Ontario Review Board
Re: Spencer Hambly
ORB File No: 8600
Hearing held on: Thursday, April 10, 2025
Place of Hearing: Providence Care Hospital, Kingston
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. K.A. Connidis
Members: Dr. R. Kunjukrishnan
Dr. W. Loza
Ms. N. Nathanson
Mr. R. Rainboth
Parties Appearing:
Accused: Spencer Hambly
Counsel: Mr. M. Ertel
Person in charge of hospital: Counsel: Ms. T. Tom
Representative: Dr. M. Chan
Attorney-General of Ontario: Counsel: Ms. J. Ferguson
REASONS FOR DISPOSITION
(Dated July 28, 2025)
Introduction and Positions of the Parties
On August 1, 2024, Mr. Hambly was found not criminally responsible on account of mental disorder (‘NCR’) on March 2022 charges of unsafe storage of firearms (1 charge) and possessing a firearm knowing its serial number had been altered (4 charges). The Court made no disposition and released Mr. Hambly from custody, to live in the community under the terms of his judicial release undertaking, while awaiting his initial hearing by the Ontario Review Board.
On April 10, 2025, this panel of the Board convened at Providence Care Hospital (the 'hospital') to conduct the initial hearing. In addition to Mr. Hambly and the other parties noted above, Mr. Hambly's parents attended the hearing in support of their son.
The issues to be decided were whether Mr. Hambly poses a significant threat to the safety of the public at this time, and, if so, what disposition for him is necessary and appropriate for the coming year, taking into account the four factors set out in section 672.54 of the Criminal Code. The evidence at the hearing included a Hospital Report dated April 2, 2025 (the ‘Hospital Report’) and the viva voce evidence of Dr. M. Chan.
At the outset of the hearing, the parties indicated their anticipated positions. Ms. Tom advised that the hospital's position was that Mr. Hambly represented a significant threat to the safety of the public, and recommended a Conditional Discharge, with the conditions set out in the Hospital Report, including a weapons prohibition, a substance use restriction, and residence and reporting requirements. Ms. Ferguson, for the Attorney-General, joined in the hospital’s position. Mr. Ertel, for Mr. Hambly, had questions to ask respecting certain proposed conditions.
For the reasons set out below, the Board finds that Mr. Hambly poses a significant threat to the safety of the public and that the necessary and appropriate disposition is a Conditional Discharge, with the terms noted in our Conclusions below.
The Index Offences (March 5, 2022)
- The circumstances of the index offences are set out at length in the Hospital Report, and can be slightly summarized as follows:
On March 5, 2022, a concerned neighbour called Kingston Police to report that Mr. Hambly was exhibiting concerning behaviour and making utterances of having firearms and hostages, which had been going on for about a day. Police officers attended his apartment to check on his welfare. He was screaming and rambling-on when they arrived at his door. He refused them entry, refused to give his name or any information, and claimed to be the actor Nicholas Cage and other personalities. He told them the Dutch embassy had advised him to take up arms, and that he was going to grab his gun and protect the door.
It was evident to the police on the scene that he was suffering from a mental health crisis. They were already aware that he had a valid firearms licence – a Possession and Acquisition Licence (P.A.L.) with a restricted firearms authorization.
With the safety of the police and public in mind, they considered this was a potentially armed and barricaded person incident. They found a position of safety and arranged for both the Emergency Response Unit and the Incident Command police to attend. The incident proceeded to a standoff lasting more than eight hours. There were continuous attempts to make contact with Mr. Hambly. He continued making various nonsensical utterances and speaking in different vocal personalities. The apartment complex was evacuated. The street was shut down to prevent injury or death to the public.
The standoff concluded after the Emergency Response Unit police entered his apartment. They observed a gun-like object on his living room couch. They apprehended him under the Mental Health Act, deeming him to be suffering from a mental health crisis and his actions to pose an immediate safety risk to himself and others. He was combative in resisting arrest. It took several officers and the use of tasers to make the arrest.
The object on the couch was found to be a fully-functioning Glock pistol, loaded with a full magazine, in a 'readied' state with a round in the chamber. It was not stored as prescribed by the Criminal Code (Charge #1: Careless Storage of a Firearm).
After Mr. Hambly was removed from his apartment, police entered and seized all firearms and ammunition in it, for public safety purposes. Two gun lockers were located and unlocked with a key found in the apartment. Inside were 13 more firearms, 3 hunting bows, and a wealth of ammunition. Of the 14 firearms in total, 4 had their serial numbers ground off: an SKS semi-automatic rifle; a Winchester Model 94 lever action rifle; a New England Firearms 22 calibre break barrel rifle, and a Remington Model 700 bolt action rifle (Charges #2, 3, 4, and 5: Possessing a Firearm with an altered serial number).
Relevant Personal Background, from the Hospital Report
Reference should be made to the Hospital Report for an account of Mr. Hambly's personal history prior to the index offences. That Report being an exhibit, its detailed contents need not be reiterated here, but the following salient points from it are noted. As Dr. Chan noted in the Hospital Report, it is important to know Mr. Hambly's history of psychiatric admissions and community care, in order to understand how he got to the index offences, and what concerns they raise.
Mr. Hambly is now 33 years old. He was born and grew up in Ingleside, Ontario, the eldest of three boys. The family moved to Kingston when he was twelve years old. He described his childhood, with the exception of school, as "great". There were no remarkable problems reported, other than a bare mention, in later ACT team records, of a childhood diagnosis of oppositional defiant disorder. He was described as "highly intelligent" and "not hyperactive", and as having been bored in school. He was persistently bullied verbally by peers, in kindergarten and elementary schools. In grade 5 or 6, he was reportedly diagnosed with dysgraphia. He then continued his schooling within the structure of an individual education plan ('IEP'), up to high school graduation. He maintained average grades. He recently described school as having been hard, but noted that he excelled with the right supports.
At age fifteen, he started working at a Canadian Tire store, in the outdoor equipment section. He reported that, because the store sold hunting gear including guns, he was required to hold a firearms permit. This job was said to be "a good fit" for him, as he enjoyed a wide variety of outdoor activities, including hunting, fishing, and boating. He maintained this job until he went to college. There, he completed a one-year electrical techniques course, and did some short-term work, before securing a position with Hydro One.
His parents noticed a gradual change in his mental state and behaviour, with increasing anger and conflict with them, when he was about nineteen years old and working following college. Mr. Hambly had one or two short romantic relationships in about his early twenties.
Mr. Hambly began using cannabis in his adolescence, with daily use in college, and regular use continuing since then, in a range or approximately 0.5 to 1 gram per day. A vague reference in a previous psychiatric report to a "drinking and drug culture" at Hydro One, notes that Mr. Hambly's alcohol use "increased", but was "not heavy".
As an apprentice Lineman at Hydro One, Mr. Hambly's schedule was unpredictable, he worked long hours, and he had to travel and live out of hotel rooms for many years. He described a stressful time on a remote work placement in Ear Falls in northern Ontario in 2017, when he was about 26 years old, and it appears mental health difficulties developed. He was apparently socially isolated there. He described being targeted by local co-workers with increasing hostility, being harassed and persecuted by them for some time, and having no friends, just "acquaintances".
A fatal helicopter crash in Tweed in 2017, in which he knew two of the men who died, was noted to be a watershed moment for him. It was followed by two other serious workplace safety incidents, and his report that "something clicked … I wasn't right". He was eating and sleeping very little. He began believing co-workers were " out to get him", and that his parents – from whom he was then estranged – were collaborating with people in Ear Falls to drive him out of town. At one point, he was living in a camper van in the woods, having found people reticent to rent to him. He eventually reached out to his parents for help and moved back home. His mental health continued to deteriorate, with increasing paranoia, including believing Hydro helicopters were spying on him. His family physician prescribed medication (apparently escitalopram, for anxiety) and his symptoms improved, but he soon stopped taking the medication and his mental health deteriorated again.
