Re Jonathan Madden-Patrick, 2025 CanLII 42648

Ontario Review Board

Re: Jonathan Madden-Patrick

ORB File No: 7587

Hearing held on: Monday, March 3, 2025

Place of Hearing: Royal Ottawa Mental Health Centre

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

Before:

Alternate Chairperson: Mr. P. Capelle

Members: Dr. R. Kunjukrishnan Dr. G. Boulais Mr. P. Hageraats Mr. A. Bernardo

Parties Appearing:

Accused: Jonathan Madden-Patrick Counsel: Ms. M. Munsterman

Person in charge of hospital: Representative: Dr. F. Wood

Attorney-General of Ontario: Counsel: Ms. M. Dufort

REASONS FOR DISPOSITION

(Dated May 5, 2025)

1. On August 21, 2019, Jonathan G. Madden-Patrick, appeared in court on charges of criminal harassment and uttering threats, offences contrary to the Criminal Code of Canada.

2. The court received expert psychiatric evidence establishing that Mr. Madden-Patrick was suffering from a mental disorder when he committed the index offence. Based on that evidence, the Court ruled him to be not criminally responsible on account of mental disorder (NCR).

3. Mr. Madden-Patrick is subject to a disposition of the Ontario Review Board (ORB or “the Board”) dated February 21, 2024. He was discharged on conditions, including requirements that he not communicate in any fashion with the victim of the index offence and that he not attend anywhere in London, Ontario.

4. On March 3, 2025, the Board convened at the Royal Ottawa Mental Health Centre (ROMHC or “the hospital”) to conduct an annual review. Mr. Madden-Patrick attended by video connection from the London-Middlesex Detention Centre in London, Ontario. He was represented by counsel, Ms. M. Munsterman.

5. Three hospital treatment team members attended as observers: Mr. Madden-Patrick’s assigned hospital psychologist, Ms. Emily Proulx, the Registered Nurse, Ms. Jamie Allen, and Ms. Rosa Ng. Ms. Ng is the case manager working with Mr. Madden-Patrick at the Salus Housing Program.

6. The Board received direct testimony from the attending psychiatrist, Dr. Floyd Wood. Documents were also filed as evidence at the hearing, including:

• Hospital Report dated January 12, 2025.
• Correspondence dated January 22 and 29, 2025, between the hospital and the Board.
• London Police charge sheet, re: newly alleged offences arising on January 25, 2025.

7. The issues to be considered by the Board are whether Mr. Madden-Patrick presents a significant risk to the safety of the public, and, if so, to determine the necessary and appropriate disposition.

Positions of the Parties

8. The Board was provided with a joint submission by all three parties. Mr. Madden-Patrick’s threat level has increased, thus requiring a change of disposition: the current discharge should be replaced by a formal detention order. For the reasons set out below, the Board adopted the joint submission.

Current Psychiatric Diagnoses

• Cannabis-Induced Psychotic Disorder
• Cannabis Use Disorder
• Schizoid Personality Traits

9. From December 2020 until recently, Mr. Madden-Patrick refused to receive any form of psychiatric medication. By March 2025, he had started to accept a prescription for the oral form of Invega 3mg, along with Seroquel for insomnia.

Index Offences

10. The circumstances are described in the hospital report and in last year’s Reasons for Disposition dated March 27, 2024. In summary:

“Mr. Johnathan Madden-Patrick, then 23 years old, and the victim Rowan Baron, aged 21, had known each other for eight years. They have never been involved in an intimate relationship. Mr. Madden-Patrick was living in Ottawa. Ms. Baron resided in London.

They had first met through Mr. Madden-Patrick’s mother and Ms. Baron’s stepfather, who were friends. Over the years, Mr. Madden-Patrick became obsessed with Ms. Baron. Over time, he would send her unwanted emails and messages through Facebook. Mr. Madden-Patrick professed they were soul mates and should be together.

On April 4, 2017, Ms. Baron contacted the police in relation to unwanted contact from Mr. Madden-Patrick. A member of the London Police Services attended and spoke with Ms. Baron. At that time, Mr. Madden-Patrick’s whereabouts were unknown, and he could not be spoken with. The unwanted emails and messages continued.

