Re Shawn M. O’Neill, 2026 CanLII 21170

Re: Shawn M. O’Neill

ORB File No: 6928

Hearing held on: Friday, October 31, 2025

Place of hearing: Centre for Addiction and Mental Health

Pursuant to: Section 672.81(1) of the Criminal Code

Before: Alternate Chairperson: Mr. B. Garrow Members: Ms. J. Ferguson Dr. R. Sheppard Dr. L. O. Lightfoot Mr. S. Duffy

Parties Appearing:

Accused: Shawn M. O’Neill Counsel: Mr. M. Schloss

The person in charge of hospital: Counsel: Mr. D. Blumenkrans

Attorney General of Ontario: Counsel: Mr. R. Mushlian

REASONS FOR DISPOSITION

(Dated March 9, 2026)

Introduction

1. On March 18, 2016, Shawn M. O’Neill was found not criminally responsible on account of mental disorder (“NCR”) on charges of aggravated assault (x3), assault with a weapon (x2), attempted murder, and possession of a weapon for a dangerous purpose, all contrary to the Criminal Code of Canada (the “Criminal Code”).

2. Mr. O’Neill is currently subject to a Disposition of the Ontario Review Board (the “Board”), dated October 23, 2024, detaining him at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH” or “the hospital”), with privileges up to and including the ability to live in the community within 200 kilometers of Toronto, in accommodation approved by the person in charge.

3. On October 31, 2025, a panel of the Board convened to review Mr. O’Neill’s Disposition pursuant to s. 672.81(1) of the Criminal Code.

4. Mr. O’Neill was present for his in-person hearing and was represented by counsel, Mr. Schloss, throughout the proceedings.

5. The issues to be determined are whether Mr. O’Neill continues to represent a significant threat to the safety of the public and, if so, the necessary and appropriate disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code.

6. For the reasons set out below and based on the evidence and opinions before us, the Board concludes that Mr. O’Neill continues to represent a significant threat to the safety of the public. The Board finds that a Detention Disposition is the necessary and appropriate Order on the terms set out in our formal Disposition having regard to the safety of the public, which is the paramount concern, and also having regard to Mr. O’Neill’s mental health and other needs.

Position of the Parties

7. At the outset of the hearing the parties were canvassed as to their respective positions. The hospital recommended that the necessary and appropriate Disposition is a continuation of the current Disposition. Counsel for the Attorney General supported the hospital’s recommendation. Counsel for Mr. O’Neill was in support of the hospital’s recommendation, thereby conceding the issue of significant threat.

8. At the conclusion of the hearing, the parties maintained their joint submission.

Current Psychiatric Diagnoses

9. Mr. O’Neill is diagnosed with:

• Schizophrenia
• Substance Use Disorder
• Antisocial Personality Disorder

Index Offences

10. The circumstances of the index offences are set out in detail in the Hospital Report, dated September 9, 2024. In summary, On January 25, 2015, Mr. O’Neill, who had not been sleeping well or taking his prescribed medication, took a knife from his kitchen and walked onto Church Street, Toronto. There he stabbed Victim #1 in the lower right abdomen. He proceeded further and stabbed Victim #2, who was out on a morning run. He proceeded west and saw Victim #3 who he stabbed in her right rib cage. He continued walking west and saw two individuals and brandished the knife at them. When they were each able to avoid harm, Mr. O’Neill stabbed at Victim #4’s chest as she exited a bus. The knife blade broke off when it hit her iPhone.

Background and History

11. The Hospital Report was made an exhibit and information therein need not be repeated here beyond the following highlights:

12. Mr. O’Neill is a 71-year-old man born in Ontario. He attended the University of Western Ontario and began using drugs and alcohol at the age of 17 during his first year of university and dropped out in his third year of studies which coincided with his first psychotic break and heavy drug use.

13. Mr. O’Neill has a scant work history, in part due to his extensive criminal record and admissions to psychiatric hospitals. He is currently supported by ODSP.

