Re: Shawn Lepage
ORB File No: 8664
Hearing held on: Tuesday, January 14, 2025
Place of hearing: Royal Ottawa Mental Health Centre
Pursuant to: Sections 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. M. Labrosse
Members: Dr. S. Lessard
Dr. G. Boulais
Mr. D. D’Intino
Ms. K. Brisson
Parties Appearing:
Accused: Shawn Lepage
Counsel: Ms. L. Konarowski
Person in charge of hospital: Representative: Dr. J. Hwang
Attorney General of Ontario: Counsel: Mr. J. Wright
REASONS FOR DISPOSITION
(Dated February 26, 2026)
Introduction:
On November 15, 2024, Mr. Lepage was found not criminally responsible on account of mental disorder (“NCR”) on a charge of arson, disregard human life, uttering a threat to cause death or bodily harm, and assault peace officer, all contrary to the Criminal Code of Canada.
Mr. Lepage is currently subject to a disposition of the Ontario Review Board dated January 16, 2025, which detains him within the Integrated Forensics Program of the Royal Ottawa Mental Health Centre on terms and conditions, including permission to live in the community in accommodation approved by the person in charge.
On January 7, 2026, the Ontario Review Board (“ORB”) convened a hearing at the Royal Ottawa Mental Health Centre, hereinafter referred to as the hospital, to review Mr. Lepage’s disposition pursuant to s. 672.81(1) of the Criminal Code.
Mr. Lepage was present for the hearing and was represented by his counsel, Ms. Lauren Konarowski. A hospital report dated December 18, 2025, was entered as Exhibit 1 for the hearing.
The issues for this hearing are whether Mr. Lepage continues to pose a significant threat to the safety of the public, and if so, to determine the necessary and appropriate disposition for the coming year.
At the outset, the parties were canvassed as to their preliminary positions for this hearing at which time the hospital stated its recommendation that a detention order should be maintained, and that Mr. Lepage should be transferred to the Brockville Mental Health Centre, with the hospital maintaining the residual authority until such time as he is transferred.
Counsel for the Attorney General, Mr. Wright, indicated his likely agreement with the hospital position. Counsel for Mr. Lepage, Ms. Konarowski, stated that she was not contesting the issue of significant threat or the appropriateness of a continued detention order but that a transfer to Brockville is premature.
At the conclusion of the hearing, the parties maintained their positions.
For the reasons set out below, the Board finds that Mr. Lepage continues to pose a significant threat to the safety of the public and that a detention order with community living in approved accommodation remains the necessary and appropriate disposition. The hearing panel declined to order Mr. Lepage’s transfer to Brockville Mental Health Centre at this time.
Index Offences
- In last year’s Reasons for Disposition the index offences were summarized as follows:
« On August 22, 2024, Mr. Lepage was residing with two roommates in Ottawa. On that day, he barricaded himself inside his bedroom. He was holding a knife and stated that he wanted to die by suicide by cop. Officers observed Mr. Lepage in his room apparently heating up his knife over a metal container. When the officers demanded that he drop the knife, Mr. Lepage refused and said he would hurt the officer and he was boiling the knife so it would hurt more. Mr. Lepage then screamed that he had set fire to his room. Flames were observed and heavy black smoke filled the hallways of the apartment building, necessitating the entire second floor to be evacuated. Officers had to subdue Mr. Lepage and carry him out of the apartment to safety. He was taken to hospital where he kicked two officers in the chest multiple times.”
Background History
Mr. Lepage’s personal, legal, and psychiatric history is set out in detail in the hospital report. Briefly summarized, Mr. Lepage is currently 34 years of age. He was adopted at the age of six months and following his parents’ separation, he resided with his mother and two siblings in Ottawa. He ultimately was forced to leave the family home when he was 27 due to his destructive and violent behaviour.
Mr. Lepage completed high school and successfully completed a two-year medical Laboratory Technician program, though was unable to secure employment in that field. He worked for four years as a porter at the Queensway-Carleton Hospital until his employment was terminated following an altercation with a coworker. He is currently supported by the Ontario Disability Support Program (ODSP).
When Mr. Lepage was 10 years of age, he was assessed at the ROH due to his aggressive behaviour. He was quick to react, hypersensitive and impulsive in situations where he felt frustrated. He was diagnosed with attention deficit hyperactivity disorder (ADHD) and prescribed Ritalin. Two years later, diagnoses of Oppositional Defiance Disorder (ODD) and a learning disability were added. He engaged in individual therapy with a psychologist on anger management strategies.
