Ontario Review Board
Re: Aaron R. Maki
ORB File No: 6009
Hearing held on: Wednesday, June 4, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks
Members: Dr. S. Chatterjeee Dr. M. Kalia Mr. D. D’Intino Mr. S. Duffy
Parties Appearing:
Accused: Aaron R. Maki Counsel: Mr. T. McIver
The person in charge of hospital: Representative: Dr. J. Pytyck
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated June 18, 2025)
Introduction:
On November 28, 2011, Aaron Maki, was found not criminally responsible on account of mental disorder (“NCR”) on three charges of assaulting police, contrary to the Criminal Code of Canada. He is currently subject to a Disposition of the Ontario Review Board dated June 6, 2024, ordering that he be detained at the Forensic Program of the Ontario Shores Centre for Mental Health Sciences (“Ontario Shores” or the “hospital”) subject to a variety of terms and conditions including discretionary privileges up to entering the community within 150 kilometers of Ontario Shores, accompanied by staff or a person approved by the person in charge of the hospital.
On June 4, 2025, the Ontario Review Board (“ORB” or the “Board”) convened at Ontario Shores to conduct Mr. Maki’s annual review and to make a Disposition, pursuant to s. 672.81(1) of the Criminal Code. Mr. Maki was present and represented by his counsel, Mr. McIver.
The issues before the Board are whether Mr. Maki continues to pose a significant threat to the safety of the public as defined in s. 672.5401 of the Criminal Code and, if so, the determination of the necessary and appropriate Disposition to manage the risk, having regard to the criteria set out in s. 672.54 of the Criminal Code.
For the Reasons set forth below, the Board orders Mr. Maki be detained within the Forensic Program subject to the conditions set out in his existing Disposition save for the addition of:
indirectly supervised access to the community within 150 km of Ontario Shores for a period for up to 12 hours;
passes for up to 7 days within the community of southern Ontario, accompanied by staff or a person approved by the PIC, subject to an itinerary approved by the PIC;
the privilege to live in the community in accommodation approved by the PIC; and
when living in the community, Mr. Maki should be directed to report to the PIC, or his/her designate, not less than once per week, or as directed.
Position of the Parties:
- At the outset of the hearing, counsel for Ontario Shores submitted that the necessary and appropriate Disposition was a Detention Order on the same terms and conditions as his existing Disposition save for the addition of:
indirectly supervised access to the community within 150 km of Ontario Shores for a period for up to 12 hours;
passes for up to 7 days within the community of southern Ontario, accompanied by staff or a person approved by the person in charge of the hospital (“PIC”), subject to an itinerary approved by the PIC;
the privilege to live in the community in accommodation approved by the PIC; and
when living in the community, Mr. Maki should be directed to report to the PIC, or his/her designate, not less than once per week, or as directed.
Counsel for the Attorney General of Ontario supported the recommendations of the hospital but for the inclusion of passes for up to 7 days, indirectly supervised, and the addition of a community living privilege.
Counsel for Mr. Maki, Mr. McIver, supported the recommendations of the hospital. All counsel agreed that there would be no challenge to a finding that Mr. Maki continues to represent a significant threat to the safety of the public.
The hospital’s representative and the counsel for Mr. Maki maintained their joint recommendation in closing submissions. Counsel for the Crown asserted in closing submissions that she was not supportive of the addition of a community living privilege; however, she was otherwise supportive of the additional privileges recommended by the hospital.
Index Offences:
- The circumstances giving rise to the index offences are set out in last year’s Reasons for Disposition, as follows:
“Over the past few months, the parents of the accused, Kelly and Richard Maki, have grown increasingly concerned with the accused’s mental health. Due to his condition, his behaviour has become more unpredictable. He has written notes on pieces of paper, which illustrate his mental health issues. The Maki family has become concerned for their safety and have even resorted to locking their bedrooms at night when they sleep. Richard and Kelly Maki are also concerned for the safety of their daughter, Ashley Maki, who is sometimes at home alone with the accused.
On Sunday, August 28, 2011, Richard and Kelly Maki began to fear-for their safety due to the deteriorating mental condition of the accused and called police to their residence at [street address] in the City of Kitchener. The accused had become agitated and was shouting at Kelly Maki, "Brad, there are no serial killers allowed in this house. You are going to have to leave". Richard and Kelly Maki wanted the accused permanently removed from their home.
