Re: Mathew Lachance, 2025 CanLII 42654

Ontario Review Board

Re: Mathew Lachance ORB File No: 7159

Hearing held on: Thursday, April 10, 2025 Place of hearing: Southwest Centre for Forensic Mental Health Care, St. Thomas, Ontario Pursuant to: Section 672.81(1) of the Criminal Code

Before: Alternate Chairperson: Ms. S. Clapp Members: Dr. S. Swaminath, Dr. M. Green, Mr. R. Bigelow, Ms. C. Plyley

Parties Appearing: Accused: Mathew Lachance Counsel: Mr. S. Gehl

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

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

REASONS FOR DISPOSITION

(Dated May 8, 2025)

Introduction:

1On June 15, 2017, Mathew Lachance was found not criminally responsible on account of mental disorder (“NCR”) on a charge of breaking and entering, contrary to the Criminal Code. He is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated April 29, 2024, whereby he is detained at the Southwest Centre for Forensic Mental Health Care (“Southwest” or the “hospital”) with privileges up to and including community living in Elgin, Kent, and/or Middlesex Counties in accommodation approved by the person in charge. He is also required to abstain from substance use.

2On April 10, 2025, a panel of the Board convened at Southwest to conduct Mr. Lachance’s annual review pursuant to section 672.81(1) of the Criminal Code. Mr. Lachance attended the hearing and was represented by counsel.

3The Hospital Report dated February 18, 2025 was marked as Exhibit 1. In addition to the documentary evidence, Mr. Lachance’s attending psychiatrist, Dr. Arun Prakash, gave evidence.

4The issues to be decided at the hearing were whether Mr. Lachance continues to meet the test of posing a significant threat to the safety of the public as set out in section 672.5401 of the Criminal Code, and if so, what is the necessary and appropriate Disposition, taking into account the four factors set out in section 672.54 of the Criminal Code.

Position of the Parties:

5At the outset of the hearing the parties were asked for their initial without prejudice positions. On behalf of the hospital, Ms. Zamprogna took the position that Mr. Lachance continues to represent a significant threat to the safety of the public and that a Detention Order remained necessary and appropriate. The hospital was recommending a continuation of the existing Detention Order with the addition of indirectly supervised passes, as well as an increase in the geographical area for community living to Southwestern Ontario.

6Ms. Dalrymple agreed with the position of the hospital on behalf of the Attorney General. Mr. Gehl stated that the issue of significant threat was conceded, and they were agreeable to a Detention Order. However, Mr. Gehl was requesting that the requirement to abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant (the “abstain clause”) be removed. Both Ms. Zamprogna and Ms. Dalrymple indicated in their submissions that they did not support removal of the abstain clause.

Findings:

7For the reasons that follow, the panel found that Mr. Lachance continues to pose a significant threat to public safety. The panel concluded that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a continuation of the Detention Order, with the additional provisions as recommended by the hospital. The panel concluded that removal of the abstain clause was premature.

Index Offence:

8The circumstances of the index offence are stated as follows in the Hospital Report at page 2:

“The accused in this matter is known to the victim as he is her grandchild. The accused has caused ongoing issues for the victim who has contacted Police regarding her unwanted grandson 13 times since July 2015. Further, in November 2016 the accused was issued a Trespass Notice advising he is not to attend 115 Cecile Ave. in Chatham.

On Sunday March 5th, 2017 at 21:00hrs the victim secured her residence at 115 Cecile Ave in Chatham and went to bed for the evening. Sometime between 21:00hrs on Sunday March 5th, 2017 and 12:35hrs on Monday March 6th, 2017 the accused attended the address at 115 Cecile Ave. in Chatham and entered the home by unknown means. When the victim awoke on Monday the 6th of March 2017 she found the accused in her kitchen and eating her food. The victim subsequently contacted the Chatham Kent Police Service.”

9When initially asked about the circumstances surrounding the index offence, Mr. Lachance reported that he was hearing voices and believed that he had “counter spy work” to do at his grandmother’s home. He did not believe that he had done anything wrong because he had been “brought there.”