In 2015 and 2016, Mr. Lepage saw several psychiatrists for diagnostic clarification and medication recommendations to assist in anger management. According to the hospital report, neither Mr. Lepage nor his mother wished to participate in family therapy or rehabilitation therapy at that time.
Mr. Lepage has no history of substance use.
According to CPIC, Mr. Lepage was charged with two counts of uttering threats and one count of mischief in October 2020, which were resolved by way of a peace bond.
Following his arrest for the index offences, Mr. Lepage was admitted to the Montfort Hospital pursuant to the Mental Health Act. He reported visual and auditory hallucinations and paranoia. The admitting psychiatrist noted him to be guarded and paranoid. Mr. Lepage remained in hospital until September 20, 2024. After starting treatment, his symptoms started to abate and his distress around his auditory hallucinations and delusions decreased.
Mr. Lepage’s current diagnoses are:
Schizophrenia
Opposition Defiant Disorder – by history
ADHD – by history
Evidence at the Hearing
The hospital’s evidence was presented through its report and through the oral testimony of Dr. J. Hwang who has been Mr. Lepage’s attending psychiatrist since before admission to the hospital while he was in detention at the Ottawa-Carleton Detention Centre (“OCDC”) following the charges on the index offences.
Dr. Hwang testified that while Mr. Lepage was at OCDC, his medication compliance was suboptimal. He would decline medication for several consecutive days and then restart it for no clear reason. Several medication changes were made based on his stated preference for different antipsychotics. Mr. Lepage changed his mind many times as to what antipsychotic he was prepared to take and due to the inconsistency, he continued to be symptomatic and was observed responding to unseen stimuli at times and become irritable with correction officers without apparent triggers.
Following his transfer to the hospital on April 17, 2025, and admission to the Forensic Assessment Unit, there were several incidents resulting in code whites due to Mr. Lepage’s aggression and violence towards co-patients and staff. After several such incidents and continued ongoing psychotic symptoms, as well as Mr. Lepage’s refusal to engage in any discussion about his medication, Dr. Hwang deemed him incapable of making treatment decisions and started a course of Clozapine.
Following the introduction of Clozapine, Mr. Lepage appeared to initially respond but experienced orthostatic hypotension due to his low blood pressure. He felt very dizzy and had a number of fainting spells. Unfortunately, Clozapine had to be paused and Mr. Lepage’s mental condition continuing to fluctuate.
Mr. Lepage is currently compliant with medication though his symptoms continue to fluctuate. According to Dr. Hwang, he spends much of his time in his room but will occasionally spend time outside his room talking with nursing staff.
Mr. Lepage has recently started participating in some recreational activities, including table tennis. It is a significant improvement for him to be able to engage in that kind of activity.
Mr. Lepage’s insight into the need for medication fluctuates. Dr. Hwang advised that Clozapine has been reintroduced at a very low dose. Mr. Lepage sometimes refuses to do the blood work, which will require Clozapine to be discontinued again if he does not comply with the necessity of monitoring his blood levels.
Dr. Hwang indicated that the treatment team’s goal in the last year was to get Mr. Lepage to the point where preparation for discharge could be started. He was on the transfer list for to the Forensic Rehabilitation Unit (“FRU”) for a couple of weeks in November, before he discontinued medication and had a number of aggressive incidents, resulting in his removal from the transfer list.
In the opinion of Dr. Hwang, more time is needed to optimize medication and to monitor Mr. Lepage’s symptoms. His hospitalization could therefore be prolonged for some time and would be better accommodated at the Brockville Mental Health Centre, which is better equipped for long-term treatment and has more units that can provide a gradual increase in privileges. At this time, Mr. Lepage remains on the Forensic Assessment Unit (“FAU”) and is not able to exercise any privileges.
Dr. Hwang believes that Mr. Lepage responds well to goal setting and would be well suited to the progressive approach available at Brockville. Dr. Hwang believes that community living, though unlikely over the course of the next year, should be maintained in the disposition as this will provide an incentive to Mr. Lepage to participate and engage in treatment.
In response to questions posed to her by counsel for the Attorney General, Mr. Wright, Dr. Hwang responded as follows:
(a) Community living remains aspirational for the next year as Mr. Lepage has made no significant progress towards it in the past year. Dr. Hwang continues to believe that this is a positive condition for him and that it would make it difficult for him to work with the team if it was removed.