In December 2018, distressed, agitated, and behaving aggressively (including with his guns and, in one vaguely-described instance, with "a large knife"), he loaded his firearms into his truck, apparently intending to confront people in northern Ontario whom he believed were threatening him. His concerned family called police, who brought him to Kingston General Hospital ('KGH'), where paranoid delusions, delusions of reference, auditory hallucinations, and suicidal thoughts were noted. Admitted and treated with oral antipsychotic medication (Olanzapine), he settled. The KGH admitting psychiatrist, concerned about Mr. Hambly's access to firearms, contacted the RCMP; the RCMP were apparently already aware of his firearms access from past contact. He was discharged two weeks later with a diagnosis of "delusional disorder vs. psychosis".
In March 2019, after being referred to Providence Care Hospital, Mr. Hambly entered their Head's Up! Early Psychosis ('E.P.') outpatient program, under Dr. Ayunrinde and then Dr. Habib. There were diagnostic modifications, with a working diagnosis of "Psychosis NOS - in remission" in December 2019. At that time, he had a medical prescription for cannabis, to treat anxiety, which thus had a known composition (in the ratio of TCH, the psychoactive ingredient, to CBD content), and was noted to be "a safer and more measurable use than buying from unregulated sources".
His treatments included the oral Olanzapine antipsychotic medication, and psychoeducation on a range of topics, including cannabis health and harm reduction teaching, and anger management.
Mr. Hambly was preoccupied, from the time he entered the E.P. program, with regaining his P.A.L. firearms licence. It was reinstated later that year, in November 2019.
There were further diagnostic modifications. In June 2020, his working diagnosis was "Query cannabis-induced psychosis", with "low mood, anxiety, query depression or dysthymia, cannabis abuse, and impaired functioning" in the form of "rumination and catastrophizing." He was no longer on medication at that point, and was described as stable. In July 2020, he relapsed into psychosis, in the context of increased psycho-social stressors, abnormal sleep patterns, and increased THC use. He was described as resisting cannabis use recommendations (presumably to decrease the ratio of THC to CBD content), and a lot of concern was raised over his cannabis use potentially negatively impacting his psychotic condition.
In July 2021, his diagnoses were changed to "Unspecified psychosis - likely PTSD-related" and "Paranoid personality disorder" (emphasis added in these Reasons). He was noted to "abuse cannabis". It was noted that he had not improved on a trial of Olanzapine antipsychotic medication, apparently due to metabolic changes with weight gain, and was taking Cipralex (mood-regulating) and Imovane (short-term sleep or sedative) medications. At that point, he had reportedly completed, and found helpful, a Kingston Health Sciences Centre ('KHSC') Intensive Treatment Program for managing emotions, with skills training in distress tolerance and emotion regulation.
In August 2021, Mr. Hambly was discharged from the E.P. program, with a discharge summary indicating that a "diagnosis of schizophrenia or substance-induced psychosis had been ruled out" (emphasis added). Thus, as highlighted in the Hospital Report by Dr. Chan, the psychotic diagnosis was replaced (rather than accompanied) by a trauma / PTSD diagnosis, and Mr. Hambly was receiving no antipsychotic medication treatment. He was connected with a private psychotherapy practice, with trauma treatment recommended, and returned to his family physician, Dr. Dubois. He declined a referral to the Frontenac Assertive Community Treatment (Frontenac 'ACT') team, associated with the local community mental health agency, 'AMHS' (Addiction and Mental Health Services, for Kingston, Frontenac, Lennox & Addington).
At some point later in 2021, Mr. Hambly again developed symptoms of psychosis, including paranoia, delusions of persecution by neighbours, fear of being poisoned, thought insertion and broadcasting, and auditory hallucinations. His mother tried multiple times to connect him with services, to no avail. In January or on February 1, 2022, due to his increasing psychosis, his family physician referred him back to KHSC, apparently to Hotel Dieu Hospital. However, the hospital declined the referral, citing the E.P. Program discharge recommendations; the focus was put on attending to those recommendations, including the trauma concerns.
A month later, on March 6, 2022, the index offence occurred, resulting in his arrest and readmission to KGH, where he remained until April 20, 2022.
Mr. Hambly has no prior criminal record indicated in the CPIC Report, and no prior history with Kingston police indicated in police information, as indicated in the Hospital Report. However, its references to police involvement – in an impaired driving or "DUI charge due to cannabis use", and in the course of his hospital admission in 2018, for example – remain to be clarified.
Course following the Index Offences (March 2022) and NCR Finding (August 2024)
The Hospital Report should be referred to for an account of Mr. Hambly's course subsequent to the index offences on March 6, 2022, and the NCR finding on August 1, 2024. This history need not be reiterated in detail here, but the following relevant points are noted.
On March 6, 2022, following the index offences, Mr. Hambly was readmitted to KGH, in an apparent full relapse into psychosis. He remained in hospital for six weeks. At this point, he was diagnosed with schizophrenia along with a notation that he had been traumatized by certain events before he became psychotic. He was found incapable of consenting to medication treatment. He was begun, with substitute consent, on treatment with a long-acting injectable ('LAI') antipsychotic medication, Abilify, to good effect, and he settled in hospital.
On his April 20, 2022, discharge from KGH, his paranoid presentation and very poor insight were noted. A Community Treatment Order ('CTO') had been put in place for him while in hospital, to ensure close follow-up after discharge. He was referred again to the Frontenac ACT team, and this time he did begin follow up with them
Mr. Hambly has continued since then under this ACT team's oversight. His CTO has now been renewed five times, initially with the substitute consent of his parents. In the spring of 2022, his parents sold house and moved. Around that time, he was facing housing complaints, and was receiving ACT team support to prevent his eviction and to regain his P.A.L. firearms licence. A landlord and tenant hearing was scheduled.
By the fall of 2022, his family reported a "gigantic improvement", in his connecting with them, re-engaging in outdoor activities, and helping with maintenance. He maintained this over the months, while still seen to be "struggling with suspiciousness." His parents apparently hoped he would stop his cannabis use. He was counselled about the importance of the THC-to-CBD ratio in and the use of Nabilone (for which he had a prescription from Canadian Cannabis Clinics).
In early 2023, medication for sleep and anxiety (Mirtazapine) was added to his treatment. He apparently began seeing a psychologist, Dr. Kelly, on his family physician's recommendation, but stopped when Dr. Kelly suggested a diagnosis of schizophrenia. In the fall of 2023, he agreed that his LAI medication helped him remain calm, while still attributing his symptoms of psychosis not to schizophrenia but solely to PTSD. In a November 2023 interview with psychiatrist Dr. Ward, he described sleeping difficulties, "some anxiety", occasional nightmares about "traumatic events", but a "pretty stable" mood. In Dr. Ward's opinion, he retained residual delusional beliefs that people in his old town were working against him. His mother reported that he was "the best [they had] ever seen him" and that he participated in outdoor recreational activities and family events.
In January 2024, Mr. Hambly's ACT team psychiatric care was transferred for part of the year to Dr. Jariani. At that time, Mr. Hambly was described as having a dysphoric mood, lingering symptoms of paranoia, being in the "pre-contemplative phase" about cannabis use, and having "partial insight" and "intact judgment". Dr. Jariani suggested that he engage in cognitive-behavioural therapy for psychosis ('CBT-p') to treat his PTSD symptoms; that he reduce his cannabis use, as it could be lowering his mood and motivation and increasing his risk of relapse into psychosis, and that his Mirtazapine medication be increased. He reported that he arranged to resume working with a Limestone Clinic counsellor, Taylor Jackson, with whom he apparently had begun in early 2023, but stopped at some point.