Background:

10Mr. Lachance’s personal history is outlined in the Hospital Report in detail and will not be repeated here. In summary, Mr. Lachance is a 35-year-old single man who was born in Chatham. His parents separated when he was eight years old. He had a fraternal twin brother who recently passed away. He also has an older brother. Mr. Lachance completed grade 10 or grade 12, and did some power washing and factory work.

11Mr. Lachance has a daughter who was born around 2013.

12Mr. Lachance has a significant history of substance use. He started drinking alcohol at age 12 and was drinking daily by age 25. He started using cannabis at 11 years old and progressed to many other drugs including cocaine, ecstasy, magic mushrooms, LSD, opiates, and crystal methamphetamine He had numerous attendances at emergency departments related to substance use and intoxication, and attended the Brentwood addiction treatment centre in September 2015. Mr. Lachance was routinely diagnosed with substance abuse when assessed in emergency rooms between 2014 and 2017.

13Mr. Lachance was living a transient lifestyle and had no fixed address at the time of the index offence.

Criminal History:

14Mr. Lachance’s criminal record is set out at pages 3-4 of the Hospital Report. Between 2008 and 2017, Mr. Lachance had several convictions for failing to attend court, failing to comply with release orders and probation orders, as well as mischief and theft. He also had a conviction for assault causing bodily harm and being unlawfully in a dwelling house.

15Prior to the index offence, Mr. Lachance’s grandmother had contacted police 13 times regarding Mr. Lachance’s unwanted attendance at her home. In November 2016, Mr. Lachance was issued a Trespass Notice to not attend at his grandmother’s home.

Psychiatric History:

16The Hospital Report stated that Mr. Lachance had no prior psychiatric admissions and had never been under outpatient psychiatric care prior to the index offence. However, he had several hospital attendances as a result of paranoid and bizarre behaviour, and auditory and visual hallucinations in the context of substance abuse. He also experienced anxiety.

17In September 2016, Mr. Lachance was referred to the Canadian Mental Health Association (“CMHA”) in Chatham for ongoing support surrounding suspected mental health and addiction issues. It was noted that he was a frequent user of emergency services and was in need of long-term community supports. It does not appear that this occurred prior to the index offence.

18Mr. Lachance was admitted to Southwest on November 1, 2017. He was diagnosed with schizophrenia and exhibited both positive and negative symptoms of his illness for a number of years, including delusions about “Interpol”, bizarre gesturing, and disorganization. A number of medication changes were made and Electroconvulsive Therapy (“ECT”) was trialled, with no response. Mr. Lachance made modest improvements over the years with some variability. His urine drug screens were consistently negative. He was described as passively participating in programs.

19The Hospital Report stated that Mr. Lachance’s insight in all domains remained poor. He often stated that he did not do anything wrong at the time of the index offence and was just getting out of the rain and eating because he was hungry.

20Mr. Lachance was found incapable of consenting to treatment in May 2018 and his mother became his substitute decision-maker. He was started on Clozapine in July 2018. His mother became an Approved Person in 2019. Mr. Lachance’s mother also brings his daughter to visit. Mr. Lachance’s grandmother, who was the victim of the index offence, died in February 2020, however Mr. Lachance had telephone contact with her prior to her death.

21Mr. Lachance was discharged to the Steele Street Rehabilitation Residence on May 21, 2021. Unfortunately, he was told by his mother that his twin brother had died of a drug overdose in June 2021. This was a motivator for him to remain abstinent. Mr. Lachance settled into the Steele Street residence well and participated in all CMHA and other programming at the home. He also volunteered at a cat shelter twice a week for a few hours. Mr. Lachance accessed the community without issue, and a pass to his mother’s home for a week in the fall of 2021 went well. He also became increasingly independent with his activities of daily living.

22On October 4, 2022, Mr. Lachance moved from the Steele Street residence to a group home with less staff supervision. Soon after this he began demonstrating prominent negative symptoms and deteriorated in his functioning. He stopped volunteering and attending programs. Mr. Lachance was readmitted to hospital in November 2022 as he was unable to cope and function in a less supervised setting despite intensive supports. His urine drug screens were negative, but he had increased his smoking which affected his Clozapine levels.