On July 16, 2018, Mr. Madden-Patrick sent a threatening message to Ms. Baron: he stated he was taking the bus to London. Ms. Barron contacted the London Police Services. Constable Patrick Larochelle investigated the incident. Ms. Baron did not want charges laid. Constable Larochelle located Mr. Madden-Patrick at the Salvation Army. Mr. Madden-Patrick was warned regarding criminal harassment and was advised to stop all communications with Ms. Baron.

On August 8, 2018, at 3:59 p.m., Ms. Baron contacted the London Police Services in relation to further unwanted messages and threats received from Mr. Madden-Patrick. After Mr. Madden-Patrick was warned by Constable LaRochelle, Mr. Madden-Patrick continued to send Ms. Baron 30 to 50 messages each day. These messages continued - even on the same day that Constable LaRochelle issued the warning. Many of the messages did not make sense. Others were threatening in nature.

On August 7, 2018, Ms. Baron received the following two messages from Mr. Madden-Patrick: “I am going to massacre your family for not forcing me onto you” and “I am going to murder you with your penis because tea and gentle”.

In one message, Mr. Madden-Patrick stated he was a taking a Greyhound bus to London and that he would be arriving just after 3:00 a.m. Ms. Baron reported she was fearful of Mr. Madden-Patrick and that she was concerned he would travel to London from Ottawa. At 3:03 a.m. a London police constable arrested Mr. Madden-Patrick at the Greyhound bus station in London.

Personal Background

11. Mr. Madden-Patrick is 30, single and has no dependents. He was born east of Ottawa in nearby Buckingham, Quebec. According to his mother, Elizabeth Patrick, he reached his normal developmental milestones.

12. When Mr. Madden-Patrick was three, his parents separated. Mr. Madden-Patrick has identified his mother’s subsequent partner, Stephane, as his stepfather. At the age of ten, Mr. Madden-Patrick lived for about a year with his maternal grandmother in Madoc, Ontario. From the age of eleven to nineteen, he lived with his mother and younger brother at four different locations in Hull, Quebec. The family experienced financial stress.

13. Mr. Madden-Patrick was able to resume contact with his father in more recent years. The father lives off the grid, in a rural bush location outside Ottawa. At times, the father would supply Mr. Madden-Patrick with home-grown marijuana.

14. In 2017, Mr. Madden-Patrick lived in Toronto, staying with a friend of his brother. He wanted to be closer to Ms. Baron, the victim of the index offence. He later returned to Ottawa to live with his mother for a time - before the index offence occurred in 2018.

Criminal History

15. There is no record of criminal conviction. However, Mr. Madden-Patrick now stands charged following a new series of events at London from January 2025. Following his arrest on January 25, he has remained in custody while awaiting a bail hearing.

Psychiatric History

16. Mr. Madden-Patrick had his first contact with mental health services in July 2018. Just prior to the index offence, London Police had brought him to Emergency Services in London. When seen in psychiatry, Mr. Madden-Patrick exhibited considerable psychotic symptoms, including delusions regarding the victim. He refused to take medication and was discharged with a diagnosis of Psychosis-not otherwise specified. He then returned to Ottawa by bus. The hospital report sets out details of subsequent psychiatric contacts, both in Ottawa and London.

17. The previous reporting year, from February 2023 to February 2024 saw Mr. Madden-Patrick living in the community in supportive housing supplied by the Salus-Fisher Program in Ottawa. He had been involved in regular counselling with the hospital psychologist, Dr. Kokozaki. He was upset when Dr. Kokozaki left the program.

18. In January 2023, Mr. Madden-Patrick had travelled to London to meet the mother of the victim of the index offence. This was contrary to the Board’s requirement that he not travel to London and that he have no communication, direct or indirect, with the victim. Arriving at the train station, he saw the police were there. This prompted him to return straight away to Ottawa. On arrival in Ottawa, he was arrested and held in custody overnight before being released. No charges were laid.

19. When the ROMHC treatment team spoke to Mr. Madden-Patrick, he lied about the true facts. He claimed he had gone to London to see his own mother. At the ORB hearing held in 2023, Dr. Wood testified he had been told about some involvement by the victim’s mother, at least to the extent that she could have earlier suggested in a text communication to Mr. Madden-Patrick that he meet her “for coffee”.

