Ontario Review Board
Re: Juan Sanchez
ORB File No: 8121
Hearing held on: Wednesday, August 6, 2025
Place of Hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus
Pursuant to: Section 672.81 (2.1) of the Criminal Code
Before:
Alternate Chairperson: Ms. J. Mills
Members: Dr. J. Kis Dr. S. Swaminath Mr. E. Siebenmorgen Mr. A. Mete
Parties Appearing:
Accused: Juan Sanchez Counsel: Mr. A. Rai
The Person in Charge of Hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Ms. K. Malkovich
REASONS FOR DECISION (Dated August 20, 2025)
Introduction
On July 8, 2022, Juan Sanchez was found not criminally responsible on account of mental disorder (“NCR”) on a charge of robbery, contrary to the Criminal Code. Mr. Sanchez is subject to a Disposition of the Ontario Review Board (“ORB” or “the Board”) dated September 16, 2024 pursuant to which he is ordered detained at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (“SJHCH” or “the Hospital”), subject to various conditions and privileges, up to and including community living within the catchment area of the Hospital, in accommodation approved by the person in charge. Of note, the Disposition also provides, at the discretion of the person in charge, for passes for up to seven (7) days to travel to Nova Scotia, accompanied by a person approved by the person in charge of St. Joseph’s Healthcare Hamilton, West 5th Campus, upon first obtaining approval of his itinerary by the person in charge or designate.
By way of a letter dated July 8, 2025, the Hospital provided Notice to the Board, pursuant to s. 672.56 (2) of the Criminal Code, of an increased restriction on Mr. Sanchez’ liberties (a readmission to the Hospital from the community) that exceeded seven (7) days. On Wednesday, August 6, 2025, a panel of the Board convened in person1 at the Hospital to inquire into the circumstances and to determine: (a) whether the Hospital’s actions constituted a significant increase in the restrictions upon Mr. Sanchez’ liberties; and (b) if so, whether the increased restrictions were warranted and justified, both at the time that they occurred and for their duration.
Mr. Sanchez’ sister, Tonja Kelley, attended the hearing via telephone conference connection, as she resides in Nova Scotia. Mr. Sanchez was present for most of the hearing and was represented by his counsel, Mr. Rai. Mr. Sanchez was not present at the outset of the hearing. Mr. Rai advised the panel that he had instructions to proceed in his client’s absence, and on agreement of the other parties, Mr. Sanchez was permitted to be absent from his hearing, pursuant to s. 672.10 (a) of the Criminal Code. However, shortly after the commencement of testimony, Mr. Sanchez arrived. He remained in attendance for the balance of the hearing.
The evidence for the hearing consisted of the Hospital’s Restriction of Liberties (“ROL”) Report dated July 29, 2025, the Hospital Report dated August 26, 2024 (prepared for last year’s annual hearing), and the oral evidence of Dr. Y. Naidoo, Mr. Sanchez’ attending psychiatrist. Dr. Naidoo also authored the ROL Report.
Circumstances of the Readmission to the Hospital
- According to the July 29th letter from the Hospital:
“Mr. Sanchez was discharged to live in the community at Main East Rest Home on May 12, 2025. He was readmitted to the Forensic Inpatient Unit, Waterfall 3, on June 18, 2025. His admission was prompted by an unauthorized leave of absence (ULOA) from his community residence on Monday, June 16, 2025. Residence staff phone[d] the inpatient Social Worker on that date to inform the hospital that Mr. Sanchez did not return home the night prior. Hamilton Police were immediately notified of the escape custody. Mr. Sanchez was located in Montreal on June 17, 2025. He was escorted back to the hospital by Hamilton Police the following day.”
- The ROL Report recites that Mr. Sanchez admitted to using cannabis (prohibited under his Disposition) both before and during his unauthorized leave of absence. He expressed a strong desire to see his sons and made impulsive travel plans to go to Nova Scotia for this purpose, without notifying his treatment team or requesting permission to exercise his privilege to travel to Nova Scotia.
Positions of the Parties
- When canvassed for their initial, without prejudice positions at the start of the hearing, counsel for all parties expressed agreement that the Hospital’s actions in readmitting and subsequently maintaining Mr. Sanchez as an inpatient to the date of the hearing were warranted in the circumstances and represented the least onerous and least restrictive measures available, for the duration of those increased restrictions which continued as of the hearing date. No party suggested that the Disposition itself should be reviewed at the time of the hearing.2 The parties maintained their respective positions at the conclusion of the evidence.
Findings
- For the following Reasons, the panel accepted the parties’ joint position and found, independently, that the Hospital’s actions in readmitting and subsequently detaining Mr. Sanchez constituted a significant increase in the restrictions upon his liberty. This issue was undisputed. The panel further found that the Hospital’s actions in the circumstances were warranted and represented the least onerous and least restrictive measure available for the management of Mr. Sanchez’ risk to the safety of the public.