14. Mr. O’Neill’s first psychiatric admission to hospital was in 1975. He had at least twenty-eight psychiatric hospitalizations in Ontario between 1975 and 1986 and a further sixteen psychiatric hospitalizations between 2004 and 2016. Most of his admissions were related to psychotic symptomology, substance use, and violence directed toward others.

15. Mr. O’Neill was previously under the jurisdiction of the ORB. On June 13, 1996, Mr. O’Neill pulled a knife on a victim while walking on Queen Street in Toronto. He was charged with Assault with a Weapon, Weapons Dangerous, and Carrying a Concealed Weapon. He was subsequently found Not Criminally Responsible on those charges. While under the jurisdiction of the Board he continued to use substances. He received an Absolute Discharge in January 2014. Shortly thereafter, Mr. O’Neill quickly returned to using substances. He was admitted to CAMH in April 2014 and remained in hospital until July 10, 2014.

16. Mr. O’Neill then committed the index offences in January 2015. Following the NCR finding, he was admitted to CAMH. He remained in hospital until June of 2019 when he was discharged to a 24-hour supervised mental health residence. Notwithstanding supervision, he returned to substance use. On July 2, 2019, he was readmitted to CAMH pursuant to a warrant of committal and remained there for a short period of time. He was readmitted in August 2019 due to his continuing substance use and potential for harm. He remained in hospital until he was discharged to Habitat Housing in November 2020. He was not able to maintain abstinence from substances, and was re-admitted repeatedly to CAMH at various times for varying lengths of time as outlined in the Hospital Report

Evidence at the Hearing

17. The evidence at the hearing consisted of the Hospital Report and oral evidence from Dr. Owen O’Sullivan, Mr. O’Neill’s treating psychiatrist since taking over from Dr. Chatterjee. Dr. O’Sullivan authored the Hospital Report.

18. Dr. O’Sullivan testified that during the reporting year, Mr. O’Neill again eloped from CAMH when out on a supervised pass on July 11, 2025, at about 16:30. He eventually returned of his own accord at about 21:00. Mr. O’Neill advised that after absconding from CAMH he immediately attended a cannabis dispensary and purchased cannabis and cannabis gummies which he immediately ingested. He then attended a bar and a restaurant where he had zero alcohol beer and a steak. Upon returning to CAMH he tested positive for cannabis but negative for alcohol and there were no changes to his mental state. As a result of this elopement, Mr. O’Neill’s pass level was reduced. Mr. O’Neill had also absconded from CAMH in the prior reporting year in March of 2024. Dr. O’Sullivan testified that since 2000 Mr. O’Neill has eloped a total of ten times and that his pattern with respect to unauthorized absences is consistent. There have not been any concerns about Mr. O’Neill’s behaviour with respect to violence or inappropriate behaviour during these unauthorized absences. Dr. O’Sullivan testified that Mr. O’Neill had admitted that he had planned to elope in July 2025 for some time for the express purpose of using cannabis and that he has admitted that he has been a cannabis user for about fifty years. Dr. O’Sullivan testified that Mr. O’Neill has eloped ten times since 2000.

19. Dr. O’Sullivan testified that prior to absconding in July Mr. O’Neill had quite a positive year, was compliant with taking his medications, didn’t exhibit any challenging behaviour on the unit and participated in his programming including a range of pro social activities such as going to restaurants and the theatre. Dr. O’Sullivan testified that the treatment team was making steady gains toward supportive housing placements but that finding appropriate housing takes time and it was uncertain as to whether there was appropriate housing available in the near future. In addition, as a result of having gone on an ULOA, Mr. O’Neill is on a level two pass now and he will have to work to get those privileges back.

20. Dr. O’Sullivan testified that Mr. O’Neill experienced quite a few health challenges this reporting year. Mr. O’Neill is undergoing treatment for prostate cancer with progression identified in his liver but fortunately, it is a small lesion which lends itself to being addressed as a day case and a laser ablation is due to take place next week.

21. In addition to his cancer treatment, he has had quite a few medical emergencies, and on multiple occasions required transfer to hospital. As a result of treatment resistant blood pressure issues, Mr. O’Neill was referred to a blood pressure clinic and a stroke clinic. In addition to his cancer care, Dr. O’Sullivan testified that Mr. O’Neill has a complicated medical history.