20. At the same ORB hearing held in early 2023, Dr. Wood was quite concerned about Mr. Madden-Patrick’s behaviour. Dr. Wood testified that the patient’s interest in the victim had been increasing during the months of November and December 2022. Mr. Madden-Patrick was claiming that his texts to the victim were only “jokes”. It was Dr. Wood’s impression that Mr. Madden-Patrick’s use of cannabis seemed to trigger his desire to see the victim.

21. Before Christmas 2022, Mr. Madden-Patrick was increasingly preoccupied with the victim and wanted to communicate with her. He reported thinking about her day and night and that it was she who was suffering from being kept apart from him. It was his intention, he claimed, to reassure her about this. In late 2022, Mr. Madden-Patrick wrote the victim a letter, planning to give it to her mother on Christmas Day.

22. In the reporting year leading up to February 2023, the treatment team made efforts to have Mr. Madden-Patrick abstain from cannabis. He did not view his use of cannabis as harmful. There were times when he would reduce his consumption or abstain. One of his motivations for reducing or abstaining, he advised, was because it tended to lessen his skills at his main activity – online gaming. Despite this, Mr. Madden-Patrick has continued to regularly use cannabis in varying quantities and with varying frequency.

23. In late 2023, Mr. Madden-Patrick started to engage with the hospital case manager, Ms. Jaroudi. He attended all scheduled appointments. Treatment team members felt satisfied that he would report and attend as required.

24. For the next reporting year leading up to February 2024, Mr. Madden-Patrick stayed in regular contact with the hospital treatment team and with his Salus Supportive Housing worker. With her help, he was able to keep up with maintenance of his apartment. Mr. Madden-Patrick would attend the food bank for groceries. He was able to organize his bills and other payments.

25. Mr. Madden-Patrick faithfully attended at scheduled sessions with his assigned hospital psychologist, Ms. Proulx. He did so for most weeks in the same reporting year, benefitting from some 40 sessions.

26. He also kept up his regular appointments with Dr. Wood. There were no further concerning events or indications of any attempt by Mr. Madden-Patrick to communicate with the victim of the index offence.

27. However, the reporting year did see Mr. Madden-Patrick continue his longstanding pattern of limited social engagement. He remained connected with his mother and father, with whom he has amicable relations. In March 2023, he met a new woman online, Frankie, through a gaming platform. Apart from Frankie, his parents and the treatment team members, Mr. Madden-Patrick had only very limited social contact.

28. By May 2023, following a period of abstention, Mr. Madden-Patrick resumed consuming cannabis. He was frustrated by the ORB prohibitions imposed on him. He did not view cannabis to be a problem. He claimed the homegrown materials supplied by his father contained less THC.

29. He also expressed frustration about being under the ORB. Mr. Madden-Patrick felt the Board was not acting in his best interest and that their impressions of him are false. According to Mr. Madden-Patrick, earlier statements attributed to him have been taken out of context. Conditions imposed by the Board were not needed. He would reiterate wanting an apology from everyone and that the victim of the index offence had been “brainwashed” by her mother.

30. In the hospital report from February 2024, it was noted that, for several years, Mr. Madden-Patrick had refused to attend in person at any of his annual ORB review hearings.

31. It was his position that the hearings were “a joke” and that he could not sit through any more of them. He did not accept that the diagnoses of Cannabis-Induced Psychotic Disorder, Cannabis Use Disorder, and Schizoid Personality Disorder applied to him.

32. He also reported his fear that the victim of the index offence was “going to kill herself before all of this is over” or before he would be allowed to see her again. He felt the ORB was driving her into feeling he was a threat to her. He wanted to communicate with her about how awful he felt about hurting her the way he did, but he did not feel that the ORB or the Royal could understand him or help communicate this.

33. In last year’s formal risk assessment provided by Dr. Wood, Dr. Wood noted that Mr. Madden-Patrick had resumed using cannabis despite previously reporting his intention to remain abstinent. He was becoming more insistent on continuing to consume cannabis. Dr. Wood was concerned that, without any restriction from consumption, and while still unmedicated, the likelihood of Mr. Madden-Patrick’s re-establishing contact with the victim was high.

34. In the same risk assessment from February 2024, Dr. Wood noted:

The significant clinical risk items include suboptimal insight into his Schizoid Personality Disorder related social skills deficit … and suboptimal understanding of the nature of his mental health issues and how it relates to his index offence.

