Ontario Review Board
Re: Paul Stead
ORB File No: 7705
Hearing held on: Thursday, May 15, 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. M.D. Segal Members: Dr. R. Chandrasena Dr. S. Wiseman Mr. E. Siebenmorgan Ms. M. McKinnon
Parties Appearing:
Accused: Paul Stead Counsel: Mr. P. Valli
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. K. Dalrymple
REASONS FOR DISPOSITION
(Dated June 4, 2025)
Introduction
[1]. Paul Stead, age 50, was found not criminally responsible on account of mental disorder on March 20, 2025, on a charge of assault, contrary to the Criminal Code.
[2]. On May 15, 2025, Mr. Stead appeared in person for his annual hearing before the Ontario Review Board (the “Board”) from the Southwest Centre for Forensic Mental Health Care (the “hospital”). The Board had before it as Exhibit 1 the Hospital Report dated April 4, 2025, and an updated Hospital Report dated May 7, 2025, as Exhibit 2.
[3]. In preliminary positions, all parties advanced that the current Disposition was appropriate and the least onerous and least restrictive Disposition that balanced the safety of the public and the rehabilitation needs of the patient. By the conclusion of the hearing, the Board agreed with the joint submission.
Index Offence
[4]. The circumstances giving rise to the Index Offence are extracted from last year’s Board Reasons, as follows:
“In 2019, Mr. Stead attended a local business and was banging on the windows and doors, screaming at employees. He kicked the locked front door, causing it to open. He then accosted the complainant and punched him in the right neck/jaw area. He departed the store, still in an agitated state. Mr. Stead believed himself to be the owner of the premise. He has previously been charged because of a similar incident at the same store. “
Mr. Stead had criminal antecedents and contacts as noted in the hospital report.
Background
[5]. This is well captured in last year's Reasons:
“Mr. Stead’s personal history is not certain as information gathered has been inconsistent or contradictory. He did come from a very large family and came to Ontario in 2004. His education was very limited, and he falsely believed that he served in the military. His work history is limited, and he was supported through disability payments. He is single without dependents. Sources do not confirm any intimate relationships. Reports of childhood traumas are also inconsistent.
Psychiatric issues seemed to arise for Mr. Stead around 2007. Following the deaths of his parents, Mr. Stead abused drugs and developed delusional beliefs, including specific thoughts about biker gangs, organized crime, military service and deaths in his family. In that year, he was admitted to hospital where he was diagnosed with mixed personality disorder and cocaine use disorder.
In 2009, he experienced auditory hallucinations and low mood and was then diagnosed with mixed personality disorder and cannabis and cocaine substance use disorders. In 2014, he was again admitted to hospital and diagnosed with schizophrenia and adjustment disorder. Further hospitalization took place in 2016 when he was diagnosed with methamphetamine-induced psychosis and methamphetamine dependence.
In 2018, there were further hospitalizations. He was diagnosed with methamphetamine use disorder, rule out schizophrenia, stimulant use disorder and cannabis use disorder by history. He exhibited paranoid delusions, auditory hallucinations, grandiosity, and agitation, but the diagnosis at discharge was unknown.
In 2019, Mr. Stead was diagnosed with methamphetamine use disorder – severe, query substance-induced psychosis, rule out delusional disorder, rule out schizotypal/paranoid personality disorder. During this hospitalization, Mr. Stead’s overt voicing of psychotic symptoms slowly diminished, but he continued to experience chronic delusional or overvalued ideas about a biker gang. CMHA records indicated that Mr. Stead had a history of fixed delusional beliefs that he owned homes and businesses and would break into these places, in addition to beliefs that his niece or other family members were raped and murdered by some type of “ring.”
During further hospitalizations in 2019, he exhibited suicidal ideation, and psychosis that was thought to be substance-induced. Late that year, he was diagnosed with methamphetamine use disorder on several occasions, as well as cocaine and cannabis use disorders. In early 2020, he admitted using crystal methamphetamine prior to his arrest, but denied the use of other intoxicants.
When admitted to hospital prior to the NCR finding, Mr. Stead continued to express delusions about biker gangs and appeared to be withdrawn on the unit.
After being found not criminally responsible, Mr. Stead was admitted to hospital. He continued to express delusional beliefs and was very withdrawn for the most part. There were some limited instances of aggressive behaviour. He had poor insight into the index offence and his mental illness.
This unfortunate pattern continued for more than two years. However, in September of 2022, Mr. Stead was transferred from the Forensic Treatment Unit to the Rehabilitation Readiness Unit. The hospital determined that it would take a more assertive approach in behavioural activation and assessments to guide community reintegration.
Progress was slow, but in January of 2023, he was administered a new anti-depressant, and this had significant effect.
Evidence at Hearing
[6]. Dr. Arun Prakash, the patient’s psychiatrist, testified. Dr. Prakash took over responsibilities in September 2024. Mr. Stead now is in a 24/7 residence - the Chester Residence, as of August 2024. Last year was a very difficult year with several prolonged admissions. On one occasion the patient was found with a hatchet and drugs in his room. This year is a very different one. Before Mr. Stead’s mental health was fragile. Now he is stable. Before there was a lot of depression but not so much since.
[7]. Dr. Prakash noted that there are no positive symptoms of psychosis. Mr. Stead is taking part in programs offered by CHO and CMHA. He loves community gardening, but an old shoulder injury holds him back. He has received therapy for the shoulder, and he is feeling a lot better. He is also on some medication for the discomfort.
[8]. The plan is that Mr. Stead have more structure. Volunteering is more suitable than employment in his case. There are possibilities in St. Thomas to be explored.
[9]. Mr. Stead’s history is one filled with substance use. Mr. Stead has taken an extensive program through the Thames Valley Hospital on relapse prevention. The group home setting has been a very supportive setting for him.
[10]. Mr. Stead is demonstrating more self-motivation than in previous years.
[11]. The patient is on two injectables and two antidepressants. Mr. Stead gets along well with both the hospital outreach staff and staff at his group home.
[12]. There are some family issues to be resolved. Family is a protective feature but also causes stress. Mr. Stead’s sister, who lives in Woodstock, is his SDM. Mr. Stead wishes to remain in St. Thomas.
[13]. Mr. Stead has good insight regarding the need and impact of medications and their role in relation to the index offences. This year, a focus will be on improving insight into his illness.
[14]. Before his current residence, Mr. Stead was at an Indwell residence where drug availability was more prominent. Mr. Stead is calmer now and not prone to outbursts of anger as in past.
[15]. Mr. Stead could be a candidate for a Community Treatment Order dependent on whether he can demonstrate several months of stability.
[16]. Recently, Mr. Stead navigated a sleep apnea examination in London on his own and the hospital is waiting on the results.
[17]. Mr. Stead could be considered, if all goes well, for a conditional discharge provided there is no substance abuse. Care will be taken to ensure that there is no recurrence of command hallucinations, a high -risk consideration.
Analysis
[18]. Mr. Stead has been doing very well for some months. This year has been a much better year. He is abstinent and adherent. He is accepting recommendations and working well with hospital outreach staff and staff at his group home. His insight continues to develop. At the hearing he appeared well and content. The joint submission made eminent sense. After hearing and reading all the evidence The Board was satisfied that the patient continues to represent a significant threat to the safety of the public. There are some areas that will be focused on in the upcoming year. The current Disposition is well situated to deal with those possible developments and will remain in place without changes. We wish Mr. Stead well.
DATED this 4^th^ day of June 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
Office of the Registrar Ontario Review Board