Acting Sgt. Hopiavuori, Cst. Gren, Cst. Amaral and Cst. Cheng responded. It was determined that the accused required evaluation under the Mental Health Act. Police made attempts to peacefully remove the accused from the residence to no avail. The accused repeatedly made a motion with his leg, like drawing a line with his foot on the carpet. Cst. Amaral and Cst. Cheng approached the accused from either side, attempting to apprehend him under the Mental Health Act and remove him from the residence as requested by the family. However, the accused became assaultive, swinging his arms violently.
During the struggle to control the accused, Cst. Amaral and Cst. Cheng were punched on the left side of the head. Acting Sgt. Hopiavuori was struck in his left eye and Cst. Gren was bitten on his right thumb and left calf. Cst. Gren delivered a closed punch strike to defend himself against the accused and broke his right thumb.
Upon gaining compliance of the accused, he was grounded and at 6:02 p.m., he was arrested for Assault Peace Officer.
When the situation had calmed, Cst. Amaral and Cst. Cheng brought the accused onto his feet where he immediately turned and spit in Cst. Amaral's face. He was grounded again and his legs were restrained using a rip-hobble. He was carried out to the police cruiser and secured.”
Personal Background:
Mr. Maki’s personal and psychiatric history are set out in the Hospital Report to the ORB dated May 23, 2025 (the “Hospital Report”), which was marked as an Exhibit, and will not be repeated in detail here. Briefly stated, Mr. Maki, who is a 36-year-old man, was born and raised in Kitchener, Ontario. His family still reside there. He has one sibling, an older sister. He was an A-student until his teenage years but around that time, conflict developed with his parents due to his lack of motivation, poor choices, drug use and problems at school. He would frequently leave home to be with his friends. He began to be assaultive towards his mother and engaged in self-harm, usually by cutting himself.
Mr. Maki left school before completing grade 11 but did complete his GED through adult classes. His employment history has been sporadic with only a few part-time jobs in the food service sector.
Mr. Maki has a long history of substance abuse starting when he was about 14 years of age. He used cannabis on a daily basis for several years and also used crystal methamphetamine and ecstasy. Mr. Maki self-identified as homosexual.
Psychiatric History:
The Hospital Report sets out a long history of involvement with mental health care commencing in 2005 when he was 16 years old. His first psychiatric contact occurred after he locked himself in the bathroom with an exacto knife. He was apprehended under the Mental Health Act.
Prior to the index offences, he had been apprehended under the Mental Health Act on at least six separate occasions. Many of those admissions involved violent and threatening behaviour or suicidal ideation.
Following the finding of NCR, Mr. Maki was initially detained at Waypoint Centre for Mental Health Care – High Secure Provincial Forensic Program (“Waypoint”) until his transfer to St. Joseph's Healthcare Hamilton (“St. Joseph's”).
In Hamilton, Mr. Maki was able to transition to living in the community where he had obtained employment. Mr. Maki was granted a Conditional Discharge by the Board on November 15, 2016. He began living with his parents on March 31, 2016. Unfortunately, he was arrested on October 30, 2017 and charged with assault, assault with a weapon, assault bodily harm and weapons dangerous against his parents. Mr. Maki was in the kitchen with his parents when he attempted to strike his mother in the head twice with a knife. Luckily, he only cut her hand. Mr. Maki then stabbed his mother in the back. His father intervened and he was also stabbed in the hand. His father was able to call the police and Mr. Maki was arrested. He smelled of alcohol and admitted to having consumed alcohol prior to the incident.
Mr. Maki was readmitted to the hospital and, on November 2, 2017 at his ORB hearing, Mr. Maki was ordered detained on the secure unit with only compassionate privileges. The Board was advised that the criminal charges resolved in June of 2018. Mr. Maki was sentenced to time served and probation.
Mr. Maki continued to reside on the general forensic unit at St. Joseph's. In 2020, Mr. Maki was transferred back to Waypoint. He remained at Waypoint until his transfer to Ontario Shores on April 22, 2024.