35. In testifying before the Board last year, Dr. Wood stated that cannabis use will worsen the patient’s paranoia. While the team was not then seeing any increased preoccupation in Mr. Madden-Patrick about the victim, that could change, for example, if Mr. Madden-Patrick were to break up with “Frankie” or should there be a change in their relationship.

36. Dr. Wood testified that cannabis is a negative factor for Mr. Madden-Patrick: it makes his paranoia worse and is a “straight danger to his risk”. Based on the concerns voiced at last year’s hearing, while also noting that Mr. Madden-Patrick was being closely followed by the hospital, and with stable housing assured, the Board was prepared to have Mr. Madden-Patrick continue to be discharged with conditions, as opposed to issuing a formal detention order.

37. In coming to that conclusion, the Board took note that there was no realistic assurance that Mr. Madden-Patrick’s mental state would remain stable while he continued to use cannabis. The Board expressed its further concern that the delusional aspects of Mr. Madden-Patrick’s condition have never been addressed by any pharmacological treatment.

Evidence at the Hearing

38. The first half of 2024 proved to be largely uneventful. Mr. Madden-Patrick engaged regularly in psychotherapy with Ms. Proulx and with his Salus caseworkers. As before, he kept up appointments with the attending psychiatrist, Dr. Wood.

39. However, by the end of September 2024 he started to show signs of psychosis. He talked about a refocus on the victim. He provided a bizarre narrative about activities with the victim and was expressing other delusional beliefs. At one point, Mr. Madden-Patrick called his mother while he was dancing on the streets. He had run away from his apartment, fleeing an “internal source”. He was eating psychedelic mushrooms and acknowledged having used ‘shrooms’ for at least three days.

40. Mr. Madden-Patrick began a pattern of not attending appointments with team members, despite multiple reminders and prompts. He largely disengaged from psychotherapy with Ms. Proulx.

41. Mr. Madden-Patrick was admitted to the Ottawa General Hospital from October 11 to October 28, 2024. This was on a Form 1, filled out by the Salus case manager. After refusing to engage with the psychiatry team, he escalated and started shouting expletives. He reported having a “psychic marriage” with the victim of the index offences. Remaining capable for treatment decisions, Mr. Madden-Patrick declined any antipsychotic medication.

42. At one point, he voiced a threat to kill his uncle. When confronted, he denied any aggressive or homicidal ideation. By October 18, 2024, with noted improvements bringing him closer to his baseline, Mr. Madden-Patrick was expressing motivation to maintain complete sobriety. He was able to reflect with some insight upon the events that had led to his hospitalization (psilocybin-induced psychotic symptoms).

43. Mr. Madden-Patrick was hospitalized for a second time from November 8 to November 11, 2024. He had been evading contact with the treatment team, including the Salus worker. Concerns about his aggression and grandiose thinking were reported by various sources, including the landlord and his mother. Mr. Madden-Patrick had left the door to his apartment open at night. He also caused some damage when moving furniture to the hallway.

44. The police brought him to the hospital on a Form 1. He reported feeling bugs in his head. He believed he was physically contagious and was breathing out bugs on people. Mr. Madden-Patrick expressed further delusions on different topics, including about the victim of the index offence. He confirmed having used mushrooms that day and that he still had three bags of mushrooms in his room.

45. Between December 3 and December 20, 2024, Mr. Madden-Patrick attended the hospital emergency department on six occasions. Each time, he expressed concerns of bugs in his head. However, he ended up leaving hospital before being seen by the attending physician.

46. The hospital report contains more detailed information about Mr. Madden-Patrick’s course for the months of November and December 2024. Suffice it to say, he was displaying increased preoccupation with the victim of the index offence, while causing treatment team members great concern about his ability to manage safely in the community.

47. In January 2025, the Salus case worker, Ms. Ng attended with a team member at Mr. Madden-Patrick’s apartment due to concerns about his mental health. He was reluctant to let them in. There were serious concerns about the apartment’s condition. It was observed to be very dirty and cluttered, with food and garbage along with sharp objects all over the floor.

48. Mr. Madden-Patrick did not feel he was unwell. He disagreed with the team members’ observations even though they could see him responding to internal stimuli, acting in a suspicious and guarded manner, with poor hygiene.