23Following readmission to hospital, a restriction of liberty hearing was held. Some medication adjustments were made and Mr. Lachance showed gradual improvement. A seven day pass to his mother’s home over the Christmas holidays in 2022 went well.

24The ORB requested that a cognitive assessment be performed for Mr. Lachance. This was completed in December 2022 and concluded that Mr. Lachance’s general cognitive ability was in the Borderline range.

25In January 2024, Mr. Lachance began a leave of absence to reside at Port Bruce Manor, an adult assisted living facility under the Community Homes for Opportunity (“CHO”) program. Following a brief readmission for medical reasons (elevated liver enzymes), he was discharged to this facility. The services provided there include personal care, an emergency response system, meals, housekeeping, linen changes, laundry, social/recreational programs, and transportation. The facility is staffed 24 hours a day and seven days a week. Staff administer medications for all tenants.

26Mr. Lachance’s current diagnoses are Schizophrenia and Substance Use Disorder, in remission.

Evidence at the Hearing:

27The Hospital Report stated that Mr. Lachance has not experienced any positive symptoms of his illness and his mood has remained stable. The group home staff report that he is one of their most polite residents. He demonstrates good motivation and follow-through, attends programming, gets along well with his peers, and easily engages with the treatment team. Numerous passes to his mother’s home have gone well.

28Mr. Lachance independently approached staff for support in obtaining future housing that is closer to Chatham where his mother and daughter (who is now 13 years old) live, and this has been his main focus and goal. The recommended increase in the geographical area for community living is to allow Mr. Lachance to live in the Chatham area. A group home in Merlin, Ontario (which is about 20-30 minutes from Chatham) has been identified and Mr. Lachance is now on the waiting list there. Mr. Lachance visited the home in Merlin with staff and liked it. His mother is also supportive of the move. The group home houses mostly seniors so this will be an adjustment for Mr. Lachance. Although Mr. Lachance is adamant that he has changed his lifestyle, there are some concerns that he will be closer to a group of peers who use substances. This will have to be tested. Dr. Prakash testified that they have patients in the Chatham area and it would not be a problem to visit Mr. Lachance there.

29Dr. Prakash testified that the group homes in Chatham are not taking people for wait lists. He did not know how long it would be before Mr. Lachance would be accepted into the group home in Merlin. He also noted that community supports for Mr. Lachance’s mental and physical health will need to be established in that area.

30The treatment team has submitted an application for Mr. Lachance to be assessed for eligibility for Developmental Services Ontario (“DSO”) and Passport Funding. Further psychological and cognitive testing has been requested.

31The Hospital Report stated that Mr. Lachance’s insight is developing, however it fluctuates. While he has acknowledged the index offence and expressed that it was wrong, he does not appear to accept that there was a direct connection between his mental health and the index offence. Mr. Lachance is able to identify that he has Schizophrenia and can sometimes identify his symptoms. He is aware that he has a mental illness and knows that he needs medication, but has refused any further education on this topic. The Hospital Report stated that Mr. Lachance demonstrated a lack of insight into his need for medication when he asked to lower his dose of antidepressants and Abilify this year because he has not had symptoms for some time. Mr. Lachance has also voiced that he no longer needs the support of the treatment team as he has taken care of himself in the past. He does not believe that he will ever become unwell again because he is taking his medications and not using substances. The Hospital Report also stated that Mr. Lachance’s insight into his risk for relapse and early warning signs needs further development.

