Ontario Review Board
Re: Jade Nelson
ORB File No: 7461
Hearing held on: Wednesday, March 4, 2026
Place of Hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Flanagan
Members: Dr. R. Sheppard
Dr. G. Nexhipi
Mr. D. Sandor (via Zoom)
Mr. W. Apted
Parties Appearing:
Accused: Jade Nelson
Counsel: Mr. J. Wilton
The person in charge of hospital: Counsel: Mr. J. McIntyre
Attorney General of Ontario: Counsel: Ms. S. Malik
REASONS FOR DISPOSITON
(Dated March 18, 2026)
Introduction
On December 5, 2018, Ms. Jade Nelson was found not criminally responsible on account of mental disorder (“NCR”) on charges of attempted murder (x4), and assault, all contrary to the Criminal Code.
Ms. Nelson is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”), dated February 27, 2025, detaining her at the Centre for Addiction and Mental Health (“CAMH”), with privileges up to and including, to live in the community of the Greater Toronto Area in accommodation approved by the person in charge.
On March 4, 2026, the Board convened at CAMH to conduct Ms. Nelson’s annual review and to make a Disposition pursuant to s. 672.81(1) of the Criminal Code. Ms. Nelson attended her hearing and was represented by her counsel, Mr. J. Wilton. A Hospital Report dated February 9, 2026, was marked as Exhibit 1 at the hearing.
The issues for the hearing are whether Ms. Nelson continues to pose a significant threat to the safety of the public and, if so, to determine the necessary and appropriate Disposition in all the circumstances.
For the reasons set out below, this Board concluded that Ms. Nelson continues to represent a significant threat to the safety of the public and that the necessary and appropriate Disposition is a continuation of the existing Disposition on the same terms and conditions.
Initial Position of the Parties
At the outset of the hearing, the parties were canvassed as to their recommendations to the Board.
Mr. McIntyre, on behalf of the Hospital, submitted that the appropriate Disposition is a continuation of the existing Disposition which includes community living.
Ms. Malik, on behalf of the Attorney General of Ontario, supported the Hospital’s recommendation.
Mr. Wilton, on behalf of Ms. Nelson, also agreed with the recommendation of the Hospital and conceded the issue of significant threat.
Index Offences
- The details of the index offences are according to the Police Synopsis and summarized from the Hospital Report as follows:
“On Tuesday, July 3, 2018, the four victims were on a Bampton Transit bus in the area of Queen Street and McVean Road in the city of Brampton. At approximately 9:15 pm, the accused brandished a knife and started attacking people at random on the bus.
The victims sustained the following injuries, stab wound to back right shoulder, slash to face, and staples to reattach the left ear (Victim One), stab wound to neck lacerating the thyroid (Victim Two), stab wound to right chest (Victim Three), two slashes to the head, one slash to the face, and one laceration to the back (Victim Four). At 9:22 pm, Ms. Nelson was arrested for Assault with a Weapon and read her rights to counsel, which she indicated that she understood. At 11:55 pm, she was advised that the charges were upgraded to four counts of Attempted Murder. After receiving medical treatment at Brampton Civic hospital, she was transported to 21 Division where she was held pending an EDP bail hearing.”
Personal Background/Psychiatric History
Ms. Nelson’s personal background and psychiatric history are extensively set out in the Hospital Report and need not be repeated here.
Briefly Ms. Nelson is a 27-year-old single female born in Jamaica. She has two younger maternal half-siblings and one older paternal stepbrother. She was raised by her mother in Jamaica until age four when she moved to Canada to live with her father.
Ms. Nelson completed grade nine education and had a number of short-term jobs since leaving high school. Ms. Nelson stated that her longest period of employment was for approximately four to six months at the age of 16. Ms. Nelson had a relationship with a boyfriend who passed away in 2022.
Ms. Nelson stated that she began using cannabis in middle school which increased after she left her father’s home in 2017, at the age of 18. A year prior to the index offences, Ms. Nelson was charged with assault, punching her female landlord in the face, while living on her own in a basement apartment. At the time of the index offences, Ms. Nelson was of no fixed address.
Ms. Nelson has had contact with several hospital psychiatric facilities which are extensively detailed in the Hospital Report.
On March 13, 2016, she attended hospital voluntarily for a mental health evaluation. Her urine test was positive for cannabis and MDMA. Upon discharge, her father called the police, as he believed that she was a danger to herself. Ms. Nelson became very physically aggressive and was given an anti-psychotic medication injection.