At the time of this initial hearing, Mr. Hambly remained with the Frontenac ACT team in the care of Dr. Delva, and under his CTO. He was being treated to good effect with Abilify antipsychotic medication (now in oral format daily), and had settled on it again.
With respect to his cannabis use, Mr. Hambly had in the past reported receiving medical marijuana for anxiety, in strains with a higher ratio of THC to CBD than today. He reported, in a recent clinical interview, that he purchased his cannabis from local dispensaries, he preferred Indica strains which contain approximately equal parts THC and CBD, and he used approximately 1 gram a day. He has been prescribed Nabilone. He reported having a glass of bourbon on occasion, and having tried cocaine once in early adulthood.
Mr. Hambly has been unemployed since October 2018, and receiving a long-term disability pension through his employment benefits with Hydro One, which reportedly provides good coverage up to age 65. This pension has been sufficient for him to have his own apartment for the past five years, to buy a new truck in addition to his Smart Car, and to be approved for a mortgage.
Mr. Hambly is in contact with his parents and his two brothers, who are employed and have young families. He has his aunt and uncle in Lansdowne, whom he has said he could rely on if needed, and he also has paternal grandparents in Lyndhurst.
Current Risk Assessments, in the Hospital Report
The Hospital Report includes detailed information on the assessment of Mr. Hambly's risk of seriously harmful re-offence. Extracts from a Psychological Risk Assessment Report ('Report') dated March 14, 2025, provided by Dr. R. Douglas, include a concisely thorough elaboration of the results for Mr. Hambly as scored on three actuarially-based risk measurement tools.
On the LSI-R (Level of Service Inventory-Revised), the results for Mr. Hambly place him in a low range for both his risk for harmful re-offence and his needs for risk management (lower than 93.4% of male offenders in the sample group). The primary risk factors noted – social isolation, absence of employment, absence of organized leisure activities, and emotional/personal difficulties – are noted to all fall into the 'current or dynamic' rather than 'fixed or historic' risk categories, and to thus be potentially changeable.
The results on the HCR-20-v.3 (Historical-Clinical-Risk Management-20, Version 3) – which is a both clinically- and actuarially-derived tool for structuring professional judgment on future violence risk – identify as risk factors that are present or partially or possibly present: six of the ten historical risk items, with a seventh item ( requiring further exploration; two of the five current or dynamic risk items; and of the five risk management items, three if under a Board disposition, and all five if not under the Board's oversight.
The results on the SAPROF (Structured Assessment of Protective Factors for violence risk, 2nd Edition), indicate a number of factors that diminish Mr. Hambly's risk of violent re-offence. These include numerous "internal" and "motivational" protective factors, with some noted personal strengths, and numerous "external" protective factors, with his "professional care" highlighted as a "key" protective factor for him.
Dr. Douglas concluded, in brief summary, that Mr. Hambly's risk for violence (including seriously harmful re-offence) falls in the low to low-moderate range, while noting that his "risk to others is currently well managed in the context of a number of protective factors" – specifically including as "key protective factors" his medication adherence, self-control, pro-social life goals, and professional care – as well as his family support and his legal (including ORB) involvement, both of which serve to maintain his medication adherence and professional care.
Dr. Chan noted his risk concerns and assessment in a "Summary of Risk and Conclusions" in the Hospital Report, concluding, in part, as follows:
Mr. Hambly remains a risk to the safety of the public because he cannot see himself as risky at all presently. For the past three years he has not had police involvement, but it is attributed to the close aftercare he has received. Absent this his risk will elevate as it did into February/March 2022, when psychiatric aftercare was missing."
Viva Voce Evidence of Dr. M. Chan
- Dr. Chan provided his report at this initial hearing as the hospital's psychiatrist, although not Mr. Hambly's treating psychiatrist. Dr. Chan adopted the contents of the Hospital Report, and testified further in chief, in summary, as follows:
(a) Mr. Hambly continues to be followed in the community by the Frontenac Assertive Community Treatment ('ACT') team, with Dr. Delva his ACT team treating psychiatrist.
(b) Mr. Hambly's NCR finding was not made until August 2024. Given that he is from the Kingston area, it was very unusual for the hospital's Forensic Service to not have been involved until now. Dr. Chan does not know why that happened, but his case was pursued through his Ottawa counsel and then later he was found to be NCR.
(c) Dr. Chan has met with Mr. Hambly two times in the past number of weeks and has reviewed the information relating to him – including from Dr. Ward; from his two earlier admissions to Providence Care Hospital, first in December 2018 and then in March 2022 following the index offences, and from his local contacts.
(d) Dr. Chan confirmed his opinion that Mr. Hambly presents a significant threat to the safety of the public. It is clear to Dr. Chan from this information, and it was clear to others at earlier times, that Mr. Hambly is suffering from a psychotic illness.
(e) However, Mr. Hambly has had great difficulty accepting this illness. He was able to convince other psychiatrists, including his treating psychiatrist on the Heads Up! team in 2021, that the problem was not a psychotic illness but trauma.
(f) On that basis, in August 2021, he was discharged from the Heads Up! Program. He then came off his antipsychotic medication. By the beginning of 2022, his family were very concerned about his mental state. They went to his family doctor, she referred him to Hotel Dieu Hospital, but they refused to see him, putting all the emphasis on the trauma condition, and none on the psychotic illness diagnosis. Then, the index offence incidents unfolded.
(g) Mr. Hambly should have stayed on the antipsychotic medication. It was critical. Whatever his particular diagnosis, it is on the psychotic disorder spectrum. His coming off his antipsychotic medication set the stage for his psychotic relapses, both in 2018 and in 2021-22. His illness is a recurring one by nature, if treatment is not attended to.
(h) Recently, Dr. Chan first asked Mr. Hambly what his take is on his diagnosis, and he put a lot of emphasis on his trauma. This was the same view he had after his discharge from Heads Up! This concerns Dr. Chan. This is the risk: he still struggles with the psychotic label and the implications of it.
(i) At this time, Mr. Hambly's treatment is being handled by his community ACT team. If the hospital's Forensic Outpatient Service ('forensic outpatient') team felt Mr. Hambly was slipping, then Dr. Chan would need to be in touch with the ACT team in order to take steps.
(j) At this time, Mr. Hambly has no idea what the forensic system is about. He was very stressed and anxious about coming into it, and feared he would be pulled into the hospital. Dr. Chan has begun explaining to him how the admissions system works, and what arrangements could be considered.
(k) Their second meeting was in more recent weeks. Dr. Chan explained to Mr. Hambly then that both trauma and psychotic illness play a role, that if something stressful pushes him over the cliff into psychosis, that means one problem negatively impacts the other. But with a psychotic illness, it is most important that it be treated, because psychotic relapse is at risk. And if weapons are involved, it is a very serious risk. Dr. Chan explained they would be helping him to be well, and eventually to be able to leave the system.
(k) Mr. Hambly's medication, Abilify, is still a work in progress and something to discuss with the ACT team. He used to be on a long-acting injectable ('LAI'), which was switched to an oral medication because he was having a side effect of upper G.I. problems. However, he still has an upset stomach, with nausea and vomiting. The concern is that he might be tempted to want to change course and come off his medications. Dr. Delva is looking into this side-effect concern.
(l) With respect to his recommendation of a Conditional Discharge, Dr. Chan explained that at this point, with Mr. Hambly having lived in the community all this time without incident, it was hard for him to argue for any other disposition than that.
