat and accepted the Hospital's position regarding the Disposition. She stated that she felt it would be helpful if the Hospital could highlight what Mr. Tran needed to do in the coming year.
All parties maintained their respective positions at the conclusion of the hearing.
Background and Index Offences:
Mr. Tran's personal background and history are set out in detail in the Hospital Report and need not be repeated at length here. Briefly summarized, Mr. Tran was 34 years old at the time of the hearing. He was born in Waterloo and is one of three siblings of parents who immigrated to Canada in 1989. At the time, Mr. Tran's parents had lived in a refugee camp in Indonesia for several years. Although his parents separated after their arrival in Canada, they remained very supportive of Mr. Tran.
Mr. Tran's behavioural problems began in his teens. He was expelled from secondary school after a "gang assault". He completed grade 12 at a Youthdale Treatment Centre where he spent a year in 2008. He eventually managed to complete his high school credits through an adult learning program.
Mr. Tran has a limited employment history and has been supported by the Ontario Disability Support Program for several years.
In addition to significant alcohol use, Mr. Tran reported a history of using heroin, ketamine and marijuana. The Hospital Report indicates that Mr. Tran stated that he used ketamine daily since his teens until he was placed in hospital.
Mr. Tran's current psychiatric diagnoses consist of the following:
Schizophrenia
Substance Use Disorder, in sustained remission in a controlled environment
Antisocial Personality Disorder
- The circumstances of the index offences are taken from last year's Reasons for Decision and Disposition, as follows:
"On September 14, 2017, the victim and a neighbour were walking on Driftwood Avenue in Toronto. Mr. Tran approached them and began stabbing the victim multiple times in the head and body. Despite attempts by witnesses to intervene, Mr. Tran persisted, ignoring their efforts. The assault, captured on cellphone video, lasted approximately four minutes until police arrived. An officer then shot Mr. Tran, ending the attack.
The victim sustained severe injuries, including ten stab wounds to his face and head, a three-inch laceration on his left hand, and a sternum wound. Mr. Tran and the victim were not acquainted, and the victim had no prior recollection of him. Police recovered a broken stainless steel kitchen knife with a six-inch blade.
At the time of the index offences, Mr. Tran had been previously convicted in April 2017 of assault bodily harm and assault peace officer. He received a suspended sentence and was subject to a 36-month Probation Order, which included conditions to 'keep the peace' and refrain from possessing any weapons."
Evidence at Hearing:
The evidence at the hearing consisted of the Hospital Report dated February 14, 2025, as well as the testimony of Dr. Mishra.
Mr. Thompson called Dr. Mishra to give evidence on behalf of the hospital with respect to the Restriction of Liberty, Significant Threat and Disposition. The doctor stated that he had reviewed the Hospital Report and was in agreement with its contents and recommendations.
Annual Review:
- Mr. Tran's progress since his last annual review is summarized in the Hospital Report as follows:
"Mr. Tran remained an inpatient on the Beckwith A program for the entirety of the year. The course of his illness fluctuated throughout the year and he endured 5 periods of seclusion in the reporting year; the most recent of these was from January 5 to February 14, 2025.
Mr. Tran participated in various leisure activities throughout the course of the year. He was an active participant in recreational groups. He maintained regular contact with his family, and appreciated their support. Mr. Tran enjoyed increasing levels of privilege to go off the unit and was unaccompanied over the latter half of 2024. On a positive note, on November 5, 2024, he began attending vocational services in the greenhouse program, 2 days/week. Reports of his engagement and attendance at work were uniformly positive without any absences. He enjoyed it and looked forward to attending there. He was able to work safely and effectively with a variety of garden tools. His motivation to participate in work had a positive impact on his overall presentation on the unit including personal hygiene."
Dr. Mishra informed the Board that Mr. Tran had had a relatively good reporting period despite the seclusion that occurred earlier this year. The Hospital made a change to Mr. Tran's medication last year which seems to have made a bit of a difference. He is now on oral as well as injectable medications and has experienced an overall reduction in psychosis. There is no plan to change his current medication regimen as he is tolerating it quite well.