32With respect to Substance Use Disorder, the Hospital Report stated that Mr. Lachance’s insight into his risk for relapse and early warning signs needs further development. The Hospital Report stated the following about Mr. Lachance’s insight into substance use issues (at pages 132-133):

“Mr. Lachance has a history of substance use which has negatively impacted his mental health. This year he voiced wishing to have a beer for his birthday but refrained from doing so. He stated that he would not drink alcohol even if he was no longer part of the Forensic system because it would interfere with his medication. He has been sober for approximately eight years, and stated that he will continue to remain sober because using substances "messes with your head (August 2, 2024)." He also shared that he wants "nothing to do with drugs" and feels it is easy to say no if offered. He explained that he "feels stronger" after he says no (not referencing a specific time) because he is proud of himself and his ongoing sobriety. He shared that he only has negative thoughts about relapsing on substances. When asked about alcohol, he shared it is more difficult. He noted he would like to be able to have a beer but will not test it. When asked, he stated he would still refrain from consuming even after an Absolute because it would interfere with his medication. He said he would also be interested in AA meetings (Brentwood) if moved to Chatham-Kent area.”

33The Hospital Report stated that all of Mr. Lachance’s urine drug screens have been negative this year. He has shared that he has ongoing cravings, noting a desire to consume alcohol in the future on his birthday or at the beach. It was noted that other tenants at his home engage in substance and alcohol use, and Mr. Lachance has refrained. He is also willing to engage in community addiction programming.

34The Integrated Judgment of Risk for the HCR-20 and SAPROF indicated a low risk for violent reoffending if Mr. Lachance were to remain on a Detention Order while residing in his current living environment with parallel supports. If given a Conditional Discharge, his risk for violence would increase to moderate, and high with an Absolute Discharge.

35The Re-Offence Scenario included in the Hospital Reports states the following (at page 141):

“Absent the current level of supervision and support, Mr. Lachance would likely live in the community independently. It would be unlikely that he would be able to structure and organize his days to maintain his stability due to his cognitive limitations and his ongoing need for support. He would become non-concordant with his medication and increase his cigarette smoking, resulting in changes in his clozapine levels, or drink excessive amounts of coffee and energy drinks, resulting in an increase in his anxiety. He would withdraw from his personal support and would cope with isolation and avoidance. He would likely relapse on substances, absent utilizing functional coping strategies. As a result, his symptoms, including hallucinations, delusions and affective instability, would likely intensify leading to violent behaviours, as historically demonstrated.”

36The Hospital Report stated that it is imperative for the treatment team to be in a position to approve Mr. Lachance’s future housing to ensure the necessary levels of monitoring, support and supervision. Mr. Lachance has a history of disengaging from treatment and becoming isolative in new and less supervised environments, and he is not able to identify symptoms of his mental illness when he starts to decompensate. As such, the Mental Health Act (“MHA”), which is reactive as supposed to preventive, would not be sufficient to protect the public.

37Dr. Prakash testified that Mr. Lachance is clinically well with no negative symptoms. His liver enzymes are still somewhat elevated but are moving in the right direction. Once they are at normal levels, the plan is to increase Mr. Lachance’s dose of Clozapine because his levels remain low, likely as a result of cigarette smoking. His medications are not optimized yet.

38Dr. Prakash testified that Mr. Lachance is on all oral medications because he does not like needles. He reiterated that Mr. Lachance’s insight is not robust; he is feeling good and therefore wants to go off the Abilify and antidepressant medications.

39Dr. Prakash stated that it is important for the team to be able to supervise Mr. Lachance over the coming year. He noted that it took a long time for Mr. Lachance to stabilize as an inpatient (from 2017 to 2020), and he needs support as a result of his cognitive limitations.

40With respect to substance use, Dr. Prakash acknowledged and commended Mr. Lachance for being abstinent since he has come under the Board. He stated that he was “almost there”, but noted that Mr. Lachance had problems with alcohol from a young age, and a significant history of alcohol and substance abuse which was a contributing factor to his criminal behaviours. He also does not yet have full insight into his issues with alcohol. Dr. Prakash stated that the goal is for Mr. Lachance to attend the Brentwood addiction treatment centre program again. Dr. Prakash did not think it was appropriate to remove the abstain clause until Mr. Lachance is settled in the new group home in Merlin and has completed the Brentwood program. Dr. Prakash stated that he is not familiar with the group home in Merlin and has never had a patient there, so he would like to see how things go once Mr. Lachance is settled before removing the abstain clause.