(b) With respect to a transfer to Brockville, Dr. Hwang acknowledged that Mr. Lepage has mixed fillings about it and that though he sees the potential benefit of a gradual approach, it will be difficult for his mother to visit him there as she has some physical limitations. Mr. Lepage has also spent his entire life in Ottawa and wishes to remain here.
(c) In order to be ready for community living, Mr. Lepage would have to demonstrate better medication compliance and cooperation with necessary blood work as well as better insight into his mental illness and better engagement with the treatment team. Though Mr. Lepage engages well with nurses on the unit, he has not so far engaged with other members of the treatment team with respect to rehabilitative and psychosocial programming.
(d) Dr. Hwang does not believe that they are yet at the point of starting an O.T. assessment to determine his suitability for community living; however, she expects that the likely starting point for Mr. Lepage, once he is ready for discharge, will be a supervised setting.
(e) Dr. Hwang acknowledged that the Royal Ottawa Hospital is currently able to manage Mr. Lepage but that as recently as November of 2025, the hospital was seeking a transfer to a high security unit at Waypoint due to his acute violence on the unit.
(f) Dr. Hwang stated that another benefit of Brockville is that it has seclusion rooms which would obviate the need to use mechanical restraints which have been utilized when Mr. Lepage has been very violent.
- In response to questions posed to her by counsel for Mr. Lepage, Ms. Konarowski, Dr. Hwang responded as follows:
(a) Mr. Lepage was not transferred from OCDC until April 17, 2025, and has therefore only been in the hospital for approximately eight months.
(b) Dr. Hwang acknowledges that though Mr. Lepage has mental health supports while he was at OCDC, the seven-month period that he spent in custody was not good for his mental health. Once transferred to the hospital, he demonstrated a continuation of violent behaviour and there was more room for him to act out in hospital than in jail, where he was more confined.
(c) Mr. Lepage’s capacity to consent to treatment has largely fluctuated since his admission in April of 2025. In July, after agreeing to try Clozapine, there were no code whites between the beginning of July and November when Clozapine was interrupted.
(d) In order for Mr. Lepage to be put back on the list for transfer to the FRU, Dr. Hwang stated that the treatment team would need to see good medication compliance, no violent incidents, and the ability to participate in group programming.
(e) Dr. Hwang acknowledged that the side effects from the Clozapine have caused Mr. Lepage to have a significant setback in his progress.
(f) Since December 4, 2025, Clozapine has been restarted. Though he is receiving a low dose at 75 mg, he did improve to the point where the transfer to Waypoint was no longer needed, nor has he required any mechanical restraints in some time.
(g) Though Mr. Lepage’s response to medication is good enough that he maybe ready for transfer to the FRU, Dr. Hwang is concerned about the tolerability of the Clozapine and the extremely significant side effects requiring cardiology consultations due to the hypotension. Mr. Lepage is currently tolerating the low dose but in order to be therapeutic, Dr. Hwang expects that he would need 500 to 600 mg. In October, when the Clozapine was discontinued, he was receiving a dose of approximately 300 mg.
(h) It is not clear how long it might take Mr. Lepage to reach a level of stability to be ready for transfer to the FRU which took approximately four months last year. Dr. Hwang acknowledged that a transfer to Brockville could be disruptive but that sometimes it is a positive process for some patients.
- In response to questions posed to her by members of the hearing panel, Dr. Hwang responded as follows:
(a) Dr. Hwang acknowledged that Mr. Lepage is currently taking several antipsychotics at low doses which the hospital would plan to discontinue if he is able to tolerate increases in his dose of Clozapine. Dr. Hwang stated that Aripiprazole had been Mr. Lepage’s previous medication and that there will be consideration given whether to keeping that as part of his medication regimen. At this time Mr. Lepage has agreed to increase the Clozapine to 100 mg and the hospital expects to monitor that carefully as he will likely experience increased dizziness.
(b) With respect to the transfer to Brockville, other than the fact that there are more units and a seclusion room, Dr. Hwang indicated that once community passes are appropriate, they are monitored more gradually by the staff who are able to verify compliance with the itinerary provided. In Dr. Hwang’s opinion, other than the loss of family proximity, there is no other downside to a transfer.
(c) With respect to insight, Mr. Lepage has improved in recent months, but as recently as November he denied having any mental illness when he was experiencing more symptoms. Mr. Lepage has not yet participated in any therapeutic programming and has not demonstrated any willingness to engage.