(m) Mr. Hambly's use of cannabis is a controversial issue. He has used it for a long time, since he was a teenager, using a gram a day. He is a regular daily user, and it is a struggle for him to stop. He says he cannot live without it. After many discussions with Dr. Habib at Heads Up!, its composition was changed to less THC, the psychoactive part, and more CBD (25% THC to 75% CBD), and he gets it at a dispensary. Dr. Chan and his team did not like his ongoing use, because they know THC can push someone with a psychotic illness into psychosis. However, although they were not thrilled about it, they felt they could manage the risk, with the content and quality of the cannabis being controlled, and so they recommended allowing his continued use of cannabis in his disposition.
(n) Alcohol was not involved in the index offence. Mr. Hambly does drink, apparently being fond of bourbon. An alcohol prohibition is recommended because in general psychiatrists do not like a patient with a psychotic illness to drink, because alcohol can be a disinhibiting agent. The concern is that, under stress, a patient might drink, thinking that will help settle them down, but too much alcohol will be disinhibiting, and the next step could take them to persecutory thinking. This is a theoretical concern, at this point, in that it has not popped up in any practical way with Mr. Hambly.
(o) The use of alcohol and cannabis together is also a theoretical risk, and an additional risk, and something that needs to be monitored and supervised.
(p) With respect to the two teams working together, Dr. Chan would foresee that the forensic outpatient team would meet with Mr. Hambly at least twice a month, providing an extra pair of eyes on his mental state. Dr. Chan and the outpatient team know both Dr. Delva and case manager Ms. Deb Darling, who are currently following him. They know Deb well, from Mr. Hambly's previous relapse when he was at Providence Care Hospital: It is just as if the ACT case manager is their own. The ACT team and the forensic outpatient team are sharing information. If there is a concern, the FOPS team would bring it Dr. Delva's attention.
- In answer to questions from Ms. Ferguson for the Attorney General, Dr. Chan testified, in summary, as follows:
(a) Dr. Chan noted his concern that, Mr. Hambly having been a shy and sensitive child who was bullied and then picked on by his work colleagues up North, a fragile sense of self affected his social development, and now, as an adult, he feels he needs to protect himself if he perceives a threat. This has been the problem, given his psychosis.
(b) Use of any intoxicant would worry Dr. Chan. Certainly, mixing cannabis with alcohol would have an additive effect. If Mr. Hambly was confronted with a stressful situation and felt he needed courage to deal with it, alcohol could come into the picture. Its effect on his Abilify medication, breaking it down, would also be something to worry about.
(c) Mr. Hambly has a medical prescriber for cannabis, which is better than a street source, because the quality and the prescription are both controlled. The FOPS team should perhaps be in touch with the prescriber, to be sure they are on the same page respecting the quality, quantity, and control of his cannabis use.
(d) Dr. Chan reiterated that they know there is vulnerability in his use of cannabis, without a doubt: cannabis can push a person over into psychosis if there are vulnerabilities.
(e) Respecting the "DUI" noted in the clinical record, as Dr. Chan best recalled, that was in 2018, when Mr. Hambly stormed off from a party gathering, where there had been drinking and he had weapons. Dr. Chan had no information regarding the "large knife" noted in the ER Records.
(f) Any time weapons arise, Dr. Chan would be concerned. He would talk first with Mr. Hambly and his parents, to review and get to know Mr. Hambly better. Dr. Chan reiterated that he is still getting to know Mr. Hambly and does not want to overwhelm him with too many questions yet, but these questions will be forthcoming.
(g) The tensions Mr. Hambly had with his parents seemed to come down to their seeing when he was not well, and his being upset that they were being intrusive. It was almost as if he was holding a grudge against them. Dr. Chan has said to him: we all want the best for you, we are all working for your wellness.
(h) Respecting the information in the Hospital Report that "Mr. Hambly does not have a history of problems with other antisocial behaviour", Dr. Chan noted that Mr. Hambly is very respectful of rules and regulations.
(i) Respecting the risk of harm if Mr. Hambly relapsed, Dr. Chan reiterated that he worried about what would happen. Referring to Mr. Hambly's explanation that he had intended to confront his co-workers directly with the firearms (on his hospital admission in December 2018), Dr. Chan stressed that he would be very concerned about any attempt like that, and Mr. Hambly was very fortunate all went well, as it could have been a lot worse.
(j) The reason Mr. Hambly was grinding off the serial numbers on his guns was because of his paranoid fear and abnormal thinking that they could be used to frame him.
- In answer to questions from Mr. Ertel, counsel for Mr. Hambly, Dr. Chan testified:
(a) Dr. Chan confirmed it was unusual that no Court-ordered assessment was requested, and this was done privately for Mr. Hambly. Dr. Ward is a forensic psychiatrist whom Dr. Chan is very familiar with, and provided a key report, and there was nothing negative about it. What was unusual was that, although a mental health issue was obviously involved, this matter was not flagged early on by the legal system, for referral to the hospital for a 30-day assessment. Dr. Chan added that his comment is only that it was unusual, not that he is upset about the different process.
(b) Dr. Chan agreed that Mr. Hambly was released after arrest and given a court date, with no conditions imposed on him, and with no criminal behaviour since his release.
(c) Mr. Hambly's struggle with the psychotic label is a risk because that is what had led him to conclude in 2021 that he did not need to be on medication anymore.
(d) While Mr. Hambly is now being given three days' oral medication at a time, and his treatment team is apparently content with this, Dr. Chan noted that this is a concern because pills are easier to stop taking than LAI medication, and he has new side-effects which will have to be resolved. Dr. Chan considered that they could be resolved potentially by other medications or by addressing a condition with his stomach itself.
(e) Respecting the cannabis Mr. Hambly is using, Dr. Chan would be concerned if the formulation had more THC than the ratio 25% THC to 75% CBD, and in addition to the ratio, he would be concerned with the amount prescribed.
(f) Dr. Chan agreed that, in the three years since the index offence, Mr. Hambly apparently consumed alcohol and smoked quantities of cannabis from time to time, with no problems that have been seen. Dr. Chan agreed that it seems, with his compliance with medication, his substance use has not triggered any psychotic response. Dr. Chan described the situation as seeming to be under control but reiterated that he was concerned about the theoretical issue, to ensure that nothing did occur to trigger a psychotic response.
(g) When it was put to him that there is no basis for that theoretical concern in what has happened with Mr. Hambly, Dr. Chan described it as his job to worry about what could happen, to try to think ahead about the potential risks. Dr. Chan agreed that, with respect to the substance use conditions requested, the risks do not present themselves at this time but may at some time need to be addressed. Dr. Chan agreed that the point is not to eliminate 100 percent of the risk by locking a patient in a room, but to deal with reasonable or realistic concerns about risk. Dr. Chan agreed that Mr. Hambly is very respectful of rules.
(h) Respecting Mr. Hambly's diagnosis, Dr. Chan firmly reiterated that he has a chronic recurring psychotic condition, and that is not in question. In 2018, when he was paranoid and the diagnosis of schizophrenia was made, it was noted that the symptomatology could be schizophrenia and could also be a mood problem. Dr. Chan is happy to keep an open mind respecting the cause of Mr. Hambly's psychosis. The treatment does not depend on the specific cause; the antipsychotic medication will be used in the same way. They will continue to look at the source of the psychosis. The problem is that Mr. Hambly does not buy into the diagnosis label, and still struggles with it.
(i) Respecting the wording in the recommended weapons prohibition, that Mr. Hambly not be "in the company of a person possessing a firearm", Mr. Ertel raised the point that the special meaning of the word "possession" in the Criminal Code includes, for example, being with a person who has a gun in a locker at their home. Mr. Ertel suggested that the Board disposition need only prohibit Mr. Hambly from being with "a person who has immediate possession of a gun" or words to that effect. Dr. Chan had no reply to that suggestion, which was later addressed by the hospital's counsel in closing submissions.