Current Diagnoses:
- Mr. Maki’s current diagnoses are:
Schizoaffective disorder, Bipolar type; and
Amphetamine-type substance use disorder, Moderate.
Criminal History:
His criminal record, prior to the index offences, included convictions for mischief (x2), possession of a weapons dangerous, and assault peace officer (x3).
As stated above, Mr. Maki was arrested on October 30, 2017 and charged with assault, assault with a weapon, assault bodily harm and weapons dangerous in relation to a violent knife attack against his parents.
Evidence at the Hearing:
Dr. J. Pytyck, Mr. Maki’s treating psychiatrist, gave evidence at the hearing to supplement the contents of the Hospital Report which was entered as Exhibit. She has been his most responsible psychiatrist since November 2024. Dr. Pytyck endorsed the contents of the Hospital Report.
Following last year’s ORB hearing, Mr. Maki remained on a secure forensic unit. He managed well on that secure forensic unit and had been medication compliant and abstinent of substances. He did not present as a management problem.
Mr. Maki was transferred from the Forensic Assessment Rehabilitation Unit (“FARU”) to the Forensic Transitional Unit (“FTU”), a general forensic unit, on November 22, 2024. He shared a room with a co-patient and they have managed well together. Mr. Maki is noted to be selective in interacting with co-patients and mostly keeps to himself. He has not posed a management problem. There have been no incidents of verbal, physical or environmental aggression.
Dr. Pytyck advised that over the winter months in 2025, Mr. Maki was presenting as more downcast and he expressed feelings of frustration regarding the fact that he had reached the ceiling of privileges under his ORB Disposition.
On March 10, 2025, Mr. Maki moved to an independent room due to an incident that was reported by a male co-peer alleging that Mr. Maki had offered sexual favors to him. Mr. Maki denied making sexual advances to his roommate but was happy to have his own room.
Mr. Maki keeps himself busy with exercise, sports, TV, music, and going on outings. He volunteers twice a week at the hospital’s gift shop and is engaged in weekly CBT. He has occasionally been accompanied off unit on town passes.
Mr. Maki is in infrequent contact with his family who visited him only two or three times over the past year.
Mr. Maki is capable to make treatment decisions and he currently receives daily oral doses of an antipsychotic medication, Olanzapine, as well as a mood-stabilizer, Valproic Sodium. Over the past reporting year, he has declined to make changes to his medications particularly with respect to those addressing his sleep challenges. Additionally, Mr. Maki has been resistant to recommendations of the treatment team to adjusting his medications to respond to what appeared to be a depressed mood.
Recently, in April 2025, Mr. Maki agreed to a trial of Mirtazapine, an antidepressant medication. Following treatment with this medication, he presented with improved sleep and mood. Unfortunately, Mr. Maki disclosed experiencing breakthrough psychotic symptoms after this medication was added. As a result, the antidepressant medication was discontinued. Dr. Pytyck testified that there were no overt behavioural changes in Mr. Maki’s presentation but, to his credit, he disclosed experiencing past delusional beliefs. Mr. Maki recently agreed to an increase in his Valproic Sodium medication and has now returned to his psychiatric baseline.
Mr. Maki has indicated an intention to seek out employment opportunities in the community over the upcoming reporting year.
In terms of his mental state, Mr. Maki denies the presence of any ongoing psychotic symptoms, suicidal or homicidal ideation. His thought form presents as generally organized. No overt signs of severe psychosis have been observed over the year in review other than in the winter of 2025 when, as stated, his mood was observed to be lower than his baseline present.
When suffering from the symptoms of his illness, he has experienced mania, hallucinations, paranoid delusions with violent or aggressive themes. These symptoms have resulted in his experience of distress, agitation, and numerous incidents of self-injurious behaviours.
Over the year, Mr. Maki progressed to using indirectly supervised hospital grounds privileges without issue while on the secure unit. In addition, he also used staff accompanied community privileges. He has disclosed experiencing cravings to use cannabis, and, less frequently, crystal methamphetamine, but for the bulk of the year in review, he had been successful in avoiding relapse.
Unfortunately, on March 10, 2025, Mr. Maki’s urine specimen tested positive for amphetamines/methamphetamines and, as a result, his indirectly supervised privileges were put on hold.