On January 16, 2018, she was brought by police to Humber River Regional Hospital. She exhibited persecutory and bizarre delusions such as she believed the FBI was monitoring her and that there were bugs “everywhere,” including in her phone and that she was being recorded. She was discharged three days later with a diagnosis of cannabis induced psychosis, rule-out schizophrenia.
Ms. Nelson was again admitted to Humber River on March 2, 2018, and released on March 6, 2018. She appeared more paranoid and was behaving more erratically than during her last admission in January 2018. She blamed her behaviour on smoking cannabis.
Ms. Nelson was brought by police to Brampton Civic Hospital where she stayed voluntarily from April 5 to April 8, 2018. She presented with symptoms of paranoid delusions and poor insight and judgment. Ms. Nelson denied the use of substances but refused to undergo urine drug testing. She insisted on being discharged, became uncooperative and eventually had to be placed into physical restraints.
On March 15, 2018, Ms. Nelson was brought to the CAMH emergency department by her legal aid worker. She had reportedly been staying at the York University campus library for a week. At the hospital she was unable to answer most questions and appeared guarded, and internally preoccupied. She was involuntarily admitted for further observation, administered anti-psychotic medication, and discharged the same day.
On July 2, 2018 (the day before the index offences), the police brought her to Brampton Civic Hospital after she had been observed running into traffic and "picking grass." She was not referred for psychiatric assessment and was discharged with a diagnosis of “situational crisis.”
On December 3, 2018, Ms. Nelson was found NCR on the index offences and admitted to CAMH under the jurisdiction of the Ontario Review Board.
Current Diagnoses
- Mr. Nelson’s diagnoses are schizophrenia and cannabis use disorder.
Evidence at the Hearing
The Hospital’s evidence was presented through the oral testimony of Dr. Robert McMaster to supplement the Hospital Report filed as an exhibit at the hearing.
Dr. McMaster has been Ms. Nelson’s attending psychiatrist since she was discharged in October 2025 into Transitional Rehabilitation Housing Program (CMHA-THRP2), which is in close proximity to the hospital. This accommodation is a 24-hour supervised high-support program that provides on-site medication monitoring, curfew, urine drug screen collection, case management, and programming.
The doctor advised that Ms. Nelson has been doing very well and is engaged with her forensic out-patient team. There have been no incidents of aggression or violence, medication non-adherence, or pass misuse/AWOLs during the reporting year. Further, all urine drug screens were negative for any substances during the reporting year. Ms. Nelson has maintained contact with her mother, who lives in New York.
Over the reporting year, Ms. Nelson reported experiencing psychotic symptoms including auditory hallucinations and paranoid delusions. She experienced negative symptoms associated with her condition, such as reduced motivation, impulsivity, mood fluctuations, and occasional disorganization. Recently, in January 2026, she advised her individual therapist, Dr. Cripps, that she has been struggling with auditory hallucinations and had been playing very loud music as a coping mechanism. Dr. McMaster advised that following warnings from staff about the noise, she has been doing better in keeping the sound down.
The doctor confirmed that Ms. Nelson’s insight remained limited and that there were certainly gains to be made, particularly with respect to substance use. In this regard, Ms. Nelson does not agree with her Cannabis Use Disorder diagnosis. The doctor advised that although it has been two years since Ms. Nelson has used cannabis, she has an interest returning to it and does not feel it causes any problems with her mental health.
Dr. McMaster advised that although there may be transient calming effects of cannabis use, overall, it would be a high risk for psychosis. He emphasized that substance use was an integral risk for violence because psychosis is directly linked to violence in her past and cannabis increases the risk for psychosis. The doctor confirmed that in her less stressful environment, Ms. Nelson has less cravings to use cannabis and is more accepting of the prohibition against substance use in her Disposition. Dr. McMaster underlined however, that if not under an ORB Disposition, Ms. Nelson would return to cannabis use.
Dr. McMaster agreed that Ms. Nelson remains a significant threat to the safety of the public. She has a severe persistent major mental illness which is quite brittle and has ongoing symptoms, even in the high support setting. Ms. Nelson has had lengthy hospitalization related to difficulties caring for herself and still requires reminders even for medication. Without such high level of support, there would be a risk of ongoing stressors, decline in her mental state, psychosis, and substance use that would lead to violence as seen in the past. He confirmed that the existing substance uses prohibition in her Disposition remains necessary as such use would increase her level of risk leading to violence.