- In answer to questions from members of the Board panel, Dr. Chan testified:
(a) Mr. Hambly is not working now. His employment disability insurance pension meets all his financial needs. He needs to find something to be fulfilled in his life, but something that would not affect this private insurance coverage, and would not put him back into a stressful situation such as he had going to Northern Ontario with his Hydro One job.
(b) Mr. Hambly is not engaged at this time in any programs or recovery groups in-house at the hospital. He has not started with the recommended counsellor at Limestone Clinic, so far as Dr. Chan knows. He certainly had some programs with Heads Up!, but Dr. Chan has no details of them.
(c) Dr. Chan has spoken with Mr. Hambly's mother, when she accompanied her son to his two contacts with Dr. Chan, and Dr. Chan has also briefly spoken separately with her.
(d) If the alcohol prohibition is imposed, Mr. Hambly would not be able to have alcohol.
(e) Mr. Hambly's CTO was renewed on the Friday before this hearing, with his agreement. The CTO under the Mental Health Act is the only focus there has been on Mr. Hambly, with the community ACT team in place for the past few years. The CTO is an attempt in Ontario to come up with a community framework similar to the forensic framework.
(f) Mr. Hambly's insight into his diagnosis and need for medication remains an issue. He still struggles to accept the psychotic diagnosis or label, and says it is all PTSD or trauma. He was able to convince previous psychiatrists that that was the problem. Until they can get Mr. Hambly on board with the problem of psychosis and need for medication, this risk is a big, big concern.
(g) At their second meeting, Mr. Hambly seems to have got the idea that he can have both trauma and psychosis. This was Dr. Chan's first time of hope that they could work on this from the same perspective.
(h) The only concern with Mr. Hambly's medications is with respect to the side effects.
(i) Dr. Chan confirmed that he is recommending a Conditional Discharge for the reason that Mr. Hambly has been able to function without problems in the after-care arrangements that have been in place.
(j) Hunting is one of many outdoor activities that Mr. Hambly enjoys. It is clearly hard for him not to be able to go hunting.
(k) Any talk of Mr. Hambly coming off his medication is a huge risk factor. This was seen in August 2021 through to 2023.
(l) Mr. Hambly has not yet been under the hospital's jurisdiction and will not be until after this hearing and a Board disposition.
(m) He is a very anxious person. His biggest worry is to be hauled into hospital. He requires sensitivity in working together.
(n) He says, "I am not a risk, I have had no police involvement for three years." Work with him is still needed to help him understand what his risk is.
(o) In answer to numerous questions from panel members, Dr. Chan elaborated on how the community ACT team and the hospital's forensic outpatient team could work together in the year ahead:
(p) Mr. Hambly has not yet been under the hospital's jurisdiction. His treatment with the ACT team has been ongoing since the charges were laid three years ago. He has been happy so far with them, and the Dr. Chan and the forensic team felt they could maintain that, even going forward with the forensic umbrella. This is an open question. They still need to work out the details of their coordination with the ACT team and clarify the future treatment and management by the forensic team; if they continued in their current roles, it would be an unusual situation.
(q) The ACT team is a community team, not under the hospital's umbrella. The ACT team is dealing with his medication, with his attending psychiatrist Dr. Delva in the prescribing physician role, rather than Dr. Chan; Dr. Chan will talk with Dr. Delva about that, and about the forensic team liaising with the ACT team on it. The forensic team will also talk with the ACT team about coordinating psychotherapy and recovery programs; there are ones the hospital has that may be good for Mr. Hambly.
(r) As for reporting at least every two weeks, Mr. Hambly would be meeting periodically with the forensic team, and with Dr. Chan, not as frequently as two times a month, but at a minimum once a month, when the forensic team conferences Mr. Hambly, as they do with all their patients. In addition, Mr. Hambly would have ongoing contact every one or two weeks with both his forensic team and his ACT team case managers. The key person right now is Mr. Hambly's case manager with the ACT team, Deb, who was with the hospital a few years ago. Mr. Hambly would be meeting weekly with her, Dr Chan thought, and also be meeting less frequently with Dr. Delva. Ms. Bryant, the forensic team's case manager, has already met with his ACT team.
(s) Dr. Chan would take action if he sees anything that concerns him. He does not want to see Mr. Hambly fall between the cracks.
(t) Dr. Chan agreed that this is a more complicated arrangement, but noted that it has worked well with Mr. Hambly, and he is still suspicious of the hospital team. For it to work well, it will need good communication all around. Dr. Chan's expressed his clear view that the two teams can work together.
(u) At the same time, Dr. Chan could also understand the concern about that. If anything else is needed to shore up the teams' coordination, Dr. Chan thought that could be covered in the Board's Reasons, and he would leave the legal wording for the lawyers to craft.
Closing Submissions
In closing, the parties maintained their joint positions respecting both a finding of significant threat and a Conditional Discharge for the year ahead, with two of the recommended conditions contested.
Ms. Tom submitted on behalf of the hospital that the parties' joint positions were supported by the evidence given by Dr. Chan and in the Hospital Report. Respecting all the recommended conditions, Ms. Tom noted it is still early days since the NCR finding in August 2024; it took some time for Mr. Hambly to come to the Board system, and to date he has had no other connection than what is in place with the AMHS Frontenac ACT team he has been working with. Providence Care Hospital was not involved with him until recently. Mr. Hambly has met twice with Dr. Chan, has also met Ms. Bryant, the forensic team has been able to connect with Ms. Darling, and the connection between the two service providers is good.
With respect to the condition prohibiting alcohol, Ms. Tom submitted that Dr. Chan's concern may be theoretical, but alcohol is a disinhibitor, and more concerning in combination with cannabis use. With respect to the weapons prohibition, the clause proposed by the hospital is the one generally asked for by Board panels.
Ms. Tom highlighted that the forensic team does not want to upend what has been in place for Mr. Hambly with the ACT team, with no problems, and that the hospital is being thoughtful and careful to not disrupt the positive work and supports Mr. Hambly has now, while also looking after the forensic concerns. The next stage will be to sort out how the two complementary systems will work together. In the future, they will be seeing Mr. Hambly engaging in community resources. One piece to put in place is the continued open communication and sharing of information between the two teams. The ACT team doctor and social worker and the forensic team may have concerns respecting any deterioration in Mr. Hambly's mental health. If they do, an early hearing can be requested, which the Board would be required to provide.
Ms. Ferguson adopted Ms. Tom's submissions entirely, and acknowledged Mr. Hambly's progress and encouraged him to continue, to find meaningful employment, stay away from firearms, and control his cannabis use.
Mr. Ertel agreed with his fellow counsels' submissions, except respecting two conditions. The alcohol prohibition was not reasonable, Mr. Ertel submitted, given that there is no evidence alcohol is a problem for Mr. Hambly or he was ever drinking to intoxication, and that nothing has happened for the past three years when he has complied with medications. The term in the firearms prohibition requiring that Mr. Hambly not be "in the company of any person possessing a firearm", Mr. Ertel submitted, went too far, given the broad definition of "possession" in the Criminal Code that would apply; he recommended instead a condition regularly imposed by the courts in criminal trials, which refers to "actual, immediate, physical, present possession" by a person.
Findings and Conclusions of the Board
- On the first issue, we find that Mr. Hambly presents a significant threat to the safety of the public at this time. This finding was uncontested, and is well supported by the evidence.
