Ontario Review Board
Re: Bin Van Le
ORB File No: 4270
Hearing held on: Tuesday, June 24, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. J. Weinstein Members: Dr. L.E. Cappe Dr. L.O. Lightfoot Ms. M. den Haan Mr. A. Mete
Parties Appearing:
Accused: Bin Van Le Counsel: Ms. S. Dubb
The person in charge of hospital: Counsel: Mr. J. McIntyre
Attorney General of Ontario: Counsel: Mr. J. Canton
REASONS FOR DISPOSITION
(Dated August 19, 2025)
Introduction
1. On August 26, 2005, Bin Van Le was found not criminally responsible on account of mental disorder on a charge of manslaughter, contrary to the Criminal Code of Canada, (the "Criminal Code").
2. Mr. Le is subject to a disposition of the Ontario Review Board (the "Board") dated August 16, 2024, detaining him at the general forensic unit of the Centre for Addiction and Mental Health ("CAMH" or the "hospital") with privileges up to live in the community in 24 hour a day supervised accommodation approved by the person in charge that will permit him accommodation as the sole occupant of a room in such accommodation.
3. On June 24, 2025, the Board convened at CAMH to conduct Mr. Lawless' annual review hearing pursuant to s. 672.81(1) of the Criminal Code. Mr. Le was present at the hearing along with his counsel, Ms. S. Dubb. Mr. Le was assisted by a Vietnamese interpreter throughout the hearing.
4. A Hospital Report dated June 10, 2025 (the "Hospital Report") was entered as Exhibit 1.
5. The issues to be determined at the hearing were whether Mr. Le continued to represent a significant threat to the safety of the public, as defined in s. 672.5401 of the Criminal Code, and if so, what was the necessary and appropriate Disposition which was also the least restrictive and least onerous taking into account the factors set out in s. 672.54 of the Criminal Code.
6. The parties jointly submitted that there be no change to Mr. Le's current Disposition. The issue of significant threat was not contested.
7. For the reasons set out below, the Board finds that Mr. Le continues to pose a significant threat to the safety of the public and that the terms and conditions of the existing Disposition should continue in force.
Index Offence
8. The details of the index offence are taken from last year's Reasons for Disposition, as follows:
"Mr. Le and the victim were roommates at a residence in Toronto known as MacDonell House. This residence provides care for persons suffering from mental health issues.
Both men had been diagnosed with paranoid schizophrenia. The deceased took his medication consistently and never exhibited violent behaviour. On the date of the offence, May 25, 2004, Mr. Le had refused his oral medication for a month and had refused his injectable medication for two weeks. When not on medication, Mr. Le has had a history of violence and acting aggressively. On that afternoon Mr. Le bound the victim's hands together with shoelaces and assaulted him with a four-foot-long tree limb, resulting in considerable trauma to his head and face area and ultimately his death."
Background
9. Mr. Le's personal and psychiatric history, including the details of his mental disorder and treatment since being found NCR, are described in detail in the Hospital Report. Briefly, Mr. Le is 60 years of age, single with no dependents. Mr. Le has 14 siblings, 10 of whom live in the Toronto area. Mr. Le has minimal contact with them.
10. Mr. Le completed Grade 9 or 10 in Vietnam but did not pursue further education after immigrating to Canada. He has been attending ESL classes in hospital.
11. Mr. Le's first psychiatric hospitalization was in 1995 after he was found lying on a streetcar track masturbating. He was diagnosed with Schizophrenia and prescribed antipsychotic medication. Between 1997 and 2004, he was admitted to hospitals numerous times. These admissions were the result of Mr. Le experiencing active symptoms of schizophrenia following medication non-adherence.
12. Mr. Le had several criminal charges prior to the index offences and was convicted for assault on two occasions in 2003.
13. He is unemployed and has been financially supported by Ontario Disability Support Program (ODSP) since 1996. He is incapable of consenting to psychiatric treatment and the Public Guardian and Trustee ("PGT") serves as his substitute decision maker.
14. Mr. Le lives in the community in Regeneration High Support Housing in Toronto, ("Dowling Avenue housing") in a private room. He was returned to hospital on August 15, 2024, until September 24, 2024, then again on October 5, 2024. A Restriction of Liberty hearing was held on November 19, 2024. Mr. Le has remained in hospital since that hearing but will return to his housing when he is discharged.
15. Mr. Le's current diagnoses are Schizophrenia and Polysubstance Use Disorder (alcohol and cocaine) in remission in a controlled environment. There is also a differential diagnosis of Paraphilia NOS.