When asked, Dr. McMaster stated that a Conditional Discharge Disposition would not suffice to manage Ms. Nelson’s risk in the community. As stated on page 41 of the Hospital Report:
“Taken together, when weighing Ms. Nelson’s pertinent risk and protective factors, her risk of any future violence would be Low while subject to a detention order with community living. However, should she be conditionally discharged, her risk of future violence would be Moderate”.
The hospital must approve housing to ensure proper risk management. Additionally, the hospital must be prepared to promptly readmit Ms. Nelson if any alteration in her mental state occurs, including subtle changes that may not meet the admission criteria outlined by the MHA.
When asked what it might take to move her towards a Conditional Discharge Disposition, Dr. McMaster stated that the goal would be more independent housing commensurate with her needs, taking her medication independently without staff oversight and continuing to abstain from substances together with improved insight.
No further evidence was presented at the hearing.
Final Submissions by the Parties
Mr. McIntyre, on behalf of the Hospital, maintained his initial position and submitted that the necessary and appropriate Disposition was the continuation of the existing Detention Disposition on the same terms and conditions. He submitted there is a joint submission by the parties and sufficient evidence on the issue of significant threat. Mr. McIntyre stated that a Conditional Discharge Disposition was not realistic at this juncture. He further highlighted that the cannabis prohibition continues to be necessary and is integral to her risk management plan.
Ms. Malik, on behalf of the Attorney General of Ontario, stated that Ms. Nelson has an extensive history of substance use, with a particular focus on cannabis, which has previously been linked to an increased risk of psychosis and subsequent violent behaviour. She submitted that despite ongoing psychoeducation, Ms. Nelson’s insight into the effects of substance use on her illness remains limited, which is a concern. Finally, Ms. Malik submitted that the MHA would not be sufficient to manage Ms. Nelon’s risk and that the existing Detention Disposition is the most appropriate and necessary Disposition.
Mr. Wilton, on behalf of Ms. Nelson, agreed with the Hospital’s position. He highlighted that Ms. Nelson has a good reporting year and was very pleased to be in transitional housing in the community. He submitted that Ms. Nelson recognizes that the level of support she receives is helping her maintain stability and reduce her risk.
Analysis and Conclusion
Having considered all the evidence presented at the hearing, this Board finds that Ms. Nelson continues to pose a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code. We make this finding based on the oral evidence of Dr. McMaster and the evidence contained in the Hospital Report filed as an exhibit at the hearing, notwithstanding the joint position on significant threat by the parties.
Ms. Nelson’s index offences involved a serious stabling of four unsuspecting individuals on a public bus. She has a severe persistent major mental illness which is quite brittle and has ongoing psychotic symptoms, even in a high support environment. Her risk factors include the ongoing symptoms of her illness, history of non-compliance and past substance use. As stated by Dr. McMaster, whose evidence we accept, without the high level of support in the community there would be a risk of ongoing stressors, decline in her mental state, psychosis, and substance use that would lead to violence as was the case in her index offences.
This Board finds Ms. Nelson’s position on cannabis use concerning. Although she has less cravings in her new environment, she does not agree with her Cannabis Use Disorder diagnosis and does not believe cannabis use would have a deleterious effect on her mental state. As emphasized by Dr. McMaster in his evidence, substance use is an integral risk for violence because psychosis is directly linked to violence in her past and cannabis use increases the risk for psychosis. This Board is hopeful that Ms. Nelson will gain more insight into the negative effect cannabis use can have on her mental state.
On a positive note, Ms. Nelson has made meaningful clinical gains over the last reporting period. She has moved to a high support transitional accommodation and has been doing very well. She remains engaged with her forensic outpatient team and there have been no incidents of aggression or violence. She remains medication compliant, and all her urine drug screens have been negative. In addition, Ms. Nelson remains in contact with her mother who resides in New York and continues to meet with her individual therapist.
Although not advanced by the parties, a Conditional Discharge Disposition is not appropriate at this juncture. The hospital must retain the ability to act quickly and efficiently prior to Ms. Nelson becoming certifiable under the MHA to manage her risk to the public, and it remains necessary to approve her accommodations for risk management purposes.
Consequently, we find that the most necessary and appropriate Disposition is the continuation of the existing Detention Disposition on the same terms and conditions
In reaching our decision, this Board has considered the safety of the public, Ms. Nelson’s mental condition, her reintegration into society, and her other needs.
DATED this 18^th^ day of March, 2026, at the City of Toronto, in the Toronto Region.
Mr. C. Flanagan
Alternate Chairperson
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Office of the Registrar
Ontario Review Board