The Threshold Issue of Significant Threat to the Safety of the Public
The term “significant threat” is defined in s. 672.5401 of the Criminal Code as “a risk of serious physical or psychological harm to a member of the public … resulting from conduct that is criminal in nature but not necessarily violent.” Our finding is guided by the principles established in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625, as applied and elaborated in many judicial decisions since then. To state that jurisprudence in only a nutshell: A finding of significant threat cannot be speculative: it must be based on the law and the evidence. It requires positive findings, supported by the evidence, that the threat of a person engaging in criminal conduct is not speculative but a “real” threat, and that this conduct would cause “serious” harm. Both findings are required: Neither a miniscule risk of grave harm, nor a high risk of trivial harm, is sufficient to find a real threat of serious harm.
We find six factors, in Mr. Hambly's circumstances at this time, cause or contribute to a significant threat of serious harm to others: (1) his chronic recurring psychosis, which requires management by an effective antipsychotic medication, (2) the unreliability of his adherence to such medication, (3) his vulnerability to stress, including as a result of past trauma, (4) his longstanding cannabis use, and occasional alcohol use, (5) his lack of insight into his key risk factors, and (6) the seriously harmful reoffence that could realistically result from a relapse. These factors are summarized here, and are also relevant to the contested disposition conditions, addressed below.
(1) Chronic condition of recurring psychosis
Mr. Hambly has a chronic condition of relapsing into psychosis. This is the expert opinion of Dr. Chan, well supported by the evidence, and we accept it. When Mr. Hambly relapses into psychosis, the symptoms are serious and distressing. They have included (as seen in his past relapses in December 2018, July 2020, and March 2022): persecutory delusions (involving co-workers, neighbours, parents, and others he believed were threatening him); delusions of reference, thought insertion and broadcasting; auditory hallucinations, and suicidal thoughts. These symptoms have led to Mr. Hambly becoming increasingly distressed and agitated, and engaging in seriously threatening behaviour with weapons, most notably his own firearms.
This chronic recurring psychosis is at the core of Mr. Hambly's risk. Various diagnoses for it have been proposed over the years. The current schizophrenia diagnosis was first made in 2018. In the intervening years, diagnoses included psychosis NOS, and mood-related, cannabis-related, and trauma-related psychosis. Effective treatment of Mr. Hambly's psychosis does not depend on a specific diagnosis or cause, as Dr. Chan stressed, because antipsychotic medication will have the same effect in managing the symptoms whatever the cause. Dr. Chan is keeping an open mind in looking into contributing causes of this psychosis, including in particular a trauma-related cause.
(2) Medication effectiveness and adherence
Mr. Hambly is now being treated with Abilify antipsychotic medication. He had been found treatment incapable in March 2022, after his admission to KGH hospital in full-blown psychosis following the index offences, but he was recently found treatment capable, and has continued to consent to and adhere to his medication treatment.
However, this treatment is a work in progress. There are two concerns about its reliability. One concern is a side-effect of nausea and vomiting, even after having switched now from the LAI to an oral format of the medication. Dr. Chan thinks this problem can potentially be resolved, and the ACT team's Dr. Delva is looking into it. The other concern is two-fold. Mr. Hambly might be tempted to come off his medication or fail to adhere to it, given his histories of resisting a psychosis diagnosis and of unreliable medication adherence, combined with this new unwanted side-effect. As well, he could stop his medication more easily now – in the absence of Board oversight and support – given the new daily oral pill format, and given that he has so far only been taking medication in the context of legally-imposed structured supervision, with the CTO and ACT team in place for the past three years of his judicial release pending this Board hearing.
On this evidence, we find there is a real risk of Mr. Hambly failing to adhere to his medication, and consequently relapsing into serious psychosis. This is again notably a concern in these early days, when unwanted side-effects of the medication are still being addressed, when he is just about to begin with Dr. Chan and the forensic outpatient team, and when relevant facts of his history are still to be clarified.
(3) Vulnerability to stress
- Mr. Hambly's vulnerability to psycho-social stress has also played a role in his relapses into psychosis. His early history and his sensitive nature are noted to have affected his personality and social development, such as in his felt need to protect himself if he perceives he is being threatened. Mr. Hambly has a history of coping very poorly with stress, such as in July 2020, when increased psycho-social stressors and increased cannabis use were both noted to contribute to his relapse. His social isolation apparently increased his vulnerability to such stressors in northern Ontario, where he made no friends, just "acquaintances", and had seemingly no personal supports at all until he renewed his contact with his family.
(4) Cannabis use and alcohol use
Mr. Hambly's longstanding daily cannabis use goes back to his regular use of cannabis as a teenager. He reportedly has a past impaired driving charge "due to cannabis use" (details unclear). He has for some years had a medical prescription for cannabis, to treat anxiety. When in the EP Program, he was prescribed cannabis with a lower content of THC (the psychoactive ingredient), at a ratio of 25% THC to 75% CBD. However, at this time the THC content is unclear: Dr. Chan would be concerned if it was a higher ratio than that, but in a recent interview he apparently reported that he preferred cannabis strains containing approximately equal parts THC and CBD.
Dr. Chan stated firmly that any intoxicant, including cannabis, can push a person who has a psychotic illness into psychosis. Dr. Chan has no doubt Mr. Hambly has this vulnerability in his cannabis use. This psychiatric concern has repeatedly been expressed to him over the years, and reflected in cannabis-related diagnoses and in treatment and use-reduction recommendations. We accept Dr. Chan's firm opinion and its basis in his forensic psychiatry knowledge and experience. Again, Mr. Hambly's risk of increased his cannabis or THC use would be elevated if he experiences increased psycho-social stressors in the community.
In addition, Dr. Chan stated his concern that Mr. Hambly could turn to alcohol, to help him cope in a stressful situation, and that mixing cannabis with alcohol would have an additive negative effect. Mr. Hambly reports simply having an occasional glass of bourbon. At the same time, he has a vaguely noted history of "increased" but "not heavy" alcohol use when working at Hydro One, and of occasional drinking along with his cannabis in the past few years use – with no details of the reasons or contexts of his drinking, the amounts of alcohol, and its effects. This is another important aspect of his history that is yet to be clarified in these early days.
On this evidence, we find Dr. Chan's concerns, respecting both cannabis and alcohol use, are realistic; each of them creates or contributes to a real risk – not a speculative one – of Mr. Hambly relapsing into psychosis with serious symptoms including persecutory delusions, and as a result engaging in seriously harmful criminal conduct.
(5) Lack of insight into key risk factors
As concisely summarized in the Hospital Report by Dr. Chan: "Mr. Hambly remains a risk to the safety of the public because he cannot see himself as risky at all presently." He has always resisted the diagnostic label of a psychotic illness, and insisted his symptoms are solely PTSD- or trauma-related. He still struggles to accept this diagnosis and the need for antipsychotic medication treatment, and furthermore, still does not appear to appreciate the dangerous nature of his index offence and the seriousness of the reoffence risk if he relapses. This lack of insight into his illness and need for medication is "a big, big concern", Dr. Chan emphasized in his testimony at the hearing, and we accept this opinion, well based on all the evidence.
Notably, in their most recent second meeting, Dr. Chan had the positive impression that Mr. Hambly understood he can have both trauma and psychosis, and that the two of them could go on to work together from that shared perspective. This has opened up a window of hope, which bodes well for Mr. Hambly's future ability to develop reliable insight and act on it.
(6) Seriousness of the harm, and re-offence scenario
Finally, the very real threat of immediate and serious harm, should Mr. Hambly reoffend, is clear on the evidence. The combination of Mr. Hambly's recurring persecutory delusions with his associated reckless and threatening criminal conduct, involving his firearms or another weapon, is, as Dr. Chan put it, "a deadly combination".