49. Ottawa Police mental health workers informed the team that they’d had additional contact with Mr. Madden-Patrick on January 10, 2025, at 3 o’clock in the morning. He had phoned the police and was difficult to understand but expressed feeling scared and fearful. He reported being afraid someone was going to shoot him with a gun. When seen at the apartment, he said voices were telling him they would shoot him with a gun. He expressed concerns for the victim of the index offence, asking police to check on her. There was no apparent evidence of substance use, and he reported taking his medications.

50. The hospital report dated shortly after, from January 12, 2025, saw Dr. Wood prepare an updated formal risk assessment. Dr. Wood noted that Mr. Madden-Patrick’s overall level of risk had elevated significantly. Based on continued use of cannabis, and now with recent use of psychedelic mushrooms, along with Mr. Madden-Patrick’s largely having disengaged from therapeutic involvement, he was becoming much more difficult to manage.

51. Dr. Wood came to the opinion that existing mechanisms were becoming too limited to address ongoing concerns about the patient’s current mental health and risk. Accordingly, Dr. Wood felt that a detention order would allow the team to more meaningfully intervene to restore Mr. Madden-Patrick to his baseline.

52. Dr. Wood intended to have Mr. Madden-Patrick admitted to the Forensic Assessment Unit promptly and to activate an early ORB hearing for a restriction of liberties. The intention was to place Mr. Madden-Patrick on long-acting injectable antipsychotic medication while monitoring his psychotic symptoms and while having him engage in addictions treatment.

53. In his written report, Dr. Wood further noted that Mr. Madden-Patrick’s apartment was at risk based on information received from the landlord. In his recommendations to the Board, Dr. Wood noted that Mr. Madden-Patrick’s level of risk to the public, including to the victim, was now “moderate to high”.

Alleged Events of January 2025

54. Before the hospital was able to readmit the patient, as Dr. Wood had recommended on January 12, 2025, Mr. Madden-Patrick made his way to London. This contravened the terms of his ORB disposition.

55. At 1:54 a.m. on January 25, 2025, according to the London police report provided, Mr. Madden-Patrick was spotted by the mother of the victim at the front of their residence in London, Ontario. He was pacing up and down her driveway and walking up to her front porch. Opening the front door, the mother shouted at him to leave immediately. He walked away without acknowledging her presence. Immediately the London Police were contacted. Within minutes, Mr. Madden-Patrick was tracked by a police canine unit. They found him a short distance away, hiding behind a dumpster.

56. Mr. Madden-Patrick was arrested on the spot. He faces new charges and is being held in custody in London pending court appearances there. He is charged with criminal harassment - by watching and besetting - under the Criminal Code of Canada.

57. The same London Police report sets out details of emails allegedly sent by Mr. Madden-Patrick to the victim on various dates via social media: January 7, 10, 11, 20, 21, and 31, 2025. Details of the allegations are set out in the police report filed with the Board at the present hearing.

Testimony of Dr. Floyd Wood

58. Dr. Wood remains the patient’s attending psychiatrist. Dr. Wood is the author of the hospital report filed in evidence. He confirmed that Mr. Madden-Patrick remains in custody in London.

59. Mr. Madden-Patrick has been on a waitlist for admission to the ROMHC since October 2024. His position on the list is quite high so that when he arrives back in Ottawa, the hospital will likely be able to provide a forensic bed. Dr. Wood placed emphasis on Mr. Madden-Patrick’s earlier ability to function well in the community. His functioning, however, has fluctuated in the last months.

60. During the earlier time while still attending psychotherapy, Mr. Madden-Patrick did quite well. That said, he now needs to completely abstain from cannabis and magic mushrooms.

61. Dr. Wood explained that the hospital requires the ability to quickly bring Mr. Madden-Patrick into hospital. Previous hospitalizations based on Form 1 of The Mental Health Act did not adequately deal with the situation. On both occasions in late 2024, Form 1’s were discontinued soon after Mr. Madden-Patrick no longer met the criteria for involuntary admission.

62. Dr. Wood noted that Mr. Madden-Patrick has started to express interest in considering long-acting injectable antipsychotic medication. This was during discussions held back in December 2024. Earlier on, he would not have considered it. In December 2024, Mr. Madden-Patrick also recognized that a detention order was becoming more likely given the decompensation and changes he had been experiencing following his use of psychedelic mushrooms.