(d) Dr. Hwang confirmed that use of substances is not a concern with Mr. Lepage.
(e) Mr. Lepage assaulted a number of staff members at the hospital and Dr. Hwang indicated that she is not aware whether any of them have been unable to come back to work.
(f) Mr. Lepage remains incapable of consenting to treatment. With respect to the fluctuation of symptoms and his capacity to consent to treatment, the hospital has queried whether or not there might be an affective side to Mr. Lepage’s illness but that is not conclusive at this time.
(g) Dr. Hwang does not expect Mr. Lepage to go back on a long-acting injectable antipsychotic as they have been tried in the past and have not been effective or well tolerated by him.
(h) Dr. Hwang believes that there have been no in-person visits between Mr. Lepage and his mother in recent months but that they have frequent telephone contact.
(i) Dr. Hwang stated that low blood pressure is not uncommon in patients and people can develop a better response to medication. In the case of Mr. Lepage, the hospital is opting to do things very gradually to see how he tolerates gradual increases in the dose of Clozapine.
In response to questions arising from Ms. Konarowski, Dr. Hwang stated that she is not sure when a bed would become available at Brockville. She acknowledged that on December 12, 2025, Brockville had responded to the Rule 13 request by stating that a bed was available at that time, but that Dr. Hwang believes that that is no longer the case.
The hospital’s risk assessment is found on pages 44 to 45 of the hospital report and the possible reoffence scenario is summarized as follows:
“Based on this assessment, the most likely scenario involving risk of violence would be Mr. Lepage going off his medications resulting in an increase in his psychotic symptoms. This would include worse persecutory and somatic delusions, command auditory hallucinations and thought disorganization where he would target individuals that are in close proximity to him.”
- No other evidence was presented.
Submissions of the Parties
- The parties maintained the positions as expressed out at the outset of the hearing.
Analysis and Conclusion
Having considered all of the evidence tendered at the hearing, and the submissions of the parties, the Board does find that Mr. Lepage continues to pose a significant threat to the safety of the public as defined in s. 672.5401 of the Criminal Code of Canada and as further defined in the Supreme Court of Canada decision Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
According to R. v. Winko, a significant threat to the safety of the public means a real risk of physical or psychological harm to members of the public that is serious in the sense of going beyond the merely trivial or annoying. The conduct giving rise to the harm must be criminal in nature.
Our finding that Mr. Lepage continues to present a significant threat to the safety of the public is based on his history of major mental illness, namely schizophrenia, which has been difficult to treat, and his propensity to act out violently to those around him. When he is experiencing symptoms, Mr. Lepage can be highly aggressive and violent, and this behaviour continued for many months after the index offences while in jail and even since his transfer to the hospital.
Since his admission to hospital in April 2025 after a lengthy period of detention at OCDC, Mr. Lepage has had a difficult course. There have been many incidents of aggressive and violent conduct requiring code whites and the administration of mechanical restrains. There have been setbacks with treatment, given Mr. Lepage’s propensity to developing hypotension while on Clozapine. Other antipsychotics have been tried without good results.
While we agree that Mr. Lepage is not at all ready for discharge to the community, and that he will require a further period of stabilization and optimization of treatment, the evidence does not persuade us that a transfer to Brockville is necessary at this time. Mr. Lepage has been at the hospital for only 8 months and though he has had a difficult course since his admission, he has demonstrated an ability to improve when able to tolerate medication. There is cause for optimism with Clozapine having been restarted and being titrated up very carefully. The hospital may then be able to simplify the medication regimen and discontinue some of the other antipsychotics that are not at an optimized level.
A few months ago, Mr. Lepage was able to progress to the point where he was on the transfer list of the FRU and there is no evidence suggesting that he cannot do that again. Mr. Lepage has been doing better since the reintroduction of Clozapine in early December. There have been no recent incidents of violence.
If the situation should again deteriorate to the point where a longer admission appears inevitable, the hospital can bring an early hearing request to have the request for a transfer reconsidered by the Board.
We have taken into consideration the factors at s. 672.54 of the Criminal Code of Canada, namely the protection of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society and his other needs in coming to the unanimous finding that a detention order on the same terms and conditions remains necessary and appropriate and least onerous and least restrictive disposition in all of the circumstances.
DATED this 26th day of February 2026, at the City of Toronto, in the Toronto Region.
Ms. M. Labrosse Alternate Chairperson
Office of the Registrar
Ontario Review Board