41Dr. Prakash stated that the rationale for providing Mr. Lachance with indirectly supervised passes is so that he can travel to visit his family on his own. This provides him with increased opportunities as he progresses with reintegration into the community.

Analysis and Conclusions:

42Based on the Hospital Report and the evidence of Dr. Prakash, the panel concluded that Mr. Lachance remains a significant threat to public safety. Mr. Lachance has an extensive criminal history and poor supervision response (i.e., failures to comply with court orders). While the symptoms of his major mental illness have currently remitted, he has underdeveloped insight into his illness, the need for continuing treatment, and his risk for future violence. He also has a significant history of substance abuse which was closely connected to his criminal behaviours, the index offence, and his risk of violence. The panel accepted the re-offence scenario included in the Hospital Report (and cited above), and concluded that without the supervision and support of the Board, Mr. Lachance’s mental state would decompensate which would likely lead to violent behaviours.

43The panel decided that a continuation of a Detention Order, with the changes recommended by the hospital was necessary and appropriate, and the least onerous and least restrictive Disposition in the circumstances. While Mr. Lachance has progressed well in the last couple of years, he is hoping to be able to move to a group home in Merlin this year so that he can be closer to his family. The change in the geographical area for community living to Southwestern Ontario in the Disposition allows for this move, and was supported by the parties.

44This will be a significant transition for Mr. Lachance as it will be a new home, with new routines and residents, and a new environment. It will also be further from the hospital. Mr. Lachance has experienced stress and anxiety with new and changing settings in the past, and will require intensive support and supervision during any transition. Importantly, the hospital needs to retain the ability to approve the housing for Mr. Lachance to ensure that it has the appropriate level of support and supervision for him. The panel noted that a transition to a less supervised home at the end of 2022 was not successful. The hospital also requires the ability to bring Mr. Lachance back to the hospital expeditiously in the event that any new housing does not work out, or he experiences a decompensation in the community.

45The panel agreed with the parties that adding indirectly supervised passes was appropriate. Mr. Lachance has used his privileges and passes into the community without incident, and should be provided with the opportunity to travel on his own to visit his family. This will assist with his gradual reintegration into the community, and potentially into a new group home.

46The panel decided that it was premature to remove the abstain clause from the Disposition at this time, and accepted Dr. Prakash’s evidence on this point. The panel commends Mr. Lachance for his eight years of abstinence while under the jurisdiction of the ORB and appreciates that he would like to have a drink from time to time. However, the evidence was clear that Mr. Lachance has a long and troublesome history with alcohol and substances, and that his use of substances was a contributing factor to his offending behaviour. In the context of his medication still being optimized, his underdeveloped insight into his substance use disorder, his request to stop some of his medications, his stated desire to have a drink, and the fact that he has not been in the community for that long, the panel found that the abstain clause was necessary and appropriate.

47This was especially true in light of the fact that Mr. Lachance hopes to move to a new group home near Chatham in the upcoming year. As was discussed above, this will be a significant transition for Mr. Lachance in many respects, and will take him back to the environment where the index offence occurred, with peers who use alcohol and substances. The panel accepted Dr. Prakash’s testimony that it will be important for Mr. Lachance to attend a comprehensive substance abuse program, and settle into the group home before the abstain clause is removed.

48The panel did not accept Mr. Gehl’s submission that there was no evidence that it was likely that Mr. Lachance would consume alcohol or substances in excess which would destabilize his mental state, or that he should be considered in the same context as a large segment of the population that is able to consume substances without any problematic behaviours. The panel relied on the evidence and reasoning outlined in paragraphs 46 and 47 above, including Mr. Lachance’s significant history of alcohol and substance abuse that was directly related to problematic behaviours, and his sensitivity in times of stress and transition. The panel was satisfied on the evidence that keeping the abstain clause in the Disposition is necessary at this time in order to support Mr. Lachance to successfully continue with his reintegration into the community, and to protect the safety of the public. The panel also found that this was the least onerous and least restrictive Disposition in the circumstances.