A further urine specimen collected on March 21, 2025, revealed that Mr. Maki tested positive for amphetamines/methamphetamines. This was discovered on March 26, 2025. Another urine specimen collected on April 4, 2025, revealed, on April 9, 2025, that Mr. Maki tested positive for benzoylecgonine (a cocaine metabolite). Of note, Mr. Maki’s use of these substances did not result in any exacerbation of the symptoms of his illness; however, the Hospital Report notes that, “…he did engage in some unusual and intrusive behaviours that suggested disinhibition in poor judgement.”
The Hospital Report notes that “…Mr. Maki has not demonstrated any explicit or well-formed plans about how he will prevent future slips and has been vague about what motivated him to use substances again after a lengthy period of abstinence.”
Dr. Pytyck stated that Mr. Maki has re-engaged in concurrent disorders programming and there have been no further incidences of substance use.
In terms of programming, Mr. Maki has also participated in the anger management group and he completed the IMR: Building Social Supports group.
Dr. Pytyck stated that Mr. Maki expresses reasonably good insight into his illness, past symptoms of mood disturbance and psychosis, and need for ongoing treatment with antipsychotic, antidepressant, and mood-stabilizing medication. He demonstrates less fulsome insight into the deleterious impact of substance use on his mental state. Over the past year in review, he has had difficulties maintaining abstinence, particularly during a recent depressive episode in the spring of 2025. Dr. Pytyck stated that Mr. Maki is very aware of the fact that any further use of substances will delay his discharge to the community. His insight is underdeveloped in understanding the nexus between past substance use and his violent behaviours although he is able to recognize that substance use has the potential to accentuate the symptoms of his illness.
Dr. Pytyck testified that Mr. Maki understands that he will likely need to remain detained in hospital over the balance of the upcoming reporting year in order to demonstrate his commitment to abstinence and his ability to progress through the privilege ladder. He clearly understands that he needs to demonstrate sustained mental stability in context of being granted increased liberties.
At the present time, Mr. Maki does not have an Approved Person. The doctor stated that his parents may choose to apply to be designated as Approved Persons but they have not yet approached the treatment team in this regard. The process takes several months.
Dr. Pytyck testified that it is highly unlikely that Mr. Maki would be discharged to reside in the community over the upcoming reporting period. She stated that he will need to evidence 6-8 months of sustained stability and progress through the privilege ladder before the team would be likely to place him on waitlists for supervised community housing. The doctor stated that the addition of a community living privilege could be helpful in terms of getting Mr. Maki on waitlists which, she added, are typically quite lengthy. In response to a question posed, the doctor stated that the addition of community living privilege might be a motivating factor for Mr. Maki even though he is well aware that he would not be likely to transition to community living over the upcoming year.
Dr. Pytyck stated that on his initial discharge to the community, the team would likely be looking at 24/7 supervised accommodation for Mr. Maki. Shye commented that this level of supervision and oversight would be important to mitigate his risk of relapse to substance use.
The Hospital Report indicates that:“… a possible re-offence scenario, given a Detention order with a provision for Community Living includes the following: Mr. Maki would resume using substances and fall away from medication. Given his history of rapid decompensation without regular medication administration, he will experience a return of his manic and psychotic symptoms, including irritability, suspiciousness and paranoid delusions. In this state, his risk of acting out violently towards a member of staff, another patient or a member of the community would increase significantly.” Dr. Pytyck however, indicated that despite the conclusion expressed in the Hospital Report that Mr. Maki’s risk of violent offending would be “moderate” if under a Detention Order augmented by a community living privilege, she considered it would be somewhat lower.
In terms of the plan going forward, the doctor advised that, should the Board issue a Disposition as recommended by the hospital, then Mr. Maki will slowly and cautiously be granted increasingly liberal privileges to see how he manages same, particularly with regard to his use of substances. Further, the hospital will continue to assess if his mood symptoms are optimally treated. Enhanced community access will allow Mr. Maki to potentially engage in vocational or other structured activities outside of the hospital. In the doctor’s opinion, if Mr. Maki is able to maintain a positive trajectory, including medication compliance, abstinence from substance use, and appropriate use of increasingly liberal privileges for a sustained period of time then, thereafter, it would be reasonable to consider his appropriateness for discharge to supervised community housing.