63. Dr. Wood explained that the patient’s use of mushrooms would have brought on his recent psychotic decompensation. However, Dr. Wood added, the decompensation has continued even now, and without ongoing use of mushrooms.

64. Dr. Wood stated that, for the reporting year to come, it remains possible that Mr. Madden-Patrick could live in the community in hospital-approved accommodation. Dr. Wood prefers to have the treatment team left free to assess whether this would take the form of supervised accommodation or in a less strict setting. Dr. Wood noted that, before September 2024, Mr. Madden-Patrick was doing quite well at managing and organizing his apartment as observed and assisted by his Salus worker, Ms. Ng. For now, Mr. Madden-Patrick’s condition requires that he be admitted to hospital.

65. A question was asked about Mr. Madden-Patrick’s ongoing use of cannabis. Throughout 2023 and 2024, the hospital was tolerating Mr. Madden-Patrick’s doing so, despite the prohibition put in place by the ORB. Dr. Wood confirmed that Mr. Madden-Patrick’s past cannabis use was a problem: it led to more dysregulated emotion, more stress, more attenuated psychotic symptoms, and increased preoccupation with the victim.

66. Dr. Wood was asked about cannabis use in a context where the patient is treated with long-acting injectable antipsychotic medication. Dr. Wood explained that cannabis is also problematic in that regard: it blocks the same receptors which are targeted by the psychiatric medication. This makes treatment with medication less effective.

67. Asked directly whether Mr. Madden-Patrick has a Cannabis Substance Use Disorder, Dr. Wood agreed.

68. Dr. Wood confirmed that Mr. Madden-Patrick remains capable of making his own decisions about receiving treatment with psychiatric medication.

69. A panel member asked for Dr. Wood’s thoughts on a substance use prohibition that would contain wording to prohibit any kind of cannabis use, including cannabis use for medical purposes. Dr. Wood agreed with this.

70. The parties presented no further evidence.

Submissions of the Parties

71. Counsel for the patient and for the Attorney-General supported the hospital’s recommendation in all respects. On behalf of Mr. Madden-Patrick, Ms. Munsterman stated that, given the events of September and in the last few months, they accept that a detention order, including possible community living, is necessary and appropriate. Counsel expressed no objection to a proposed change of wording regarding a prohibition from the use of substances.

Conclusions and Disposition.

72. Based on the clear and uncontradicted evidence, the Board had no difficulty coming to the unanimous conclusion that Jonathan Madden-Patrick continues to present a significant threat to public safety. This is based on the circumstances of the index offence, driven further by the ongoing and potentially deepening nature of the patient’s ongoing delusions regarding the victim. Mr. Madden-Patrick is greatly in need of psychiatric treatment, which has yet to be adequately implemented. Having regard to the heightened risk presented, a major change of disposition terms is needed. No disposition, short of a detention order, will keep members of the public, including the victim, safe.

73. The Board finds a detention order is necessary and appropriate on the further basis that the hospital needs to strictly control the patient’s place of residence, should he progress to the point of becoming eligible for community living once his condition stabilizes. When that happens, he will need to be very closely monitored.

74. As was stated by last year’s ORB panel, we remain very concerned about Mr. Madden-Patrick’s risk profile, specifically regarding his long-held refusal to accept medical treatment for his diagnosed psychiatric illness. Mr. Madden-Patrick’s substance use disorder aggravates the overall picture. Mr. Madden-Patrick needs to completely abstain from substances, including cannabis and all other psycho-active agents.

75. Counsel for Mr. Madden-Patrick has advised that efforts are being made to have the new charges transferred from London to the Court at Ottawa. We leave this for counsel to pursue in the manner they feel is most appropriate and which the Courts may be prepared to endorse.

76. For these reasons, considering the primary need to keep the public safe, while balancing the patient’s mental condition, his reintegration and other needs, a detention order will be issued. Terms and conditions are as set out in the disposition.

77. We thank Dr. Wood, the treatment team members, and both counsel for their assistance.

DATED this 5th day of May 2025, at the City of Toronto, in the Toronto Region.

Mr. P. Hageraats

Legal Member

Office of the Registrar

Ontario Review Board