Index Offence
- The basic circumstances surrounding the index offence are summarized in the Reasons for Disposition dated October 9, 2024, and are reproduced as follows:
" On February 23, 2022, Mr. Sanchez attended a car dealership in Fort Erie. While test driving a new vehicle, with the salesperson as his passenger, he exited the dealership driving in an aggressive manner. Several minutes later he stopped in front of the dealership and instructed the salesperson to exit the vehicle. He had his left hand positioned in his left side jacket pocket and the victim became concerned he may have been in possession of a weapon. The salesperson refused to exit the vehicle, and the accused aggressively responded, “get the fuck out”, and then pushed the victim in the chest. Fearing for his safety, the salesperson decided to exit the vehicle. He returned to the dealership and notified police.”
- As noted below, Mr. Sanchez has little prior connection to the Province of Ontario. Prior to the index offence, he had taken his mother’s car without permission and drove it to Ontario. After a brief hospitalization in Buffalo, New York, he arrived in Niagara Region where he stayed at a hotel for just days before the index offence. He consumed three grams of cannabis and two alcoholic coolers over the two days prior to the index offences, though not on the actual day. According to his self-report, he intended to drive to Canada’s west coast, swim in the ocean and kill himself. After stealing the vehicle involved in the index offence, he drove toward Toronto at speeds up to 180 kilometres per hour, ran a red light, struck an O.P.P. cruiser and another vehicle, and drove north on Highway 400, again at high speeds. The vehicle was found abandoned the next day in Sault Ste. Marie, where Mr. Sanchez was ultimately arrested.
Background Information
Mr. Sanchez is 49 years of age and was raised in Nova Scotia. He has four children, two daughters and two sons, from three different relationships. He reportedly has an amicable relationship with one former partner and her daughter but has had no contact with his two young sons since 2018. His personal history, criminal record, psychiatric history and course under the Board are summarized in last year’s Reasons for Disposition. This information is captured in greater detail in the Hospital Report. As the Hospital Report is in evidence at the hearing, the information need not be summarized for the purpose of these Reasons. The portions that provide context for the issues at this hearing are highlighted below.
Mr. Sanchez is capable to make treatment decisions and is financially capable. His diagnoses as reported in last year’s Hospital Report are:
schizophrenia;
OCD with fair insight;
other specified trauma/stressor related disorder;
cannabis use disorder; and
alcohol use disorder, in remission in a controlled environment.
Both Mr. Sanchez and his mother reported that in recent years, Mr. Sanchez occasionally fled Nova Scotia without notice. He often took his mother’s car. During one of these trips, he was hospitalized in Alberta from September 21 to October 1, 2021. In his interview for a 2022 psychological assessment following the index offence, Mr. Sanchez elaborated on some of his experiences, specifically in 2021. He reported hearing the voices of God or the devil telling him that people, including his family, were harming or trying to kill him, and endorsing the belief that neighbours were transmitting radiation through the adjoining walls. He recalled that these experiences prompted him to flee the province.
During his psychological testing in 2022, Mr. Sanchez acknowledged that cannabis use exacerbates his paranoia and he at times reduced his consumption for this reason.
Mr. Sanchez was previously discharged to live in the community on June 10, 2024. He was living in an independent apartment with his mother, who had moved from Nova Scotia to Hamilton specifically to assist him. He was readmitted to hospital on August 2, 2024. Despite being seen twice weekly by his outpatient team, Mr. Sanchez began to consistently use cannabis while living with his mother, unbeknownst to the team. He reported experiencing frequent stress from living with his mother during the period leading to his readmission.
Evidence at the Hearing
Dr. Naidoo testified that he has been involved in Mr. Sanchez’ care for approximately three years. He elaborated on the contents of the ROL Report.
Dr. Naidoo testified that the treatment team learned of Mr. Sanchez’ whereabouts through his sister. He testified that he was eventually able to speak with Mr. Sanchez on the telephone directly on June 17, learning from him that he had gone to Toronto, was enroute to the east coast to reunite with his children, but had no real plan to get there or a place to stay.
To his credit, Mr. Sanchez was cooperative with Dr. Naidoo and followed his direction to attend at the nearest police station so that he could be returned to Hamilton.
Prior to Mr. Sanchez’ readmission, he was being seen twice weekly and appeared to be in his normal state of health until June 15. Upon admission to the Hospital, he demonstrated active symptoms of his illness, mood instability and emotional distress. He expressed disappointment and anger about his ex-partner’s lack of communication and was preoccupied with paranoid thoughts. Dr. Naidoo explained that this preoccupation related to alerts he said he was receiving on his phone, which he associated with his ex-partner and certain gang affiliations. He also demonstrated irritability and sadness. According to the ROL Report, he reported disturbed sleep, feelings of rejection, and occasional thoughts of ending his life, which he linked to the burden of persistent auditory hallucinations. Ultimately, he was assessed as exhibiting symptoms reflecting residual psychosis worsened by cannabis use. In the ROL Report, Dr. Naidoo expressed the opinion that Mr. Sanchez’ behaviour during his elopement “. . . was influenced by paranoid thinking and impaired judgment, including beliefs that his ex-partner was tracking him and that others were trying to harm him”.