Evidence at the Hearing
16. The hospital's evidence was presented through the Hospital Report and through the oral testimony of Dr. Van. Dr. Van is Mr. Le's inpatient psychiatrist and adopted the contents of the Hospital Report.
17. Dr. Van testified that there was an update to the Hospital Report, in that Mr. Le was reported to have grabbed a co-patient's genitals the week before the hearing. Mr. Le explained it as a joke. Mr. Le's Aripiprazole injection was discontinued as a result. Dr. Van explained that for some patients, Aripiprazole will lead to hypersexuality and impulsivity. The treatment team will continue to monitor Mr. Le for inappropriate sexual behaviour.
18. Dr. Van testified that:
- the treatment team is currently working with the housing provider to prepare Mr. Le for a potential discharge back to the Dowling Avenue housing. This will be a cautious and measured discharge, and Mr. Le will have several visits at the Dowling residence prior to any discharge. The goal of the transition visits is to increase Mr. Le's familiarity with the housing again and decrease any anticipatory anxiety of a discharge;
- a Conditional Discharge is inappropriate at this time, as Mr. Le has required two readmissions during this treatment year. A warrant was needed for both returns to hospital, and therefore the Mental Health Act is insufficient for an expedient response if Mr. Le's mental state decompensates while he is in the community. Mr. Le's mental state deteriorates quickly, and sometimes there are no obvious triggers for decompensation; and
- the hospital requires the ability to approve housing, in order to ensure the appropriate supports are in place to manage Mr. Le's risk. When he is well, Mr. Le is an active participant on the unit, attends groups such as the soccer group, outings, and is generally amiable and sociable with his co-patients. When he is unwell, he requires higher supervision.
19. In response to questions from counsel for the Attorney General, Dr. Van testified that:
- Mr. Le's risk decreases while he is adherent with his medication and abstaining from the use of substances;
- concerns about recent decompensation have been communicated to Mr. Le's long-term case manager. Historically, there have also been decompensations in Mr. Le's mental state without obvious triggers;
- some individuals, such as Mr. Le, have very fragile illnesses, and mental or physical stressors will lead to a relapse of symptoms;
- it may have been a contributing factor that Mr. Le's decompensation occurred close to the time that he was preparing to be discharged into the community. The treatment team is ensuring that Mr. Le's transition back to Dowling Avenue housing will be gradual and the transition visits will be helpful for this;
- Mr. Le's clozapine levels are sufficient and are at a therapeutic level. His clozapine dosage was increased this year to 500 mg. Mr. Le still experiences some bouts of deterioration of his mental state, including as recently as April of this year;
- Mr. Le's PCL-R score is 29 and antisocial personality traits are noted on page 42 of the Hospital Report; and
- this is not concerning to Dr. Van, as this was scored years ago based on historic factors. Antisocial personality traits can be confounded if a patient is experiencing active psychotic symptoms. When Mr. Le is in remission of his symptoms, he does not exhibit frank antisocial personality traits, and his mood is good, he follows rules, he gets along with staff and co-patients, and he is kind and considerate. For example, he will pull out a chair for someone to be able to sit. When Mr. Le is well antisocial personality traits are much less evident.
20. In response to questions from counsel for Mr. Le, Dr. Van testified that:
- the discontinuation of Mr. Le's Aripiprazole was recent. His injection was due the week prior to the hearing, and it was not given to him. He is currently only taking Clozapine;
- Mr. Le was taking Aripiprazole in December when he was transferred to her care, but there is no sign of a difference in his mental state before or after the Aripiprazole. Mr. Le's Clozapine dose is in the therapeutic range. If there is a relapse, the treatment team may consider another injectable medication;
- there were no transition visits to the Dowling Avenue residence prior to Mr. Le's April discharge back to the residence;
- Mr. Le has expressed interest in returning to the Dowling Avenue housing;
- Mr. Le's substance use is in remission in a controlled environment;
- Mr. Le's ability to attend programs at the hospital is limited due to his language constraints and the difficulty of attending groups in English;
- In terms of other supports for discharge for Mr. Le, there is an expanded FOPS service and specialized case managers will visit housing when Mr. Le is residing there;
- in April, the hospital encouraged Mr. Le to participate in outpatient groups, Mr. Le attended Friday's soccer outings with the outpatient program, and he still attends the soccer programs;
- she hopes that Mr. Le will develop further familiarity with the team at Dowling Avenue housing and continue structured activities at the hospital;
- this familiarity and structure will help Mr. Le to abstain from substances and that further structure will assist in stability of his mental state;
- to his credit, Mr. Le has been abstinent from substances for several years; and
- there will be closer observation of Mr. Le, in order for there to be quick intervention if there is any decompensation in his mental state.