Currently, Mr. Tran is living in the Hospital's Beckwith A unit. He wants to move forward towards the Beausoleil unit. In order to do this, he would need to remain out of seclusion for 5 to 6 months and then could transfer when a bed became available. Beausoleil is not much different from his current unit but a move would be a source of positive reinforcement which would hopefully serve as a motivator for continued progress.
Mr. Tran also works in the greenhouse program. He enjoys this program and is well regarded there. He is also taking better care of his clothing and appearance.
Dr. Mishra stated that Mr. Tran does have some insight into his illness but that it fluctuates. He understands that he likely would not have engaged in the index offences if he had been medicated if he had been medicated and in a structured and supportive environment.
Dr. Mishra felt that the incident in January was not as a result of psychosis. The doctor noted that Mr. Tran wants to move forward but gets anxious. When things are going well and he is moving forward, he sabotages himself.
Mr. Tran re-established contact with his family over the past year and has two FaceTime calls each week with his mother and sister which he enjoys. He is also re-connecting with his brother. Mr. Tran is engaging with a group CBT skill development program. He had previously avoided therapeutic treatment and Dr. Mishra felt that this was another improvement during the past reporting period. The doctor felt that this could also lead to one-to-one therapy if Mr. Tran was willing. The Hospital would like to see Mr. Tran engage in psychotherapy in the coming year and feels that he would be in a better position at next year's annual review if he were to participate in this kind of therapy.
Mr. Tran's long-term goal is to be transferred back to CAMH so that he can be closer to his family. His short-term goal is to make himself suitable for a transfer.
Restriction of Liberty:
- The Hospital Report describes Mr. Tran's restriction of liberty as follows:
"On January 5, 2025, seclusion was initiated. Staff documented Mr. Tran was sitting in the lounge watching television with co-patients when he suddenly got up from his chair and spat in both co-patients' faces. Staff intervened and he was redirected to his room. The duty doctor was contacted and a seclusion order obtained.
Mr. Tran was assessed and provided with seclusion relief near daily. There were several instances where he refused seclusion relief or was inappropriate due to an unstable mental status. There were also some instances where seclusion relief could not be offered due to operational needs. During relief periods, Mr. Tran engaged in activities such as showering, watching television, and utilizing the phone. As per his Crisis Prevention Plan (CPP), Mr. Tran was required to progress through a 3-step de-restraint process to mitigate his risk.
On February 14, 2025, the charge nurse approached Mr. Tran about his readiness for the discontinuation of seclusion. He endorsed a desire to reintegrate into the ward milieu. He denied having any thoughts or desire to harm others, including denial of any urge to spit or hit staff or co-patients. Mr. Tran presented as calm and cooperative throughout the interaction. His thought process was organized and goal-directed. He did not perseverate or voice negative feelings or violent ideation and there was no evidence of paranoid or persecutory delusions. That afternoon, Mr. Tran came out for seclusion relief and followed direction without issue. A team decision was made to discontinue the seclusion."
Dr. Mishra noted that Mr. Tran experienced anxiety about being released from seclusion. He continues to have concerns about re-offending in the community and is also concerned about retribution of the index offence.
Dr. Mishra informed the Board that Mr. Tran has exhibited no aggression since his seclusion ended.
In response to questions from the Board, Dr. Mishra agreed that Mr. Tran's violent behaviour is driven more by personality traits than psychosis. Mr. Tran will engage in hitting or punching someone, choosing a vulnerable victim. Mr. Tran says that he does this as he wants to make a point. He does not feel remorse for this behaviour and does not say the voices told him to do it.
Findings of the Board:
Restriction of Liberty:
The analytical framework established by Campbell (Re), 2018 ONCA requires the Board to consider the liberty norm and the liberty status of an accused on a restriction. The liberty norm and liberty status for each restriction must be examined to determine the significance of the increase (if any) on the restriction of an accused's liberty caused by the restriction. In determining the liberty norm of an accused at the outset of each period of restriction, the Board must "take a contextual approach, one that considers the individual's pattern of liberty in the recent past" ((Re) Campbell, para. 66). The liberty she/he was actually experiencing (rather than what she/he was entitled to) at the time of the increase is what the Board is to consider, and that "liberty must be of sufficient duration to have become, objectively speaking, the NCR accused's norm" ((Re) Campbell, para. 65).