In response to questions posed regarding the proposed duration of the indirectly supervised community passes, Dr. Pytyck stated that such privileges would be granted for successively longer periods of time provided they were used appropriately and without incident. She indicated that Mr. Maki would be unlikely to be granted a pass in excess of 6 hours in duration unless it was for the purpose of a visit or outing with his parents or for a vocational purpose.
No further evidence was called by the parties.
Analysis and Conclusions:
The Board finds that Mr. Maki continues to pose a significant threat to public safety. Mr. Maki has a long history of violent and aggressive behaviour both predating and postdating the index offences. Even while under the Board’s jurisdiction and receiving treatment and with the support of community-based treatment team from the hospital, he committed violent acts. To his credit, over the year in review, there have been no incidents of violent aggression and Mr. Maki has demonstrated full compliance with his antipsychotic medications.
We note that Mr. Maki has a diagnosis of Schizoaffective disorder, Bipolar type, and when experiencing the symptoms of his illness, he presents with mania, hallucinations, paranoid delusions with violent or aggressive themes that result in symptom-related distress, agitation and numerous incidents of self-injurious behaviours. Mr. Maki’s presentation is further complicated by his diagnosis of Amphetamine-type substance use disorder, Moderate. Over the year in review, he relapsed to amphetamine and cocaine use in March and April, 2025. Mr. Maki demonstrates underdeveloped insight into the nexus between substance use and his risk of aggression.
The panel also notes that Mr. Maki has a history of medication noncompliance even with the support of community-based treatment teams from the hospital, which has historically resulted in the re-emergence of psychotic symptoms and rehospitalizations. For all of these reasons, the Board finds that Mr. Maki continues to represent a significant threat to public safety.
Having come to the conclusion that Mr. Maki continues to represent a significant threat to public safety, we must craft the least restrictive and least onerous, as well as the necessary and appropriate, Disposition.
Overall, Mr. Maki had a fairly positive year in review. He has not presented with aggressive behaviours and has not posed as a management problem. He volunteered weekly in the hospital, attended regular individual therapy sessions with a Psychologist, regularly attended EPEC programming and was described by group facilitators as a “highly engaged” group member.
Unfortunately, Mr. Maki did relapse into substance use over a one-month period, in March and April, 2025. For the balance of the year in review however, he had used his privileges, including indirectly supervised privileges, appropriately. He has currently reached the ceiling of the privileges afforded to him under his current Disposition.
The Board finds that at this juncture, the necessary and appropriate Disposition to manage the risk is a continuation of his existing Detention Order with the addition of the privileges referred to below. In addition, we find that the hospital continues to require the risk management tools afforded by a Detention Order. This Disposition allows the hospital to maintain oversight into Mr. Maki’s placement in the community as well as maintaining the ability to promptly readmit him should he experience any decompensation in his mental state for any reason, or relapse to substance use. We concur with the recommendation of the hospital that the civil commitment measures of the Mental Health Act would not adequately address Mr. Maki’s risk profile at this juncture.
The Board agrees with the hospital that. It is necessary and appropriate to add a community living privilege in Mr. Maki’s Disposition at this time. She noted that the inclusion of such a provision will likely motivate him to use his privileges appropriately so he can progress to full community reintegration. The Board notes that privileges granted in an ORB Disposition do not grant an entitlement, rather they are privileges to be granted in the discretion of the hospital based on a patient’s clinical presentation.
The Board therefore orders that Mr. Maki be detained within the Forensic Program subject to the conditions set out in his existing Disposition save for the addition of:
indirectly supervised access to the community within 150 km of Ontario Shores for a period for up to 12 hours;
passes for up to 7 days within the community of southern Ontario, accompanied by staff or a person approved by the PIC, subject to an itinerary approved by the PIC;
the privilege to live in the community in accommodation approved by the PIC; and
when living in the community, Mr. Maki should be directed to report to the PIC, or his/her designate, not less than once per week, or as directed.
- In making this Disposition, the panel reviewed the provisions of section 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Maki’s mental condition, his reintegration into society, and his other needs.
DATED this 18th day of June 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar Ontario Review Board