21. In response to questions from the panel, Dr. Van testified:
- with respect to the Paraphilia Not Otherwise Specified differential diagnosis at page 42 of the Hospital Report, all inappropriate sexual behaviours have been in the context of psychosis, and historically more apparent during acute decompensation;
- some inappropriate sexual behaviours have been noticed when Mr. Le's mental state has been more stable including sexually inappropriate gestures, which has led to the differential diagnosis;
- the history is incomplete on Mr. Le's early development and whether there are any learning disabilities;
- it is difficult to fully assess Mr. Le's cognitive function level, especially with the language barrier, but no major concerns exist with respect to his neurocognitive abilities;
- when Mr. Le is well his memory and attention are quite good, he is financially capable, does his own banking, is able to manage large expenses (for example, purchase of dentures), and can ascertain how much money he requires and have it available to pay;
- there has not been a formal intellectual assessment to Dr. Van's knowledge;
- a referral for a sexual assessment will be made if there is sexually inappropriate behaviour while Mr. Le's mental state is stable and there are behaviours not associated with psychosis;
- there was a sexual component to the index offences, but in Dr. Van's opinion the differential diagnosis is sufficient as his risk factor has not been assessed; and
- Mr. Le does not currently have family contact while he is at the hospital, but Dr. Van stated that while Mr. Le was at the Dowling Avenue residence, he had some communications with his brother. He has not expressed an interest to the treatment team in contacting his family.
22. No further evidence was called.
Submissions of the Parties
23. In closing submissions, the hospital maintained the recommendation to continue the existing Disposition without change. Counsel for the Attorney General continued to support the hospital position as did counsel for Mr. Le.
Conclusion and Disposition
24. Having heard and considered the entirety of the evidence, as well as the submissions of the parties, the Board agrees with the joint submission: Mr. Le remains a significant threat to the safety of the public. In coming to its conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Van and the clinical, actuarial, and structured professional judgment risk assessment set out in the Hospital Report.
25. In particular, the Board relies on the Risk Opinion set out in the Risk Assessment at page 40 of the Hospital Report: "Overall, his level of protection was deemed to be moderate, with level of risk being moderate-high.
26. The Board also relies on the Clinical Risk Assessment set out at page 41 of the Hospital Report:
"Clinical or dynamic risk factors which may serve as proximal indicators for violent reoffence include active symptoms of his schizophrenia, non-compliance with medications, use of alcohol or illicit drugs, and exacerbation of underlying antisocial personality traits.
If Mr. Le is to reoffend, this will likely occur in the context of variable/non-compliance with his medications, exposure to destabilizers and stressors, the return to his historical pattern of the use of alcohol and psychoactive agents, and the acute exacerbation of psychosis. In addition, in the past year the clinical team has witnessed Mr. Le experience decompensation in his mental state while compliant with medications and abstinent from substances. The precipitating factors for such mental deterioration is unknown. While psychotic, Mr. Le has engaged in violent behaviours, such as those at the time of the index offence, and during his recent admission this year."
27. Mr. Le's mental status has deteriorated in the past notwithstanding adherence to medication and abstaining from substances. His illness is fragile, and he has exhibited symptoms of psychosis without obvious trigger. Mr. Le is incapable of consent to treatment.
28. Mr. Le was discharged into the community in December 2021 and demonstrated relative stability until December of 2022. He required a prolonged hospitalization in 2023, and he was readmitted to hospital twice during this reporting year. At the time of the hearing, he remains an inpatient in hospital following a sudden mental state deterioration in April of 2025, which resulted in Mr. Le assaulting a co-patient. The treatment team is exercising caution and a careful transition back into the community in the near future for Mr. Le.
29. It is clear based on the evidence that the hospital requires the authority to approve housing for Mr. Le and retain the ability to rapidly admit him to hospital should his mental state deteriorate or if there are issues with medication nonadherence or substance use. Dr. Van's evidence is that the Mental Health Act would not adequately address these issues.
30. In arriving at our Disposition, the Board has considered the paramount factor of the safety of the public, Mr. Le's community reintegration, his mental condition, and his other needs, all as required by s. 672.54 of the Criminal Code.
DATED this 19th day of August, 2025, at the City of Toronto, in the Region of Toronto.
Ms. M. den Haan Legal Member
__________________ Office of the Registrar Ontario Review Board