In summary, based on all the evidence, we find there is a real risk that the following would occur, were Mr. Hambly not under the Board's jurisdiction at this time: He would not adhere to his medication and other recommended treatment, and would fall away from forensic care and oversight, resulting in his relapse into serious symptoms of psychosis, including persecutory delusions, as happened in 2018, 2020, and 2022. He would be unable to cope on his own with the psycho-social stressors he would inevitably face in the community. In a state of emerging psychosis and increased stress, he would use cannabis without oversight of the content and quantity, and would be at greater risk of increasing cannabis or THC use; this risk would be compounded if he engaged in increased alcohol use as well. His delusions of threats and persecution would heighten, along with increased agitation. He would lose what insight he might have gained into his re-offence risk, take his firearms or other accessible weapons, and engage in seriously harmful criminal conduct similar to that in his past history including in his index offence.
At this time, Mr. Hambly is not able to manage his risk and treatment needs on his own. The safety of the public requires the hospital's care, support, and oversight under the Board's jurisdiction.
The Disposition for the Year Ahead
In deciding what disposition is necessary and appropriate for the year ahead for Mr. Hambly, the Board is required by s. 672.54 of the Criminal Code to take four factors into account: the safety of the public, as the paramount consideration, and Mr. Hambly's mental condition, his reintegration into society, and his other needs.
The parties joined in the recommendation of a Conditional Discharge, and we agree. Since his hospital discharge in April 2022, Mr. Hambly has been living in the community under a judicial release order, with the minimal condition of his undertaking to appear in court, and with after-care arrangements (the CTO and ACT team) in place. Throughout the three years since then, Mr. Hambly has respected his ACT team's guidance, and the authority of his CTO (consistently renewed, including recently on his own consent). He has adhered to his medication and remained stable, with no report of any relapse, police engagement, or criminal conduct. A continued positive trajectory likely to continue with the addition of a forensic outpatient team in place for him. Mr. Hambly and Dr. Chan have already had two promising meetings together.
Crucially, as testified by Dr. Chan, it is due to the close after-care arrangements put in place for him, that Mr. Hambly has been able to function in the community without problems. This close support will continue under a Conditional Discharge. The two teams working together will be able to provide a greater level of monitoring, support, and rehabilitation initiatives, with forensic psychiatry expertise as well. There is no evidence that a Detention Order with a Warrant of Committal is additionally needed to protect the public, or to ensure Mr. Hambly attends as requested by either team, or to support him in his treatment, community integration, and other needs.
We find all the terms of the Conditional Discharge recommended by the hospital to be necessary and appropriate at this time. Those terms that all parties support include, in short, that Mr. Hambly: (1) continue to reside in the City of Kingston, (2) report not less than once every two weeks, (3) give specified notices regarding absence from his residence, (4) attend immediately upon request for assessment at the hospital, (5) not have any weapon in his possession, and (6) provide samples for monitoring his use of any intoxicating substances.
Four topics relating to the terms the Conditional Discharge were the main focus of questions to Dr. Chan and the parties' submissions: (1) the roles and coordination between the continuing ACT team and the forensic outpatient team now coming on board; (2) the exclusion of cannabis from the substance use prohibition; (3) the alcohol use prohibition, which was contested at the hearing, and (4) the weapons prohibition extending to "being in the company of any person possessing a firearm", the scope of which was contested.
(1) The respective roles and the coordination of the two Teams
We agree entirely with Dr. Chan's view that it is best at this time to maintain the positive status quo Mr. Hambly has with his ACT team, while going forward under the forensic umbrella. We agree entirely also with Ms. Tom's submission that the hospital is being thoughtful and careful to not disrupt, and rather to build on, the positive support Mr. Hambly has had with his ACT team over the three years since the index offence.
The evidence is that Mr. Hambly has worked well with his ACT team and has maintained his medication adherence and stability under their oversight. At this time, he is unfamiliar with and anxious about the Board process and the hospital forensic team, just now being introduced to him. Dr. Chan, appreciating Mr. Hambly is a sensitive person, plans to take time with him as they begin, and help him maintain his good work with the ACT team as they move forward.
The key members of the ACT and forensic outpatient teams know each other and have already begun working well together. Dr. Chan elaborated what he envisioned would be the respective roles of the two teams and how they coordinate their work (see testimony summarized above in these Reasons, in para's 41, 43-44). Briefly, the plan is for each team's case manager and psychiatrist to have regular contact with Mr. Hambly every one or two weeks. Dr. Chan thought Mr. Hambly is now meeting weekly with his ACT team case manager, Ms. Darling, and anticipated he would begin meeting with his forensic team case manager, Ms. Bryant, at least twice a month; Ms. Bryant has now already met with Mr. Hambly and his ACT team. Mr. Hambly is meeting less frequently with Dr. Delva, and he would at a minimum meet once a month with Dr. Chan. Dr. Chan will also meet with the other team, not as frequently as twice a month.
Dr. Chan acknowledged this is a more complicated arrangement than usual. He stressed that it would require good communication all round, and that he wanted to see Mr. Hambly succeed, and that he would take action if anything concerned him. At the same time, Dr. Chan noted that the team structure has been working well for Mr. Hambly, and that his ACT team case manager, the key person as the teams begin working together, is already known well by the forensic team, and positively as if she is "one of their own", from their past work together in the hospital.
Dr. Chan expressed his confidence that the two teams can work well together, and we have no hesitation in accepting his opinion on this matter of clinical expertise and experience. In our view, this coordinated two-teams approach is likely to achieve the best outcome for Mr. Hambly. It will place extra demands on both teams, and require their effective ongoing consultations and information sharing, as Dr. Chan noted. It should also be mutually helpful and reinforcing, both for them and for Mr. Hambly. It is an unusual approach that is innovative, realistic for theses two teams, and attuned to Mr. Hambly's distinct circumstances and positive future prospects.
We simply wish to note what is well known to Dr. Chan and the hospital: A Board disposition is a legal command to the person in charge of the hospital to see that its terms are properly carried out. The hospital remains responsible for seeing to this, including with respect to tasks delegated to an outside party such as a community ACT team, which is something commonly done, appropriately and indispensably, under the proper exercise of the hospital's authority.
(2) Cannabis not included in the Substance Use Prohibition
The substance use prohibition recommended by the hospital as a condition of Mr. Hambly's disposition, requires that he "abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant, excluding cannabis".
Cannabis use is a significant risk factor for relapse into psychosis and serious re-offence in Mr. Hambly's case, it has been an ongoing issue, and he has found it difficult or impossible to stop or reduce his use. In his circumstances, the hospital has recommended allowing him to continue his cannabis use. Dr. Chan considered the team could manage this, given that he has a medical prescriber for cannabis (thus controlling its quantity and its THC content), he obtains it from a medical dispensary, and he has had no relapse into psychosis, despite his cannabis use, while adhering to his antipsychotic medication for the past three years.
Notably, in January 2024, Mr. Hambly was described as in the "pre-contemplative phase" of cannabis use. His then-ACT team psychiatrist, Dr. Jariani, recommended he reduce his cannabis use, as it could be lowering his mood and motivation and increasing his risk of relapse into psychosis, but it is not apparent that he did so. Dr. Jariani also recommended cognitive-behavioural therapy to treat PTSD symptoms, but it does not appear he engaged in this treatment, which might help with the anxiety he takes cannabis for. It appears he has never had a period of supported abstinence from cannabis use, nor a period of a supported harm reduction approach.
We respect and support Dr. Chan's clinical decision to support Mr. Hambly's continued cannabis use through a medical prescriber. This is a potentially helpful approach for him, and a more challenging one for his teams, requiring closer monitoring and support, and liaison with his prescriber, for risk management and treatment purposes. There are also benefits to gain in further clarity respecting his current cannabis use, what effects it is having for him (positive or negative), and what assistance a well-supported harm reduction approach might provide.