The test to be applied to significant increases in the restriction of liberty is the same as is required for dispositions, that is, whether the significant increase is necessary and appropriate to protect the safety of the public.
Prior to his seclusion, Mr. Tran had been residing in the general population of the Beckwith A unit at Waypoint. Mr. Tran's security level was a C4 meaning that his privileges included on-unit access, where he could attend the lounge areas, corridors, dining room, courtyard and socialize with co-patients at his discretion, and independent off-unit access, where he could attend the recreation centre and canteen. for a prescribed period.
For this reason, the Board finds that at the time of his seclusion, Mr. Tran's liberty norm was level C4 privileges. Once in seclusion, Mr. Tran did not have the ability to leave the seclusion room unless seclusion relief was offered to him and only then in the company of the seclusion relief staff. The Board finds that the inability to leave the seclusion room at will represents a significant increase in the restrictions on Mr. Tran's liberty.
The Board further finds that the unprovoked spitting on two co-patients' faces by Mr. Tran was serious and given Mr. Tran's history of violence, it was necessary to seclude him from the general population to ensure the safety of both co-patients and staff. For these reasons, the Board finds that the significant restriction on Mr. Tran's liberty was necessary and appropriate at the time it was imposed.
Mr. Tran's seclusion was reviewed daily by the duty doctor and reviewed by an independent psychiatrist at 24 hours, 72 hours and seven days post seclusion. While in seclusion, Mr. Tran was offered seclusion relief regularly (consistent with his clinical presentation) and is provided with newspapers and an MP3 player while in the seclusion room. As such, the Board finds that the Hospital is aware of its responsibility to impose the least restrictive conditions upon a patient, co-existent with public safety, and is pursuing this goal.
For these reasons, the Board finds that the significant increase in the restriction of Mr. Tran's liberty was necessary and appropriate and the least onerous and least restrictive at the time it was imposed and continued until February 14, 2025.
Significant Threat:
- The Board unanimously finds that Mr. Tran continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Mishra that Mr. Tran continues to pose a significant threat. The Board also relies on the Hospital Report, which notes the following:
"Mr. Tran suffers from a major mental illness, namely schizophrenia. He continues to exhibit violent behavior, despite ongoing treatment with 2 antipsychotic medications, including clozapine. This violent behavior is directed at others on a regular basis, in the form of unprovoked attacks, which he states are in response to commands by auditory hallucinations. There is an evidence of victim selection for his assault and he will often choose vulnerable fellow patients as targets. He regularly requests that his medication be reduced. Although he acknowledges the benefit from medication, his insight remains poor. He has a history of significant violence in the past when unwell and a history of poor compliance with treatment if not closely supervised. He also has a history of substance use problems which increases the risk of recidivism independently of mental illness. The risk he poses to public safety is currently managed by the structure and support of the highly structured Beckwith inpatient unit. His actions have not resulted in any incidents of significant harm to anyone due to staff vigilance. He requires the current structure and support from the Beckwith programs in the high-secure forensic psychiatric setting under the auspices of the Ontario Review Board to maintain his recovery and manage the threat to public safety."
Necessary and Appropriate Disposition
- The Board finds that the necessary and appropriate and least onerous and least restrictive Disposition is a continuation of the current Disposition. Mr. Tran has made some gains in the latter part of the reporting period. He is doing relatively well on his current unit and is engaging in appropriate activities such as working in the greenhouse. It is hoped that in the coming year, Mr. Tran will be able to remain out of seclusion and could be in a position to transfer to the Beausoleil program at Waypoint.
DATED this 7th day of May 2025, at the City of Toronto, in the Toronto Region.
Ms. M. Chamberlain Legal Member
Office of the Registrar Ontario Review Board