22. Dr. O’Sullivan gave evidence that because Mr. O’Neill cannot progress to indirectly supervised passes at this time, his treatment has stalled but that if he can demonstrate a commitment to abstinence, and achieve the appropriate use of indirectly supervised passes, there is a possibility he can progress to community living within this next reporting year.

23. With respect to moving Mr. O’Neill into the community, Dr. O’Sullivan testified that over the course of the next few moths, discharge planning with view to long term care would be started and as early as next week Mr. O’Neill will be assessed by staff from housing with a view to finding him 24-hour supportive housing with a view to transitioning him to long term care housing. Dr. O’Sullivan testified that Mr. O’Neill needs to continue relapse programming and continue to develop leisure activities to mitigate risk once he is in the community.

24. Dr. O’Sullivan testified that Mr. O’Neill’s risk factors are the result of unauthorized leaves of absence coupled with repeated substance use, which places him at risk of acute deterioration in his mental status and psychosis. He has a lack of insight with regard to abstinence and how abstinence will contribute to controlling his risk to the public.

25. When asked why Dr. O’Sullivan considered Mr. O’Neill to be a significant threat, he testified that Mr. O’Neill has a longstanding history of his schizophrenia relapsing and remitting and that his treatment is complicated by his substance use and medication non-compliance. Mr. O’Neill was in a state of acute psychosis when he committed the 2015 index offences which included multiple stabbings and attempted murder. Dr. O’Sullivan testified that over many years, Mr. O’Neill’s treatment has been complicated by a number of factors, especially the times he has absconded, most recently in July. Mr. O’Neill absconds from both secure and general units, on unsupervised and supervised passes and then uses cannabis and/or alcohol. At times these ULOAs are premeditated but he returns of his own accord. Dr. O’Sullivan testified that without a detention order, Mr. O’Neill would decompensate, become floridly psychotic and cause public harm. In Dr. O’Sullivan’s clinical opinion, Mr. O’Neill still poses a significant threat to the safety of the public but that the current detention order adequately addresses that issue, that he was not recommending any changes and that all of the existing conditions are necessary.

Analysis and Conclusions

26. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees Mr. O’Neill remains a significant threat to the safety of the public. Although this was not disputed at the hearing, but the Board nevertheless considered this issue.

27. Mr. O’Neill is under the jurisdiction of the Board for the second time, with the Index Offences relating to the current finding of NCR showing a similar pattern of violent behaviour to those of his first set of Index Offences in 1996. He has a psychotic illness that, if untreated, has led to the Index Offences. In the past reporting year, Mr. O’Neill has been managed in hospital with medication, structure, support and supervision. When given the opportunity, he elopes and resumes use of illicit substances. His history makes clear that he remains at significant risk of substance relapse, psychosis and ultimately violence if his substance use is not monitored and externally controlled.

28. In Winko the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the expert evidence of Dr. O’Sullivan in addition to the documentary evidence before us.

29. Given the finding of significant threat, the Board is charged with making a disposition for the coming year which is the most appropriate, least onerous and restrictive option necessary to manage the risk posed by Mr. O’Neill.

30. Mr. O’Neill’s substance use when he has the opportunity to use substances remains a serious concern. His substance use has historically precipitated psychotic symptoms that were present during the Index Offences. Without close monitoring by the treatment team his substance use would increase significantly, which would result in his disengagement from treatment, increase the likelihood of medication non-compliance, and lead to the return of psychotic symptoms accompanied by violent behaviours. His risk to the public would increase significantly were he not under a Detention Disposition.

31. The Board accepts the joint submission. The necessary and most appropriate, least onerous and restrictive Disposition to manage Mr. O’Neill’s risk in the coming reporting year is a continuation of the Detention Order at the Forensic Service at CAMH, on the same conditions as are currently in place.

DATED this 9th day of March, 2026, at the City of Toronto, in the Region of Toronto.

Ms. J. Ferguson Legal Member

Office of the Registrar Ontario Review Board