(3) Alcohol included in the Substance Use Prohibition
Alcohol use is expressly prohibited in the recommended substance use condition, which requires Mr. Hambly to "abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant, excluding cannabis". Mr. Ertel, counsel for Mr. Hambly, opposed the alcohol prohibition, on the basis that it was not a reasonable condition because there was no evidence of alcohol being a problem for Mr. Hambly or his ever drinking to intoxication, and that he has had no relapse or any problem for the past three years, despite his using cannabis daily and occasionally drinking alcohol.
However, we find that the weight of the evidence relating to the added risk of drinking alcohol, in Mr. Hambly's circumstances at this time, supports this prohibition for the year ahead, as the measure that properly protects the safety of the public, and in a manner that is least onerous and least restrictive for him, and best serves his treatment and community living needs.
Briefly, Dr. Chan's expert opinion evidence relating to the clinical risk of alcohol use for Mr. Hambly is that: (1) alcohol is an intoxicating substance and drinking too much alcohol has a disinhibiting effect, heightening the relapse risk for someone with a condition of recurring psychosis; (2) a stressful situation could lead to increased drinking to settle the anxiety, and too much drinking could lead to a relapse into symptoms of psychosis; (3) Mr. Hambly has this vulnerability in his use of cannabis, another intoxicating substance, which can push him over into psychosis; (4) when alcohol and cannabis use are combined, the disinhibiting effect is additive or compounded, and (5) Dr. Chan is also concerned about the deleterious effect of alcohol use in breaking down the antipsychotic medication Mr. Hambly is taking.
The evidence is that over the past three years, Mr. Hambly has consumed alcohol, which he has described as a glass of bourbon on occasion, while continuing his cannabis use. While specific problems have not been reported, the lack of relevant detail indicates there has not necessarily been any monitoring in place. Dr. Chan is concerned about this, given the above risk factors. As Dr. Chan qualified his evidence in answer to questions from Mr. Ertel, Mr. Hambly "apparently" consumed alcohol and smoked "quantities" of cannabis, "from time to time", with no problems "that have been seen" and the situation "seeming" to be under control. We find this reflects a lack of detailed information from any monitoring or reporting. Details are not known respecting what he was drinking, how much and how often, what the circumstances of his drinking have been, and what if any effects it had on him.
It is relevant that for these three years, Mr. Hambly has been adhering to his medication, to his credit, and he has been under the authority of a judicial interim release order while awaiting his Board hearing, with a CTO and follow-up by his community ACT team. These external factors protect him from relapse and reoffence, and are key treatment and risk management needs for him.
Historical factors must be taken into account in assessing the risk if Mr. Hambly uses alcohol, particularly his longstanding and still ongoing poor insight into his illness, need for medication, and risk of a serious re-offence should he relapse into psychosis. His strength in being a rule-abiding person does not hold when he has relapsed into psychosis.
The historical evidence relating to the risk of alcohol use for Mr. Hambly includes a reference in a previous psychiatric report to "a drinking and drug culture" at Hydro One when he was working there, and to his alcohol use having "increased" but "not heavy". It also includes a reference in the clinical record to police involvement in a "DUI" or impaired driving charge "due to cannabis", which Dr. Chan thought related to Mr. Hambly storming off from a party gathering where there was drinking, and he had weapons. There are no other details respecting these bare psychiatric notes, at a time when he was not under legal oversight and not taking medication, and when there is again no evidence of monitoring or reporting of his substance use.
Dr. Chan used the term "theoretical" risk or concern to characterize his opinion on the potential effects of Mr. Hambly's alcohol use, and mixed alcohol and cannabis use, on his mental state and conduct. Dr. Chan described these as problems that have not "popped up in any practical way" at this point and "seem" to be under control, with Dr. Chan's concern being to ensure that this continues, and nothing does occur to trigger a psychotic response. When it was put to him by Mr. Ertel that there is no basis for a theoretical concern with Mr. Hambly, Dr. Chan replied that the risks may still present themselves at some time, and his job is to worry about "what could happen" and to "try to think ahead about the potential risks".
We consider this reference to a "theoretical" risk by Dr. Chan, indicates a risk that has not occurred in concrete reality, but that could realistically and foreseeably could occur in given potential circumstances that are realistic and foreseeable, based on expert knowledge and experience in the forensic psychiatry field. We unanimously find that it is necessary and appropriate for alcohol use to be prohibited for the year ahead, on this evidence and all the evidence of Mr. Hambly's circumstances at this time,.
(4) Weapons prohibition, "in the company of any person possessing a firearm"
Finally, Mr. Ertel opposed the weapons prohibition term requiring Mr. Hambly to refrain from "being in the company of any person possessing a firearm, other than a police officer", on the ground that it was too restrictive. Mr. Ertel submitted that a specific broad definition of "possession" in the Criminal Code, which includes, for example, someone who has a gun in a locker at home, would apply to this term "possessing" in Mr. Hambly's Disposition condition, and he suggested that the term be amended along the line of only prohibiting his being in the company of a person who has "immediate, physical possession of a gun".
We are not persuaded by Mr. Ertel's submission that the Criminal Code definition, relevant to criminal offences such as a person's illegal possession of firearms, necessarily applies to the term that is used in this Board disposition and, as Ms. Tom noted, is the term generally used in this context. A stronger basis in facts and law would be required to make the link from this term to the Criminal Code definition relating to illegal possession offences.
As well, considering this term "any person possessing a firearm" in its context in the weapons prohibition in Mr. Hambly's Disposition, we would not apply it only to immediate physical possession by the other person he is with, but to any access to that person's firearm – such as, for example, on a table or in a locker in his vicinity and accessible to him at the time – that would enable him to grab hold of it and act impulsively and dangerously with it.
Our view is that this term is a necessary and appropriate condition for Mr. Hambly for the year ahead. We do not consider it to be unduly onerous or restrictive of his liberties, but rather to be the least onerous and least restrictive manner of controlling his access to weapons that is consistent with protecting the safety of the public. His access to a firearm, should he have another relapse into psychosis, would create an extremely serious risk, with a potentially deadly result, which he seemingly has not yet grasped. It is absolutely clear on the evidence that, at this time, Mr. Hambly must not have access – and notably not easy or quick access – to firearms.
We appreciate that this prohibition deprives Mr. Hambly of his ability to go hunting. We also understand that hunting is just one of his many outdoor pursuits and other interests, which he recently described as including fishing, hiking, camping, boating, and what he called "geeky" pursuits in building and fixing things – all to his credit.
In overall summary, on the evidence, this Conditional Discharge with these recommended privileges and conditions, while necessary and appropriate for protecting the safety of the public, in these early days and for the coming year, should also well support Mr. Hambly in continuing his progress. The planned range of close supports from both teams in his treatment, monitoring, and oversight in the year ahead will be indispensable to his moving forward to establish a safe and successful life in the community. The close support includes helping Mr. Hambly to develop better insight; to learn and practice managing his medication and his cannabis use, reliably; to engage actively in recommended individual and group treatment programs, and sustain his productive engagement; to engage perhaps in vocational programs or appropriate employment or structured community activities, and to participate in the teams' gathering of pertinent information respecting his ongoing risk and needs.
It is important to note the evidence that speaks to Mr. Hambly's own strengths, achievements, and personal potential, from the time of his early schooling when his intelligence was noted, through to his work at Canadian Tire, his college studies, and his career during a challenging time in his life.
We wish all the best to Mr. Hambly in the year ahead, in continuing his successful work, with his ACT team and now with his forensic outpatient team members as well. We also wish him the best in his times with his family, including his aunt and uncle, his brothers and parents, and with the other professional and personal supports he may have in his work and life in the community.
DATED this 28th day of July, 2025, at the City of Toronto, in the Toronto Region.
Ms. K.A. Connidis Alternate Chairperson
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Office of the Registrar Ontario Review Board