Dr. Naidoo testified that following his readmission, Mr. Sanchez, who is capable of consenting to his psychiatric treatment, agreed to restart olanzapine. While in the community, he was only on long-acting injectable antipsychotic medication. Mr. Sanchez began to show improved mood and engagement but complained that the olanzapine was too sedating, allegedly interfering with his ability to defend himself. In the last two to three weeks prior to the hearing, the olanzapine was switched to oral Abilify. This medication also yielded a positive response, though Mr. Sanchez still complained of being too sedated.
Mr. Sanchez has presented no management issues in the Hospital and is described as a polite and cooperative individual. Nevertheless, he has reportedly demonstrated limited insight into his actions, emotional lability, and preoccupation with perceived threats since his readmission. Dr. Naidoo explained that Mr. Sanchez understands the severity of his breaches to some extent but not in a fulsome way.
Dr. Naidoo confirmed that Mr. Sanchez lost his community residence following his readmission to the Hospital. The residence did provide a degree of supervision and oversight in relation to its residents. Nevertheless, it was Dr. Naidoo’s opinion that absent a readmission, Mr. Sanchez’ cannabis use would have continued, and his psychosis would have continued to intensify.
Dr. Naidoo testified that beginning on June 25, Mr. Sanchez was approved for staff-accompanied privileges off the unit, including the Hospital grounds, and on July 21, staff-accompanied community privileges were added. More recently, indirectly supervised off-unit (Level 2) privileges were added. These privileges were reinstituted after observing Mr. Sanchez, Dr. Naidoo’s discussions with him, and following fulsome team discussions to give the team confidence that Mr. Sanchez would not elope.
Dr. Naidoo confirmed that the treatment team plans to put Mr. Sanchez on housing wait lists again once he is ready for community living. The team has not discussed putting him on immediate wait lists (having regard to the anticipated waiting periods for available community residential programs) as there is uncertainty as to the type of residence that would be appropriate for him. Dr. Naidoo stated that the treatment team needs to first see that Mr. Sanchez is at a state in which he can engage in such discussions. As Dr. Naidoo expressed the situation, Mr. Sanchez’ elopement and recent loss of two residential placements due to cannabis use and associated worsening of his symptoms has required a “re-setting of the clock” in terms of his community reintegration.
No further evidence was led following Dr. Naidoo’s testimony.
Analysis and Conclusions
The panel had no difficulty accepting the parties’ joint position and found that Mr. Sanchez’ readmission to the Hospital was entirely warranted in the circumstances apparent to the treatment team. Mr. Sanchez had failed to return to his community residence, prompting an alert by housing staff to the treatment team. He had left Southern Ontario in breach of his Disposition and had not informed or sought permission from his team. In the context of his history of suddenly leaving his home province and trying to travel across the country, and his conduct leading to and during the index offence, Mr. Sanchez’ elopement represented an increased risk to public safety. At minimum, he required readmission for assessment upon his return from Montreal.
The panel was further satisfied that Mr. Sanchez’ continued detention in the Hospital and the gradual reinstitution of his privileges were also warranted, representing the least onerous, least restrictive approach to the management of his risk. Mr. Sanchez consumed cannabis both prior to and during his elopement. He had also done so prior to the index offence and during the period leading up to his readmission in August of 2024. By his own prior admission, cannabis has aggravated the symptoms of his illness. He also exhibited increased symptoms of his mental illness, aggravated by his cannabis use, following his hospital readmission. Oral antipsychotic medication, supplementing his long-acting injectable medication, helped to stabilize him, but this of necessity took some appreciable time, and following complaints by Mr. Sanchez, a change in his oral medication also occurred. Furthermore, given the increased public safety risk associated with Mr. Sanchez’ history of impulsive elopements and his cannabis use, it was necessary that the treatment team be satisfied that Mr. Sanchez’ current elopement risk could be managed prior to permitting him to have off-unit access on an indirectly supervised basis.
Mr. Sanchez lost his community residence as a consequence of his conduct. The panel was satisfied, on the evidence of Dr. Naidoo, that Mr. Sanchez is not yet ready to be discharged back to the community. Indeed, considering the circumstances of Mr. Sanchez’ hospital readmissions in 2024 and 2025, it is uncertain what type of community residence is appropriate for him. In the absence of the identification and availability of an appropriate community residence, it was necessary that Mr. Sanchez’ hospital admission continue.
Accordingly, the panel concluded that the significantly increased restrictions on Mr. Sanchez’ liberty, flowing from his hospital readmission on June 17, 2025, and his ongoing detention in the Hospital as of the hearing date, were on the evidence entirely warranted, representing the least onerous and least restrictive measures open to the Hospital for the management of his risk.
In approaching this matter, the panel has considered the evidence through the lens of the factors in s. 672.54 of the Criminal Code.
DATED this 20th day of August 2025, at the City of Toronto, in the Toronto Region.
Eric Siebenmorgen Legal Member
Office of the Registrar Ontario Review Board
Footnotes
- By agreement of the parties, Dr. Naidoo, who is Mr. Sanchez’ attending psychiatrist, gave his evidence via videoconference technology as he had been required to attend court in another city on the day of the hearing.
- As all parties were aware, Mr. Sanchez’ annual review of his Disposition is scheduled for September 9, 2025.